BACKGROUND: The varying nature of chronic pain (CP) is difficult to correlate to neural activity using typical functional magnetic resonance imaging methods. Arterial spin labeling is a perfusion-based imaging technique allowing the absolute quantification of regional cerebral blood flow, which is a surrogate measure of neuronal activity. METHODS: Subjects with chronic low back and radicular pain and matched healthy normal subjects, undergoing identical procedures, participated in three sessions: a characterization and training session and two arterial spin labeling sessions. In the first imaging session, CP (if any) was exacerbated using clinical maneuvers; in the second session, noxious heat was applied to the affected leg dermatome, the intensity of which was matched to the pain intensity level of the CP exacerbations for each back pain subject. RESULTS: The clinically significant worsening of ongoing CP (≤ 30%, n = 16) was associated with significant regional blood flow increases (6-10 mm/100 g of tissue/min, P less than 0.01) within brain regions known to activate with experimental pain (somatosensory, prefrontal, and insular cortices) and in other structures observed less frequently in experimental pain studies, such as the superior parietal lobule (part of the dorsal attention network). This effect is specific to changes in ongoing CP as it is observed during worsening CP, but it is not observed after thermal pain application, or in matched, pain-free healthy controls. CONCLUSIONS: Study findings demonstrate the use of arterial spin labeling to investigate the neural processing of CP, and these findings are a step forward in the quest for objective biomarkers of the chronic pain experience.
BACKGROUND: The varying nature of chronic pain (CP) is difficult to correlate to neural activity using typical functional magnetic resonance imaging methods. Arterial spin labeling is a perfusion-based imaging technique allowing the absolute quantification of regional cerebral blood flow, which is a surrogate measure of neuronal activity. METHODS: Subjects with chronic low back and radicular pain and matched healthy normal subjects, undergoing identical procedures, participated in three sessions: a characterization and training session and two arterial spin labeling sessions. In the first imaging session, CP (if any) was exacerbated using clinical maneuvers; in the second session, noxious heat was applied to the affected leg dermatome, the intensity of which was matched to the pain intensity level of the CP exacerbations for each back pain subject. RESULTS: The clinically significant worsening of ongoing CP (≤ 30%, n = 16) was associated with significant regional blood flow increases (6-10 mm/100 g of tissue/min, P less than 0.01) within brain regions known to activate with experimental pain (somatosensory, prefrontal, and insular cortices) and in other structures observed less frequently in experimental pain studies, such as the superior parietal lobule (part of the dorsal attention network). This effect is specific to changes in ongoing CP as it is observed during worsening CP, but it is not observed after thermal pain application, or in matched, pain-free healthy controls. CONCLUSIONS: Study findings demonstrate the use of arterial spin labeling to investigate the neural processing of CP, and these findings are a step forward in the quest for objective biomarkers of the chronic pain experience.
Authors: Marco L Loggia; Chantal Berna; Jieun Kim; Christine M Cahalan; Marc-Olivier Martel; Randy L Gollub; Ajay D Wasan; Vitaly Napadow; Robert R Edwards Journal: J Pain Date: 2015-04-30 Impact factor: 5.820
Authors: Karin B Jensen; Chantal Berna; Marco L Loggia; Ajay D Wasan; Robert R Edwards; Randy L Gollub Journal: Neurosci Lett Date: 2012-03-14 Impact factor: 3.046
Authors: Rick P F Wolthusen; Garth Coombs; Emily A Boeke; Stefan Ehrlich; Stephanie N DeCross; Shahin Nasr; Daphne J Holt Journal: Biol Psychiatry Cogn Neurosci Neuroimaging Date: 2017-07-13
Authors: Ajay D Wasan; Edward Michna; Robert R Edwards; Jeffrey N Katz; Srdjan S Nedeljkovic; Andrew J Dolman; David Janfaza; Zach Isaac; Robert N Jamison Journal: Anesthesiology Date: 2015-10 Impact factor: 7.892
Authors: Ann T Farrell; Julie Panepinto; C Patrick Carroll; Deepika S Darbari; Ankit A Desai; Allison A King; Robert J Adams; Tabitha D Barber; Amanda M Brandow; Michael R DeBaun; Manus J Donahue; Kalpna Gupta; Jane S Hankins; Michelle Kameka; Fenella J Kirkham; Harvey Luksenburg; Shirley Miller; Patricia Ann Oneal; David C Rees; Rosanna Setse; Vivien A Sheehan; John Strouse; Cheryl L Stucky; Ellen M Werner; John C Wood; William T Zempsky Journal: Blood Adv Date: 2019-12-10
Authors: Hoameng Ung; Justin E Brown; Kevin A Johnson; Jarred Younger; Julia Hush; Sean Mackey Journal: Cereb Cortex Date: 2012-12-17 Impact factor: 5.357