Spinal and Supraspinal Processing of Thermal Stimuli: An fMRI Study

PurposeTo assess and characterize responses to innocuous/noxious thermal stimuli and heat allodynia using functional spinal magnetic resonance imaging (spinal fMRI). Materials and MethodsSpinal/supraspinal activation patterns of 16 healthy subjects were investigated by applying painful and nonpainful heat stimuli to dermatome C6 baseline and after sensitization with the heat/capsaicin model using fMRI (3T, single-shot TSE, TR 9000 msec, TE 38 msec, FOV 288 x 144 x 20 mm, matrix 192 x 96, voxel size 1 x 1 x 2 mm). ResultsIncreased activity was observed in ipsi- and contralateral ventral and dorsal spinal horn during noxious heat and heat allodynia. During noxious heat, but not during heat allodynia, activations were visible in the periaqueductal gray, ipsilateral cuneiform nucleus, and ipsilateral dorsolateral pontine tegmentum (DLPT). However, during heat allodynia activations were observed in bilateral ruber nuclei, contralateral DLPT, and rostral ventromedial medulla oblongata (RVM). Activations in contralateral subnucleus reticularis dorsalis (SRD) were visible during both noxious heat and heat allodynia (T >2.5, P<0.01 for all of the above). After sensitization, activations in RVM and SRD correlated with activations in the ipsilateral dorsal horn of the spinal cord (R=0.52-0.98, P<0.05). ConclusionSpinal fMRI successfully demonstrates increased spinal activity and secondary changes in activation of supraspinal centers involved in pain modulation caused by peripheral nociceptor sensitization. J. Magn. Reson. Imaging 2015;41:1046-1055. (c) 2014 Wiley Periodicals, Inc.