Thalamic activity and biochemical changes in individuals with neuropathic pain after spinal cord injury

• Published in: Pain (Amsterdam) Vol. 155; no. 5; pp. 1027 - 1036
• Main Authors: Gustin, S.M., Wrigley, P.J., Youssef, A.M., McIndoe, L., Wilcox, S.L., Rae, C.D., Edden, R.A.E., Siddall, P.J., Henderson, L.A.
• Format: Journal Article Web Resource
• Language: English
• Published: Philadelphia, PA Elsevier B.V 01.05.2014; International Association for the Study of Pain; Elsevier
• Subjects: Adult; Aged; Aspartic Acid - analogs & derivatives; Aspartic Acid - metabolism; Aspartic Acid/analogs & derivatives/metabolism; Biological and medical sciences; Female; Functional Neuroimaging; Fundamental and applied biological sciences. Psychology; Gamma amino butyric acid; Humans; Life sciences; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Male; Medical sciences; Middle Aged; MRI; Nervous system involvement in other diseases. Miscellaneous; Neuralgia - etiology; Neuralgia - metabolism; Neuralgia - physiopathology; Neuralgia/etiology/metabolism/physiopathology; Neurology; Neuropathic pain; Pain Measurement; Sciences du vivant; Somesthesis and somesthetic pathways (proprioception, exteroception, nociception); interoception; electrolocation. Sensory receptors; Spin Labels; Spinal Cord Injuries - complications; Spinal Cord Injuries - metabolism; Spinal Cord Injuries - physiopathology; Spinal Cord Injuries/complications/metabolism/physiopathology; Spinal cord injury; Thalamus; Thalamus - metabolism; Thalamus - physiopathology; Thalamus/metabolism/physiopathology; Vertebrates: nervous system and sense organs; Gamma amino butyric acid; Thalamus; Spinal cord injury; MRI; Neuropathic pain; Spinal cord; Aminoacid; Central nervous system; Lesion; Nuclear magnetic resonance imaging; Encephalon
• ISSN: 0304-3959; 1872-6623; 1872-6623
• DOI: 10.1016/j.pain.2014.02.008

Neuropathic pain following spinal cord injury is associated with altered thalamic biochemistry, structure and function, which may disturb central processing and play a key role in the persistent experience of pain. There is increasing evidence relating thalamic changes to the generation and/or maintenance of neuropathic pain. We have recently reported that neuropathic orofacial pain is associated with altered thalamic anatomy, biochemistry, and activity, which may result in disturbed thalamocortical oscillatory circuits. Despite this evidence, it is possible that these thalamic changes are not responsible for the presence of pain per se, but result as a consequence of the injury. To clarify this subject, we compared brain activity and biochemistry in 12 people with below-level neuropathic pain after complete thoracic spinal cord injury with 11 people with similar injuries and no neuropathic pain and 21 age- and gender-matched healthy control subjects. Quantitative arterial spinal labelling was used to measure thalamic activity, and magnetic resonance spectroscopy was used to determine changes in neuronal variability quantifying N-acetylaspartate and alterations in inhibitory function quantifying gamma amino butyric acid. This study revealed that the presence of neuropathic pain is associated with significant changes in thalamic biochemistry and neuronal activity. More specifically, the presence of neuropathic pain after spinal cord injury is associated with significant reductions in thalamic N-acetylaspartate, gamma amino butyric acid content, and blood flow in the region of the thalamic reticular nucleus. Spinal cord injury on its own did not account for these changes. These findings support the hypothesis that neuropathic pain is associated with altered thalamic structure and function, which may disturb central processing and play a key role in the experience of neuropathic pain.