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Currently, the degree to which signs and symptoms of neuropathic pain correlate with functional impairments and\/or anatomical deficits remains unclear. This study aimed to identify structural and functional determinants associated with neuropathic pain in individuals with focal spinal lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_sjpain-2025-0065_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Individuals fulfilling the diagnostic criteria of neuropathic pain were identified among individuals with cervical myelopathy presenting with focal spinal lesions. Lesion volume and the extent of structural damage affecting the spinothalamic tract, dorsal columns, dorsal horn, and ventral horn were evaluated with tract-specific MRI of the cervical spinal cord. Quantitative sensory testing (QST) (i.e.,\u00a0thermal\/mechanical thresholds) was performed at the most affected skin area. Additionally, contact heat-evoked potentials (CHEPs) were acquired following stimulation at the most affected skin area to objectively assess the functional integrity of the spinothalamic\u00a0tract.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_sjpain-2025-0065_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>MRI-derived structural damage was similar for individuals with (n=8) and without (n=8) neuropathic pain in all regions of interest (p&gt;0.05). Mechanical hyperalgesia upon QST was observed in both groups. However, functional preservation of the spinothalamic system, measured by CHEPs, was present in 87\u202f% of individuals with neuropathic pain, compared to 38\u202f% of pain-free individuals (p=0.039).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_sjpain-2025-0065_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These observations suggest that segmental hyperexcitability resulting from structural spinal cord damage, in combination with residual sparing of spinothalamic afferents, may represent a key pathophysiological constellation contributing to central neuropathic\u00a0pain following focal spinal lesions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/sjpain-2025-0065","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T19:53:41Z","timestamp":1781898821000},"source":"Crossref","is-referenced-by-count":1,"title":["Multimodal investigation of neuropathic pain mechanisms in focal spinal lesions"],"prefix":"10.1515","volume":"26","author":[{"given":"Paulina S.","family":"Scheuren","sequence":"first","affiliation":[{"name":"Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich , Zurich , Switzerland"},{"name":"International Collaboration on Repair Discoveries, University of British Columbia , Vancouver , BC , Canada"},{"name":"Department of Anesthesiology , Pharmacology & Therapeutics, Faculty of Medicine, University of British Columbia , Vancouver , BC , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gergely","family":"David","sequence":"additional","affiliation":[{"name":"Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich , Zurich , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John L.K.","family":"Kramer","sequence":"additional","affiliation":[{"name":"International Collaboration on Repair Discoveries, University of British Columbia , Vancouver , BC , Canada"},{"name":"Department of Anesthesiology , Pharmacology & Therapeutics, Faculty of Medicine, University of British Columbia , Vancouver , BC , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine R.","family":"Jutzeler","sequence":"additional","affiliation":[{"name":"Department of Health Sciences and Technology (D-HEST) , ETH Zurich , Zurich , Switzerland"},{"name":"SIB Swiss Institute of Bioinformatics , Lausanne , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Hupp","sequence":"additional","affiliation":[{"name":"Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich , Zurich , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Freund","sequence":"additional","affiliation":[{"name":"Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich , Zurich , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Magerl","sequence":"additional","affiliation":[{"name":"Department of Neurophysiology , Mannheim Center for Translational Neurosciences, Heidelberg University , Mannheim , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armin","family":"Curt","sequence":"additional","affiliation":[{"name":"Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich , Zurich , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mich\u00e8le","family":"Hubli","sequence":"additional","affiliation":[{"name":"Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich , Zurich , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Rosner","sequence":"additional","affiliation":[{"name":"Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich , Zurich , Switzerland"},{"name":"Danish Pain Research Center, Department of Clinical Medicine, Aarhus University , Aarhus , Denmark"},{"name":"University Clinic for Neurorehabilitation, Spinal Cord Injury Center of Western Denmark, Department of Clinical Medicine, Aarhus University , Aarhus , Denmark"},{"name":"Department of Neurology , University Hospital Bern, Inselspital, University of Bern , Bern , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,6,19]]},"reference":[{"key":"2026061919554589317_j_sjpain-2025-0065_ref_001","doi-asserted-by":"crossref","unstructured":"Rosner, J, de Andrade, DC, Davis, KD, Gustin, SM, Kramer, JLK, Seal, RP, et al.. 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