title: Association of pain and CNS structural changes after spinal cord injury.
abstract: Traumatic spinal cord injury (SCI) has been shown to trigger structural atrophic changes within the spinal cord and brain. However, the relationship between structural changes and magnitude of neuropathic pain (NP) remains incompletely understood. Voxel-wise analysis of anatomical magnetic resonance imaging data provided information on cross-sectional cervical cord area and volumetric brain changes in 30 individuals with chronic traumatic SCI and 31 healthy controls. Participants were clinically assessed including neurological examination and pain questionnaire. Compared to controls, individuals with SCI exhibited decreased cord area, reduced grey matter (GM) volumes in anterior cingulate cortex (ACC), left insula, left secondary somatosensory cortex, bilateral thalamus, and decreased white matter volumes in pyramids and left internal capsule. The presence of NP was related with smaller cord area, increased GM in left ACC and right M1, and decreased GM in right primary somatosensory cortex and thalamus. Greater GM volume in M1 was associated with amount of NP. Below-level NP-associated structural changes in the spinal cord and brain can be discerned from trauma-induced consequences of SCI. The directionality of these relationships reveals specific changes across the neuroaxis (i.e., atrophic changes versus increases in volume) and may provide substrates of underlying neural mechanisms in the development of NP.
authors.affiliation: Spinal Cord Injury Center, University Hospital Balgrist, University of Zurich, Zurich, Switzerland.
authors.forename: Catherine R
authors.initials: CR
authors.lastname: Jutzeler
authors.affiliation: Spinal Cord Injury Center, University Hospital Balgrist, University of Zurich, Zurich, Switzerland.
authors.forename: Eveline
authors.initials: E
authors.lastname: Huber
authors.affiliation: Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, University College London, London, UK.
authors.forename: Martina F
authors.initials: MF
authors.lastname: Callaghan
authors.affiliation: Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland.
authors.forename: Roger
authors.initials: R
authors.lastname: Luechinger
authors.affiliation: Spinal Cord Injury Center, University Hospital Balgrist, University of Zurich, Zurich, Switzerland.
authors.forename: Armin
authors.initials: A
authors.lastname: Curt
authors.affiliation: Spinal Cord Injury Center, University Hospital Balgrist, University of Zurich, Zurich, Switzerland.|Faculty of Education, School of Kinesiology, ICORD, University of British Columbia.
authors.forename: John L K
authors.initials: JL
authors.lastname: Kramer
authors.affiliation: Spinal Cord Injury Center, University Hospital Balgrist, University of Zurich, Zurich, Switzerland.|Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, University College London, London, UK.|Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, University College London, London, UK.|Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Freund
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000473:pathology; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009437:Neuralgia / Q000175:diagnosis* / Q000209:etiology; D010147:Pain Measurement; D013116:Spinal Cord / Q000473:pathology*; D013119:Spinal Cord Injuries / Q000175:diagnosis*; D055815:Young Adult