Abstract
It is widely believed that cortical changes are a consequence of longstanding neuropathic
pain (NP). In this article, we demonstrate that NP in individuals with subacute spinal
cord injury (SCI) has characteristic electroencephalography markers (EEG) that precede
the onset of pain. EEG was recorded in a relaxed state and during motor imagination
tasks in 10 able-bodied participants and 31 patients with subacute SCI (11 with NP,
10 without NP, and 10 who had pain develop within 6 months of EEG recording). All
20 patients with SCI initially without NP were tested for mechanically induced allodynia,
but only 1 patient, who later had pain develop, reported an unpleasant sensation.
The EEG reactivity to eye opening was reduced in the alpha band and absent in the
theta and beta bands in the patients who later developed pain and was reduced in those
who already had pain. Alpha band power was reduced at BA7 in both the relaxed state
and during motor imagination in patients who either had or later developed pain compared
with those without pain. All SCI groups had reduced dominant alpha frequency and beta
band power at BA7. EEG reactivity to eye opening and reduced spontaneous and induced
alpha activity over the parietal cortex were predictors of future NP, as well as markers
of existing NP.
Clinical Trial Registration Number: NCT02178917
Perspective
We demonstrate that brain activity in patients with subacute SCI reveals both early
markers and predictors of NP, which may manifest before sensory discomfort. These
markers and predictors may complement known sensory phenotypes of NP. They may exist
in other patient groups suffering from NP of central origin.
Key words
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Article Info
Publication History
Published online: May 08, 2018
Accepted:
April 21,
2018
Received in revised form:
March 10,
2018
Received:
January 8,
2018
Footnotes
☆This research was been supported by the Higher Committee for Education Development, Iraq.
✯✯Conflicts of interest: none
Identification
Copyright
© 2018 by the American Pain Society
