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Wang G, Chen X, Wang X, Duan Y, Gao H, Ji X, Zhu Y, Xiang X, Ma H, Li Y, Xue Q. Abnormal brain spontaneous neural activity in neuromyelitis optica spectrum disorder with neuropathic pain. Front Neurol 2024; 15:1408759. [PMID: 38938780 PMCID: PMC11210278 DOI: 10.3389/fneur.2024.1408759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 05/30/2024] [Indexed: 06/29/2024] Open
Abstract
Background Neuropathic pain is one of the most common symptoms in neuromyelitis optica spectrum disorder (NMOSD). Notwithstanding, its underlying mechanism remains obscure. Methods The amplitude of low-frequency fluctuations (ALFF) metric was employed to investigate spontaneous neural activity alterations via resting-state functional magnetic resonance imaging (rs-MRI) data from a 3.0 T MRI scanner, in a sample of 26 patients diagnosed with NMOSD with neuropathic pain (NMOSD-WNP), 20 patients with NMOSD but without neuropathic pain (NMOSD-WoNP), and 38 healthy control (HC) subjects matched for age and sex without the comorbidity of depressive or anxious symptoms. Results It was observed that patients with NMOSD-WNP displayed a significant ALFF decrease in the left amygdala and right anterior insula, relative to both patients with NMOSD-WoNP and HC subjects. Furthermore, ALFF values in the left amygdala were negatively correlated with the scores of the Douleur Neuropathique en 4 Questions and McGill Pain Questionnaire (both sensory and affective descriptors) in patients with NMOSD-WNP. Additionally, there were negative correlations between the ALFF values in the right anterior insula and the duration of pain and the number of relapses in patients with NMOSD-WNP. Conclusion The present study characterizes spontaneous neural activity changes in brain regions associated with sensory and affective processing of pain and its modulation, which underscore the central aspects in patients with NMOSD-WNP. These findings might contribute to a better understanding of the pathophysiologic basis of neuropathic pain in NMOSD.
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Affiliation(s)
- Gendi Wang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Department of Neurology, Yancheng Third People’s Hospital, Yancheng, China
| | - Xiang Chen
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaoyuan Wang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yinghui Duan
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Hanqing Gao
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaopei Ji
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yunfei Zhu
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xuanyi Xiang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Hairong Ma
- Department of Neurology, Kunshan Hospital of Chinese Medicine, Suzhou, China
| | - Yonggang Li
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Institute of Medical Imaging, Soochow University, Suzhou, China
- National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Qun Xue
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Medical College of Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Clinical Immunology, Jiangsu Institute of Clinical Immunology, The First Affiliated Hospital of Soochow University, Suzhou, China
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Li CN, Keay KA, Henderson LA, Mychasiuk R. Re-examining the Mysterious Role of the Cerebellum in Pain. J Neurosci 2024; 44:e1538232024. [PMID: 38658164 PMCID: PMC11044115 DOI: 10.1523/jneurosci.1538-23.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 03/06/2024] [Accepted: 03/06/2024] [Indexed: 04/26/2024] Open
Abstract
Pain is considered a multidimensional experience that embodies not merely sensation, but also emotion and perception. As is appropriate for this complexity, pain is represented and processed by an extensive matrix of cortical and subcortical structures. Of these structures, the cerebellum is gaining increasing attention. Although association between the cerebellum and both acute and chronic pain have been extensively detailed in electrophysiological and neuroimaging studies, a deep understanding of what functions are mediated by these associations is lacking. Nevertheless, the available evidence implies that lobules IV-VI and Crus I are especially pertinent to pain processing, and anatomical studies reveal that these regions connect with higher-order structures of sensorimotor, emotional, and cognitive function. Therefore, we speculate that the cerebellum exerts a modulatory role in pain via its communication with sites of sensorimotor, executive, reward, and limbic function. On this basis, in this review, we propose numerous ways in which the cerebellum might contribute to both acute and chronic pain, drawing particular attention to emotional and cognitive elements of pain. In addition, we emphasise the importance of advancing our knowledge about the relationship between the cerebellum and pain by discussing novel therapeutic opportunities that capitalize on this association.
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Affiliation(s)
- Crystal N Li
- Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Kevin A Keay
- School of Medical Sciences (Neuroscience) and Brain and Mind Centre, University of Sydney, NSW 2006, Australia
| | - Luke A Henderson
- School of Medical Sciences (Neuroscience) and Brain and Mind Centre, University of Sydney, NSW 2006, Australia
| | - Richelle Mychasiuk
- Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC 3004, Australia
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Wu Z, Feng K, Huang J, Ye X, Yang R, Huang Q, Jiang Q. Brain region changes following a spinal cord injury. Neurochem Int 2024; 174:105696. [PMID: 38354751 DOI: 10.1016/j.neuint.2024.105696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 01/16/2024] [Accepted: 02/10/2024] [Indexed: 02/16/2024]
Abstract
Brain-related complications are common in clinical practice after spinal cord injury (SCI); however, the molecular mechanisms of these complications are still unclear. Here, we reviewed the changes in the brain regions caused by SCI from three perspectives: imaging, molecular analysis, and electrophysiology. Imaging studies revealed abnormal functional connectivity, gray matter volume atrophy, and metabolic abnormalities in brain regions after SCI, leading to changes in the structure and function of brain regions. At the molecular level, chemokines, inflammatory factors, and damage-associated molecular patterns produced in the injured area were retrogradely transmitted through the corticospinal tract, cerebrospinal fluid, or blood circulation to the specific brain area to cause pathologic changes. Electrophysiologic recordings also suggested abnormal changes in brain electrical activity after SCI. Transcranial magnetic stimulation, transcranial direct current stimulation, and deep brain stimulation alleviated pain and improved motor function in patients with SCI; therefore, transcranial therapy may be a new strategy for the treatment of patients with SCI.
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Affiliation(s)
- Zhiwu Wu
- Department of Neurosurgery, Ganzhou People's Hospital (Ganzhou Hospital-Nanfang Hospital, Southern Medical University), 16th Mei-guan Avenue, Ganzhou, 341000, China
| | - Kaiming Feng
- Department of Neurosurgery, Ganzhou People's Hospital (Ganzhou Hospital-Nanfang Hospital, Southern Medical University), 16th Mei-guan Avenue, Ganzhou, 341000, China
| | - Jinqing Huang
- Department of Neurosurgery, Ganzhou People's Hospital (Ganzhou Hospital-Nanfang Hospital, Southern Medical University), 16th Mei-guan Avenue, Ganzhou, 341000, China
| | - Xinyun Ye
- Department of Neurosurgery, Ganzhou People's Hospital (Ganzhou Hospital-Nanfang Hospital, Southern Medical University), 16th Mei-guan Avenue, Ganzhou, 341000, China
| | - Ruijin Yang
- Department of Neurosurgery, Ganzhou People's Hospital (Ganzhou Hospital-Nanfang Hospital, Southern Medical University), 16th Mei-guan Avenue, Ganzhou, 341000, China
| | - Qianliang Huang
- Department of Neurosurgery, Ganzhou People's Hospital (Ganzhou Hospital-Nanfang Hospital, Southern Medical University), 16th Mei-guan Avenue, Ganzhou, 341000, China.
| | - Qiuhua Jiang
- Department of Neurosurgery, Ganzhou People's Hospital (Ganzhou Hospital-Nanfang Hospital, Southern Medical University), 16th Mei-guan Avenue, Ganzhou, 341000, China.
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4
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Chen Q, Lv H, Wang Z, Li X, Wang X, Huang Y, Zhao P, Yang Z, Gong S, Wang Z. Multimodal quantitative magnetic resonance imaging of the thalamus in tinnitus patients with different outcomes after sound therapy. CNS Neurosci Ther 2023; 29:4070-4081. [PMID: 37392024 PMCID: PMC10651975 DOI: 10.1111/cns.14330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/08/2023] [Accepted: 06/18/2023] [Indexed: 07/02/2023] Open
Abstract
AIMS This study systematically investigated structural and functional alterations in the thalamus and its subregions using multimodal magnetic resonance imaging (MRI) and examined its clinical relevance in tinnitus patients with different outcomes after sound therapy (narrowband noise). METHODS In total, 60 patients with persistent tinnitus and 57 healthy controls (HCs) were recruited. Based on treatment efficacy, 28 patients were categorized into the effective group and 32 into the ineffective group. Five MRI measurements of the thalamus and its seven subregions, including gray matter volume, fractional anisotropy, fractional amplitude of low-frequency fluctuation, and functional connectivity (FC), were obtained for each participant and compared between the groups. RESULTS Patients in both the groups exhibited widespread functional and diffusion abnormalities in the whole thalamus and several subregions, with more obvious changes observed in the effective group. All tinnitus patients had abnormal FC compared with the HCs; FC differences between the two patient groups were only observed in the striatal network, auditory-related cortex, and the core area of the limbic system. We combined the multimodal quantitative thalamic alterations and used it as an imaging indicator to evaluate prognosis before sound therapy and achieved a sensitivity of 71.9% and a specificity of 85.7%. CONCLUSION Similar patterns of thalamic alterations were identified in tinnitus patients with different outcomes, with more obvious changes observed in the effective group. Our findings support the tinnitus generation hypothesis of frontostriatal gating system dysfunction. A combination of multimodal quantitative thalamic properties may be used as indicators to predict tinnitus prognosis before sound therapy.
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Affiliation(s)
- Qian Chen
- Department of RadiologyBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Han Lv
- Department of RadiologyBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Zhaodi Wang
- Department of OtolaryngologyBeijing Jingmei Group General HospitalBeijingChina
| | - Xiaoshuai Li
- Department of RadiologyBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Xinghao Wang
- Department of RadiologyBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | | | - Pengfei Zhao
- Department of RadiologyBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Zhenghan Yang
- Department of RadiologyBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Shusheng Gong
- Department of Otolaryngology Head and Neck SurgeryBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Zhenchang Wang
- Department of RadiologyBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
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Matsubayashi K, Shinozaki M, Hata J, Komaki Y, Nagoshi N, Tsuji O, Fujiyoshi K, Nakamura M, Okano H. A shift of brain network hub after spinal cord injury. Front Mol Neurosci 2023; 16:1245902. [PMID: 37915973 PMCID: PMC10616864 DOI: 10.3389/fnmol.2023.1245902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/25/2023] [Indexed: 11/03/2023] Open
Abstract
Background Spinal cord injury (SCI) causes severe sequelae and significant social loss, depending on the extent of the damage. Most previous studies have focused on the pathology of the spinal cord to develop treatments for SCI. However, it is now known that the brain, which is not directly damaged, also undergoes morphological changes after spinal cord injury, which could affect natural recovery and treatment. In recent years, magnetic resonance imaging (MRI) has been developed to analyze functional changes in the brain. Resting-state functional MRI (rsfMRI), which captures brain activity at rest, can calculate functional connections between brain areas and identify central hubs by network analysis. Purpose We aim to investigate functional connectivity in the brain using rsfMRI after SCI and to determine how brain-network main hubs change over time. Methods We evaluated rsfMRI in 10 mice of the contusional SCI model and calculated connectivity using graph theory. We evaluated "centrality," a representative parameter of network analysis. The subtype of centrality was degree centrality, which indicates the hub function of a single area. The five times of rsfMRI were performed in each individual mouse: before injury and at 1, 3, 7, and 14 weeks post-injury. Results Before the injury, the degree centralities of the primary and secondary motor cortex were high, suggesting that these motor cortices served as main hubs for motor function. After SCI, the hub function of the motor cortices decreased by 14 weeks. In contrast, hub function in the external capsule and the putamen comparatively increased with time after injury, suggesting that the extrapyramidal/subcortical system, which runs the ventral side of the spinal cord and remains after injury in this model, becomes dominant. Conclusion We demonstrated the shift of the brain network hub after SCI. The results of this study provide basic information for understanding brain network changes after SCI and would be useful for treatment selection and evaluation of its efficacy in SCI patients.
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Affiliation(s)
- Kohei Matsubayashi
- Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, Japan
| | - Munehisa Shinozaki
- Department of Physiology, School of Medicine, Keio University, Tokyo, Japan
| | - Junichi Hata
- Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Yuji Komaki
- Live Animal Imaging Center, Central Institute for Experimental Animals, Kanagawa, Japan
| | - Narihito Nagoshi
- Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, Japan
| | - Osahiko Tsuji
- Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, Japan
| | - Kanehiro Fujiyoshi
- Department of Orthopaedic Surgery, Murayama Medical Center (NHO), Tokyo, Japan
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, Japan
| | - Hideyuki Okano
- Department of Physiology, School of Medicine, Keio University, Tokyo, Japan
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Chen X, Wang L, Zheng W, Yang Y, Yang B, Hu Y, Du J, Li X, Lu J, Chen N. The gray matter atrophy and related network changes occur in the higher cognitive region rather than the primary sensorimotor cortex after spinal cord injury. PeerJ 2023; 11:e16172. [PMID: 37842067 PMCID: PMC10569206 DOI: 10.7717/peerj.16172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 09/03/2023] [Indexed: 10/17/2023] Open
Abstract
Objective This study used functional magnetic resonance imaging (fMRI) to explore brain structural and related network changes in patients with spinal cord injury (SCI). Methods Thirty-one right-handed SCI patients and 31 gender- and age-matched healthy controls (HC) were included. The gray matter volume (GMV) changes in SCI patients were observed using voxel-based morphometry (VBM). Then, these altered gray matter clusters were used as the regions of interest (ROIs) for whole-brain functional connectivity (FC) analysis to detect related functional changes. The potential association between GMV and FC values with the visual analog scale (VAS), the American Spinal Injury Association (ASIA) score, and the course of injuries was investigated through partial correlation analysis. Results GMV of the frontal, temporal, and insular cortices was lower in the SCI group than in the HC group. No GMV changes were found in the primary sensorimotor area in the SCI group. Besides, the altered FC regions were not in the primary sensorimotor area but in the cingulate gyrus, supplementary motor area, precuneus, frontal lobe, and insular. Additionally, some of these altered GMV and FC regions were correlated with ASIA motor scores, indicating that higher cognitive regions can affect motor function in SCI patients. Conclusions This study demonstrated that gray matter and related network reorganization in patients with SCI occurred in higher cognitive regions. Future rehabilitation strategies should focus more on cognitive functions.
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Affiliation(s)
- Xin Chen
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Ling Wang
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Weimin Zheng
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Yanhui Yang
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Beining Yang
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Yongsheng Hu
- Department of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jubao Du
- Department of Rehabilitation Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xuejing Li
- Department of Radiology, China Rehabilitation Research Center, Beijing, China
| | - Jie Lu
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Nan Chen
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
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Chen Q, Lv H, Wang Z, Li X, Wang X, Huang Y, Zhao P, Yang Z, Gong S, Wang Z. Role of insula and its subregions in progression from recent onset to chronic idiopathic tinnitus. Brain Commun 2023; 5:fcad261. [PMID: 37869577 PMCID: PMC10586310 DOI: 10.1093/braincomms/fcad261] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/08/2023] [Accepted: 10/06/2023] [Indexed: 10/24/2023] Open
Abstract
We determined the structural and functional alterations in the insula and its subregions in patients with idiopathic tinnitus in order to identify the neural changes involved in the progression from recent onset to chronic tinnitus. We recruited 24 recent-onset tinnitus patients, 32 chronic tinnitus patients and 36 healthy controls. We measured the grey matter volume and fractional amplitude of low-frequency fluctuation of the insula and its subregions and the functional connectivity within the insula and between the insula and the rest of the brain. Relationships between MRI and clinical characteristics were estimated using partial correlation analysis. Both recent-onset and chronic tinnitus patients showed decreased fractional amplitude of low-frequency fluctuation in the insula and its subregions, but only chronic tinnitus patients showed bilateral grey matter atrophy in the ventral anterior insula. Abnormal functional connectivity was detected in recent-onset and chronic tinnitus patients relative to the healthy controls, but functional connectivity differences between recent-onset and chronic tinnitus patients were found in only the auditory-related cortex, frontal cortex and limbic system. Functional alterations (fractional amplitude of low-frequency fluctuation and functional connectivity of the left ventral anterior insula), but not structural changes, were correlated with clinical severity. Bilateral grey matter atrophy in the ventral anterior insula decreased regional activities in the left ventral anterior insula and left posterior insula, and abnormal functional connectivity of the insula subregions with auditory and non-auditory areas were implicated in the progression from recent onset to chronic tinnitus. This suggests that tinnitus generation and development occur in a dynamic manner and involve aberrant multi-structural and functional (regional brain activity and abnormal functional connectivity) reorganization of the insula.
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Affiliation(s)
- Qian Chen
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Han Lv
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Zhaodi Wang
- Department of Otolaryngology, Beijing Jingmei Group General Hospital, Beijing 102300, China
| | - Xiaoshuai Li
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Xinghao Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | | | - Pengfei Zhao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Shusheng Gong
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
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Huynh V, Lütolf R, Rosner J, Luechinger R, Curt A, Kollias S, Michels L, Hubli M. Intrinsic brain connectivity alterations despite intact pain inhibition in subjects with neuropathic pain after spinal cord injury: a pilot study. Sci Rep 2023; 13:11943. [PMID: 37488130 PMCID: PMC10366123 DOI: 10.1038/s41598-023-37783-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 06/27/2023] [Indexed: 07/26/2023] Open
Abstract
Endogenous pain modulation in humans is frequently investigated with conditioned pain modulation (CPM). Deficient pain inhibition is a proposed mechanism that contributes to neuropathic pain (NP) after spinal cord injury (SCI). Recent studies have combined CPM testing and neuroimaging to reveal neural correlates of CPM efficiency in chronic pain. This study investigated differences in CPM efficiency in relation to resting-state functional connectivity (rsFC) between 12 SCI-NP subjects and 13 age- and sex-matched healthy controls (HC). Twelve and 11 SCI-NP subjects were included in psychophysical and rsFC analyses, respectively. All HC were included in the final analyses. Psychophysical readouts were analysed to determine CPM efficiency within and between cohorts. Group differences of rsFC, in relation to CPM efficiency, were explored with seed-to-voxel rsFC analyses with pain modulatory regions, e.g. ventrolateral periaqueductal gray (vlPAG) and amygdala. Overall, pain inhibition was not deficient in SCI-NP subjects and was greater in those with more intense NP. Greater pain inhibition was associated with weaker rsFC between the vlPAG and amygdala with the visual and frontal cortex, respectively, in SCI-NP subjects but with stronger rsFC in HC. Taken together, SCI-NP subjects present with intact pain inhibition, but can be differentiated from HC by an inverse relationship between CPM efficiency and intrinsic connectivity of supraspinal regions. Future studies with larger cohorts are necessary to consolidate the findings in this study.
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Affiliation(s)
- Vincent Huynh
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland.
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich & University of Zurich, Zurich, Switzerland.
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland.
| | - Robin Lütolf
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland
| | - Jan Rosner
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland
- Department of Neurology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Roger Luechinger
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Armin Curt
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland
| | - Spyridon Kollias
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich & University of Zurich, Zurich, Switzerland
| | - Lars Michels
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich & University of Zurich, Zurich, Switzerland
| | - Michèle Hubli
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland
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9
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Yu H, Chen D, Jiang H, Fu G, Yang Y, Deng Z, Chen Y, Zheng Q. Brain morphology changes after spinal cord injury: A voxel-based meta-analysis. Front Neurol 2022; 13:999375. [PMID: 36119697 PMCID: PMC9477418 DOI: 10.3389/fneur.2022.999375] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 08/15/2022] [Indexed: 12/03/2022] Open
Abstract
Objectives Spinal cord injury (SCI) remodels the brain structure and alters brain function. To identify specific changes in brain gray matter volume (GMV) and white matter volume (WMV) following SCI, we conducted a voxel-based meta-analysis of whole-brain voxel-based morphometry (VBM) studies. Methods We performed a comprehensive literature search on VBM studies that compared SCI patients and healthy controls in PubMed, Web of Science and the China National Knowledge Infrastructure from 1980 to April 2022. Then, we conducted a voxel-based meta-analysis using seed-based d mapping with permutation of subject images (SDM-PSI). Meta-regression analysis was performed to identify the effects of clinical characteristics. Results Our study collected 20 studies with 22 GMV datasets and 15 WMV datasets, including 410 patients and 406 healthy controls. Compared with healthy controls, SCI patients showed significant GMV loss in the left insula and bilateral thalamus and significant WMV loss in the bilateral corticospinal tract (CST). Additionally, a higher motor score and pinprick score were positively related to greater GMV in the right postcentral gyrus, whereas a positive relationship was observed between the light touch score and the bilateral postcentral gyrus. Conclusion Atrophy in the thalamus and bilateral CST suggest that SCI may trigger neurodegeneration changes in the sensory and motor pathways. Furthermore, atrophy of the left insula may indicate depression and neuropathic pain in SCI patients. These indicators of structural abnormalities could serve as neuroimaging biomarkers for evaluating the prognosis and treatment effect, as well as for monitoring disease progression. The application of neuroimaging biomarkers in the brain for SCI may also lead to personalized treatment strategies. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021279716, identifier: CRD42021279716.
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Affiliation(s)
- Haiyang Yu
- Department of Orthopedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Duanyong Chen
- Department of Orthopedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Hai Jiang
- Department of Orthopedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Guangtao Fu
- Department of Orthopedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yuhui Yang
- Department of Orthopedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Zhantao Deng
- Department of Orthopedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yuanfeng Chen
- Department of Orthopedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Research Department of Medical Science, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- *Correspondence: Qiujian Zheng
| | - Qiujian Zheng
- Department of Orthopedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Department of Orthopedics, Southern Medical University, Guangzhou, China
- Yuanfeng Chen
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10
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Wang L, Li X, Zheng W, Chen X, Chen Q, Hu Y, Cao L, Ren J, Qin W, Lu J, Chen N. Motor imagery evokes strengthened activation in sensorimotor areas and its effective connectivity related to cognitive regions in patients with complete spinal cord injury. Brain Imaging Behav 2022; 16:2049-2060. [PMID: 35994188 DOI: 10.1007/s11682-022-00675-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2022] [Indexed: 11/28/2022]
Abstract
The objective of this study was to investigate the alterations of brain activation and effective connectivity during motor imagery (MI) in complete spinal cord injury (CSCI) patients and to reveal a potential mechanism of MI in motor rehabilitation of CSCI patients. Fifteen CSCI patients and twenty healthy controls underwent the MI task-related fMRI scan, and the motor execution (ME) task only for healthy controls. The brain activation patterns of the two groups during MI, and CSCI patients during the MI task and healthy controls during the ME task were compared. Then the significantly changed brain activation areas in CSCI patients during the MI task were used as regions of interest for effective connectivity analysis, using a voxel-wise granger causality analysis (GCA) method. Compared with healthy controls, increased activations in left primary sensorimotor cortex and bilateral cerebellar lobules IV-VI were detected in CSCI patients during the MI task, and the activation level of these areas even equaled that of healthy controls during the ME task. Furthermore, GCA revealed decreased effective connectivity from sensorimotor related areas (primary sensorimotor cortex and cerebellar lobules IV-VI) to cognitive related areas (prefrontal cortex, precuneus, middle temporal gyrus, and inferior temporal gyrus) in CSCI patients. Our findings demonstrated that motor related brain areas can be functionally preserved and activated through MI after CSCI, it maybe the potential mechanism of MI in the motor rehabilitation of CSCI patients. In addition, Sensorimotor related brain regions have less influence on the cognitive related regions in CSCI patients during MI (The trial registration number: ChiCTR2000032793).
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Affiliation(s)
- Ling Wang
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, 100053, China
| | - Xuejing Li
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.,Department of Radiology, China Rehabilitation Research Center, Beijing, 100068, China
| | - Weimin Zheng
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, 100053, China
| | - Xin Chen
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, 100053, China
| | - Qian Chen
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Yongsheng Hu
- Department of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Lei Cao
- Department of Rehabilitation Medicine, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Jian Ren
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Wen Qin
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Jie Lu
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, 100053, China
| | - Nan Chen
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China. .,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, 100053, China.
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11
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Leemhuis E, Giuffrida V, De Martino ML, Forte G, Pecchinenda A, De Gennaro L, Giannini AM, Pazzaglia M. Rethinking the Body in the Brain after Spinal Cord Injury. J Clin Med 2022; 11:jcm11020388. [PMID: 35054089 PMCID: PMC8780443 DOI: 10.3390/jcm11020388] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 01/12/2022] [Indexed: 02/05/2023] Open
Abstract
Spinal cord injuries (SCI) are disruptive neurological events that severly affect the body leading to the interruption of sensorimotor and autonomic pathways. Recent research highlighted SCI-related alterations extend beyond than the expected network, involving most of the central nervous system and goes far beyond primary sensorimotor cortices. The present perspective offers an alternative, useful way to interpret conflicting findings by focusing on the deafferented and deefferented body as the central object of interest. After an introduction to the main processes involved in reorganization according to SCI, we will focus separately on the body regions of the head, upper limbs, and lower limbs in complete, incomplete, and deafferent SCI participants. On one hand, the imprinting of the body’s spatial organization is entrenched in the brain such that its representation likely lasts for the entire lifetime of patients, independent of the severity of the SCI. However, neural activity is extremely adaptable, even over short time scales, and is modulated by changing conditions or different compensative strategies. Therefore, a better understanding of both aspects is an invaluable clinical resource for rehabilitation and the successful use of modern robotic technologies.
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Affiliation(s)
- Erik Leemhuis
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; (E.L.); (V.G.); (M.L.D.M.); (A.P.); (L.D.G.); (A.M.G.)
- Action and Body Lab, IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy
| | - Valentina Giuffrida
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; (E.L.); (V.G.); (M.L.D.M.); (A.P.); (L.D.G.); (A.M.G.)
- Action and Body Lab, IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy
| | - Maria Luisa De Martino
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; (E.L.); (V.G.); (M.L.D.M.); (A.P.); (L.D.G.); (A.M.G.)
- Action and Body Lab, IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy
| | - Giuseppe Forte
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; (E.L.); (V.G.); (M.L.D.M.); (A.P.); (L.D.G.); (A.M.G.)
- Action and Body Lab, IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy
- Correspondence: (G.F.); (M.P.); Tel.: +39-6-49917633 (M.P.)
| | - Anna Pecchinenda
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; (E.L.); (V.G.); (M.L.D.M.); (A.P.); (L.D.G.); (A.M.G.)
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; (E.L.); (V.G.); (M.L.D.M.); (A.P.); (L.D.G.); (A.M.G.)
- Action and Body Lab, IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy
| | - Anna Maria Giannini
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; (E.L.); (V.G.); (M.L.D.M.); (A.P.); (L.D.G.); (A.M.G.)
| | - Mariella Pazzaglia
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; (E.L.); (V.G.); (M.L.D.M.); (A.P.); (L.D.G.); (A.M.G.)
- Action and Body Lab, IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy
- Correspondence: (G.F.); (M.P.); Tel.: +39-6-49917633 (M.P.)
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12
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Defrin R, Gruener H, Gaidukov E, Bondi M, Rachamim-Katz O, Ringler E, Blumen N, Zeilig G. From acute to long-term alterations in pain processing and modulation after spinal cord injury: mechanisms related to chronification of central neuropathic pain. Pain 2022; 163:e94-e105. [PMID: 33863855 DOI: 10.1097/j.pain.0000000000002315] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 04/10/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT A severe and debilitating consequence of a spinal cord injury (SCI) is central neuropathic pain (CNP). Our aim was to investigate the processes leading to CNP emergence and chronification by analyzing causal relationship over time between spinothalamic function, pain excitability, and pain inhibition after SCI. This longitudinal follow-up study included 53 patients with acute SCI and 20 healthy controls. Spinothalamic, pain excitability, and intrasegmental and extrasegmental pain inhibition indices were repeatedly evaluated at 1.5, 3, and 6 months post-SCI. Between- and within-group analyses were conducted among those patients who eventually developed CNP and those who did not. Healthy controls were evaluated twice for repeatability analysis. Patients who developed CNP, compared with those who did not, exhibited increased thermal thresholds (P < 0.05), reduced pain adaptation (P < 0.01), and conditioned pain modulation (P < 0.05), early post-injury, and the CNP group's manifestations remained worse throughout the follow-up. By contrast, allodynia frequency was initially similar across SCI groups, but gradually increased in the subacute phase onward only among the CNP group (P < 0.001), along with CNP emergence. Early worse spinothalamic and pain inhibition preceded CNP and predicted its occurrence, and early worse pain inhibition mediated the link between spinothalamic function and CNP. Crossover associations were observed between early and late pain inhibition and excitability. Inefficient intrasegmental and extrasegmental inhibition, possibly resulting from spinothalamic deafferentation, seems to ignite CNP chronification. Pain excitability probably contributes to CNP maintenance, possibly via further exhaustion of the inhibitory control. Preemptive treatment promoting antinociception early post-SCI may mitigate or prevent CNP.
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Affiliation(s)
- Ruth Defrin
- Department of Physical Therapy at Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Hila Gruener
- Department of Physical Therapy at Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Evgeni Gaidukov
- Department of Neurological Rehabilitation, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Department of Rehabilitation Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Moshe Bondi
- Department of Neurological Rehabilitation, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Department of Rehabilitation Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Orna Rachamim-Katz
- Barzilai Day Care Rehabilitation Unit, Barzilai Medical Center, Ashkelon, Israel
| | - Erez Ringler
- Department of Neurological Rehabilitation, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Department of Rehabilitation Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nava Blumen
- Department of Neurological Rehabilitation, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Department of Rehabilitation Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gabi Zeilig
- Department of Neurological Rehabilitation, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Department of Rehabilitation Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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13
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Huynh V, Lütolf R, Rosner J, Luechinger R, Curt A, Kollias S, Hubli M, Michels L. Supraspinal nociceptive networks in neuropathic pain after spinal cord injury. Hum Brain Mapp 2021; 42:3733-3749. [PMID: 34132441 PMCID: PMC8288099 DOI: 10.1002/hbm.25401] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 02/18/2021] [Accepted: 02/22/2021] [Indexed: 12/13/2022] Open
Abstract
Neuropathic pain following spinal cord injury involves plastic changes along the whole neuroaxis. Current neuroimaging studies have identified grey matter volume (GMV) and resting-state functional connectivity changes of pain processing regions related to neuropathic pain intensity in spinal cord injury subjects. However, the relationship between the underlying neural processes and pain extent, a complementary characteristic of neuropathic pain, is unknown. We therefore aimed to reveal the neural markers of widespread neuropathic pain in spinal cord injury subjects and hypothesized that those with greater pain extent will show higher GMV and stronger connectivity within pain related regions. Thus, 29 chronic paraplegic subjects and 25 healthy controls underwent clinical and electrophysiological examinations combined with neuroimaging. Paraplegics were demarcated based on neuropathic pain and were thoroughly matched demographically. Our findings indicate that (a) spinal cord injury subjects with neuropathic pain display stronger connectivity between prefrontal cortices and regions involved with sensory integration and multimodal processing, (b) greater neuropathic pain extent, is associated with stronger connectivity between the posterior insular cortex and thalamic sub-regions which partake in the lateral pain system and (c) greater intensity of neuropathic pain is related to stronger connectivity of regions involved with multimodal integration and the affective-motivational component of pain. Overall, this study provides neuroimaging evidence that the pain phenotype of spinal cord injury subjects is related to the underlying function of their resting brain.
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Affiliation(s)
- Vincent Huynh
- Department of Neuroradiology, Clinical Neuroscience CenterUniversity Hospital Zurich & University of ZurichZurichSwitzerland
- Spinal Cord Injury CenterBalgrist University Hospital, University of ZurichZurichSwitzerland
| | - Robin Lütolf
- Spinal Cord Injury CenterBalgrist University Hospital, University of ZurichZurichSwitzerland
| | - Jan Rosner
- Spinal Cord Injury CenterBalgrist University Hospital, University of ZurichZurichSwitzerland
- Department of Neurology, InselspitalBern University Hospital, University of BernBernSwitzerland
| | - Roger Luechinger
- Institute for Biomedical EngineeringUniversity and ETH ZürichZürichSwitzerland
| | - Armin Curt
- Spinal Cord Injury CenterBalgrist University Hospital, University of ZurichZurichSwitzerland
| | - Spyridon Kollias
- Department of Neuroradiology, Clinical Neuroscience CenterUniversity Hospital Zurich & University of ZurichZurichSwitzerland
| | - Michèle Hubli
- Spinal Cord Injury CenterBalgrist University Hospital, University of ZurichZurichSwitzerland
| | - Lars Michels
- Department of Neuroradiology, Clinical Neuroscience CenterUniversity Hospital Zurich & University of ZurichZurichSwitzerland
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14
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Tan LL, Kuner R. Neocortical circuits in pain and pain relief. Nat Rev Neurosci 2021; 22:458-471. [PMID: 34127843 DOI: 10.1038/s41583-021-00468-2] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 02/07/2023]
Abstract
The sensory, associative and limbic neocortical structures play a critical role in shaping incoming noxious inputs to generate variable pain perceptions. Technological advances in tracing circuitry and interrogation of pathways and complex behaviours are now yielding critical knowledge of neocortical circuits, cellular contributions and causal relationships between pain perception and its abnormalities in chronic pain. Emerging insights into neocortical pain processing suggest the existence of neocortical causality and specificity for pain at the level of subdomains, circuits and cellular entities and the activity patterns they encode. These mechanisms provide opportunities for therapeutic intervention for improved pain management.
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Affiliation(s)
- Linette Liqi Tan
- Institute of Pharmacology, Heidelberg University, Heidelberg, Germany.
| | - Rohini Kuner
- Institute of Pharmacology, Heidelberg University, Heidelberg, Germany.
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