Elsevier

Clinical Neurophysiology

Volume 129, Issue 8, August 2018, Pages 1669-1679
Clinical Neurophysiology

Central neuropathic pain in paraplegia alters movement related potentials

https://doi.org/10.1016/j.clinph.2018.05.020Get rights and content
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Highlights

  • Central neuropathic pain dominantly influences movement related cortical potentials in a domain comprising the limbic system.

  • Both pain and paralysis affect the reafferentation potential, which is delayed.

  • Central neuropathic pain influences cognitive processes in a domain specific manner.

Abstract

Objectives

Spinal 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).

Methods

SCI 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.

Results

Three 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.

Conclusion

SCI but not CNP affects the movement preparation, and both SCI and CNP affect sensory processes.

Significance

Rehabilitation strategies of SCI patients based on MRCP should take into account the presence of CNP.

Keywords

Central neuropathic pain
Spinal cord injury
Movement related cortical potentials
Event related potentials
Motor imagery
Measure projection analysis

Abbreviations

CNP
Central Neuropathic Pain
SCI
spinal cord injury
MI
motor imagery
AB
able bodied
PwP
patients with pain
PnP
patients without pain
MRCP
movement related cortical potentials
ERS/ERD
event related synchronisation/desynchronisation
ERP
event related potentials
ASIA
American Spinal Injury Association
VAS
Visual Numerical Scale

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