MR Spectroscopy as a Diagnostic and Outcome Measure in Pain and SCI (MRS)
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Purpose
The goal of this study is to compare the changes that occur in sensation and chemical properties of the brain following SCI between individuals that experience chronic pain and those that do not, and between those with SCI and the able-bodied.
| Condition |
|---|
|
Spinal Cord Injury Hyperalgesia, Secondary Hyperalgesic Sensations |
| Study Type: | Observational |
| Study Design: | Observational Model: Case Control Time Perspective: Prospective |
| Official Title: | MR Spectroscopy (MRS) as a Diagnostic and Outcome Measure in Pain and SCI |
- Using MR Spectroscopy to measure the concentration of N-acetyl aspartate, glutamate/glutamine, and myo-inositol in the areas of the brain thought to process pain. [ Time Frame: Two measures at intervals of 2 to 4 weeks ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 110 |
| Study Start Date: | October 2007 |
| Study Completion Date: | September 2010 |
| Primary Completion Date: | July 2010 (Final data collection date for primary outcome measure) |
| Groups/Cohorts |
|---|
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1
Spinal cord injured with chronic central neuropathic pain.
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2
Spinal cord injured without chronic central neuropathic pain.
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3
Able-bodied without history of chronic pain of any type
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4
Traumatically Brain Injured with a history of pain that onset after their TBI
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Detailed Description:
This study investigates the differences in certain neurochemicals present in areas of the brain linked to pain processing in people with SCI and neuropathic pain, in people with SCI but no pain, and in able-bodied persons. We will also investigate the relationship between these concentrations of neurochemicals and different aspects of chronic neuropathic pain, including the intensity of pain, quality of life issues, sensitivity changes in areas of the body that are both painful and non-painful, and neurological status.
Eligibility| Ages Eligible for Study: | 18 Years to 70 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
| Sampling Method: | Non-Probability Sample |
Both spinal cord injured (85) and able-bodied (25) subjects will be studied. Of those with spinal cord injury, 60 will be those who experience central neuropathic pain and 25 will not. An additional 25 people who screen positive for mild to moderate TBI symptoms and pain attributable to TBI will be studied.
Inclusion Criteria:
SCI and neuropathic pain:
- fluent in English
- incomplete or complete traumatic SCI
- the injury must have occurred at least 2 years prior to entering the study
- the injury level must be above L1 and the subjects must have evidence of preserved distal cord functions (lower extremity reflexes and bulbocavernosus or anal wink reflexes)
- must have experienced chronic neuropathic pain at or below the level of injury for a minimum of six months
- must have moderately severe or greater neuropathic pain
- must be able to attend three sessions ranging from 2 to 6 hours over a period of 4 to 5 weeks
SCI and no neuropathic pain:
- same as a., but participants in this group must NOT have unremitting moderate-severe pain and there will only be two sessions ranging from 2 to 6 hours over a period of 1 to 2 weeks
Able-bodied control subjects:
- fluent in English
- no history of chronic pain conditions
- no substantial brain or body injury
- must be able to attend two sessions ranging from 2 to 6 hours over a period of 1 to 2 weeks
Exclusion Criteria:
- current pregnancy or women who are contemplating pregnancy
- recent (one-year) history of alcohol or drug abuse
- known intra-cerebral pathology or epilepsy
- MRI findings indicative of intra-cerebral pathology
- significant post-traumatic encephalopathy from head trauma sustained at SCI or cognitive impairment indicative of traumatic brain injury
- current diagnosis of DSM-IV Axis I disorder
- inability to meet the MRI screening requirements (including, but not limited to, the presence of a pacemaker or other electronic devices, prosthesis, artificial limb or joint, shunt, some metal rods, some tattoos, or moderate to severe claustrophobia or anxiety)
Contacts and Locations| United States, Florida | |
| VA Medical Center, Miami | |
| Miami, Florida, United States, 33125 | |
| Principal Investigator: | Eva G. Widerstrom-Noga, DDS PhD | VA Medical Center, Miami |
More Information
Additional Information:
No publications provided
| Responsible Party: | Widerstrom-Noga, Eva - Principal Investigator, Department of Veterans Affairs |
| ClinicalTrials.gov Identifier: | NCT00561782 History of Changes |
| Other Study ID Numbers: | B5023R |
| Study First Received: | November 19, 2007 |
| Last Updated: | December 14, 2010 |
| Health Authority: | United States: Federal Government |
Keywords provided by Department of Veterans Affairs:
|
Spinal Cord Injury Pain Chronic Neuropathic Pain SCI Pain Pain, Chronic Neuropathic |
Spectroscopy, Magnetic Resonance MRS Traumatic Brain Injury Pain |
Additional relevant MeSH terms:
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Hyperalgesia Spinal Cord Injuries Somatosensory Disorders Sensation Disorders Neurologic Manifestations Nervous System Diseases |
Signs and Symptoms Spinal Cord Diseases Central Nervous System Diseases Trauma, Nervous System Wounds and Injuries |
ClinicalTrials.gov processed this record on May 23, 2013