Metabolite Concentrations in the Anterior Cingulate Cortex Predict High Neuropathic Pain Impact After Spinal Cord Injury

Abstract

Persistent pain is a common reason for reduced quality of life after a spinal cord injury (SCI). Biomarkers of neuropathic pain may facilitate translational research and the understanding of underlying mechanisms. Research suggests that pain and affective distress are anatomically and functionally integrated in the anterior cingulate cortex and can modulate sensory and affective aspects of pain. We hypothesized that severe neuropathic pain with a significant psychosocial impact would be associated with metabolite concentrations (obtained by magnetic resonance spectroscopy) in the anterior cingulate cortex, indicating neuronal and/or glial dysfunction. Participants with SCI and severe, high-impact neuropathic pain (SCI-HPI; n = 16), SCI and moderate, low-impact neuropathic pain (SCI-LPI; n = 24), SCI without neuropathic pain (SCInoNP; n = 14), and able-bodied, pain-free control subjects (A-B; n = 22) underwent a 3-T magnetic resonance imaging brain scan. Analyses revealed that the SCI-HPI group had significantly higher levels of myoinositol (Ins) (P < .000), creatine (P = .007), and choline (P = . 014), and significantly lower levels of N-acetyl aspartate/Ins (P = .024) and glutamate-glutamine (Glx)/Ins (P = .003) ratios than the SCI-LPI group. The lower Glx/Ins ratio significantly discriminated between SCI-HPI and the A-B (P = .006) and SCI-noNP (P = .026) groups, displayed excellent test-retest reliability, and was significantly related to greater pain severity, interference, and affective distress. This suggests that the combination of lower glutamatergic metabolism and proliferation of glia and glial activation are underlying mechanisms contributing to the maintenance of severe neuropathic pain with significant psychosocial impact in chronic

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Document Details

Document Type
Technical Report
Publication Date
Feb 01, 2013
Accession Number
ADA583204

Entities

People

  • Alberto Martinez-arizala
  • Diana D. Cardenas
  • Elizabeth R. Felix
  • Eva Widerstroem-noga
  • Pradip M. Pattany
  • Salome Perez
  • Yenisel Cruz-almeida

Organizations

  • Veterans Administration Medical Center

Tags

DTIC Thesaurus Topics

  • Brain
  • Chemistry
  • Correlation Analysis
  • Demography
  • Department Of Veterans Affairs
  • Depression
  • Diseases And Disorders
  • Drug Abuse
  • Magnetic Resonance
  • Magnetic Resonance Imaging
  • Medical Personnel
  • Neuroglia
  • Pain
  • Pain Management
  • Psychiatry
  • Spinal Cord
  • Spinal Injuries

Fields of Study

  • Medicine

Readers

  • Neuroscience
  • Neurotrauma and Rehabilitation Medicine.