Exploration by NMR Spectroscopy of the Choline Concentrations in the Insular Cortex of Patients Suffering of Neuropathic Pain Induced by Oxaliplatin

  • STATUS
    Recruiting
  • participants needed
    46
  • sponsor
    University Hospital, Clermont-Ferrand
Updated on 21 June 2021
Investigator
Patrick LACARIN
Primary Contact
CHU de Clermont-Ferrand (0.0 mi away) Contact
MRI
oxaliplatin
neuropathic pain
neuralgia

Summary

Neurotoxic chemotherapy, including oxaliplatin, are responsible for very disabling neuropathic pain that can last for months or even years after the end of chemotherapy. Currently, there is no effective neuroprotective treatment to prevent or relieve this pain. The only strategy is the reduction of oxaliplatin doses or premature discontinuation of therapy, with the risk of burdening the prognosis for remission. Thus, a better understanding of the pathophysiology of these iatrogenic neuropathies appears necessary in order to discover new potential therapeutic targets.

Preclinical works were able to demonstrate important metabolic changes in certain brain structures in an animal model of oxaliplatin-induced neuropathy. A significant increase of choline concentration has been found in the posterior insular cortex of neuropathic animals compared with control animals. Furthermore, the concentrations of choline were positively correlated to nociceptive thresholds. Thus, neuropathic pain induced by oxaliplatin would involve the posterior insular cortex and would be associated with an increase in choline concentration at this level. Clinical translation of these preclinical results is feasible in practice since choline concentration can be determined in the brain by non-invasive magnetic resonance spectroscopy.

Description

The objective of this study is to demonstrate a significant increase in choline concentration in the insular cortex of patients with an oxaliplatin induced neuropathy. Other objectives will assess the correlation between metabolite concentrations in the insular cortex and frequency / intensity of pain and neuropathic symptoms, cold and heat-induced pain and comorbidities (anxiety, pain, quality of life).

Details
Condition Pain, Neuropathy, Post-Surgical Pain, Pain (Pediatric), ache, neuropathies, nerve disorders
Treatment NMR Spectroscopy, NMR Spectroscopy
Clinical Study IdentifierNCT02340403
SponsorUniversity Hospital, Clermont-Ferrand
Last Modified on21 June 2021

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