JNNP: Tissue bridge predicts neuropathic pain after spinal cord injury.

Spinal cord injury (SCI) is a devastating and life-changing event.
most cases, it will produce immediate and permanent sensations below the injury level, motor and autonational neurological dysfunction, thereby reducing the quality of life.
, in addition to functional impairments, most patients experience neuropathic pain (NP).
usually appears early after SCI, is often difficult to treat, and usually lasts for several years, and may increase in intensity.
the origin of NP is not yet known, it is believed to be the cause of the tissue bridge that remains near the lesions cavity in myelin.
important is that NP below the injury level develops over time.
suggests that over time, part of the sense pathway in the retained organizational bridge becomes active.
, the recovery of spinal pasum beam function in SCI patients has been enhanced.
NP and its severity were associated with pain intensity.
study aims to explore the value of vector-like tissue bridges (abdominal and back-side) in predicting the emergence and maintenance of SCI-related NPs obtained from regular T2-weighted (T2w) continuous scans.
, the authors studied the relationship between the width of abdominal and back-side tissue bridges and pain intensity and their clinical characteristics.
method: In this retrospective study, there were 44 subacute SCI patients (28 quadriplegics and 16 paraplegics) who were selected continuously at Balgrist University Hospital (Zurich, Switzerland) between May 1996 and January 2019.
of these 44 patients, all received clinical evaluations and 32 neuroimaging follow-ups 12 months after follow-up to SCI.
Using 1- and 12-month neuroimaging examinations, neuropathological pain and clinical data from these patients, group differences and clinical pathological relationships and outcome prediction were investigated through regression analysis and unethical recursive zoning (URP).
of interest include lesions parameters, pain, and clinical outcome indicators in follow-up for 1 month and 12 months.
On the EMSCI questionnaire, patients rated all aspects of pain (e.g., current pain intensity, average and maximum pain intensity in the last week of the assessment, location and quality of pain, abnormal pain, and intensity of sensory abnormalities).
used an 11-point digital scale to quantify the intensity of pain, with a "0" for no pain and "10" for the most severe pain imaginable.
data from the EMSCI Pain Questionnaire can be used in 43 SCI patients (24 NP, 19 painless patients) and 42 SCI patients 12 months after surgery (28 NP, 14 painless patients).
1 patient and 2 patients without EMSCI pain questionnaire reported NP at 1 month and 12 months, respectively.
all study participants were MRI on 1.5 or 3 T Philips (Philips Healthcare, Best, Netherlands), Siemens (Siemens Healthcare, Erlangen, Germany) or GE Medical Systems, Waukesha, Wisconsin, USA scanners.
results: Forty-four SCI patients (n - 35 men (79.5%)), with an average age of 50.05 x 18.88 years.
NP patients (50.40 x 17.38 years, n x 25) and painless patients (49.58 x 21.17 years, n x 1 9) There is no difference in age at 1 month (-mean=-0.82,95%CI=12.55 to 10.91, p=0.888).
between injury and 1 month of scans (i.e., subacute phase) was 32.95 to 16.85 days.
the time after injury was no difference between NP patients (30.88 x 17.55 days, n x 25) and painless patients (35.68 x 15.93 days) (4.80, 95% CI -5.56 to 15.17, p x 0.355), n x 19).
had NP in six patients who were initially pain-free.
NP patients who reported NP in 1 month (56.8%) and 12 month follow-up (68.2%) reported an average NP intensity of 3.67 x 1.611.6 and 3. 68 to 1.61 (0.01, 95% CI -0.89 to 0.91, p to 0.979) respectively.
SCI patients with NP had a sting score of 70.08 x 28.40 at 1 month, and a needle score of 80.16 x 27.88 in the 12 months after SCI (10.08, 95% CI 2.66 to 17.50, p .
in painless patients, the one-month acupuncture score was 57.84 to 25.02, and there was no significant change over time (follow-up was 60.58 to 27.25 (2.74, 95% CI -7.36 to 12.84, p to 0.576, n 19).
There was no difference in needle score between the two patient groups at 1 month (median x 15.00, 95% CI -7.00 to 29.00, p s. 0.184), and no difference in needle score change rate from 1 month to follow-up.
at 12 months (median s 3.00, 95% CI -3.00 to 12.00, p s 0.286).
the study identified a backup tissue bridge as a quantifiable neuroimaging biomarker for predictable NP emergence and maintenance through routine MRI assessment.
specifically, it was determined that the 1-month width of the abdominal tissue bridge was the strongest predictive indicator of NP strength and needle score in the 12 months after SCI.
In turn, the abdominal tissue bridge represents ANRI indicators that can be easily implemented in routine clinical procedures as reliable and time-saving neuroimaging biomarkers for monitoring NP and stratiting patient subgroups in interventional clinical trials.
Pfyffer D, Vallotton K, Curt A, et al Tissue Bridges predict neuropathic pain form after spinal cord injury Journal of Neurology, Neurosurgery and Psimsy Published Online First: 11 August 2020. doi: 10.1136/jnnp-2020-323150MedSci Original Source: MedSci Original !-- Content Presentation End -- !-- Judge Whether to Log In End.