Association of pain and CNS structural changes after spinal cord injury

Jutzeler, Catherine R.; Huber, Eveline; Callaghan, Martina F.; Luechinger, Roger; Curt, Armin; Kramer, John L. K.; Freund, Patrick

doi:10.1038/srep18534

Cited by 87 publications

(112 citation statements)

References 72 publications

(109 reference statements)

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“…A cervical lesion affects the structural integrity of a higher number of axons and neurons compared with a thoracic lesion. 52,53 However, consistent with previous results, 44 we observed more atrophy in our spastic participants regardless of the level of injury, suggesting that it is less likely that this factor affected our results.…”

Section: Discussionsupporting

confidence: 91%

Residual descending motor pathways influence spasticity after spinal cord injury

Sangari

Lundell

Kirshblum

et al. 2019

Annals of Neurology

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Objective: Spasticity is one of the most common symptoms manifested in humans with spinal cord injury (SCI). The neural mechanisms contributing to its development are not yet understood. Using neurophysiological and imaging techniques, we examined the influence of residual descending motor pathways on spasticity in humans with SCI. Methods: We measured spasticity in 33 individuals with motor complete SCI (determined by clinical examination) without preservation of voluntary motor output in the quadriceps femoris muscle. To examine residual descending motor pathways, we used magnetic and electrical stimulation over the leg motor cortex to elicit motor evoked potentials (MEPs) in the quadriceps femoris muscle and structural magnetic resonance imaging to measure spinal cord atrophy. Results: We found that 60% of participants showed symptoms of spasticity, whereas the other 40% showed no spasticity, demonstrating the presence of 2 clear subgroups of humans with motor complete SCI. MEPs were only present in individuals who had spasticity, and MEP size correlated with the severity of spasticity. Spinal cord atrophy was greater in nonspastic compared with spastic subjects. Notably, the degree of spared tissue in the lateral regions of the spinal cord was positively correlated with the severity of spasticity, indicating preservation of white matter related to motor tracts when spasticity was present. Interpretation: These results support the hypothesis that preservation of descending motor pathways influences spasticity in humans with motor complete SCI; this knowledge might help the rehabilitation and assessment of people with SCI.

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Section: Discussionsupporting

confidence: 91%

Residual descending motor pathways influence spasticity after spinal cord injury

Sangari

Lundell

Kirshblum

et al. 2019

Annals of Neurology

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“…A recent study using voxel-wise analysis of anatomical magnet resonance imaging data looked at cross-sectional cervical cord area and volumetric brain changes after human SCI patients with and without below-level NP [82]. In individuals with paraplegia a reduction in the cross-sectional cervical cord area was associated with below-level NP, whereby cortical changes were bidirectional [82].…”

Section: 2 Biomarkersmentioning

confidence: 99%

“…In individuals with paraplegia a reduction in the cross-sectional cervical cord area was associated with below-level NP, whereby cortical changes were bidirectional [82]. …”

Section: 2 Biomarkersmentioning

confidence: 99%

Assessments of sensory plasticity after spinal cord injury across species

Haefeli

Huie

Morioka

et al. 2017

Neuroscience Letters

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Spinal cord injury (SCI) is a multifaceted phenomenon associated with alterations in both motor function and sensory function. A majority of patients with SCI report sensory disturbances, including not only loss of sensation, but in many cases enhanced abnormal sensation, dysesthesia and pain. Development of therapeutics to treat these abnormal sensory changes require common measurement tools that can enable cross-species translation from animal models to human patients. We review the current literature on translational nociception/pain measurement in SCI and discuss areas for further development. Although a number of tools exist for measuring both segmental and affective sensory changes, we conclude that there is a pressing need for better, integrative measurement of nociception/pain outcomes across species to enhance precise therapeutic innovation for sensory dysfunction in SCI.

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“…atrophic changes versus increases in volume) and may provide substrates for the underlying neural mechanisms in the development of NP. 16,17 Anticonvulsants remain the most studied and supported pharmacotherapy for NP post-SCI. Antidepressants likely showed reduction in pain only among those with comorbid depression.…”

Section: Discussionmentioning

confidence: 99%

Chromaffin cell transplantation for neuropathic pain after spinal cord injury: a report of two cases

Chen¹,

Hao²,

Xiao³

et al. 2017

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Neuropathic pain (NP), a common secondary complication following spinal cord injury (SCI), presenting at or below the level of injury is largely refractory to current pharmacological, physical, and surgical treatments. Previous studies have demonstrated the promising value of cell therapy including adrenal chromaffin cells that have the capacity to act as mini-pumps that release amines and peptides for alleviating chronic pain. The paper presents the cases of two gentlemen suffering from severe central NP after thoracic SCI. Six months after chromaffin cell intrathecal injection, their pain relieved significantly. The results demonstrated the preliminary therapeutic efficacy of chromaffin cell transplants in people with NP, and support further research of this treatment strategy for the management of intractable chronic pain due to SCI.

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Association of pain and CNS structural changes after spinal cord injury

Cited by 87 publications

References 72 publications

Residual descending motor pathways influence spasticity after spinal cord injury

Residual descending motor pathways influence spasticity after spinal cord injury

Assessments of sensory plasticity after spinal cord injury across species

Chromaffin cell transplantation for neuropathic pain after spinal cord injury: a report of two cases

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