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Using arterial spin labelling to investigate spontaneous and evoked ongoing musculoskeletal pain

View ORCID ProfileKarolina A. Wartolowska, View ORCID ProfileDaniel P. Bulte, View ORCID ProfileMichael A. Chappell, View ORCID ProfileMark Jenkinson, View ORCID ProfileThomas W. Okell, Matthew A. Webster, Andrew J. Carr
doi: https://doi.org/10.1101/163196
Karolina A. Wartolowska
1Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
2Wellcome Centre for Integrative Neuroimaging (WIN), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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  • For correspondence: karolina.wartolowska@chch.oxon.org
Daniel P. Bulte
2Wellcome Centre for Integrative Neuroimaging (WIN), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
3Institute of Biomedical Engineering (IBME), Department of Engineering Science, University of Oxford, Oxford, UK
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Michael A. Chappell
2Wellcome Centre for Integrative Neuroimaging (WIN), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
3Institute of Biomedical Engineering (IBME), Department of Engineering Science, University of Oxford, Oxford, UK
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Mark Jenkinson
2Wellcome Centre for Integrative Neuroimaging (WIN), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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Thomas W. Okell
2Wellcome Centre for Integrative Neuroimaging (WIN), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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Matthew A. Webster
2Wellcome Centre for Integrative Neuroimaging (WIN), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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Andrew J. Carr
1Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
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Abstract

Clinical pain is difficult to study using standard Blood Oxy-genation Level Dependent (BOLD) magnetic resonance imaging because it is often ongoing and, if evoked, it is associated with stimulus-correlated motion. Arterial spin labelling (ASL) offers an attractive alternative. This study used arm repositioning to evoke clinically-relevant musculoskeletal pain in patients with shoulder impingement syndrome. Fifty-five patients were scanned using a multi post-labelling delay pseudo-continuous ASL (pCASL) sequence, first with both arms along the body and then with the affected arm raised into a painful position. Twenty healthy volunteers were scanned as a control group. Arm repositioning resulted in increased perfusion in brain regions involved in sensory processing and movement integration, such as the contralateral primary motor and primary somatosensory cortex, mid- and posterior cingulate cortex, and, bilaterally, in the insular cortex/operculum, putamen, thalamus, midbrain and cerebellum. Perfusion in the thalamus, midbrain and cerebellum was larger in the patient group. Results of a post hoc analysis suggested that the observed perfusion changes were related to pain rather than arm repositioning. This study showed that ASL can be useful in research on clinical ongoing musculoskeletal pain but the technique is not sensitive enough to detect small differences in perfusion.

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Posted September 18, 2018.
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Using arterial spin labelling to investigate spontaneous and evoked ongoing musculoskeletal pain
Karolina A. Wartolowska, Daniel P. Bulte, Michael A. Chappell, Mark Jenkinson, Thomas W. Okell, Matthew A. Webster, Andrew J. Carr
bioRxiv 163196; doi: https://doi.org/10.1101/163196
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Using arterial spin labelling to investigate spontaneous and evoked ongoing musculoskeletal pain
Karolina A. Wartolowska, Daniel P. Bulte, Michael A. Chappell, Mark Jenkinson, Thomas W. Okell, Matthew A. Webster, Andrew J. Carr
bioRxiv 163196; doi: https://doi.org/10.1101/163196

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