Targeting inflammation as a treatment modality for neuropathic pain in spinal cord injury: a randomized clinical trial.
The purpose of the present study was to examine the effectiveness of an anti-inflammatory intervention as a treatment for neuropathic pain following spinal cord injury (SCI).



This randomized, parallel-group, controlled clinical trial (NCT02099890) examined 20 participants with varying levels and severities of SCI, randomized (3:2) to either a 12-week anti-inflammatory diet, or control group. Outcome measures consisted of self-determined indices of pain as assessed using the neuropathic pain questionnaire (NPQ) and markers of inflammation as assessed by various pro- and anti-inflammatory cytokines, as well as the eicosanoids PGE2 and LTB4.



A significant group × time interaction was found for sensory pain scores (p < 0.01). A Mann-Whitney test revealed that the change scores (3-month baseline) were significantly different between groups for IFN-y (U = 13.0, p = 0.01), IL-1β (U = 14.0, p = 0.01), and IL-2 (U = 12.0, p = 0.01). A Friedman test revealed the treatment group had a significant reduction in IFN-y (x (2) = 8.67, p = 0.01), IL-1β (x (2) = 17.78, p < 0.01), IL-6 (x (2) = 6.17, p < 0.05), while the control group showed no significant change in any inflammatory mediator. A stepwise backward elimination multiple regression analysis showed that the change in sensory neuropathic pain was a function of the change in the proinflammatory cytokines IL-2 and IFN-y, as well as the eicosanoid PGE2 (R = 0.689, R (2) = 0.474).



Overall, the results of the study demonstrate the efficacy of targeting inflammation as a means of treating neuropathic pain in SCI, with a potential mechanism relating to the reduction in proinflammatory cytokines and PGE2.



ClinicalTrials.gov, NCT02099890.
Department of Kinesiology, Brock University, St Catharines, Ontario, L2S 3A1, Canada. dallison@brocku.ca.|Brock-Niagara Centre for Health and Well-being, St Catharines, Ontario, L2T 1W4, Canada. dallison@brocku.ca.
David J
DJ
Allison
Department of Kinesiology, Brock University, St Catharines, Ontario, L2S 3A1, Canada.
Aysha
A
Thomas
Department of Kinesiology, Brock University, St Catharines, Ontario, L2S 3A1, Canada.
Kayleigh
K
Beaudry
Department of Kinesiology, Brock University, St Catharines, Ontario, L2S 3A1, Canada.|Brock-Niagara Centre for Health and Well-being, St Catharines, Ontario, L2T 1W4, Canada.
David S
DS
Ditor
D000328:Adult; D000368:Aged; D000975:Antioxidants / Q000008:administration & dosage*; D050528:Diet, Carbohydrate-Restricted / Q000379:methods; D018753:Diet, Protein-Restricted / Q000379:methods; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000037:antagonists & inhibitors / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000097:blood* / Q000175:diagnosis / Q000178:diet therapy*; D013119:Spinal Cord Injuries / Q000097:blood* / Q000175:diagnosis / Q000178:diet therapy*; D016896:Treatment Outcome
D000975:Antioxidants; D018836:Inflammation Mediators
Anti-inflammatory diet; Inflammation; Neuropathic pain; Spinal cord injury