Imaging of Neuropathic Pain

REVIEW
Mohamed A Bedewi

 
International Journal of Biomedicine. 2022;12(1):19-23.
DOI: 10.21103/Article12(1)_RA2
Originally published March 10, 2022

Abstract: 

The International Association for the Study of Pain (IASP) defined neuropathic pain as “pain arising as a direct consequence of a lesion or disease affecting the somatosensory system.” The origin of neuropathic pain (NP) could be from the brain, spinal cord, or peripheral nerves. NP represents a major neurological problem, with a prevalence of 1%-2% of the total population. It is disabling, rendering an urgent need for non-addictive, effective new therapies, and is characterized by resistance to treatment and poor patient satisfaction. We aim to review the role of modern imaging in the diagnosis of NP and the potential advantages and limitations of each modality. Functional MRI is one of the commonly used imaging modalities for NP.

Keywords: 
neuropathic pain • peripheral nerves • imaging
References: 

1. Tung KW, Behera D, Biswal S. Neuropathic pain mechanisms and imaging. Semin Musculoskelet Radiol. 2015 Apr;19(2):103-11. doi: 10.1055/s-0035-1547371. 
2. Meacham K, Shepherd A, Mohapatra DP, Haroutounian S. Neuropathic Pain: Central vs. Peripheral Mechanisms. Curr Pain Headache Rep. 2017 Jun;21(6):28. doi: 10.1007/s11916-017-0629-5. 
3. Treede RD, Jensen TS, Campbell JN, Cruccu G, Dostrovsky JO, Griffin JW, Hansson P, Hughes R, Nurmikko T, Serra J. Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology. 2008 Apr 29;70(18):1630-5. doi: 10.1212/01.wnl.0000282763.29778.59. 
4. Geha PY, Apkarian AV. Brain imaging findings in neuropathic pain. Curr Pain Headache Rep. 2005 Jun;9(3):184-8. doi: 10.1007/s11916-005-0060-1. 
5. Calvo M, Davies AJ, Hébert HL, Weir GA, Chesler EJ, Finnerup NB, Levitt RC, Smith BH, Neely GG, Costigan M, Bennett DL. The Genetics of Neuropathic Pain from Model Organisms to Clinical Application. Neuron. 2019 Nov 20;104(4):637-653. doi: 10.1016/j.neuron.2019.09.018. 
6. Kushnarev M, Pirvulescu IP, Candido KD, Knezevic NN. Neuropathic pain: preclinical and early clinical progress with voltage-gated sodium channel blockers. Expert Opin Investig Drugs. 2020 Mar;29(3):259-271. doi: 10.1080/13543784.2020.1728254.
7. Chong MS, Bajwa ZH. Diagnosis and treatment of neuropathic pain. J Pain Symptom Manage. 2003 May;25(5 Suppl):S4-S11. doi: 10.1016/s0885-3924(03)00064-2. 
8. Jensen TS, Gottrup H, Sindrup SH, Bach FW. The clinical picture of neuropathic pain. Eur J Pharmacol. 2001 Oct 19;429(1-3):1-11. doi: 10.1016/s0014-2999(01)01302-4.
9. Vranken JH. Elucidation of pathophysiology and treatment of neuropathic pain. Cent Nerv Syst Agents Med Chem. 2012 Dec;12(4):304-14. doi: 10.2174/187152412803760645.
10. Zilliox LA. Neuropathic Pain. Continuum (Minneap Minn). 2017 Apr;23(2, Selected Topics in Outpatient Neurology):512-532. doi: 10.1212/CON.0000000000000462. 
11. Shkodra M, Brunelli C, Zecca E, Formaglio F, Bracchi P, Lo Dico S, Caputo M, Kaasa S, Caraceni A. Neuropathic pain: clinical classification and assessment in patients with pain due to cancer. Pain. 2021 Mar 1;162(3):866-874. doi: 10.1097/j.pain.0000000000002076.
12. Szok D, Tajti J, Nyári A, Vécsei L. Therapeutic Approaches for Peripheral and Central Neuropathic Pain. Behav Neurol. 2019 Nov 21;2019:8685954. doi: 10.1155/2019/8685954.
13. Murphy D, Lester D, Clay Smither F, Balakhanlou E. Peripheral neuropathic pain. NeuroRehabilitation. 2020;47(3):265-283. doi: 10.3233/NRE-208002. 
14. Sasaki H, Takatsuna H, Inoue T, Matsui D, Sakoda H, Yokoyama M, Shiosakai K, Seki H, Uetake Y, Okuizumi K. A Cross-sectional Survey of Patients with Suspected Diabetic Peripheral Neuropathic Pain in Japan. Intern Med. 2021 Feb 1;60(3):357-365. doi: 10.2169/internalmedicine.5512-20. 
15. Macone A, Otis JAD. Neuropathic Pain. Semin Neurol. 2018 Dec;38(6):644-653. doi: 10.1055/s-0038-1673679. 
16. Attal N, Martinez V, Bouhassira D. Potential for increased prevalence of neuropathic pain after the COVID-19 pandemic. Pain Rep. 2021 Jan 27;6(1):e884. doi: 10.1097/PR9.0000000000000884. 
17. Baron R, Binder A, Wasner G. Neuropathic pain: diagnosis, pathophysiological mechanisms, and treatment. Lancet Neurol. 2010 Aug;9(8):807-19. doi: 10.1016/S1474-4422(10)70143-5. 
18. Finnerup NB, Kuner R, Jensen TS. Neuropathic Pain: From Mechanisms to Treatment. Physiol Rev. 2021 Jan 1;101(1):259-301. doi: 10.1152/physrev.00045.2019.
19. Thompson SJ, Bushnell MC. Rodent functional and anatomical imaging of pain. Neurosci Lett. 2012 Jun 29;520(2):131-9. doi: 10.1016/j.neulet.2012.03.015.
20. Bernetti A, Agostini F, de Sire A, Mangone M, Tognolo L, Di Cesare A, Ruiu P, Paolucci T, Invernizzi M, Paoloni M. Neuropathic Pain and Rehabilitation: A Systematic Review of International Guidelines. Diagnostics (Basel). 2021 Jan 5;11(1):74. doi: 10.3390/diagnostics11010074. 
21. St John Smith E. Advances in understanding nociception and neuropathic pain. J Neurol. 2018 Feb;265(2):231-238. doi: 10.1007/s00415-017-8641-6. 
22. Gilron I, Baron R, Jensen T. Neuropathic pain: principles of diagnosis and treatment. Mayo Clin Proc. 2015 Apr;90(4):532-45. doi: 10.1016/j.mayocp.2015.01.018. 
23. Cruccu G, Truini A. A review of Neuropathic Pain: From Guidelines to Clinical Practice. Pain Ther. 2017 Dec;6(Suppl 1):35-42. doi: 10.1007/s40122-017-0087-0. 
24. Husain SF, Lam RWM, Hu T, Ng MWF, Liau ZQG, Nagata K, Khanna S, Lam Y, Bhakoo K, Ho RCM, Wong HK. Locating the Site of Neuropathic Pain In Vivo Using MMP-12-Targeted Magnetic Nanoparticles. Pain Res Manag. 2019 Mar 6;2019:9394715. doi: 10.1155/2019/9394715. 
25. Shen B, Behera D, James ML, Reyes ST, Andrews L, Cipriano PW, Klukinov M, Lutz AB, Mavlyutov T, Rosenberg J, Ruoho AE, McCurdy CR, Gambhir SS, Yeomans DC, Biswal S, Chin FT. Visualizing Nerve Injury in a Neuropathic Pain Model with [18F]FTC-146 PET/MRI. Theranostics. 2017 Jul 8;7(11):2794-2805. doi: 10.7150/thno.19378. 
26. Dou Z, Yang L. The application of functional magnetic resonance imaging in neuropathic pain. In: Medical imaging principles and applications. IntechOpen,  10/2019 UK. doi: 10.5772/intechopen.89200.
27. McCarthy TJ, Sheriff AU, Graneto MJ, Talley JJ, Welch MJ. Radiosynthesis, in vitro validation, and in vivo evaluation of 18F-labeled COX-1 and COX-2 inhibitors. J Nucl Med. 2002 Jan;43(1):117-24.
28. Jacobs KE, Behera D, Rosenberg J, Gold G, Moseley M, Yeomans D, Biswal S. Oral manganese as an MRI contrast agent for the detection of nociceptive activity. NMR Biomed. 2012 Apr;25(4):563-9. doi: 10.1002/nbm.1773.
29. Sneag DB, Queler S. Technological Advancements in Magnetic Resonance Neurography. Curr Neurol Neurosci Rep. 2019 Aug 24;19(10):75. doi: 10.1007/s11910-019-0996-x. 
30. Agarwal A, Chandra A, Jaipal U, Bagarhatta M, Mendiratta K, Goyal A, Kumar R, Mangalhara N. Can imaging be the new yardstick for diagnosing peripheral neuropathy?-a comparison between high resolution ultrasound and MR neurography with an approach to diagnosis. Insights Imaging. 2019 Nov 1;10(1):104. doi: 10.1186/s13244-019-0787-6. 
31. Ogon I, Takebayashi T, Takashima H, Morita T, Iesato N, Tanimoto K, Terashima Y, Yoshimoto M, Yamashita T. Analysis of Neuropathic Pain Using Magnetic Resonance Imaging T2 Mapping of Intervertebral Disc in Chronic Low Back Pain. Asian Spine J. 2019 Jun;13(3):403-409. doi: 10.31616/asj.2018.0147. 
32. Alomar S, Bakhaidar M. Neuroimaging of neuropathic pain: review of current status and future directions. Neurosurg Rev. 2018 Jul;41(3):771-777. doi: 10.1007/s10143-016-0807-7.
33. Logothetis NK. The neural basis of the blood-oxygen-level-dependent functional magnetic resonance imaging signal. Philos Trans R Soc Lond B Biol Sci. 2002 Aug 29;357(1424):1003-37. doi: 10.1098/rstb.2002.1114. 
34. Hubbard CS, Khan SA, Xu S, Cha M, Masri R, Seminowicz DA. Behavioral, metabolic and functional brain changes in a rat model of chronic neuropathic pain: a longitudinal MRI study. Neuroimage. 2015 Feb 15;107:333-344. doi: 10.1016/j.neuroimage.2014.12.024.
35. Lu H, Yuping N. When neuroscience meets network thinking: A new perspective on brain disorders. Chinese Journal of Neuromedicines. 2014;13(12):1292-1296
36. Berger SE, Baria AT, Baliki MN, Mansour A, Herrmann KM, Torbey S, Huang L, Parks EL, Schnizter TJ, Apkarian AV. Risky monetary behavior in chronic back pain is associated with altered modular connectivity of the nucleus accumbens. BMC Res Notes. 2014 Oct 20;7:739. doi: 10.1186/1756-0500-7-739.
37. Henry DE, Chiodo AE, Yang W. Central nervous system reorganization in a variety of chronic pain states: a review. PM R. 2011 Dec;3(12):1116-25. doi: 10.1016/j.pmrj.2011.05.018. 
38. Cao S, Qin B, Zhang Y, Yuan J, Fu B, Xie P, Song G, Li Y, Yu T. Herpes zoster chronification to postherpetic neuralgia induces brain activity and grey matter volume change. Am J Transl Res. 2018 Jan 15;10(1):184-199. 
39. Montano N, Conforti G, Di Bonaventura R, Meglio M, Fernandez E, Papacci F. Advances in diagnosis and treatment of trigeminal neuralgia. Ther Clin Risk Manag. 2015 Feb 24;11:289-99. doi: 10.2147/TCRM.S37592. 
40. Chai W, You C, Zhang W, Peng W, Tan L, Guan Y, Chen K. Diffusion tensor imaging of microstructural alterations in the trigeminal nerve due to neurovascular contact/compression. Acta Neurochir (Wien). 2019 Jul;161(7):1407-1413. doi: 10.1007/s00701-019-03851-2. 
41. Jutzeler CR, Curt A, Kramer JL. Relationship between chronic pain and brain reorganization after deafferentation: A systematic review of functional MRI findings. Neuroimage Clin. 2015 Oct 3;9:599-606. doi: 10.1016/j.nicl.2015.09.018.
42. Cauda F, Sacco K, D'Agata F, Duca S, Cocito D, Geminiani G, Migliorati F, Isoardo G. Low-frequency BOLD fluctuations demonstrate altered thalamocortical connectivity in diabetic neuropathic pain. BMC Neurosci. 2009 Nov 26;10:138. doi: 10.1186/1471-2202-10-138. 
43. Cifre I, Sitges C, Fraiman D, Muñoz MÁ, Balenzuela P, González-Roldán A, Martínez-Jauand M, Birbaumer N, Chialvo DR, Montoya P. Disrupted functional connectivity of the pain network in fibromyalgia. Psychosom Med. 2012 Jan;74(1):55-62. doi: 10.1097/PSY.0b013e3182408f04. 
44. Chen F, Chen F, Shang Z, Shui Y, Wu G, Liu C, Lin Z, Lin Y, Yu L, Kang D, Tao W, Li Y. White matter microstructure degenerates in patients with postherpetic neuralgia. Neurosci Lett. 2017 Aug 24;656:152-157. doi: 10.1016/j.neulet.2017.07.023. 

Download Article
Received January 17, 2022.
Accepted January 28, 2022.
©2022 International Medical Research and Development Corporation.