Central Neuropathic Pain and Profiles of Quantitative Electroencephalography in Multiple Sclerosis Patients

Abstract

Pain has a significant impact on the quality of life of patients with multiple sclerosis (MS). However, the neurophysiological mechanisms of central neuropathic pain in a MS course are not known. We hypothesized that changes in power spectral density (PSD) that take place in the electroencephalography (EEG) of MS patients with and without the central neuropathic pain (CNP) would differ. The study aimed to assess the features of quantitative EEG using the PSD indicator along with peak frequencies in the standard frequency bands in MS patients with and without CNP. We have analyzed the quantitative spectral content of the EEG at a resting state in 12 MS patients with CNP, 12 MS patients without CNP, and 12 gender-and age-matched healthy controls using fast Fourier transformation. Based on the ANOVA, at the group level, the theta band absolute and relative PSD showed an increase, whereas alpha band relative PSD showed a decrease in MS patients both with and without CNP. However, only in MS with CNP group, the absolute and relative PSD in the beta1 and beta2 bands increased and exceeded that in patients without pain. Only MS patients with CNP demonstrated the significantly increased absolute PSD for the theta, beta1, and beta2 frequency bands in most regions of interest. In the theta band, MS patients with CNP displayed the increase in absolute spectral power for the mid-temporal derivation of the right hemisphere and the increase in relative spectral power for the prefrontal derivation of this hemisphere. In the beta1 band, the increase in absolute spectral power was observed for the three temporal derivations of the right hemisphere, whereas in the beta2 band, for the occipital, parietal, and temporal lobes of both hemispheres. In the alpha band, only a relative spectral power decrease was revealed for the occipital lobes of both hemispheres and parietal lobe of the right hemisphere. In MS patients with CNP, the frequencies of the dominant spectral power (peak frequencies) in the high-frequency beta band were higher than in the healthy control in posterior areas of the left hemisphere. Data could represent central nervous system alterations related to central neuropathic pain in MS patients that lead to the disturbances in cortical communication.

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“…2018 ). Other studies also indicate a strong association between downregulation of I h or HCN channel deletion in the cortex and increased δ and θ frequency oscillations during the wake state and sleep ( Krupina et al. 2020 ).…”

“…1999 ), as well as in patients with MS ( Leocani et al. 2000 ; Leocani and Comi 2000 ; Krupina et al. 2020 ).…”

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“…1. Central neuropathic pain [53,43] -these articles dealt with neuropathic pain caused by central nervous system disorders (multiple sclerosis) and spinal cord injuries;…”

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“…Cognitive deficits Correlation between increased alpha power (global) and overall deficits as well as attention/IPS and memory deficits [28][29][30] Trend toward a correlation between increased theta power (i.e., parietotemporal regions) and global as well as memory deficits [29] Correlation between increased frontal theta/beta waves ratio and attentional/IPS deficits [28,38] Fatigue Correlation between fatigue and abnormalities involving the cortico-cortical connectivity in beta/theta bands and the sensorimotor network activity of the left dominant hemisphere in the beta band [9][10][11][12] Correlation between fatigue and increased beta temporo-parietal FCR and increased beta and theta fronto-frontal FCR [12] Increased alpha and decreased beta SW in the left hemisphere among fatigued patients; correlation between beta SW and fatigue [12] Increased ERD and ERS in frontocentral regions among fatigued patients [13]; correlation between ERD/ERS and fatigue Correlation between asymmetry of right and left sensorimotor cortices EEG power and fatigue [16] Increased interhemispheric connectivity among fatigued patients; correlation between the interhemispheric coherence index and fatigue during a right-hand movement [16] Pain Slowing of alpha peak power, increase of the alpha power and decrease of the beta-band power in regions belonging to the pain matrix in patients with MS suffering from chronic pain; correlation between such abnormalities and pain intensity [35] Increased absolute and relative PSD in the beta bands as well as absolute PSD in beta and theta bands among patients with MS suffering from central neuropathic pain [37] FCR, Functional connectivity at rest; HC, Healthy controls; EEG, Electroencephalography; ERD, Event-related desynchronization; ERS, Event-related synchronization; IPS, information processing speed; MS, Multiple sclerosis; PSD, Power spectral density; SW, Small-worldness.…”

“…Such abnormalities involved the links between the salience network and each of the default mode network, the ascending nociceptive pathway, and the descending anti-nociceptive pathway [34][35][36]. In resting-state MEG or EEG studies, PwMS with chronic pain were found to have a slowing of peak power frequency in the alpha band [35], an increased power in the alpha band, or a decreased power in the beta band in regions that belong to the pain matrices with a correlation with pain intensity [35,37]. Compared to PwMS without central neuropathic pain (CNP), those suffering from CNP had higher absolute and relative power spectral density (PSD) in the beta band and higher absolute PSD in the theta and beta bands in most of the studied areas [37].…”