Tissue bridges predict neuropathic pain emergence after spinal cord injury.
Tissue bridges predict neuropathic pain emergence after spinal cord injury.
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DOI：
10.1136/jnnp-2020-323150
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发表时间：
2020-10
期刊：
影响因子：
--
通讯作者：
Freund P
中科院分区：
文献类型：
--
作者：
Pfyffer D;Vallotton K;Curt A;Freund P
评估保存的脊髓组织与脊髓损伤后神经病理性疼痛发展的关系。这项回顾性纵向研究包括44例(男性35例，平均年龄50.05(18.88)岁)亚急性(即1个月)脊髓损伤患者(25例神经病理性疼痛患者，19例无痛患者)和神经影像资料，他们在12个月时进行了临床随访。根据正中矢状面T2加权图像计算组织桥的宽度，并进行跨组比较。回归分析被用来确定这些神经成像指标与先前评估的疼痛强度和针刺评分之间的关系。25例有神经病理性疼痛的患者针刺评分从1个月到12个月( 平均为10.08，95%CI为2.66至17.50，P=0.010)，而无疼痛患者的针刺评分与之相似(Δ平均为2.74，95%CI为7.36至12.84，P=0.576)。与无疼痛患者相比，在1个 月时，他们的腹侧组织桥也更大(Δ中位数=0.80，95%可信区间0.20to1.71，p=0.008)。条件推理树分析显示，腹侧组织桥宽度(≤2.1或>；2.1 mm)对12 月神经病理性疼痛强度(1.9±2.26 和3.83±1.19，p=0.042)和12个月针刺评分(63.84±28.26和92.67±19.43，p=0.025)的预测作用最强。脊髓损伤后1 个月，腹侧组织桥较宽--脊髓丘脑束功能的替代指标--与神经病理性疼痛的出现和维持以及针刺感觉的增加有关。备用腹侧组织桥可作为神经病理性疼痛的神经影像生物标志物，并可用于预测和监测介入试验中患者的疼痛结局和分层。
To assess associations between preserved spinal cord tissue quantified by the width of ventral and dorsal tissue bridges and neuropathic pain development after spinal cord injury. This retrospective longitudinal study includes 44 patients (35 men; mean (SD) age, 50.05 (18.88) years) with subacute (ie, 1 month) spinal cord injury (25 patients with neuropathic pain, 19 pain-free patients) and neuroimaging data who had a follow-up clinical assessment at 12 months. Widths of tissue bridges were calculated from midsagittal T2-weighted images and compared across groups. Regression analyses were used to identify relationships between these neuroimaging measures and previously assessed pain intensity and pin-prick score. Pin-prick score of the 25 patients with neuropathic pain increased from 1 to 12 months (Δmean=10.08, 95% CI 2.66 to 17.50, p=0.010), while it stayed similar in pain-free patients (Δmean=2.74, 95% CI −7.36 to 12.84, p=0.576). They also had larger ventral tissue bridges (Δmedian=0.80, 95% CI 0.20 to 1.71, p=0.008) at 1 month when compared with pain-free patients. Conditional inference tree analysis revealed that ventral tissue bridges’ width (≤2.1 or >2.1 mm) at 1 month is the strongest predictor for 12 months neuropathic pain intensity (1.90±2.26 and 3.83±1.19, p=0.042) and 12 months pin-prick score (63.84±28.26 and 92.67±19.43, p=0.025). Larger width of ventral tissue bridges—a proxy for spinothalamic tract function—at 1 month post-spinal cord injury is associated with the emergence and maintenance of neuropathic pain and increased pin-prick sensation. Spared ventral tissue bridges could serve as neuroimaging biomarkers of neuropathic pain and might be used for prediction and monitoring of pain outcomes and stratification of patients in interventional trials.
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影响因子：
9.9
作者：
Pfyffer, Dario;Huber, Eveline;Freund, Patrick
通讯作者：
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DOI：
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