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Howard, MA

Huggins, JP

Khawaja, N

Krause, K

Massat, N

Renton, TF

Schumann, G

Vennart, W

Williams, SCR

Zelaya, F

PLoS ONE

English

PubMed

Queen Mary Research Online

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Quantification of pain-induced changes in cerebral blood flow by perfusion MRI.

Quantitative prediction of subjective pain intensity from whole-brain fMRI data using Gaussian processes.

Regions of interest analysis in pharmacological fMRI: how do the definition criteria influence the inferred result?

Reported Pain: Perfusion Magnetic Resonance Imaging Demonstrates Reproducible Cerebral Representation of Ongoing Post-Surgical Pain Matthew A. Howard1*, Kristina Krause1,2, Nadine Khawaja3, Nathalie Massat4, Fernando Zelaya1, Gunter Schumann2,

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Beyond Patient Reported Pain: Perfusion Magnetic Resonance Imaging Demonstrates Reproducible Cerebral Representation of Ongoing Post-Surgical Pain

Development of treatments for acute and chronic pain conditions remains a challenge, with an unmet need for improved sensitivity and reproducibility in measuring pain in patients. Here we used pulsed-continuous arterial spin-labelling [pCASL], a relatively novel perfusion magnetic-resonance imaging technique, in conjunction with a commonly-used post-surgical model, to measure changes in regional cerebral blood flow [rCBF] associated with the experience of being in ongoing pain. We demonstrate repeatable, reproducible assessment of ongoing pain that is independent of patient self-report. In a cross-over trial design, 16 participants requiring bilateral removal of lower-jaw third molars underwent pain-free pre-surgical pCASL scans. Following extraction of either left or right tooth, repeat scans were acquired during post-operative ongoing pain. When pain-free following surgical recovery, the pre/post-surgical scanning procedure was repeated for the remaining tooth. Voxelwise statistical comparison of pre and post-surgical scans was performed to reveal rCBF changes representing ongoing pain. In addition, rCBF values in predefined pain and control brain regions were obtained. rCBF increases (5-10%) representing post-surgical ongoing pain were identified bilaterally in a network including primary and secondary somatosensory, insula and cingulate cortices, thalamus, amygdala, hippocampus, midbrain and brainstem (including trigeminal ganglion and principal-sensory nucleus), but not in a control region in visual cortex. rCBF changes were reproducible, with no rCBF differences identified across scans within-session or between post-surgical pain sessions. This is the first report of the cerebral representation of ongoing post-surgical pain without the need for exogenous tracers. Regions of rCBF increases are plausibly associated with pain and the technique is reproducible, providing an attractive proposition for testing interventions for on-going pain that do not rely solely on patient self-report. Our findings have the potential to improve our understanding of the cerebral representation of persistent painful conditions, leading to improved identification of specific patient sub-types and implementation of mechanism-based treatments

Howard, Matthew A

Krause, Kristina

Khawaja, Nadine

Massat, Nathalie

Zelaya, Fernando

Schumann, Gunter

Huggins, John P

Vennart, William

Williams, Steven C R

Renton, Tara F

King's Research Portal

Beyond Patient Reported Pain:Perfusion magnetic resonance imaging demonstrates reproducible cerebral representation of ongoing post-surgical pain

Matthew A Howard

Kristina Krause

Nadine Khawaja

Nathalie Massat

Fernando Zelaya

Gunter Schumann

John P Huggins

William Vennart

Steven C R Williams

Tara F Renton

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Beyond patient reported pain: perfusion magnetic resonance imaging demonstrates reproducible cerebral representation of ongoing post-surgical pain.

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3044150

Beyond Patient Reported Pain: Perfusion Magnetic Resonance Imaging Demonstrates Reproducible Cerebral Representation of Ongoing Post-Surgical Pain

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