Central neuropathic pain in paraplegia alters movement related potentials

Aleksandra Vučković,Mohammed Jarjees,Muhammad Abul Hasan,Makoto Miyakoshi,Matthew Fraser

doi:10.1016/j.clinph.2018.05.020

Abstract

ObjectivesSpinal Cord Injured (SCI) persons with and without Central Neuropathic Pain (CNP) show different oscillatory brain activities during imagination of movement. This study investigates whether they also show differences in movement related cortical potentials (MRCP). MethodsSCI paraplegic patients with no CNP (n = 8), with CNP in their lower limbs (n = 8), and healthy control subjects (n = 10) took part in the study. EEG clustering involved independent component analysis, equivalent current dipole fitting, and Measure Projection to define cortical domains that have functional modularity during the motor imagery task. ResultsThree domains were identified: limbic system, sensory-motor cortex and visual cortex. The MRCP difference between the groups of SCI with and without CNP was reflected in a domain located in the limbic system, while the difference between SCI patients and control subjects was in the sensorimotor domain. Differences in MRCP morphology between patients and healthy controls were visible for both paralysed and non paralysed limbs. ConclusionSCI but not CNP affects the movement preparation, and both SCI and CNP affect sensory processes. SignificanceRehabilitation strategies of SCI patients based on MRCP should take into account the presence of CNP.

Highlights

Central Neuropathic Pain (CNP) is caused by an injury to the somatosensory system (Jensen et al, 2011) affecting more than 40% Spinal Cord Injured (SCI) patients (Siddall, 2003)
movement related cortical potential (MRCP) is a subtype of Event Related Potential (ERP) and presents the type of postsynaptic responses of main pyramidal neurons (Shibasaki et al, 1980, Luck, 2005) triggered by an overt or covert motor action while ERS/ERD present changes in parameters that control oscillations in neuronal networks (Pfurtscheller and Lopes da Silva, 1999)
While in Vuckovic et al (2014) we defined the influence of CNP on different frequency bands, in this study we investigate the effect of CNP on ERP based on different phases of cue-based motor task

Summary

Introduction

Central Neuropathic Pain (CNP) is caused by an injury to the somatosensory system (Jensen et al, 2011) affecting more than 40% Spinal Cord Injured (SCI) patients (Siddall, 2003). A. Vuckovic et al / Clinical Neurophysiology 129 (2018) 1669–1679 both event-related synchronisation/desynchronisation (ERS/ERD) (Pfurtscheller et al, 2009) and movement related cortical potential (MRCP) (Castro et al, 2013). MRCP is a subtype of Event Related Potential (ERP) and presents the type of postsynaptic responses of main pyramidal neurons (Shibasaki et al, 1980, Luck, 2005) triggered by an overt or covert motor action while ERS/ERD present changes in parameters that control oscillations in neuronal networks (Pfurtscheller and Lopes da Silva, 1999). They found that people with SCI have lower readiness and movement related potentials while imagining to move paralysed limbs than able bodied while executing the same movement

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Conclusion