Electroencephalographic predictors of neuropathic pain in subacute spinal cord injury

Vuckovic, Aleksandra and Jajrees, Mohammed and Purcell, Mariel and Berry, Helen and Fraser, Matthew (2018) Electroencephalographic predictors of neuropathic pain in subacute spinal cord injury. Journal of Pain. pp. 1-35. ISSN 1526-5900

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    It is widely believed that cortical changes are a consequence of long standing neuropathic pain (NP). In this paper we demonstrate that NP in people with subacute spinal cord injury (SCI) has characteristic electroencephalographic (EEG) markers which precede the onset of pain. EEG was recorded in a relaxed state and during motor imagination tasks in 10 able bodied participants and 31 subacute SCI participants (11 with NP, 10 without NP and 10 who developed pain within 6 months of EEG recording). All 20 SCI participants initially without NP were tested for mechanically induced allodynia but only one person, who later developed pain, reported an unpleasant sensation. The EEG reactivity to opening eyes was reduced in the alpha band and absent in the theta and beta bands in participants who later developed pain, and it was reduced in participants who already had pain. Alpha band power was reduced at BA7 in both the relaxed state and during motor imagination in participants who either had or later developed pain compared to participants without pain. All SCI groups had reduced dominant alpha frequency and beta band power at BA7. Electroencephalographic reactivity to eyes 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 Perspectives: We demonstrate that brain activity in subacute SCI contains 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.