Alteration of metabolic connectivity in a rat model of deafferentation pain: a 18F-FDG PET/CT study

Bei-Bei Huo MD1, Jun Shen MD1, Xu-Yun Hua MD, PhD1,3, Mou-Xiong Zheng MD, PhD1,3, Ye-Chen Lu MD1, Jia-Jia Wu MD, PhD1,2, Chun-Lei Shan MD, PhD1,2, and Jian-Guang Xu MD, PhD1,2
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  • 1 School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine; and
  • | 2 Departments of Rehabilitation Medicine and
  • | 3 Trauma and Orthopedics, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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OBJECTIVE

Refractory deafferentation pain has been evidenced to be related to central nervous system neuroplasticity. In this study, the authors sought to explore the underlying glucose metabolic changes in the brain after brachial plexus avulsion, particularly metabolic connectivity.

METHODS

Rats with unilateral deafferentation following brachial plexus avulsion, a pain model of deafferentation pain, were scanned by small-animal 2-deoxy-[18F]fluoro-d-glucose (18F-FDG) PET/CT to explore the changes of metabolic connectivity among different brain regions. Thermal withdrawal latency (TWL) and mechanical withdrawal threshold (MWT) of the intact forepaw were also measured for evaluating pain sensitization. Brain metabolic connectivity and TWL were compared from baseline to 1 week after brachial plexus avulsion.

RESULTS

Alterations of metabolic connectivity occurred not only within the unilateral hemisphere contralateral to the injured forelimb, but also in the other hemisphere and even in the connections between bilateral hemispheres. Metabolic connectivity significantly decreased between sensorimotor-related areas within the left hemisphere (contralateral to the injured forelimb) (p < 0.05), as well as between areas across bilateral hemispheres (p < 0.05). Connectivity between areas within the right hemisphere (ipsilateral to the injured forelimb) significantly increased (p = 0.034). TWL and MWT of the left (intact) forepaw after surgery were significantly lower than those at baseline (p < 0.001).

CONCLUSIONS

This study revealed that unilateral brachial plexus avulsion facilitates pain sensitization in the opposite limb. A specific pattern of brain metabolic changes occurred in this procedure. Metabolic connectivity reorganized not only in the sensorimotor area corresponding to the affected forelimb, but also in extensive areas involving the bilateral hemispheres. These findings may broaden our understanding of central nervous system changes, as well as provide new information and a potential intervention target for nosogenesis of deafferentation pain.

ABBREVIATIONS

BPA = brachial plexus avulsion; 18F-FDG = 2-deoxy-[18F]fluoro-d-glucose; fMRI = functional MRI; MWT = mechanical withdrawal threshold; ROI = region of interest; SUV = standard uptake value; TWL = thermal withdrawal latency.

Illustration from Duan et al. (pp 1174–1181).

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Contributor Notes

Correspondence Jian-Guang Xu: School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China. xjg@shutcm.edu.cn.

INCLUDE WHEN CITING Published online March 1, 2019; DOI: 10.3171/2018.11.JNS181815.

B.B.H. and J.S. contributed equally to this work.

Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

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