Lütolf, Robin; De Schoenmacker, Iara; Rosner, Jan; Sirucek, Laura; Schweinhardt, Petra; Curt, Armin; Hubli, Michèle (2022). Anti- and Pro-Nociceptive Mechanisms in Neuropathic Pain after Human Spinal Cord Injury. European journal of pain, 26(10), pp. 2176-2187. Wiley-Blackwell 10.1002/ejp.2029
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European_Journal_of_Pain_-_2022_-_L_tolf_-_Anti__and_Pro_Nociceptive_Mechanisms_in_Neuropathic_Pain_after_Human_Spinal_Cord.pdf - Accepted Version Available under License Publisher holds Copyright. Download (1MB) | Preview |
BACKGROUND
Deficient endogenous pain modulation and increased nociceptive excitability are key features of central sensitization and can be assessed in humans by conditioned pain modulation (CPM, anti-nociceptive) and temporal summation of pain (TSP, pro-nociceptive), respectively. This study aimed to investigate these measures as proxies for central sensitization in subjects with chronic neuropathic pain (NP) after spinal cord injury (SCI).
METHODS
In paraplegic subjects with NP (SCI-NP; n=17) and healthy controls (HC; n=17), parallel and sequential sham-controlled CPM paradigms were performed using pressure pain threshold at the hand, i.e., above lesion level, as test stimulus. The conditioning stimulus was a noxious cold (verum) or lukewarm water bath (sham) applied contralaterally. Regarding pro-nociceptive mechanisms, a TSP protocol with individually-adjusted pressure pain stimuli at the thenar eminence was employed. CPM and TSP magnitudes were related to intensity and spatial extent of spontaneous NP.
RESULTS
Neither the parallel nor sequential sham-controlled CPM paradigm showed any significant inhibition of above-level pressure pain thresholds for SCI-NP or HC. Accordingly, no group difference in CPM capacity was found, however, subjects with more intense spontaneous NP showed lower inhibitory CPM capacity. TSP was observed for both groups, but was not enhanced in SCI-NP.
CONCLUSIONS
Our results do not support altered above-level anti- or pro-nociceptive mechanisms in SCI-NP compared to HC, however, they also highlight the relevance of spontaneous NP intensity with regard to the capacity of endogenous pain modulation in SCI subjects.
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: |
Pubmed Import |
Date Deposited: |
26 Aug 2022 10:58 |
Last Modified: |
25 Aug 2023 00:25 |
Publisher DOI: |
10.1002/ejp.2029 |
PubMed ID: |
36000307 |
BORIS DOI: |
10.48350/172364 |
URI: |
https://boris.unibe.ch/id/eprint/172364 |
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