Enlargement of choroid plexus in complex regional pain syndrome

Zhou, Guangyu; Hotta, Jaakko; Lehtinen, Maria K.; Forss, Nina; Hari, Riitta

doi:10.1038/srep14329

Cited by 33 publications

(28 citation statements)

References 30 publications

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“…More recently, morphometric changes have been found in the CRPS patients' brains with anatomical T1 MRI (Baliki, Schnitzer, Bauer, & Apkarian, 2011; Barad, Ueno, Younger, Chatterjee, & Mackey, 2014; Geha et al., 2008; Pleger et al., 2014), and we have observed the enlargement of choroid plexus (Zhou, Hotta, Lehtinen, Forss, & Hari, 2015), in line with the suggestion that neuroinflammation might play a role in the pathophysiology of CRPS (Linnman, Becerra, & Borsook, 2013). In neuroinflammatory diseases, brain's white matter can possess microstructural abnormalities although it appears normal in anatomical T1 MRI (Filippi et al., 2012).…”

Section: Introductionsupporting

confidence: 86%

Complex regional pain syndrome: The matter of white matter?

et al. 2017

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IntroductionMany central pathophysiological aspects of complex regional pain syndrome (CRPS) are still unknown. Although brain‐imaging studies are increasingly supporting the contribution of the central nervous system to the generation and maintenance of the CRPS pain, the brain's white‐matter alterations are seldom investigated.MethodsIn this study, we used diffusion tensor imaging to explore white‐matter changes in twelve CRPS‐type‐1 female patients suffering from chronic right upper‐limb pain compared with twelve healthy control subjects.ResultsTract‐based spatial‐statistics analysis revealed significantly higher mean diffusivity, axial diffusivity, and radial diffusivity in the CRPS patients, suggesting that the structural connectivity is altered in CRPS. All these measures were altered in the genu, body, and splenium of corpus callosum, as well as in the left anterior and posterior and the right superior parts of the corona radiata. Axial diffusivity was significantly correlated with clinical motor symptoms at whole‐brain level, supporting the physiological significance of the observed white‐matter abnormalities.ConclusionsAltogether, our findings further corroborate the involvement of the central nervous system in CRPS.

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Section: Introductionsupporting

confidence: 86%

Complex regional pain syndrome: The matter of white matter?

et al. 2017

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“…For instance, a recent multimodal study in AD demonstrated a negative association between gray matter volume and [ 11 C]PBR28-measured TSPO levels 133 , thus supporting a relationship between gray matter loss and neuroinflammation. While most of the MRI structural studies focus on gray and white matter, a recent investigation used VBM to demonstrate enlarged choroid plexus volume in complex regional pain syndrome (CRPS) 134 . As the choroid plexus sits at an important entry point for circulating immune cells into the CNS, these results suggest yet one more link between neuroinflammation and chronic pain 44 , and further highlight the flexibility of MR-based methods.…”

Section: Imaging Pathological Consequences Of Neuroinflammationmentioning

confidence: 99%

In Vivo Imaging of Human Neuroinflammation

Albrecht¹,

Granziera

Hooker³

et al. 2016

ACS Chem. Neurosci.

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Neuroinflammation is implicated in the pathophysiology of a growing number of human disorders, including multiple sclerosis, chronic pain, traumatic brain injury, and amyotrophic lateral sclerosis. As a result, interest in the development of novel methods to investigate neuroinflammatory processes, for the purpose of diagnosis, development of new therapies, and treatment monitoring, has surged over the past 15 years. Neuroimaging offers a wide array of non- or minimally invasive techniques to characterize neuroinflammatory processes. The intent of this Review is to provide brief descriptions of currently available neuroimaging methods to image neuroinflammation in the human central nervous system (CNS) in vivo. Specifically, because of the relatively widespread accessibility of equipment for nuclear imaging (positron emission tomography [PET]; single photon emission computed tomography [SPECT]) and magnetic resonance imaging (MRI), we will focus on strategies utilizing these technologies. We first provide a working definition of “neuroinflammation” and then discuss available neuroimaging methods to study human neuroinflammatory processes. Specifically, we will focus on neuroimaging methods that target (1) the activation of CNS immunocompetent cells (e.g. imaging of glial activation with TSPO tracer [11C]PBR28), (2) compromised BBB (e.g. identification of MS lesions with gadolinium-enhanced MRI), (3) CNS-infiltration of circulating immune cells (e.g. tracking monocyte infiltration into brain parenchyma with iron oxide nanoparticles and MRI), and (4) pathological consequences of neuroinflammation (e.g. imaging apoptosis with [99mTc]Annexin V or iron accumulation with T2* relaxometry). This Review provides an overview of state-of-the-art techniques for imaging human neuroinflammation which have potential to impact patient care in the foreseeable future.

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“…A review article concluded that functional destabilization of the choroid plexus and ependymal wall in the brain following TBI has marked effects on CSF homeostasis and periventricular neurogenic viability (57). Using a morphometric MRI analysis, a previous study reported larger estimated choroid plexus volume in patients suffering from complex regional pain syndrome (58). Although the current implication of choroid plexus-related processes (e.g., neuroinflammation and CSF/brain maintenance and homeostasis) in the pathophysiology of MTBI is intriguing, the choroid plexus has received relatively little attention in clinical neuroscience, partly because a precise delineation of the structure using MRI data is often difficult.…”

Section: Discussionmentioning

confidence: 99%

Predicting Outcome 12 Months after Mild Traumatic Brain Injury in Patients Admitted to a Neurosurgery Service

et al. 2017

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ObjectiveAccurate outcome prediction models for patients with mild traumatic brain injury (MTBI) are key for prognostic assessment and clinical decision-making. Using multivariate machine learning, we tested the unique and added predictive value of (1) magnetic resonance imaging (MRI)-based brain morphometric and volumetric characterization at 4-week postinjury and (2) demographic, preinjury, injury-related, and postinjury variables on 12-month outcomes, including global functioning level, postconcussion symptoms, and mental health in patients with MTBI.MethodsA prospective, cohort study of patients (n = 147) aged 16–65 years with a 12-month follow-up. T1-weighted 3 T MRI data were processed in FreeSurfer, yielding accurate cortical reconstructions for surface-based analyses of cortical thickness, area, and volume, and brain segmentation for subcortical and global brain volumes. The 12-month outcome was defined as a composite score using a principal component analysis including the Glasgow Outcome Scale Extended, Rivermead Postconcussion Questionnaire, and Patient Health Questionnaire-9. Using leave-one-out cross-validation and permutation testing, we tested and compared three prediction models: (1) MRI model, (2) clinical model, and (3) MRI and clinical combined.ResultsWe found a strong correlation between observed and predicted outcomes for the clinical model (r = 0.55, p < 0.001). The MRI model performed at the chance level (r = 0.03, p = 0.80) and the combined model (r = 0.45, p < 0.002) were slightly weaker than the clinical model. Univariate correlation analyses revealed the strongest association with outcome for postinjury factors of posttraumatic stress (Posttraumatic Symptom Scale-10, r = 0.61), psychological distress (Hospital Anxiety and Depression Scale, r = 0.52), and widespread pain (r = 0.43) assessed at 8 weeks.ConclusionWe found no added predictive value of MRI-based measures of brain cortical morphometry and subcortical volumes over and above demographic and clinical features.

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Enlargement of choroid plexus in complex regional pain syndrome

Cited by 33 publications

References 30 publications

Complex regional pain syndrome: The matter of white matter?

Complex regional pain syndrome: The matter of white matter?

In Vivo Imaging of Human Neuroinflammation

Predicting Outcome 12 Months after Mild Traumatic Brain Injury in Patients Admitted to a Neurosurgery Service

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