The Reorganization of Insular Subregions in Individuals with Below-Level Neuropathic Pain following Incomplete Spinal Cord Injury

Neural Plasticity, 2020 · DOI: https://doi.org/10.1155/2020/2796571 · Published: March 10, 2020

Simple Explanation

This study investigates how the different parts of the insula, a brain region involved in pain processing, change in people with neuropathic pain after incomplete spinal cord injury. The researchers used MRI to examine the structure and function of the insula in individuals with and without neuropathic pain after spinal cord injury, and compared them to healthy individuals. The findings suggest that different subregions of the insula are involved in pain processing through different connections in the brain, indicating potential therapeutic targets for neuropathic pain.

Study Duration

Not specified

Participants

10 ISCI individuals with below-level NP (ISCI-P), 11 ISCI individuals without NP (ISCI-N), and 25 healthy controls (HCs)

Evidence Level

Level 3, comparative analysis of structure and function connectivity

Key Findings

1
Compared to ISCI individuals without neuropathic pain, those with neuropathic pain showed increased functional connectivity between the left posterior insula and the right cerebellum VIIb and VIII, as well as Brodmann area 37.
2
ISCI-P patients showed enhanced functional connectivity between the left ventral anterior insula and right BA18 compared with ISCI-N patients.
3
Relative to healthy controls, ISCI-P individuals presented increased functional connectivity in the left hippocampus when the left dorsal anterior insula was examined.

Research Summary

This study investigated the reorganization of insular subregions in individuals suffering from neuropathic pain (NP) after incomplete spinal cord injury (ISCI) to disclose the underlying mechanism of NP. The study indicated that distinctive patterns of FC in each subregion of insula suggest that the insular subareas participate in the NP processing through different FC following ISCI. The findings may contribute to the understanding of NP neural mechanisms and provide an accurate treatment target for NP following ISCI.

Practical Implications

Therapeutic Target Identification

The insula subregions could serve as a therapeutic target for NP following ISCI.

Pain Pathway Understanding

The left PI-cerebellum posterior lobe pathway participates in the modulation of pain perception and intensity following SCI.

Stimulus Target Selection

Enhanced activation in the right cerebellum VIIb and VIII may provide a theoretical basis for precisely selecting stimulus targets.

Study Limitations

1
Only right-handed subjects were recruited.
2
The sample size was relatively small.
3
Whether symmetrical information transmission between the right and left insula occurs remained to be investigated

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