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  4. Effects of Alterations in Resting-State Neural Networks on the Severity of Neuropathic Pain after Spinal Cord Injury

Effects of Alterations in Resting-State Neural Networks on the Severity of Neuropathic Pain after Spinal Cord Injury

Bioengineering, 2023 · DOI: 10.3390/bioengineering10070860 · Published: July 20, 2023

Spinal Cord InjuryNeuroimagingPain Management

Simple Explanation

This study investigates the brain regions involved in maintaining a resting state and their connection to the severity of neuropathic pain (NP) in individuals with incomplete spinal cord injury (SCI). The research uses resting-state functional magnetic resonance imaging (fMRI) to analyze brain activity and graph theory to understand the connections between different brain regions. The study found that the severity of neuropathic pain is associated with changes in brain activity, particularly in the middle frontal gyrus and posterior cingulate gyrus.

Study Duration
Not specified
Participants
73 subjects (41 patients with incomplete SCI and 32 age- and sex-matched healthy controls)
Evidence Level
Not specified

Key Findings

  • 1
    Patients with moderate to severe neuropathic pain showed reduced node degree and fALFF (fractional Amplitude of Low Frequency Fluctuation) in the left middle frontal gyrus compared to those with mild pain and healthy controls.
  • 2
    Patients with severe neuropathic pain demonstrated increased average path lengths and reduced fALFF values in the posterior cingulate gyrus.
  • 3
    Changes in intrinsic oscillations of fMRI signals in the middle frontal gyrus and posterior cingulate gyrus were significant when considering the severity of neuropathic pain.

Research Summary

The study aimed to identify brain regions involved in maintaining a resting state and their link to neuropathic pain (NP) severity in patients with incomplete spinal cord injury (SCI). Graph theory and fractional amplitude of low-frequency fluctuation (fALFF) analyses were performed on resting-state fMRI data to compare brain activity among healthy controls, mild NP, and moderate-severe NP groups. The key finding was that changes in intrinsic oscillations of fMRI signals in the middle frontal gyrus and posterior cingulate gyrus were significantly associated with the severity of NP after SCI.

Practical Implications

Therapeutic Target Identification

The findings could help identify candidate brain regions for controlling severe and refractory neuropathic pain using noninvasive brain stimulation.

Rehabilitation Strategies

The study suggests that physiotherapy following SCI, which could affect functional neuroplastic changes, may help relieve neuropathic pain depending on the onset time of SCI.

Personalized Treatment Approaches

Understanding the relationship between spontaneous neural changes and the severity of neuropathic pain can contribute to the development of more comprehensive and personalized rehabilitation strategies.

Study Limitations

  • 1
    Small sample size
  • 2
    Lack of SCI patients without NP as a control group
  • 3
    The interslice gap technique was not introduced

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