Lütolf, Robin; Rosner, Jan; Curt, Armin; Hubli, Michèle (2021). Identifying discomplete spinal lesions: New evidence from pain-autonomic interaction in spinal cord injury. Journal of neurotrauma, 38(24), pp. 3456-3466. M.A. Liebert 10.1089/neu.2021.0280
|
Text
L_tolf__2021__Identifying_discomplete_spinal_lesions.pdf - Accepted Version Available under License Publisher holds Copyright. Download (945kB) | Preview |
The clinical evaluation of spinal afferents is an important diagnostic and prognostic marker for neurological and functional recovery after spinal cord injury (SCI). Particularly important regarding neuropathic pain following SCI is the function of the spinothalamic tract (STT) conveying nociceptive and temperature information. Here, we investigated the added value of neurophysiological methods revealing discomplete STT lesions, i.e., residual axonal sparing in clinically complete STT lesions. Specifically, clinical pinprick testing and thermal thresholds were compared to objective contact heat-evoked potentials (CHEPs) and a novel measure of pain-autonomic interaction employing heat-induced sympathetic skin responses (SSR). The test stimuli (i.e., contact heat, pinprick) were applied below the lesion level in 32 subjects with thoracic SCI while corresponding heat-evoked responses (i.e., CHEPs and SSR) were recorded above the lesion (i.e., scalp and hand, respectively). Readouts of STT function were related to neuropathic pain characteristics. In subjects with abolished pinprick sensation, measures of thermosensation (10%), CHEPs (33%) and SSR (48%) revealed residual STT function. Importantly, SSRs can be used as an objective readout and when abolished, no other proxy indicated residual STT function. No relation was found between STT function readouts and spontaneous neuropathic pain intensity and extent. However, subjects with clinically preserved STT function presented more often with allodynia (54%) than subjects with discomplete (13%) or complete STT lesions (18%). In individuals with absent pinprick sensation, discomplete STT lesions can be revealed employing pain-autonomic measures. The improved sensitivity to discern STT lesion completeness might support revealing the interference with neuropathic pain following SCI.
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: |
0897-7151 |
Publisher: |
M.A. Liebert |
Language: |
English |
Submitter: |
Chantal Kottler |
Date Deposited: |
22 Dec 2021 11:06 |
Last Modified: |
01 Jan 2023 00:25 |
Publisher DOI: |
10.1089/neu.2021.0280 |
PubMed ID: |
34806429 |
Uncontrolled Keywords: |
ELECTROPHYSIOLOGY SENSORY FUNCTION spinal cord injury |
BORIS DOI: |
10.48350/162298 |
URI: |
https://boris.unibe.ch/id/eprint/162298 |
Actions (login required)
 |
Edit item |