Dynamic oscillatory signatures of central neuropathic pain in spinal cord injury

Central Neuropathic Pain (CNP) is believed to be accompanied by increased activation of the sensory and motor cortices. Our knowledge on this interaction is based mainly on fMRI studies, but there is little direct evidence on how these changes manifest in terms of dynamic neuronal activity. This study reports on the presence of transient EEG based measures of brain activity during motor imagery in spinal cord injured patients with CNP. We analyse dynamic EEG responses during imaginary movements of arms and legs in 3 groups of 10 volunteers each, comprising able-bodied people, paraplegic patients with CNP (lower abdomen and legs) and paraplegic patients without CNP. Paraplegic patients with CNP had increased event-related desynchronisation in the theta, alpha and beta bands (16-24 Hz) during imagination of movement of both non-painful (arms) and painful limbs (legs). Compared to patients with CNP, paraplegics with no pain showed a much reduced power in relaxed state and reduced event-related desynchronisation during imagination of movement. Understanding these complex dynamic, frequency-specific activations in CNP in the absence of nociceptive stimuli could inform the design of interventional therapies for patients suffering from CNP and possibly further understanding of the mechanisms involved.