American Journal of Neuroradiology 23:901-905, June-July 2002
© 2002 American Society of Neuroradiology
SPINE
Proton Magnetic Resonance Spectroscopy of the Thalamus in Patients with Chronic Neuropathic Pain after Spinal Cord Injury
a Department of Radiology, University of Miami School of Medicine
b Miami Project to Cure Paralysis, University of Miami School of Medicine
c Department of Neurology, University of Miami School of Medicine
d Department of Orthodontics, University of Florida Gainesville, FL
Address reprint requests Pradip M. Pattany, PhD, Department of Radiology, MRI Center, University of Miami School of Medicine, 1115 NW 14th St, Miami, FL 33136
BACKGROUND AND PURPOSE: Spinal cord injury (SCI) results in a number of consequences; one of the most difficult to manage is chronic neuropathic pain. Thus, defining the potential neural and biochemical changes associated with chronic pain after SCI is important because this may lead to development of new treatment strategies. Prior studies have looked at the thalamus, because it is a major sensory relay station. The purpose of our study was to define alterations in metabolites due to injury-induced functional changes in thalamic nuclei by using single-voxel stimulated echo acquisition mode MR spectroscopy.
METHODS: Twenty-six men were recruited: 16 patients with SCI and paraplegia (seven with pain, nine without pain) and 10 healthy control subjects. Pain was evaluated in an interview, which included the collection of information concerning the location, quality, and intensity of pain, carefully identifing the dysesthetic neuropathic pain often seen in SCI. Localized single-voxel (8-cm3 volume) proton spectra were acquired from the left and right thalami.
RESULTS: The concentration of N-acetyl (NA) was negatively correlated with pain intensity (r = -0.678), and the t test showed that NA was significantly different between patients with pain and patients without pain (P = .006). Myo-inositol was positively correlated with pain intensity (r = 0.520); difference between patients with pain and those without pain was almost significant (P = .06).
CONCLUSION: The observed differences in metabolites in SCI patients with and pain and in those without pain suggest anatomic, functional, and biochemical changes in the thalamic region.
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