Accession Number : ADA583204


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


Descriptive Note : Journal article


Corporate Author : VETERANS ADMINISTRATION MEDICAL CENTER MIAMI FL


Personal Author(s) : Widerstroem-Noga, Eva ; Pattany, Pradip M ; Cruz-Almeida, Yenisel ; Felix, Elizabeth R ; Perez, Salome ; Cardenas, Diana D ; Martinez-Arizala, Alberto


Full Text : https://apps.dtic.mil/dtic/tr/fulltext/u2/a583204.pdf


Report Date : Feb 2013


Pagination or Media Count : 23


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


Descriptors :   *METABOLITES , *PAIN , *SPINAL CORD , CONCENTRATION(COMPOSITION) , MAGNETIC RESONANCE IMAGING , NEUROLOGY , RELIABILITY , SPECTROSCOPY , STATISTICAL ANALYSIS , WOUNDS AND INJURIES


Subject Categories : Biochemistry
      Anatomy and Physiology
      Medicine and Medical Research


Distribution Statement : APPROVED FOR PUBLIC RELEASE