Case report: Utilizing diffusion-weighted MRI on a patient with chronic low back pain treated with spinal cord stimulation.

Autor:	Ailes I; Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, United States.; Jefferson Integrated Magnetic Resonance Imaging Center (JIMRIC), Department of Radiology, Thomas Jefferson University, Philadelphia, PA, United States.; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States., Syed M; Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, United States.; Jefferson Integrated Magnetic Resonance Imaging Center (JIMRIC), Department of Radiology, Thomas Jefferson University, Philadelphia, PA, United States., Matias CM; Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, United States.; Jefferson Integrated Magnetic Resonance Imaging Center (JIMRIC), Department of Radiology, Thomas Jefferson University, Philadelphia, PA, United States., Krisa L; Jefferson Integrated Magnetic Resonance Imaging Center (JIMRIC), Department of Radiology, Thomas Jefferson University, Philadelphia, PA, United States.; Department of Occupational Therapy, Thomas Jefferson University, Philadelphia, PA, United States., Miao J; Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, United States.; College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA, United States., Sathe A; Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, United States.; Jefferson Integrated Magnetic Resonance Imaging Center (JIMRIC), Department of Radiology, Thomas Jefferson University, Philadelphia, PA, United States.; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States., Fayed I; Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, United States.; Jefferson Integrated Magnetic Resonance Imaging Center (JIMRIC), Department of Radiology, Thomas Jefferson University, Philadelphia, PA, United States., Alhussein A; Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, United States.; Jefferson Integrated Magnetic Resonance Imaging Center (JIMRIC), Department of Radiology, Thomas Jefferson University, Philadelphia, PA, United States.; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States., Natale P; Jefferson Integrated Magnetic Resonance Imaging Center (JIMRIC), Department of Radiology, Thomas Jefferson University, Philadelphia, PA, United States., Mohamed FB; Jefferson Integrated Magnetic Resonance Imaging Center (JIMRIC), Department of Radiology, Thomas Jefferson University, Philadelphia, PA, United States., Talekar K; Jefferson Integrated Magnetic Resonance Imaging Center (JIMRIC), Department of Radiology, Thomas Jefferson University, Philadelphia, PA, United States., Alizadeh M; Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, United States.; Jefferson Integrated Magnetic Resonance Imaging Center (JIMRIC), Department of Radiology, Thomas Jefferson University, Philadelphia, PA, United States.
Jazyk:	angličtina
Zdroj:	Frontiers in neuroimaging [Front Neuroimaging] 2023 May 16; Vol. 2, pp. 1137848. Date of Electronic Publication: 2023 May 16 (Print Publication: 2023).
DOI:	10.3389/fnimg.2023.1137848
Abstrakt:	Diffusion-weighted magnetic resonance imaging (dwMRI) has increasingly demonstrated greater utility in analyzing neuronal microstructure. In patients with chronic low back pain (cLBP), using dwMRI to observe neuronal microstructure can lead to non-invasive biomarkers which could provide clinicians with an objective quantitative prognostic tool. In this case report, we investigated dwMRI for the development of non-invasive biomarkers by conducting a region-based analysis of a 55-year-old male patient with failed back surgery syndrome (FBSS) treated with spinal cord stimulation (SCS). We hypothesized that dwMRI could safely generate quantitative data reflecting cerebral microstructural alterations driven by neuromodulation. Neuroimaging was performed at 6- and 12- months post-SCS implantation. The quantitative maps generated included diffusion tensor imaging (DTI) parameters; fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD) computed from whole brain tractography. To examine specific areas of the brain, 44 regions of interest (ROIs), collectively representing the pain NeuroMatrix, were extracted and registered to the patient's diffusion space. Average diffusion indices were calculated from the ROIs at both 6- and 12- months. Regions with >10% relative change in at least 3 of the 4 maps were reported. Using this selection criterion, 8 ROIs demonstrated over 10% relative changes. These ROIs were mainly located in the insular gyri. In addition to the quantitative data, a series of questionnaires were administered during the 6- and 12-month visits to assess pain intensity, functional disability, and quality of life. Overall improvements were observed in these components, with the Pain Catastrophizing Scale (PCS) displaying the greatest change. Lastly, we demonstrated the safety of dwMRI for a patient with SCS. In summary, the results from the case report prompt further investigation in applying dwMRI in a larger cohort to better correlate the influence of SCS with brain microstructural alterations, supporting the utility of dwMRI to generate non-invasive biomarkers for prognostication. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2023 Ailes, Syed, Matias, Krisa, Miao, Sathe, Fayed, Alhussein, Natale, Mohamed, Talekar and Alizadeh.)
Databáze:	MEDLINE
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