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  4. Evaluation of (R)-[11C]PK11195 PET/MRI for Spinal Cord-Related Neuropathic Pain in Patients with Cervical Spinal Disorders

Evaluation of (R)-[11C]PK11195 PET/MRI for Spinal Cord-Related Neuropathic Pain in Patients with Cervical Spinal Disorders

J. Clin. Med., 2023 · DOI: 10.3390/jcm12010116 · Published: December 23, 2022

Spinal Cord InjuryPain ManagementMedical Imaging

Simple Explanation

This study used PET/MRI imaging to visualize inflammation in the spinal cord of patients with neuropathic pain. The researchers focused on activated microglia, a type of immune cell, and a protein called TSPO that indicates their activity. The study found that inflammation, as measured by TSPO levels, was correlated with the severity of neuropathic pain in patients.

Study Duration
Not specified
Participants
7 patients with NeP related to spinal disorders and a healthy subject
Evidence Level
Not specified

Key Findings

  • 1
    TSPO is mainly expressed in activated microglia in the injured spinal cord.
  • 2
    (R)-[11C]PK11195 PET imaging visualized dynamics of activated microglia in acute and subacute phases of SCI in rats.
  • 3
    A positive correlation was found between SUVR and NPSI, suggesting potential for objective evaluation of chronic NeP.

Research Summary

The study assessed TSPO expression as an indicator of microglial activation using (R)-[11C]PK11195 PET imaging in a rat SCI model. Clinical application of (R)-[11C]PK11195 PET/MRI in patients with NeP related to cervical disorders showed limited visualization in the chronic phase. A positive correlation was found between SUVR and severity of NeP, suggesting the potential for objective evaluation of chronic NeP.

Practical Implications

Objective Pain Assessment

PET/MRI with TSPO ligands could potentially serve as an objective tool for evaluating chronic neuropathic pain.

Therapeutic Target

Microglial activation and TSPO expression may be a therapeutic target for managing neuropathic pain, especially in the acute and subacute phases after spinal cord injury.

Personalized Medicine

Further research with advanced TSPO radioligands and brain imaging could lead to personalized treatment strategies based on individual neuroinflammatory profiles.

Study Limitations

  • 1
    Lack of evaluation in an animal model in the chronic phase after SCI
  • 2
    Small number of patients in the clinical study
  • 3
    Use of a first-generation TSPO radioligand

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