Evidence map›Paper›PMID 34365850›Full record

ArticleMolecular pain

Severities in persistent mild traumatic brain injury related headache is associated with changes in supraspinal pain modulatory functions.

Matthew Flowers, Albert Leung, Dawn M Schiehser, Valerie Metzger-Smith, Lisa Delano-Wood, Scott Sorg, Alphonsa Kunnel, Angeline Wong, Michael Vaninetti, Shahrokh Golshan and 1 more

Open access · goldAbstract read
In one paragraph

Article in Molecular pain. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.3field-weighted citation impact, top 43% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 1 country.

Matthew FlowersCenter for Pain and Headache Research, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA.
Albert LeungCenter for Pain and Headache Research, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA.
Dawn M SchiehserCenter for Pain and Headache Research, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA.
Valerie Metzger-SmithCenter for Pain and Headache Research, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA.
Lisa Delano-WoodCenter for Pain and Headache Research, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA.
Scott SorgCenter for Pain and Headache Research, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA.
Alphonsa KunnelCenter for Pain and Headache Research, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA.ORCID 0000-0002-6773-0863
Angeline WongCenter for Pain and Headache Research, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA.
Michael VaninettiCenter for Pain and Headache Research, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA.
Shahrokh GolshanCenter for Pain and Headache Research, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA.
Roland LeeDepartment of Radiology, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA.
VA San Diego Healthcare System · USUniversity of California San Diego · US

Funding

Linking Injury Severity to Brainstem White Matter Integrity: A Tractography StudyI01CX000842 · VA · VA SAN DIEGO HEALTHCARE SYSTEM · PI DELANO-WOOD, LISA · 2014 to 2017
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Long Term efficacy of rTMS in Managing MTBI-related HeadacheI01RX002506 · VA · VA SAN DIEGO HEALTHCARE SYSTEM · PI LEUNG, ALBERT Y. · 2018 to 2023
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Improving Functions in MTBI Patients with Headache by rTMSI21RX001359 · VA · VA SAN DIEGO HEALTHCARE SYSTEM · PI LEUNG, ALBERT Y. · 2014 to 2016
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Improving functions in Veterans with Post-Traumatic Peripheral Neuropathic PainI21RX002366 · VA · VA SAN DIEGO HEALTHCARE SYSTEM · PI LEUNG, ALBERT Y. · 2016 to 2018
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Neurocircuitry of Prospective Memory in Veterans with Mild Traumatic Brain InjuryIK2CX001508 · VA · VA SAN DIEGO HEALTHCARE SYSTEM · PI SORG, SCOTT FRANCIS · 2017 to 2021
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CSRD VA I01 CX000842CSRD VA IK2 CX001508RRD VA I01 RX002506RRD VA I21 RX001359RRD VA I21 RX002366
6 · The paper itself

Abstract

Emerging evidence suggests mild traumatic brain injury related headache (MTBI-HA) is a form of neuropathic pain state. Previous supraspinal mechanistic studies indicate patients with MTBI-HA demonstrate a dissociative state with diminished levels of supraspinal prefrontal pain modulatory functions and enhanced supraspinal sensory response to pain in comparison to healthy controls. However, the relationship between supraspinal pain modulatory functional deficit and severity of MTBI-HA is largely unknown. Understanding this relationship may provide enhanced levels of insight about MTBI-HA and facilitate the development of treatments. This study assessed pain related supraspinal resting states among MTBI-HA patients with various headache intensity phenotypes with comparisons to controls via functional magnetic resonance imaging (fMRI). Resting state fMRI data was analyzed with self-organizing-group-independent-component-analysis in three MTBI-HA intensity groups (mild, moderate, and severe) and one control group (n = 16 per group) within a pre-defined supraspinal pain network based on prior studies. In the mild-headache group, significant increases in supraspinal function were observed in the right premotor cortex (T = 3.53, p < 0.001) and the left premotor cortex (T = 3.99, p < 0.0001) when compared to the control group. In the moderate-headache group, a significant (T = -3.05, p < 0.01) decrease in resting state activity was observed in the left superior parietal cortex when compared to the mild-headache group. In the severe-headache group, significant decreases in resting state supraspinal activities in the right insula (T = -3.46, p < 0.001), right premotor cortex (T = -3.30, p < 0.01), left premotor cortex (T = -3.84, p < 0.001), and left parietal cortex (T = -3.94, p < 0.0001), and an increase in activity in the right secondary somatosensory cortex (T = 4.05, p < 0.0001) were observed when compared to the moderate-headache group. The results of the study suggest that the increase in MTBI-HA severity may be associated with an imbalance in the supraspinal pain network with decline in supraspinal pain modulatory function and enhancement of sensory/pain decoding.

Indexed as

Brain ConcussionNeuralgiaHeadacheHumansMagnetic Resonance ImagingPain Perceptionchronic post-traumatic headachefunctional magnetic resonance imagingMTBIpain modulationresting state functional activitytraumatic brain injury

Identifiers

PMID34365850
PMCPMC8358489
OpenAlexW3192833384

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.