Pain-autonomic interaction: A surrogate marker of central sensitization.

Scheuren, Paulina S; Rosner, Jan; Curt, Armin; Hubli, Michèle (2020). Pain-autonomic interaction: A surrogate marker of central sensitization. European journal of pain, 24(10), pp. 2015-2026. Wiley-Blackwell 10.1002/ejp.1645

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BACKGROUND

Central sensitization represents a key pathophysiological mechanism underlying the development of neuropathic pain, often manifested clinically as mechanical allodynia and hyperalgesia. Adopting a mechanism-based treatment approach relies highly on the ability to assess the presence of central sensitization. The aim of the study was to investigate potential pain-autonomic readouts to operationalize experimentally induced central sensitization in the area of secondary hyperalgesia.

METHODS

Pinprick evoked potentials (PEPs) and sympathetic skin responses (SSRs) were recorded in 20 healthy individuals. Three blocks of PEP and SSR recordings were performed before and after heat-induced secondary hyperalgesia. All measurements were also performed before and after a control condition. Multivariate analyses were performed using linear mixed-effect regression models to examine the effect of experimentally induced central sensitization on PEP and SSR parameters (i.e. amplitudes, latencies and habituation) and on pinprick pain ratings.

RESULTS

The noxious heat stimulation induced robust mechanical hyperalgesia with a significant increase in PEP and SSR amplitudes (p < 0.001) in the area of secondary hyperalgesia. Furthermore, PEP and SSR habituation were reduced (p < 0.001) after experimentally induced central sensitization.

CONCLUSIONS

The findings demonstrate that combined recordings of PEPs and SSRs are sensitive to objectify experimentally induced central sensitization and may have a great potential to reveal its presence in clinical pain conditions. Corroborating current pain phenotyping with pain-autonomic markers has the potential to unravel central sensitization along the nociceptive neuraxis and might provide a framework for mechanistically founded therapies.

SIGNIFICANCE

Our findings provide evidence that combined recordings of sympathetic skin responses (SSRs) and pinprick evoked potentials (PEPs) might be able to unmask central sensitization induced through a well-established experimental pain model in healthy individuals. As such, these novel readouts of central sensitization might attain new insights towards complementing clinical pain phenotyping.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Rosner, Jan

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1090-3801

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Chantal Kottler

Date Deposited:

30 Dec 2020 14:24

Last Modified:

30 Dec 2020 14:24

Publisher DOI:

10.1002/ejp.1645

PubMed ID:

32794307

BORIS DOI:

10.48350/149355

URI:

https://boris.unibe.ch/id/eprint/149355

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