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  4. Alterations in power spectral density in motor- and pain-related networks on neuropathic pain after spinal cord injury

Alterations in power spectral density in motor- and pain-related networks on neuropathic pain after spinal cord injury

NeuroImage: Clinical, 2020 · DOI: https://doi.org/10.1016/j.nicl.2020.102342 · Published: July 25, 2020

NeuroimagingNeurologyRehabilitation

Simple Explanation

This study investigates how brain activity changes in people with spinal cord injuries (SCI) who experience neuropathic pain and mobility issues. It uses resting-state functional magnetic resonance imaging (rs-fMRI) and power spectral density (PSD) analysis to examine brain networks related to motor function and pain. The research compares brain activity patterns in SCI patients to those of healthy individuals, looking for differences in the strength and patterns of brain signals. The goal is to understand how these changes in brain activity relate to the severity of pain and the ability to move. The findings could help in developing better rehabilitation strategies that target specific brain areas to improve both mobility and pain management in people with SCI.

Study Duration
Not specified
Participants
41 patients with incomplete SCI and 33 healthy controls
Evidence Level
Not specified

Key Findings

  • 1
    Lower PSD values in supplementary motor and medial prefrontal areas were associated with greater pain severity and poorer postural balance and mobility in patients with SCI.
  • 2
    Higher PSD values in the primary motor cortex, premotor cortex, thalamus, and periaqueductal gray were associated with greater pain severity and poorer postural balance and mobility.
  • 3
    Cortical and subcortical plastic alterations in intrinsic motor- and pain-related networks were observed in patients with SCI and were simultaneously associated with neuropathic pain intensity and degree of mobility function.

Research Summary

The study investigated alterations in brain activity, specifically using power spectral density (PSD) analysis of resting-state fMRI, in patients with spinal cord injury (SCI) experiencing neuropathic pain and mobility dysfunction. Compared to healthy controls, SCI patients showed lower PSD values in motor-related areas (SMA) and pain-related medial prefrontal areas (ACC, vmPFC, and superior orbito-frontal cortex), and higher PSD values in other motor-related (M1 and PMC) and pain-related areas (thalamus and PAG). The study concludes that mobility disabilities and neuropathic pain may be mutually influenced by supraspinal plasticity in motor- and pain-related brain networks after SCI.

Practical Implications

Targeted Neurorehabilitation

Neurorehabilitation strategies should consider reducing increased spontaneous neural activity in motor-related areas through physical exercise to improve mobility and pain relief.

Combined Therapies

Combining physical exercise with pharmacological treatments that decrease spontaneous activity in pain-related areas may be an effective neurorehabilitation strategy.

Understanding Brain-Spinal Cord Connection

Understanding the changes occurring in supraspinal neural activity following spinal cord injury may suggest tailored interventions.

Study Limitations

  • 1
    Heterogeneous interval since injury among patients.
  • 2
    Patients were taking medication to relieve neuropathic pain in various periods.
  • 3
    Lack of physiological recordings during rs-fMRI data acquisition.

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