Background

The mechanisms by which mobility function and neuropathic pain are mutually influenced by supraspinal plasticity in motor- and pain-related brain networks following spinal cord injury (SCI) remains poorly understood.

Objective

To determine cortical and subcortical resting-state network alterations using power spectral density (PSD) analysis and investigate the relationships between these intrinsic alterations and mobility function and neuropathic pain following SCI.

Methods

A total of 41 patients with incomplete SCI and 33 healthy controls were included. The degree of mobility and balance function and severity of neuropathic pain and depressive mood were evaluated. The resting-state functional magnetic resonance imaging data of low-frequency fluctuations were analyzed based on PSD. Differences in PSD values between patients with SCI and controls were assessed using the two-sample t-test (false discovery rate-corrected P < 0.05). The relationship between PSD values and mobility function and pain intensity was assessed using Pearson’s correlation coefficient adjusted for the severity of depressive mood.

Results

Compared with healthy controls, lower PSD values in supplementary motor and medial prefrontal areas (the anterior cingulate cortex, ventral medial prefrontal cortex, and superior orbito-prefrontal cortex) were associated with greater pain severity and poorer postural balance and mobility (P < 0.05) in patients with SCI, whereas higher PSD values in the primary motor cortex, premotor cortex, thalamus, and periaqueductal gray were associated with greater pain severity and poorer postural balance and mobility (P < 0.05).

Conclusions

Cortical and subcortical plastic alterations in intrinsic motor- and pain-related networks were observed in patients with SCI and were simultaneously associated with neuropathic pain intensity and degree of mobility function.

中文翻译：

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脊髓损伤后神经病理性疼痛的运动和疼痛相关网络中功率谱密度的变化。

 背景

脊髓损伤（SCI）后运动和疼痛相关大脑网络中脊髓上可塑性对运动功能和神经性疼痛相互影响的机制仍知之甚少。

 客观的

使用功率谱密度 (PSD) 分析确定皮质和皮质下静息态网络改变，并研究这些内在改变与 SCI 后的运动功能和神经病理性疼痛之间的关系。

 方法

总共包括 41 名不完全 SCI 患者和 33 名健康对照者。评估活动和平衡功能的程度以及神经性疼痛和抑郁情绪的严重程度。基于PSD对低频波动的静息态功能磁共振成像数据进行分析。使用双样本t检验评估 SCI 患者和对照组之间 PSD 值的差异（错误发现率校正P < 0.05）。使用皮尔逊相关系数根据抑郁情绪的严重程度进行调整，评估 PSD 值与活动功能和疼痛强度之间的关系。

 结果

与健康对照相比，辅助运动和内侧前额叶区域（前扣带皮层、腹侧内侧前额叶皮层和上眶前额叶皮层）的 PSD 值较低与疼痛严重程度较高以及姿势平衡和活动能力较差相关 ( P < 0.05 ）在 SCI 患者中，而初级运动皮层、前运动皮层、丘脑和导水管周围灰质中较高的 PSD 值与较严重的疼痛以及较差的姿势平衡和活动能力相关（ P < 0.05）。

 结论

在 SCI 患者中观察到内在运动和疼痛相关网络的皮质和皮质下塑性改变，并且同时与神经病理性疼痛强度和活动功能程度相关。