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  4. Tissue bridges predict neuropathic pain emergence after spinal cord injury

Tissue bridges predict neuropathic pain emergence after spinal cord injury

J Neurol Neurosurg Psychiatry, 2020 · DOI: 10.1136/jnnp-2020-323150 · Published: August 11, 2020

Spinal Cord InjuryNeurologyPain Management

Simple Explanation

This study investigates the relationship between preserved spinal cord tissue, specifically ventral and dorsal tissue bridges, and the development of neuropathic pain after a spinal cord injury. The researchers measured the width of these tissue bridges using MRI scans and compared them between patients who developed neuropathic pain and those who remained pain-free. The findings suggest that larger ventral tissue bridges are associated with the emergence and maintenance of neuropathic pain, potentially serving as biomarkers for predicting and monitoring pain outcomes after spinal cord injuries.

Study Duration
12 months
Participants
44 patients with subacute spinal cord injury (35 men; mean (SD) age, 50.05 (18.88) years)
Evidence Level
Not specified

Key Findings

  • 1
    Patients with neuropathic pain had larger ventral tissue bridges at 1 month compared to pain-free patients.
  • 2
    Larger width of ventral tissue bridges at 1 month was associated with a higher mean pain intensity at 1 month.
  • 3
    Ventral tissue bridges at 1 month were identified as predictors of recovery of pin-prick scores at 12 months, with a cut-off value of 2.1 mm.

Research Summary

This retrospective longitudinal study explored the association between spared spinal cord tissue and neuropathic pain (NP) development after spinal cord injury (SCI). The study found that patients with NP had larger ventral tissue bridges at 1 month post-SCI compared to pain-free patients, and this larger width was associated with higher pain intensity and pin-prick scores at 12 months. The authors conclude that spared ventral tissue bridges could serve as neuroimaging biomarkers for predicting and monitoring pain outcomes and for stratifying patients in interventional trials.

Practical Implications

Predictive Biomarker

Ventral tissue bridges can serve as a neuroimaging biomarker to predict the emergence and maintenance of neuropathic pain after SCI.

Monitoring Tool

The width of ventral tissue bridges can be used to monitor pain outcomes in patients post-SCI.

Stratification in Clinical Trials

These findings could assist in stratifying patient subgroups in interventional clinical trials targeting neuropathic pain.

Study Limitations

  • 1
    Retrospective monocentric study design.
  • 2
    Unequal distribution of women and men in the patient cohort.
  • 3
    Quantification of tissue bridges was only performed on midsagittal slices.

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