Klinische Neurophysiologie 2012; 43 - P108
DOI: 10.1055/s-0032-1301658

Imaging Pain with ultra-high-field functional magnetic resonance imaging

S Nägel 1, D Holle 2, S Maderwald 3, S Orzada 3, A Bitz 3, Z Katsarava 1, HC Diener 1, ME Ladd 3, M Obermann 1
  • 1Klinik und Poliklinik für Neurologie; Universitätsklnikum Essen, Essen
  • 2Klinik und Poliklinik für Neurologie, Universität Duisburg-Essen, Essen
  • 3Erwin L. Hahn Institute for Magnetic Resonance Imaging, Universität Duisburg-Essen, Essen

Aims: In gerneral human pain processing is studied well, but unfortunately, a substantial portion of the pathophysiology of pain is poorly understood. Ultra-high-field MRI and its high signal to noise ratio(SNR) might help to close those gaps. The aim of our study was to establish a protocol to analyse electrically evoked human pain processing across the whole brain in ultra-high-field fMRI.

Methods: Functional images were acquired on a 7 Tesla scanner(Siemens Magnetom 7T). 6 neurologically healthy subjects took part in the study. We investigated pain processing in a block design using a multi-echo [1] echo planar imaging sequence. After various safety simulations and tests, pain was elicited to subject’s right hand and foot by a concentric electrode. As control condition we used visual stimulation by a swapping checkerboard(CB).

Results: In the CB we found massive activation of the visual cortex in all subjects. During painful stimulation activation in major parts of the pain/attention network was observed. In most patients these activations were consistently in primary and secondary somatosensory cortex as well as in the insular cortex, the anterior cingulate cortex and the thalamus. Some subjects showed additional brainstem-activation. All activations described were robust even after correction for multiple comparisons.

Discussion: In this study we were able to establish a protocol to study human pain processing in ultra-high-field fMRI. Activations in pain and in visual stimulation were consistent with neuroanatomical knowledge and previous functional imaging studies. In total the activations observed in 7T appeared to be much better compared to those seen in lower field strength fMRI using a comparable protocol. Ultra high field pain related fMRI might be able to depict structures associated with human pain processing more reliably and consistently than standard high-field fMRI and thus may help to decipher complex human pain processing.

Literatur: [1] Poser BA, et al.; Neuroimage. 2009: 1162-72.