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

• Published in: Scandinavian 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
• Language: English
• Published: Germany Elsevier B.V 01.10.2017; De Gruyter
• Subjects: Acute Pain - diagnostic imaging; Acute Pain - etiology; Adult; Ankle injuries; Ankle Injuries - complications; Ankle Injuries - diagnostic imaging; Carbon Radioisotopes; Carbon-11; Central Nervous System Agents; Chronic Pain - diagnostic imaging; Chronic Pain - etiology; Deprenyl; Female; Follow-Up Studies; Humans; Inflammation; Inflammation - diagnostic imaging; Inflammation - etiology; Male; Middle Aged; Pain; PET; Positron-Emission Tomography - methods; Radiopharmaceuticals; Selegiline; Young Adult; FU2; FU1; [11C]DDE; Deprenyl; VAS; Inflammation; Carbon-11; ROI; ACP; Ankle injuries; VOI; FTA; Pain; SUV; PET/CT; TACT; MAO; PET
• ISSN: 1877-8860; 1877-8879; 1877-8879
• DOI: 10.1016/j.sjpain.2017.10.008

[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.