{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:36:42Z","timestamp":1787031402445,"version":"build-2736575974"},"reference-count":154,"publisher":"American Spinal Injury Association","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021]]},"abstract":"<jats:p>The prevalence of obesity and of neuropathic pain are both estimated at above 50% in the population of people with chronic spinal cord injury (SCI). These secondary consequences of SCI have significant negative impact on physical functioning, activities of daily living, and quality of life. Investigations of relationships between weight or body composition and chronic neuropathic pain in people with SCI are lacking, but investigations in non-SCI cohorts suggest an association between obesity and the presence and severity of neuropathic pain conditions. In the present article, we present a review of the literature linking obesity and neuropathic pain and summarize findings suggesting that metabolic syndrome and chronic, systemic inflammation due to excess adiposity increase the risk for neuropathic pain after an SCI.<\/jats:p>","DOI":"10.46292\/sci20-00062","type":"journal-article","created":{"date-parts":[[2021,3,19]],"date-time":"2021-03-19T13:50:28Z","timestamp":1616161828000},"page":"75-83","source":"Crossref","is-referenced-by-count":10,"title":["Interrelationship of Neurogenic Obesity and Chronic Neuropathic Pain in Persons With Spinal Cord Injury"],"prefix":"10.46292","volume":"27","author":[{"given":"Elizabeth R.","family":"Felix","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida"},{"name":"Research Service, Miami Veterans Affairs (VA) Healthcare System, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Gater","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida"},{"name":"The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"25425","reference":[{"key":"i1082-0744-27-1-75-b1","series-title":"J Pain Res","first-page":"399","article-title":"The association between chronic pain and obesity","volume":"8","year":"2015","unstructured":"Okifuji\n              A,\n            \n            \n              Hare\n              BD.\n            \n          \n          The association between chronic pain and obesity.\n\t\t\t\t\tJ Pain Res.\n\t\t\t\t\t2015;\n\t\t\t\t\t8:\n\t\t\t\t\t399\u2013\n\t\t\t\t\t408."},{"issue":"7","key":"i1082-0744-27-1-75-b2","series-title":"Obesity (Silver 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Med.2018:\n\t\t\t\t\t1\u2013\n\t\t\t\t\t9."},{"issue":"2","key":"i1082-0744-27-1-75-b66","series-title":"Chest","first-page":"438","article-title":"Sleep-disordered breathing and spinal cord injury: a state-of-the-art review","volume":"155","year":"2019","unstructured":"Sankari\n              A,\n            \n            \n              Vaughan\n              S,\n            \n            \n              Bascom\n              A,\n            \n            \n              Martin\n              JL,\n            \n            \n              Badr\n              MS.\n            \n          \n          Sleep-disordered breathing and spinal cord injury: a state-of-the-art review.\n\t\t\t\t\tChest.\n\t\t\t\t\t2019;\n\t\t\t\t\t155(\n\t\t\t\t\t2):\n\t\t\t\t\t438\u2013\n\t\t\t\t\t445."},{"key":"i1082-0744-27-1-75-b67","series-title":"Nat Sci Sleep","first-page":"219","article-title":"Impact of spinal cord injury on sleep: current 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studies.\n\t\t\t\t\tMetabolism.\n\t\t\t\t\t2018;\n\t\t\t\t\t85:\n\t\t\t\t\t325\u2013\n\t\t\t\t\t339."},{"issue":"4","key":"i1082-0744-27-1-75-b70","series-title":"Endocr Rev","first-page":"1092","article-title":"Emerging roles for serotonin in regulating metabolism: new implications for an ancient molecule","volume":"40","year":"2019","unstructured":"Yabut\n              JM,\n            \n            \n              Crane\n              JD,\n            \n            \n              Green\n              AE,\n            \n            \n              Keating\n              DJ,\n            \n            \n              Khan\n              WI,\n            \n            \n              Steinberg\n              GR.\n            \n          \n          Emerging roles for serotonin in regulating metabolism: new implications for an ancient molecule.\n\t\t\t\t\tEndocr 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\n            \n              Bruckmueller\n              H,\n            \n            \n              Gierthmuhlen\n              J,\n            \n          \n          .\n\t\t\t\t\tThe serotonin receptor 2A (HTR2A) rs6313 variant is associated with higher ongoing pain and signs of central sensitization in neuropathic pain patients [published online ahead of print November 10, 2020].\n\t\t\t\t\tEur J Pain."},{"issue":"9","key":"i1082-0744-27-1-75-b74","series-title":"Diabetes Care","first-page":"2456","article-title":"Mechanisms and management of diabetic painful distal symmetrical polyneuropathy","volume":"36","year":"2013","unstructured":"Tesfaye\n              S,\n            \n            \n              Boulton\n              AJ,\n            \n            \n              Dickenson\n              AH.\n            \n          \n          Mechanisms and management of diabetic painful distal symmetrical polyneuropathy.\n\t\t\t\t\tDiabetes Care.\n\t\t\t\t\t2013;\n\t\t\t\t\t36(\n\t\t\t\t\t9):\n\t\t\t\t\t2456\u2013\n\t\t\t\t\t2465."},{"issue":"2","key":"i1082-0744-27-1-75-b75","series-title":"Top Spinal Cord Inj Rehabil","first-page":"166","article-title":"Antidepressants are effective in decreasing neuropathic pain after SCI: a meta-analysis","volume":"21","year":"2015","unstructured":"Mehta\n              S,\n            \n            \n              Guy\n              S,\n            \n            \n              Lam\n              T,\n            \n            \n              Teasell\n              R,\n            \n            \n              Loh\n              E.\n            \n          \n          Antidepressants are effective in decreasing neuropathic pain after SCI: a meta-analysis.\n\t\t\t\t\tTop Spinal Cord Inj Rehabil.\n\t\t\t\t\t2015;\n\t\t\t\t\t21(\n\t\t\t\t\t2):\n\t\t\t\t\t166\u2013\n\t\t\t\t\t173."},{"issue":"suppl 1","key":"i1082-0744-27-1-75-b76","series-title":"Pain 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\n            \n              Cant\n              ML,\n            \n            \n              Burke\n              ALJ.\n            \n          \n          Sleep disturbances and sleep disorders in adults living with chronic pain: a meta-analysis.\n\t\t\t\t\tSleep Med.\n\t\t\t\t\t2018;\n\t\t\t\t\t52:\n\t\t\t\t\t198\u2013\n\t\t\t\t\t210."},{"key":"i1082-0744-27-1-75-b1","series-title":"J Pain Res","first-page":"399","article-title":"The association between chronic pain and obesity","volume":"8","year":"2015","unstructured":"Okifuji\n              A,\n            \n            \n              Hare\n              BD.\n            \n          \n          The association between chronic pain and obesity.\n\t\t\t\t\tJ Pain Res.\n\t\t\t\t\t2015;\n\t\t\t\t\t8:\n\t\t\t\t\t399\u2013\n\t\t\t\t\t408."},{"issue":"7","key":"i1082-0744-27-1-75-b2","series-title":"Obesity (Silver Spring)","first-page":"1491","article-title":"Obesity and pain are associated in the United 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elderly.\n\t\t\t\t\tPain.\n\t\t\t\t\t2011;\n\t\t\t\t\t152(\n\t\t\t\t\t1):\n\t\t\t\t\t53\u2013\n\t\t\t\t\t59."},{"issue":"5","key":"i1082-0744-27-1-75-b4","series-title":"J Pain","first-page":"430","article-title":"Comorbidity of obesity and pain in a general population: results from the Southern Pain Prevalence Study","volume":"8","year":"2007","unstructured":"Hitt\n              HC,\n            \n            \n              McMillen\n              RC,\n            \n            \n              Thornton-Neaves\n              T,\n            \n            \n              Koch\n              K,\n            \n            \n              Cosby\n              AG.\n            \n          \n          Comorbidity of obesity and pain in a general population: results from the Southern Pain Prevalence Study.\n\t\t\t\t\tJ Pain.\n\t\t\t\t\t2007;\n\t\t\t\t\t8(\n\t\t\t\t\t5):\n\t\t\t\t\t430\u2013\n\t\t\t\t\t436."},{"issue":"9","key":"i1082-0744-27-1-75-b5","series-title":"PLoS 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Manag.\n\t\t\t\t\t2016;\n\t\t\t\t\t2016:\n\t\t\t\t\t2487924."},{"issue":"1","key":"i1082-0744-27-1-75-b8","series-title":"J Spinal Cord Med","first-page":"86","article-title":"Prevalence of metabolic syndrome in veterans with spinal cord injury","volume":"42","year":"2019","unstructured":"Gater\n              DR,\n              Jr.,\n            \n            \n              Farkas\n              GJ,\n            \n            \n              Berg\n              AS,\n            \n            \n              Castillo\n              C.\n            \n          \n          Prevalence of metabolic syndrome in veterans with spinal cord injury.\n\t\t\t\t\tJ Spinal Cord Med.\n\t\t\t\t\t2019;\n\t\t\t\t\t42(\n\t\t\t\t\t1):\n\t\t\t\t\t86\u2013\n\t\t\t\t\t93."},{"issue":"3","key":"i1082-0744-27-1-75-b9","series-title":"J Rehabil Med","first-page":"237","article-title":"Cardiovascular disease risk and the need for prevention after paraplegia determined by conventional multifactorial risk models: 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       Gater\n              DR.\n            \n          \n          Neurogenic obesity and systemic inflammation following spinal cord injury: a review.\n\t\t\t\t\tJ Spinal Cord Med.\n\t\t\t\t\t2018;\n\t\t\t\t\t41(\n\t\t\t\t\t4):\n\t\t\t\t\t378\u2013\n\t\t\t\t\t387."},{"key":"i1082-0744-27-1-75-b11","series-title":"Front Hum Neurosci","first-page":"181","article-title":"Neuro-immunity controls obesity-induced pain","volume":"14","year":"2020","unstructured":"Eichwald\n              T,\n            \n            \n              Talbot\n              S.\n            \n          \n          Neuro-immunity controls obesity-induced pain.\n\t\t\t\t\tFront Hum Neurosci.\n\t\t\t\t\t2020;\n\t\t\t\t\t14:\n\t\t\t\t\t181."},{"issue":"11","key":"i1082-0744-27-1-75-b12","series-title":"Arch Phys Med Rehabil","first-page":"1774","article-title":"Gender and minority differences in the pain experience of people with spinal cord injury","volume":"85","year":"2004","unstructured":"Cardenas\n             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Initial validation using vignettes.\n\t\t\t\t\tSpinal Cord.\n\t\t\t\t\t2012;\n\t\t\t\t\t50(\n\t\t\t\t\t6):\n\t\t\t\t\t404\u2013\n\t\t\t\t\t412."},{"issue":"4","key":"i1082-0744-27-1-75-b19","series-title":"Spinal Cord","first-page":"282","article-title":"The International Spinal Cord Injury Pain Basic Data Set (version 2.0)","volume":"52","year":"2014","unstructured":"Widerstrom-Noga\n              E,\n            \n            \n              Biering-Sorensen\n              F,\n            \n            \n              Bryce\n              TN,\n            \n          \n          .\n\t\t\t\t\tThe International Spinal Cord Injury Pain Basic Data Set (version 2.0).\n\t\t\t\t\tSpinal Cord.\n\t\t\t\t\t2014;\n\t\t\t\t\t52(\n\t\t\t\t\t4):\n\t\t\t\t\t282\u2013\n\t\t\t\t\t286."},{"issue":"1","key":"i1082-0744-27-1-75-b20","series-title":"Eur J Pain","first-page":"29","article-title":"Neuropathic pain prevalence following spinal cord injury: a systematic review and 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predictors of pain following traumatic spinal cord injury: a prospective study.\n\t\t\t\t\tJ Pain.\n\t\t\t\t\t2014;\n\t\t\t\t\t15(\n\t\t\t\t\t1):\n\t\t\t\t\t40\u2013\n\t\t\t\t\t48."},{"issue":"4","key":"i1082-0744-27-1-75-b22","series-title":"Spinal Cord","first-page":"346","article-title":"Prevalence and associated factors of pain in the Swiss spinal cord injury population","volume":"55","year":"2017","unstructured":"Muller\n              R,\n            \n            \n              Brinkhof\n              MW,\n            \n            \n              Arnet\n              U,\n            \n          \n          .\n\t\t\t\t\tPrevalence and associated factors of pain in the Swiss spinal cord injury population.\n\t\t\t\t\tSpinal Cord.\n\t\t\t\t\t2017;\n\t\t\t\t\t55(\n\t\t\t\t\t4):\n\t\t\t\t\t346\u2013\n\t\t\t\t\t354."},{"issue":"2","key":"i1082-0744-27-1-75-b23","series-title":"J Spinal Cord Med","first-page":"201","article-title":"Pain profiles in a community dwelling population 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Nutr.\n\t\t\t\t\t2000;\n\t\t\t\t\t72(\n\t\t\t\t\t3):\n\t\t\t\t\t694\u2013\n\t\t\t\t\t701."},{"issue":"9784","key":"i1082-0744-27-1-75-b27","series-title":"Lancet","first-page":"2215","article-title":"Treatment of acute postoperative pain","volume":"377","year":"2011","unstructured":"Wu\n              CL,\n            \n            \n              Raja\n              SN.\n            \n          \n          Treatment of acute postoperative pain.\n\t\t\t\t\tLancet.\n\t\t\t\t\t2011;\n\t\t\t\t\t377(\n\t\t\t\t\t9784):\n\t\t\t\t\t2215\u2013\n\t\t\t\t\t2225."},{"issue":"5","key":"i1082-0744-27-1-75-b28","series-title":"Pain Physician","first-page":"479","article-title":"Transition from acute to chronic pain: evaluating risk for chronic postsurgical pain","volume":"22","year":"2019","unstructured":"Fregoso\n              G,\n            \n            \n              Wang\n              A,\n            \n            \n              Tseng\n              K,\n            \n            \n           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       Chronic neuropathic pain in SCI: evaluation and treatment.\n\t\t\t\t\tPhys Med Rehabil Clin N Am.\n\t\t\t\t\t2014;\n\t\t\t\t\t25(\n\t\t\t\t\t3):\n\t\t\t\t\t545\u2013\n\t\t\t\t\t571,\n\t\t\t\t\tviii."},{"issue":"3","key":"i1082-0744-27-1-75-b31","series-title":"Pain","first-page":"545","article-title":"Biomarkers for predicting central neuropathic pain occurrence and severity after spinal cord injury: results of a long-term longitudinal study","volume":"161","year":"2020","unstructured":"Gruener\n              H,\n            \n            \n              Zeilig\n              G,\n            \n            \n              Gaidukov\n              E,\n            \n          \n          .\n\t\t\t\t\tBiomarkers for predicting central neuropathic pain occurrence and severity after spinal cord injury: results of a long-term longitudinal study.\n\t\t\t\t\tPain.\n\t\t\t\t\t2020;\n\t\t\t\t\t161(\n\t\t\t\t\t3):\n\t\t\t\t\t545\u2013\n\t\t\t\t\t556."},{"issue":"Pt 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clinical trials","volume":"36","year":"2019","unstructured":"Warner\n              FM,\n            \n            \n              Cragg\n              JJ,\n            \n            \n              Jutzeler\n              CR,\n            \n          \n          .\n\t\t\t\t\tProgression of neuropathic pain after acute spinal cord injury: a meta-analysis and framework for clinical trials.\n\t\t\t\t\tJ Neurotrauma.\n\t\t\t\t\t2019;\n\t\t\t\t\t36(\n\t\t\t\t\t9):\n\t\t\t\t\t1461\u2013\n\t\t\t\t\t1468."},{"issue":"7","key":"i1082-0744-27-1-75-b35","series-title":"Clin J Pain","first-page":"641","article-title":"Quantitative sensory testing in measurement of neuropathic pain phenomena and other sensory abnormalities","volume":"25","year":"2009","unstructured":"Backonja\n              MM,\n            \n            \n              Walk\n              D,\n            \n            \n              Edwards\n              RR,\n            \n          \n          .\n\t\t\t\t\tQuantitative sensory 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Sensitivity and pain detection thresholds for electrical stimulation after surgery-induced weight loss, and comparison with a nonobese population","volume":"29","year":"2013","unstructured":"Dodet\n              P,\n            \n            \n              Perrot\n              S,\n            \n            \n              Auvergne\n              L,\n            \n          \n          .\n\t\t\t\t\tSensory impairment in obese patients? Sensitivity and pain detection thresholds for electrical stimulation after surgery-induced weight loss, and comparison with a nonobese population.\n\t\t\t\t\tClin J Pain.\n\t\t\t\t\t2013;\n\t\t\t\t\t29(\n\t\t\t\t\t1):\n\t\t\t\t\t43\u2013\n\t\t\t\t\t49."},{"issue":"9","key":"i1082-0744-27-1-75-b38","series-title":"Eur J Pain","first-page":"1316","article-title":"The role of excess subcutaneous fat in pain and sensory sensitivity in obesity","volume":"17","year":"2013","unstructured":"Price\n              RC,\n            \n            \n              Asenjo\n              JF,\n            \n            \n              Christou\n              NV,\n            \n            \n              Backman\n              SB,\n            \n            \n              Schweinhardt\n              P.\n            \n          \n          The role of excess subcutaneous fat in pain and sensory sensitivity in obesity.\n\t\t\t\t\tEur J Pain.\n\t\t\t\t\t2013;\n\t\t\t\t\t17(\n\t\t\t\t\t9):\n\t\t\t\t\t1316\u2013\n\t\t\t\t\t1326."},{"issue":"2","key":"i1082-0744-27-1-75-b39","series-title":"Pain","first-page":"343","article-title":"Neuropathic pain: Are there distinct subtypes depending on the aetiology or anatomical lesion?","volume":"138","year":"2008","unstructured":"Attal\n              N,\n            \n            \n              Fermanian\n              C,\n            \n            \n              Fermanian\n              J,\n            \n            \n              Lanteri-Minet\n              M,\n            \n            \n              Alchaar\n              H,\n            \n            \n              Bouhassira\n              D.\n            \n          \n          Neuropathic pain: Are there distinct subtypes depending on the aetiology or anatomical lesion?\n          \n            Pain\n          .\n\t\t\t\t\t2008;\n\t\t\t\t\t138(\n\t\t\t\t\t2):\n\t\t\t\t\t343\u2013\n\t\t\t\t\t353."},{"issue":"3","key":"i1082-0744-27-1-75-b40","series-title":"Pain","first-page":"248","article-title":"Development and validation of the Neuropathic Pain Symptom Inventory","volume":"108","year":"2004","unstructured":"Bouhassira\n              D,\n            \n            \n              Attal\n              N,\n            \n            \n              Fermanian\n              J,\n            \n          \n          .\n\t\t\t\t\tDevelopment and validation of the Neuropathic Pain Symptom Inventory.\n\t\t\t\t\tPain.\n\t\t\t\t\t2004;\n\t\t\t\t\t108(\n\t\t\t\t\t3):\n\t\t\t\t\t248\u2013\n\t\t\t\t\t257."},{"issue":"3","key":"i1082-0744-27-1-75-b41","series-title":"Top Spinal Cord Inj Rehabil","first-page":"207","article-title":"Inflammatory stress effects on health and function after spinal cord injury","volume":"23","year":"2017","unstructured":"Noller\n              CM,\n            \n            \n              Groah\n              SL,\n            \n            \n              Nash\n              MS.\n            \n          \n          Inflammatory stress effects on health and function after spinal cord injury.\n\t\t\t\t\tTop Spinal Cord Inj Rehabil.\n\t\t\t\t\t2017;\n\t\t\t\t\t23(\n\t\t\t\t\t3):\n\t\t\t\t\t207\u2013\n\t\t\t\t\t217."},{"key":"i1082-0744-27-1-75-b42","series-title":"Exp Neurol","first-page":"174","article-title":"Serotonergic mechanisms in spinal cord injury","volume":"318","year":"2019","unstructured":"Perrin\n              FE,\n            \n            \n              Noristani\n              HN.\n            \n          \n          Serotonergic mechanisms in spinal cord injury.\n\t\t\t\t\tExp Neurol.\n\t\t\t\t\t2019;\n\t\t\t\t\t318:\n\t\t\t\t\t174\u2013\n\t\t\t\t\t191."},{"issue":"3","key":"i1082-0744-27-1-75-b43","series-title":"Gerontology","first-page":"193","article-title":"Polyneuropathy in impaired glucose tolerance: Is postprandial hyperglycemia the main culprit? 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The KORA Myocardial Infarction Registry.\n\t\t\t\t\tEur J Pain.\n\t\t\t\t\t2009;\n\t\t\t\t\t13(\n\t\t\t\t\t6):\n\t\t\t\t\t582\u2013\n\t\t\t\t\t587."},{"issue":"2","key":"i1082-0744-27-1-75-b49","series-title":"Pain Med","first-page":"393","article-title":"Neuropathic pain in diabetes, prediabetes and normal glucose tolerance: The MONICA\/KORA Augsburg Surveys S2 and S3","volume":"10","year":"2009","unstructured":"Ziegler\n              D,\n            \n            \n              Rathmann\n              W,\n            \n            \n              Dickhaus\n              T,\n            \n            \n              Meisinger\n              C,\n            \n            \n              Mielck\n              A,\n            \n            \n              Group\n              KS.\n            \n          \n          Neuropathic pain in diabetes, prediabetes and normal glucose tolerance: The MONICA\/KORA Augsburg Surveys S2 and S3.\n\t\t\t\t\tPain Med.\n\t\t\t\t\t2009;\n\t\t\t\t\t10(\n\t\t\t\t\t2):\n\t\t\t\t\t393\u2013\n\t\t\t\t\t400."},{"issue":"4","key":"i1082-0744-27-1-75-b50","series-title":"J Peripher Nerv Syst","first-page":"354","article-title":"Obesity and peripheral neuropathy risk: a dangerous liaison","volume":"10","year":"2005","unstructured":"Miscio\n              G,\n            \n            \n              Guastamacchia\n              G,\n            \n            \n              Brunani\n              A,\n            \n            \n              Priano\n              L,\n            \n            \n              Baudo\n              S,\n            \n            \n              Mauro\n              A.\n            \n          \n          Obesity and peripheral neuropathy risk: a dangerous liaison.\n\t\t\t\t\tJ Peripher Nerv Syst.\n\t\t\t\t\t2005;\n\t\t\t\t\t10(\n\t\t\t\t\t4):\n\t\t\t\t\t354\u2013\n\t\t\t\t\t358."},{"issue":"6","key":"i1082-0744-27-1-75-b51","series-title":"Nat 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