Functional Connectivity Magnetic Resonance Imaging Sequences in Patients With Postsurgical Persistent Spinal Pain Syndrome Type 2 With Implanted Spinal Cord Stimulation Systems: A Safety, Feasibility, and Validity Study. Neuromodulation 2023 Jul;26(5):1009-1014
Date
05/19/2023Pubmed ID
37204362DOI
10.1016/j.neurom.2023.04.465Scopus ID
2-s2.0-85159401230 (requires institutional sign-in at Scopus site) 1 CitationAbstract
BACKGROUND: Chronic pain has been associated with alterations in brain connectivity, both within networks (regional) and between networks (cross-network connectivity). Functional connectivity (FC) data on chronic back pain are limited and based on heterogeneous pain populations. Patients with postsurgical persistent spinal pain syndrome (PSPS) type 2 are good candidates for spinal cord stimulation (SCS) therapy. We hypothesize that 1) FC magnetic resonance imaging (fcMRI) scans can be safely obtained in patients with PSPS type 2 with implanted therapeutic SCS devices and that 2) their cross-network connectivity patterns are altered and involve emotion and reward/aversion functions.
MATERIALS AND METHODS: Resting-state (RS) fcMRI (rsfcMRI) scans were obtained from nine patients with PSPS type 2 implanted with therapeutic SCS systems and 13 age-matched controls. Seven RS networks were analyzed, including the striatum.
RESULTS: Cross-network FC sequences were safely obtained on a 3T MRI scanner in all nine patients with PSPS type 2 with implanted SCS systems. FC patterns involving emotion/reward brain circuitry were altered as compared with controls. Patients with a history of constant neuropathic pain, experiencing longer therapeutic effects of SCS, had fewer alterations in their connectivity patterns.
CONCLUSIONS: To our knowledge, this is the first report of altered cross-network FC involving emotion/reward brain circuitry in a homogeneous population of patients with chronic pain with fully implanted SCS systems, on a 3T MRI scanner. All rsfcMRI studies were safe and well tolerated by all nine patients, with no detectable effects on the implanted devices.
Author List
Pahapill PA, Chen G, Arocho-Quinones EV, Nencka ASAuthors
Elsa V. Arocho-Quinones MD Assistant Professor in the Neurosurgery department at Medical College of WisconsinAndrew S. Nencka PhD Director, Associate Professor in the Radiology department at Medical College of Wisconsin
Peter A. Pahapill MD, PhD Professor in the Neurosurgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Chronic PainFailed Back Surgery Syndrome
Feasibility Studies
Humans
Magnetic Resonance Imaging
Pain, Postoperative
Spinal Cord
Spinal Cord Stimulation
