| 제목 |
Brain plastic changes for neuropathic pain in patients with burns |
| 소속 |
Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea, 1. Department of Rehabilitation Medicine1, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland, 2. Center for Neuroprosthetics and Brain Mind Institute2, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea, 3. Department of Physical Medicine and Rehabilitation3 |
| 저자 |
So Young Joo1*, Chang-hyun Park2, Yoon Soo Cho1, Cheong Hoon Seo1, Suk Hoon Ohn3†, Jeongeun Lee3 |
Purpose
Chronic pain prevalent after burn injuries is both disabling and difficult to treat. Although the mechanism of chronic pain in patients with burns is still unknown, neuropathic pain caused by burns is explained as one of the main causes. The causes of neuropathic pain in electrical burn (EB) and non-electrical burn (NEB) are different. In this study, CBV maps in patients with chronic pain were performed to investigate the plastic changes of the pain network by comparing EB group with NEB group which has different impairment mechanisms.
Methods
Sixty patients with chronic pain [20 with EB and 40 with NEB] and 20 healthy controls were chosen in order to study change of pain network by measuring cerebral blood volume (CBV) using magnetic resonance imaging (MRI). The pain intensity measured using the visual analogue scale (VAS) with a minimum rating of 5 and depressive mood using the Beck Depression Inventory(BDI) also examined.
Results
In the whole burn group, including EB and NEB groups, there were significant differences in CBV of postcentral gyrus, frontal lobe, temporal lobe, and insula compared with healthy controls ( p<0.05). In EB group, there was significant decreased CBV in frontal and temporal lobe compared with healthy controls (p<0.05). In NEB group, there were significant increased CBV in the postcentral gyrus compared with healthy controls. There were significant decreased CBV in precentral gyrus and frontal lobe compared with healthy controls. In only EB group, there were significant positive correlation between pain severity and CBV in bilateral superior parietal lobe (p<0.05).
Conclusion
This study found CBV alterations in different regions associated with the cerebral pain network among EB group, NEB group, and healthy controls. Our findings provide strong evidence for brain plasticity in patients with chronic pain due to burns.
Keywords: Burn, cerebral blood volume, Diffusion tensor imaging, neuropathic pain
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