Background & Aims

Quantitative molecular imaging, using [11C]-DPA713 PET, has unveiled neuroinflammation at the neuroforamina in people with painful cervical radiculopathy. Neural tissue management (NTM) is a frequently utilised conservative strategy for managing painful cervical radiculopathy. Preclinical research showed that NTM mitigate neuroinflammation within the dorsal root ganglion and spinal cord in animals with induced compression neuropathies. The clinical translation of thgese findings are unclear.

Methods

Two people with a C6 painful cervical radiculopathy due to a C5/C6 discus herniation underwent six weeks of neural tissue management (NTM). NTM includes a brief educational element, nerve mobilisations, and a home program of nerve gliding exercises. A dynamic PET-CT scanning with an image-derived input function was employed to measure the uptake of [11C]-DPA713 at the affected neuroforamina and spinal cord. Neuroinflammation was expressed as the binding of [11C]-DPA713 at the target tissues and quantified using the single-tissue compartmental model (volume of distribution (VT)). Dynamic PET-CT scanning were performed before and after six-weeks NTM.

Results

In this report, we demonstrate that six-weeks of NTM seems to reduce neuroinflammation within the neuroforamina and spinal cord in both cases. Notably, this reduction in neuroinflammation is timely associated with pain reduction, with no adverse effects observed.

Conclusions

NTM seems to diminish neuroinflammation within the neuroforamina and spinal cord in two cases with painful cervical radiculopathy. This study provides clinical evidence of the neuroinflammatory modulatory effects of NTM in people with painful cervical radiculopathy. Further investigation using randomised controlled trial(s) is warranted to confirm these findings.

References

Lutke Schipholt IJ, Coppieters MW, Meijer OG, Tompra N, de Vries RBM, Scholten-Peeters GGM. Effects of joint and nerve mobilisation on neuroimmune responses in animals and humans with neuromusculoskeletal conditions: a systematic review and meta-analysis. Pain Rep. 2021;6(2):e927.

Scholten-Peeters WG, Coppieters, M., Sierra Silvestre, E., Lutke Schipholt, I., Sleijser-Koehorst, M. L. S., Koop, M., Ridehalgh, C., Nee, R. J., Boyd, B., Hall, T., Schmid, A., & Tampa, B. Editors Grieve’s Modern Musculoskeletal Physiotherapy, Neurodynamics. Gwendolen Jull AM, Deborah Falla, Jeremy Lewis, Christopher McCarthy, Michele Sterling, editor2025.

Lutke Schipholt IJ, Scholten-Peeters GGM, Koop MA, et al. Pharmacokinetic modelling of [11C]DPA-713 PETCT targeting spinal cord and neuroforamina TSPO receptors in people with cervical radiculopathy. In preperation 2024.

Lutke Schipholt IJ, Coppieters MW, Koop MA, et al. Clinical relevance of spinal cord and neuroforamina neuroinflammation in people with painful cervical radiculopathy: a 11C-DPA713 PET study. In preperation 2024.

Presenting Author

IvoLutke Schipholt

Poster Authors

Ivo Lutke Schipholt

PhD i.o.

VU Amsterdam

Lead Author

E-mail

Meghan Koop

Vrije Universiteit Amsterdam

Lead Author

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Ronald Boellaard

Lead Author

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Adriaan Lamemertsma

Lead Author

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Elsmarieke Giessen

Lead Author

E-mail

Maqsood Yaqub

Lead Author

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Michel Coppieters

Vrije Universiteit Amsterdam

Lead Author

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Topics

  • Pain Imaging