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Research ArticleBrain

Central Pain after Pontine Infarction Is Associated with Changes in Opioid Receptor Binding: A PET Study with 11C-Diprenorphine

Frode Willoch, Thomas Rudolf Tölle, Hans Jürgen Wester, Frank Munz, Axel Petzold, Markus Schwaiger, Bastian Conrad and Peter Bartenstein
American Journal of Neuroradiology April 1999, 20 (4) 686-690;
Frode Willoch
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Thomas Rudolf Tölle
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Hans Jürgen Wester
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Frank Munz
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Axel Petzold
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Markus Schwaiger
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Bastian Conrad
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Peter Bartenstein
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    fig 1.

    77-year-old patient with central poststroke pain.

    A, CT scan on the day of the event shows a hyperdense lesion corresponding to a hemorrhagic vascular infarction.

    B, MR image at the time of the PET study, at the same level as C and D.

    C, IRF60 image shows a clear difference in opioid receptor binding between the hemispheres, with decreased activity on the right.

    D, FDG image shows only slight differences in glucose utilization between left and right sides.

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    fig 2.

    Surface projections of the 11C-diprenorphine binding potential data of the control mean and the patient viewing the left (Lt.) medial, left lateral, right (Rt.) lateral and right medial surfaces. A marked asymmetry is seen between the left and right lateral surfaces in the patient with less binding on the right cortical surface. An apparent bilateral reduction in binding is identifiable on the medial surfaces of the patient's images in comparison with the control mean. In contrast to the FDG data, reduced 11C-diprenorphine binding is emphasized in the orbitofrontal cortex and in anterior parts of the cingulate cortex (regions with high opioid receptor density).>>

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    fig 3.

    Surface projections of the FDG data of the control mean and the patient from the same views as in figure 2. Upon closer examination, there is a slight asymmetry between the lateral surfaces. More obvious changes in comparison with the control mean are seen on the medial surfaces along the cingulate cortex with a bilateral reduced glucose utilization, especially pronounced in the posterior areas. The hypometabolism at the right upper temporal lobe in the patient is due to a wide sylvian fissure (fig 1B)

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    Diprenorphine binding potential data and FDG data in statistical comparison with control subjects

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American Journal of Neuroradiology
Vol. 20, Issue 4
1 Apr 1999
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Cite this article
Frode Willoch, Thomas Rudolf Tölle, Hans Jürgen Wester, Frank Munz, Axel Petzold, Markus Schwaiger, Bastian Conrad, Peter Bartenstein
Central Pain after Pontine Infarction Is Associated with Changes in Opioid Receptor Binding: A PET Study with 11C-Diprenorphine
American Journal of Neuroradiology Apr 1999, 20 (4) 686-690;

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Central Pain after Pontine Infarction Is Associated with Changes in Opioid Receptor Binding: A PET Study with 11C-Diprenorphine
Frode Willoch, Thomas Rudolf Tölle, Hans Jürgen Wester, Frank Munz, Axel Petzold, Markus Schwaiger, Bastian Conrad, Peter Bartenstein
American Journal of Neuroradiology Apr 1999, 20 (4) 686-690;
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