Research Reports - The relation between injury of the spinothalamocortical tract and pain in patients with mild traumatic brain injury

J Head Trauma Rehabil. 2015 Nov-Dec;30(6):E40-6. doi:
10.1097/HTR.0000000000000121.

Kim JH(1), Ahn SH, Cho YW, Kim SH, Jang SH.

OBJECTIVES: Little is known about the pathogenetic etiology of central pain in
patients with traumatic brain injury (TBI). We investigated the relation between
injury of the spinothalamocortical tract (STT) and chronic central pain in
patients with mild TBI.
DESIGN: Retrospective survey.
PARTICIPANTS: We recruited 40 consecutive chronic patients with mild TBI and 21
normal control subjects: 8 patients were excluded by the inclusion criteria and
the remaining 32 patients were finally recruited. The patients were classified
according to 2 groups based on the presence of central pain: the pain group (22
patients) and the nonpain group (10 patients).
METHODS: Diffusion tensor tractography for the STT was performed using the
Functional Magnetic Resonance Imaging of the Brain Software Library. Values of
fractional anisotropy (FA), mean diffusivity (MD), and tract volume of each STT
were measured.
RESULTS: Lower FA value and tract volume were observed in the pain group than in
the nonpain group and the control group (P < .05). By contrast, higher MD value
was observed in the pain group than in the nonpain group and the control group (P
< .05). However, no significant differences in all diffusion tensor imaging
parameters were observed between the nonpain group and the control group (P >
.05).
CONCLUSIONS: Decreased FA and tract volume and increased MD of the STTs in the
pain group appeared to indicate injury of the STT. As a result, we found that
injury of the STT is related to the occurrence of central pain in patients with
mild TBI. We believe that injury of the STT is a pathogenetic etiology of central
pain following mild TBI. 

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