Assessing the Feasibility of a Multimodal Approach to Pain Evaluation in Early Stages after Spinal Cord Injury.

This research evaluates the feasibility of a multimodal pain assessment protocol during rehabilitation following spinal cord injury (SCI). The protocol amalgamates clinical workup (CW), quantitative sensory testing (QST), and psychosocial factors (PSF) administered at 4 (T1), 12 (T2), and 24 (T3) weeks post injury and at discharge (T4). Molecular blood biomarkers (BB) were evaluated via gene expression and proteomic assays at T1 and T4. Different pain trajectories and temporal changes were identified using QST, with inflammation and pain-related biomarkers recorded. Higher concentrations of osteopontin and cystatin-C were found in SCI patients compared to healthy controls, indicating their potential as biomarkers. We observed altered inflammatory responses and a slight increase in ICAM-1 and CCL3 were noted, pointing towards changes in cellular adhesion linked with spinal injury and a possible connection with neuropathic pain. Despite a small patient sample hindering the correlation of feasibility data, descriptive statistical analyses were conducted on stress, depression, anxiety, quality of life, and pain interferences. The SCI Pain Instrument (SCIPI) was efficient in distinguishing between nociceptive and neuropathic pain, showing a progressive increase in severity over time. The findings emphasize the need for the careful consideration of recruitment setting and protocol adjustments to enhance the feasibility of multimodal pain evaluation studies post SCI. They also shed light on potential early adaptive mechanisms in SCI pathophysiology, warranting the further exploration of prognostic and preventive strategies for chronic pain in the SCI population.

Utilizing museomics to trace the complex history and species boundaries in an avian-study system of conservation concern.

A taxonomic classification that accurately captures evolutionary history is essential for conservation. Genomics provides powerful tools for delimiting species and understanding their evolutionary relationships. This allows for a more accurate and detailed view on conservation status compared with other, traditionally used, methods. However, from a practical and ethical perspective, gathering sufficient samples for endangered taxa may be difficult. Here, we use museum specimens to trace the evolutionary history and species boundaries in an Asian oriole clade. The endangered silver oriole has long been recognized as a distinct species based on its unique coloration, but a recent study suggested that it might be nested within the maroon oriole-species complex. To evaluate species designation, population connectivity, and the corresponding conservation implications, we assembled a de novo genome and used whole-genome resequencing of historical specimens. Our results show that the silver orioles form a monophyletic lineage within the maroon oriole complex and that maroon and silver forms continued to interbreed after initial divergence, but do not show signs of recent gene flow. Using a genome scan, we identified genes that may form the basis for color divergence and act as reproductive barriers. Taken together, our results confirm the species status of the silver oriole and highlight that taxonomic revision of the maroon forms is urgently needed. Our study demonstrates how genomics and Natural History Collections (NHC) can be utilized to shed light on the taxonomy and evolutionary history of natural populations and how such insights can directly benefit conservation practitioners when assessing wild populations.

Variability in clinical and neurophysiological evaluation of pain development following acute spinal cord injury: a case report.

INTRODUCTION: Chronic neuropathic pain (NeP) often develops following traumatic spinal cord injury (SCI). This case report explores variability in clinical and neurophysiological aspects of pain evaluation in early post-trauma stages. CASE PRESENTATION: A 34-year old female presenting with acute incomplete sensorimotor tetraplegia C4 AIS D was examined by neurological examination and pain assessment at three time points after acute trauma T1 (8 weeks), T2 (11 weeks), and T3 (24 weeks). Quantitative sensory testing (QST) and laser-evoked potentials (LEPs) were measured above (control area), at (area of NeP), and below (foot) the neurological level of injury (NLI). Musculo-skeletal and neuropathic pain were clinically present already during T1 but showed variations in localization and occurrence over time. Neuropathic pain classification varied between time points due to shifting of NLI. Above-level QST revealed minor, less pronounced abnormalities similar to at-level site. At-level QST (site of NeP) showed loss for thermal and mechanical detection thresholds but also gain of function for mechanical pain thresholds with a tendency of amelioration over time. QST below-level did not reveal remarkable changes over time. LEPs above- and below-level were within normal limits. At-level LEPs abolished after T1. DISCUSSION: In early stages post injury (up to 6 month) variations in pain presentation for both, musculo-skeletal and neuropathic pain as well as QST and LEP could be demonstrated. These findings suggest ongoing adaption mechanisms in sensory pathways, which require further exploration and may be relevant for prognostic and preventive strategies against the development of chronic neuropathic and nociceptive pain.

Cold evoked potentials: Acquisition from cervical dermatomes.

INTRODUCTION: Cold evoked potentials (CEPs) represent a novel technique to assess the integrity of cold-specific pathways within the somatosensory system. So far an objective assessment of these pathways has not been implemented into the clinical routine. Specifically, CEPs may help to elucidate the pathophysiological underpinnings of altered cold processing in neurological diseases. OBJECTIVE: To test feasibility and test-retest reliability of CEPs within two cervical dermatomes, including recording sites in glabrous and hairy skin, in order to facilitate the transition into clinical practice. METHODS: Twenty healthy subjects received 15 cold stimuli applied by a thermode either at the hand dorsum (C6 dermatome, hairy skin), the shoulder (C4 dermatome, hairy skin) or the thenar eminence (C6 dermatome, glabrous skin). Stimuli were applied from a baseline temperature of 30°C down to a destination temperature of 25°C at a rate of 20°C/s. N2 latencies and N2P2 amplitudes were recorded at the vertex using a surface electroencephalogram and test-retest statistics were calculated. RESULTS: Slight, innocuous cooling (Δ5°C) from a baseline temperature of 30°C elicited a brief percept of cooling and generated a vertex potential (N2P2) in most subjects. The latency of the vertex response is consistent with A-delta fiber activation. Based on test-retest analyses (i.e., intraclass correlation coefficients (ICCs) and Bland-Altman analyses) reliability is best within the C4 dermatome and for stimulation of hairy skin. ICCs display fair to substantial (ICCs from 0.51-0.81) reliability for amplitudes across all stimulation sites, possibly due to floor effects. CEPs latencies, however, were only poorly reliable (ICCs from -0.13 to 0.31). CONCLUSION: The acquisition of CEPs from cervical dermatomes is feasible. Since involvement of cold-specific pathways is relevant for several pathologies in clinical neurology, the application of CEPs may complement existing techniques like contact heat and laser stimulation in the assessment of peripheral and central nervous system disorders. Future studies employing different stimulation paradigms using faster cooling are warranted in order to improve the signal-to-noise ratio.