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MRI of the central nervous system in MS patients with and without pain
Author(s) -
Svendsenl Kristina Bacher,
Sørensenl Leif,
Jensenl Troels Stahelin,
Hansenl Hans Jacob,
Bachl Flemming Winther
Publication year - 2011
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1016/j.ejpain.2010.09.006
Subject(s) - spinothalamic tract , medicine , dysesthesia , allodynia , spinal cord , thalamus , central nervous system , lesion , hyperalgesia , anesthesia , nociception , radiology , surgery , receptor , psychiatry
Background: Central pain (CP) is a common symptom in MS. Multiple theories are present about the mechanism of CP. Previous studies suggested that lesion of the spinothalamic tract is a necessary condition for development of CP. No previous study has in detail evaluated the association between the specific site of demyelinations and the presence of CP in MS. Objective: The study aimed to evaluate the location of plaques in MS patients with CP including a group of MS patients without pain as a reference group. Methods: All patients underwent a bedside sensory examination and MRI of the brain and spinal cord. MR imaging was acquired on an 1.5 Tesla MR equipment. A trained neuroradiologist, blinded to pain status, evaluated the MRI. Results: Thirteen MS patients with CP and 10 MS patients without pain were included. Allodynia and/or dysesthesia were more frequent in pain patients (11/13 vs. 1/10, P <0.01). No difference was found in the number of patients with plaques in spinothalamic tract, dorsal column‐medial lemniscus, dorsolateral funiculus, grey substance, thalamus or capsula interna. A non‐significantly lower number of pain patients had lesions in thalamo‐cortical pathways (8/13 vs. 10/10, P =0.027). Conclusions: No association between CP and site of demyelinations was found, although a trend toward a higher prevalence of intact thalamo‐cortical pathways was seen in pain patients. CP was associated with allodynia, suggesting central hyperexcitability.