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

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 w...

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Autores principales: Ailes, Isaiah, Syed, Mashaal, Matias, Caio M., Krisa, Laura, Miao, Jingya, Sathe, Anish, Fayed, Islam, Alhussein, Abdulaziz, Natale, Peter, Mohamed, Feroze B., Talekar, Kiran, Alizadeh, Mahdi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10406238/
https://www.ncbi.nlm.nih.gov/pubmed/37554655
http://dx.doi.org/10.3389/fnimg.2023.1137848
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author Ailes, Isaiah
Syed, Mashaal
Matias, Caio M.
Krisa, Laura
Miao, Jingya
Sathe, Anish
Fayed, Islam
Alhussein, Abdulaziz
Natale, Peter
Mohamed, Feroze B.
Talekar, Kiran
Alizadeh, Mahdi
author_facet Ailes, Isaiah
Syed, Mashaal
Matias, Caio M.
Krisa, Laura
Miao, Jingya
Sathe, Anish
Fayed, Islam
Alhussein, Abdulaziz
Natale, Peter
Mohamed, Feroze B.
Talekar, Kiran
Alizadeh, Mahdi
author_sort Ailes, Isaiah
collection PubMed
description 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.
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spelling pubmed-104062382023-08-08 Case report: Utilizing diffusion-weighted MRI on a patient with chronic low back pain treated with spinal cord stimulation Ailes, Isaiah Syed, Mashaal Matias, Caio M. Krisa, Laura Miao, Jingya Sathe, Anish Fayed, Islam Alhussein, Abdulaziz Natale, Peter Mohamed, Feroze B. Talekar, Kiran Alizadeh, Mahdi Front Neuroimaging Neuroimaging 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. Frontiers Media S.A. 2023-05-16 /pmc/articles/PMC10406238/ /pubmed/37554655 http://dx.doi.org/10.3389/fnimg.2023.1137848 Text en Copyright © 2023 Ailes, Syed, Matias, Krisa, Miao, Sathe, Fayed, Alhussein, Natale, Mohamed, Talekar and Alizadeh. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neuroimaging
Ailes, Isaiah
Syed, Mashaal
Matias, Caio M.
Krisa, Laura
Miao, Jingya
Sathe, Anish
Fayed, Islam
Alhussein, Abdulaziz
Natale, Peter
Mohamed, Feroze B.
Talekar, Kiran
Alizadeh, Mahdi
Case report: Utilizing diffusion-weighted MRI on a patient with chronic low back pain treated with spinal cord stimulation
title Case report: Utilizing diffusion-weighted MRI on a patient with chronic low back pain treated with spinal cord stimulation
title_full Case report: Utilizing diffusion-weighted MRI on a patient with chronic low back pain treated with spinal cord stimulation
title_fullStr Case report: Utilizing diffusion-weighted MRI on a patient with chronic low back pain treated with spinal cord stimulation
title_full_unstemmed Case report: Utilizing diffusion-weighted MRI on a patient with chronic low back pain treated with spinal cord stimulation
title_short Case report: Utilizing diffusion-weighted MRI on a patient with chronic low back pain treated with spinal cord stimulation
title_sort case report: utilizing diffusion-weighted mri on a patient with chronic low back pain treated with spinal cord stimulation
topic Neuroimaging
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10406238/
https://www.ncbi.nlm.nih.gov/pubmed/37554655
http://dx.doi.org/10.3389/fnimg.2023.1137848
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