Identifying Body Awareness-Related Brain Network Changes After Cognitive Multisensory Rehabilitation for Neuropathic Pain Relief in Adults With Spinal Cord Injury: Protocol of a Phase I Randomized Controlled Trial

Top Spinal Cord Inj Rehabil, 2022 · DOI: 10.46292/sci22-00006 · Published: October 1, 2022

Spinal Cord Injury Pain Management Rehabilitation

Simple Explanation

This research explores a new treatment for neuropathic pain in people with spinal cord injuries (SCI). Current treatments often don't provide enough relief, so the study investigates cognitive multisensory rehabilitation (CMR). CMR is a physical therapy approach that has shown promise in restoring brain connections and reducing pain in other conditions, like stroke. The study aims to see if CMR can normalize pain perception by restoring connectivity in specific brain areas in adults with SCI. Participants will be divided into two groups, one receiving CMR immediately and the other after a waiting period. Brain scans and pain assessments will be conducted to measure the effects of CMR on brain function and pain levels.

Study Duration

September 1, 2020, until August 31, 2022

Participants

25 uninjured adults and 25 adults with SCI-related neuropathic pain

Evidence Level

Phase I randomized controlled trial

Key Findings

1
The study aims to determine baseline differences in brain function between adults with SCI and uninjured controls using fMRI.
2
The research seeks to identify changes in brain function and pain outcomes in adults with SCI after receiving CMR.
3
The study hypothesizes that CMR can restore the pain perception network in the brain, leading to pain reduction or relief in individuals with SCI.

Research Summary

This phase I randomized controlled trial will investigate the effectiveness of cognitive multisensory rehabilitation (CMR) for neuropathic pain relief in adults with spinal cord injury (SCI). The study will compare brain function and behavioral pain outcomes between adults with SCI and uninjured controls, as well as assess changes after CMR intervention. The researchers aim to determine if CMR can restore the pain perception network in the brain and alleviate neuropathic pain in individuals with SCI.

Practical Implications

Clinical Application

If successful, CMR could be implemented in clinical care to improve health in adults with SCI.

Further Research

The study will inform the sample size for a larger scale RCT.

Therapist Training

CMR classes are being organized at the University of Minnesota to make CMR accessible as new rehabilitation approach to therapists in the United States.

Study Limitations

1
The effect of CMR on neuropathic pain perception in the brain or on SCI brain network function is not known.
2
Study includes only adults who can self-transfer with assistance (i.e., adults with complete or incomplete paraplegia, Brown-Sequard, or incomplete quadriplegia).
3
Participants who cannot feel index finger movements or cannot press the response button associated with the robot task in the MRI scanner will not perform the robot task but will perform all other resting-state and fMRI tasks.

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