Mental Imagery as a Rehabilitative Therapy for Neuropathic Pain in People With Spinal Cord Injury: A Randomized Controlled Trial

Abstract

Background Pain of neuropathic origin in spinal cord injury (SCI) is unbearable and challenging to treat. Research studies conducted in the past have shown that mental imagery (MI) techniques have a significant impact on the reduction of symptoms of central neuropathic pain in people with SCI. Objectives The objective of this study was to evaluate the effect of MI training on pain intensity, neuropathic pain symptoms, and interference of pain with function in SCI. Methods A total of 42 SCI participants with central neuropathic pain (duration 6-12 months) were recruited and randomly allocated to MI or control groups. A MI training protocol was administered to MI group and for 30 min/d for 5 days. Outcome measures were assessed at baseline and at the end of 4 weeks. Results There was significant reduction in differences of mean [95% CI] scores of numeric rating scale (−2.1 [CI −2.78 to −1.41]; P < .001) between groups. Mean [95% CI] total scores of Neuropathic Pain Symptom Inventory declined in MI group as compared with control group (−4.52 [CI −5.86 to −3.18]; P < .001). Similarly, Brief Pain Inventory interference scale total dropped significantly ( P < .001) in MI group. Majority of participants in the MI group (55%) reported improvement in scores of Patients’ Global Impression of Change scale as compared with control group where most of the participants (52%) reported no change. Conclusions This study shows the effectiveness of the MI protocol developed as a rehabilitative approach in improving central neuropathic pain in SCI. Trial Registration. Clinical Trials Registry–India under Indian Council of Medical Research; CTRI/2018/07/014884. Registered July 16, 2018.

Cervical Spinal Lesion, Completeness of Injury, Stress, and Depression Reduce the Efficiency of Mental Imagery in People With Spinal Cord Injury

“…Imagery is a process of creating an experience in the mind similar to a sensory experience. The study of MI has gained importance in recent years because of its effectiveness in the rehabilitation of SCI 23 . In this study, KVIQ-10 was used to evaluate imagery of physiological movements (such as shoulder flexion, thumb-fingers opposition, forward trunk flexion, etc.…”

Partial restoration of spinal cord neural continuity via vascular pedicle hemisected spinal cord transplantation using spinal cord fusion technique

“…MI refers to the active process by which humans relive the sensations with or without external stimuli 37 ; moreover, MI as a rehabilitation method can improve cord central pain in SCI. 38 Also, we will review the operative technique to reduce surgical injury, thereby minimizing postoperative scarring. Finally, we propose allograft spinal cord transplantation as another potential treatment for SCI.…”

“…In addition, mental imagery (MI) therapy will be added to our postoperative rehabilitation program. MI refers to the active process by which humans relive the sensations with or without external stimuli 37 ; moreover, MI as a rehabilitation method can improve cord central pain in SCI 38 . Also, we will review the operative technique to reduce surgical injury, thereby minimizing postoperative scarring.…”

Mental Imagery Skills in Alcohol-Dependent Subjects and Their Associations With Cognitive Performance: An Exploratory Study During Residential Rehabilitation

“…Indeed, MI has been used to induce changes in the affective symptoms of mood and anxiety disorders ( 28 ). MI techniques have also shown a significant impact on the reduction of symptoms of central neuropathic pain, highlighting the promising role of MI as rehabilitative approach in improving neuropathic pain ( 55 , 56 ). Furthermore, imaginative training demonstrated positive effects in facilitating associative learning in Intellectual Disability and in increasing cognitive abilities in atypical development ( 24 , 57 ).…”