Neuroimaging reveals a potential brain-based pre-existing mechanism that confers vulnerability to development of chronic painful chemotherapy-induced peripheral neuropathy
Authors' conclusion
Before administration of any chemotherapy or appearance of CIPN symptoms, we observed altered patterns of brain activity in response to nociceptive stimulation in patients who later developed chronic sensory CIPN.
Study context
- Population
- Chemotherapy-naïve cancer patients (lung, gynaecological, colorectal malignancies), three sites in Scotland20 analysed
- Participants
- 30 patients
- Exposure
- Chemotherapy-induced peripheral neuropathy (CIPN)+ vs CIPN-
- CIPN+n = Twelve
- CIPN-n = eightreference
- Outcome
- Pre-chemotherapy brain activity in response to nociceptive (punctate, 256 mN monofilament) stimulation
Methodological detailsmulticentre, functional MRI (fMRI) (3 Tesla)
- Multicentre
- fMRI (3 Tesla)
Main finding
As reported in the abstract
Brain responses to punctate stimulation
- Group contrast: CIPN+ vs CIPN- had robust activity in sensory, motor, attentional and affective brain regions
- A priori region-of-interest analysis of periaqueductal grey: significantly increased responses in CIPN- vs CIPN+
Observational data: associations, not effects.
Further findings
Subcortical volumes
- No difference between CIPN+ and CIPN-
Original publication
Neuroimaging reveals a potential brain-based pre-existing mechanism that confers vulnerability to development of chronic painful chemotherapy-induced peripheral neuropathy. Br J Anaesth. Published 14 November 2022. doi:10.
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