Visualization of painful inflammation in patients with pain after traumatic ankle sprain using [11C]-D-deprenyl PET/CT

[Display omitted] •An increased [11C]-D-deprenyl uptake is shown in painful locations after ankle sprain.•Patients experiencing persistent pain had prolonged peripheral D-deprenyl uptake.•The described method can visualize, quantify and follow pain generating processes.•Such an objective correlate m...

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Published inScandinavian journal of pain Vol. 17; no. 1; pp. 418 - 424
Main Authors Aarnio, Mikko, Appel, Lieuwe, Fredrikson, Mats, Gordh, Torsten, Wolf, Olof, Sörensen, Jens, Thulin, Måns, Peterson, Magnus, Linnman, Clas
Format Journal Article
LanguageEnglish
Published Germany Elsevier B.V 01.10.2017
De Gruyter
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ISSN1877-8860
1877-8879
1877-8879
DOI10.1016/j.sjpain.2017.10.008

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Summary:[Display omitted] •An increased [11C]-D-deprenyl uptake is shown in painful locations after ankle sprain.•Patients experiencing persistent pain had prolonged peripheral D-deprenyl uptake.•The described method can visualize, quantify and follow pain generating processes.•Such an objective correlate may represent a progress in pain research and management. Positron emission tomography (PET) with the radioligand [11C]-D-deprenyl has shown increased signal at location of pain in patients with rheumatoid arthritis and chronic whiplash injury. The binding site of [11C]-D-deprenyl in peripheral tissues is suggested to be mitochondrial monoamine oxidase in cells engaged in post-traumatic inflammation and tissue repair processes. The association between [11C]-D-deprenyl uptake and the transition from acute to chronic pain remain unknown. Further imaging studies of musculoskeletal pain at the molecular level would benefit from establishing a clinical model in a common and well-defined injury in otherwise healthy and drug-naïve subjects. The aim of this study was to investigate if [11C]-D-deprenyl uptake would be acutely elevated in unilateral ankle sprain and if tracer uptake would be reduced as a function of healing, and correlated with pain localizations and pain experience. Eight otherwise healthy patients with unilateral ankle sprain were recruited at the emergency department. All underwent [11C]-D-deprenyl PET/CT in the acute phase, at one month and 6–14 months after injury. Acute [11C]-D-deprenyl uptake at the injury site was a factor of 10.7 (range 2.9–37.3) higher than the intact ankle. During healing, [11C]-D-deprenyl uptake decreased, but did not normalize until after 11 months. Patients experiencing persistent pain had prolonged [11C]-D-deprenyl uptake in painful locations. The data provide further support that [11C]-D-deprenyl PET can visualize, quantify and follow processes in peripheral tissue that may relate to soft tissue injuries, inflammation and associated nociceptive signaling. Such an objective correlate would represent a progress in pain research, as well as in clinical pain diagnostics and management.
ISSN:1877-8860
1877-8879
1877-8879
DOI:10.1016/j.sjpain.2017.10.008