Mechanisms and Utility of Multisensory Body Representation in SCI and SCI-Related Neuropathic Pain
Abstract
We will investigate brain mechanisms involved in neuropathic pain after spinal cord injury (SCI) and how non-invasive electrical brain stimulation in combination with bodily illusion influences these mechanisms and neuropathic pain. The research project is a direct response to SCI consumer concerns regarding the risk of addiction and negative effects of pain medication I ve used medications for the first seven, eight years, then that s when I asked to get different help, because I didn t like what they were doing to me. It felt like I was brain dead, and the need to have access to non-pharmacological treatment options. Due to current and past international conflicts, there has been an increase in active military personnel and Veterans who have sustained injuries to the spinal cord. Therefore, the results of the proposed study are highly relevant to the care and quality of life of military personnel, their significant others and their health care providers, and the general SCI community. Up to 60% of individuals with SCI develop neuropathic pain within the first year after their SCI. Chronic neuropathic pain negatively influences quality of life and independent living by interfering with sleep, mood, physical and social activities. Unfortunately, neuropathic pain after SCI is extremely difficult to treat and even the most effective medications do not usually relieve pain effectively. Therefore, there is an urgent need to further develop treatments that can be used by themselves or in combination with other treatments or self-management strategies. Noninvasive methods, known as bodily illusions (e.g., rubber hand illusion and walking illusion) can manipulate brain mechanisms and reduce pain by regulating visual, muscle and skin senses. The combination of these illusions with noninvasive electrical brain stimulation appears to be effective in reducing neuropathic pain in people with SCI. However, it is not clear in whom and how these methods reduce pain in SCI. It is also not clear how consumers perceive these potential treatment options. A scientific basis is needed for further development and improvement of SCI consumer access to these non-pharmacological methods for managing neuropathic pain. This requires a better understanding of underlying brain mechanisms of pain, how regulation of brain mechanisms correspond to decreases in pain, and consumers perspectives on these types of treatments. In this study, participants will be men or women, 30 with a traumatic SCI with moderate-to-severe neuropathic pain, 30 with SCI with no neuropathic pain, and 30 pain-free controls. All participants will take part in pain and psychosocial interviews, sensory examinations, a test of electrical activity of the brain, and cognitive measures. For the pilot clinical trial, people with SCI and neuropathic pain will go through 10 sessions of bodily illusion and noninvasive electrical stimulation applied on a brain area that processes information related to the state of the body and pain. The brain stimulation will be delivered via surface electrodes using a constant current stimulator for 30 minutes. Two types of body illusions will be used, the rubber hand illusion for the upper limbs and the walking illusion for the lower limbs (15 minutes each). The rubber hand illusion consists of stroking a visible rubber hand synchronously to the participant s own occluded hand. This will give a feeling that a rubber hand is part of one s own body. For the walking illusion, participants will sit in their wheelchair and observe their upper body in a mirror, while below, a projector-screen will show someone s legs in motion. They will be instructed to observe themselves in the mirror and move their upper body congruently with the motion of projected legs. This will give a feeling that the observed legs belong to their own body. The effects on neuropathic pain severity and psychosocial impact will be evaluated. If successful,
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 04, 2024
- Source ID
- HT94252310806
Entities
People
- Eva Widerstrom-noga
Organizations
- United States Army
- University of Miami