Association of pain and CNS structural changes after spinal cord injury

Scientific Reports, 2016 · DOI: 10.1038/srep18534 · Published: January 6, 2016

Spinal Cord Injury Neurology Pain Management

Simple Explanation

This study investigated the impact of traumatic spinal cord injury (SCI) on central nervous system (CNS) structure, and the extent to any which changes in structure were related to the presence of below-level neuropathic pain. The researchers hypothesized that below-level neuropathic pain is indicative of structural changes in the spinal cord compared to pain-free individuals and healthy control subjects. The study used cross-sectional cord area measurement to assess cord atrophy and voxel-based morphometry/thickness to assess gray and white matter volumes changes.

Study Duration

Not specified

Participants

30 individuals with chronic traumatic SCI and 31 healthy controls

Evidence Level

Not specified

Key Findings

1
Individuals with SCI exhibited decreased cord area, reduced grey matter (GM) volumes in anterior cingulate cortex (ACC), left insula, left secondary somatosensory cortex, bilateral thalamus, and decreased white matter volumes in pyramids and left internal capsule.
2
The presence of NP was related with smaller cord area, increased GM in left ACC and right M1, and decreased GM in right primary somatosensory cortex and thalamus.
3
Greater GM volume in M1 was associated with amount of NP.

Research Summary

This study shows distinct association of below-level NP with structural changes of the spinal cord and brain after SCI. In individuals with paraplegia, the reduction in SCA was associated with below-level NP independent of the level or completeness of lesion. The CNS shows extensive and complex changes (multi-directional with decrease – increase) in response to an injury.

Practical Implications

Understanding Pain Mechanisms

The study provides insights into the complex neuro-adaptive processes related to below-level neuropathic pain following SCI.

Potential Biomarkers

Neuro-imaging biomarkers may be sensitive in detecting complex pain-related neuro-adaptive changes, aiding in diagnosis and monitoring.

Intervention Considerations

Complex interactions between sensorimotor function and pain syndromes need consideration in interventional studies.

Study Limitations

1
Individuals with SCI and healthy volunteers are not matched with respect to gender.
2
The cross-sectional nature of the study restricts conclusions to a single time point only.
3
The assessment of depression and anxiety indices was outside the scope of this study.

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury