scholarly journals Sympathetic and sensory nerve fiber function in multiple system atrophy and idiopathic Parkinson’s disease

2021 ◽  
Author(s):  
Heidrun H. Krämer ◽  
Cora Rebhorn ◽  
Christian Geber ◽  
Frank Birklein
Keyword(s):  
Detection Threshold ◽  
Sensory Nerve ◽  
Research Network ◽  
Sensory Testing ◽  
Sympathetic Function ◽  
Autonomic Testing ◽  
German Research ◽  
Pain Sensitization ◽  
Mechanical Detection ◽  
Mechanical Pain Thresholds

Abstract Objective To explore small fiber somatosensory and sympathetic function in PD and MSA. Methods We recruited 20 PD patients (7 women, median age 65.5 years; IQR 54.75–70.0), 10 MSA patients (4 women; median age 68 years; IQR 66.25–74.0), and 10 healthy subjects (HC; 4 women, median age 68; IQR 59.0–71.0 years). Autonomic testing included forehead cooling, intradermal microdialysis of norepinephrine (NE; 10–5; 10–6; 10–7; and 10–8), and orthostatic hypotension (OH); somatosensory testing included quantitative sensory testing (QST) according to the protocol of the German Research Network on Neuropathic Pain (DFNS). Results OH occurred more frequently in PD (p = 0.018) and MSA (p = 0.002) compared to HC. Vasoconstriction responses were stronger in PD compared to MSA during forehead cooling (p = 0.044) and microdialysis of physiologically concentrated NE solutions (10–7; 10–8; p = 0.017). PD and MSA had impaired cold (PD: p < 0.01; MSA: p < 0.05) and warm detection thresholds (PD and MSA, both p < 0.05). The mechanical detection threshold was higher in PD (p < 0.01). Conversely, mechanical pain thresholds were decreased in PD and MSA (both p < 0.001), indicating mechanical hyperalgesia. Conclusion In contrast to MSA, we found evidence of peripheral adrenoreceptor hypersensitivity in PD, probably caused by peripheral sympathetic denervation. Sensory testing revealed peripheral neuropathy and central pain sensitization in PD and MSA. Jointly, our data demonstrate autonomic and somatosensory dysfunction in PD and MSA.

Chronic pain in thoracotomy

2012 ◽  
Vol 3 (3) ◽  
pp. 188-188
Author(s):  
J.S. Springer ◽  
B. Johnsen ◽  
A. Hojsgaard ◽  
T.S. Jensen ◽  
L. Nikolajsen
Keyword(s):  
Chronic Pain ◽  
Sensory Nerve ◽  
Nerve Damage ◽  
Research Network ◽  
Sensory Testing ◽  
Acute Postoperative Pain ◽  
German Research ◽  
Intercostal Nerves ◽  
Danish Study

Abstract Background/aims Chronic pain is frequent after thoracotomy (Wildgaard et al., 2009; Guastella et al., 2011). According to a recent Danish study with a follow-up period of 22 months, 33% of the patients developed pain after thoracotomy, and 4–12% of the patients experienced severe pain (Wildgaard et al., 2011). The mechanisms underlying chronic pain after surgery are not fully known, but several risk factors have been identified, e.g. intraoperative nerve damage and acute postoperative pain (Kehlet et al., 2006). A few studies have suggested a correlation between nerve damage during surgery and the development of pain after thoracotomy (Benedetti et al., 1997, 1998; Rogers et al., 2002). We plan to investigate if intraoperative nerve damage is responsible for the development of pain and sensory abnormalities after thoracotomy. Methods Sixty individuals with normal sensibility on the thorax will be included preoperatively. Motor and sensory nerve conduction studies (NCS) will be performed during surgery. Post-surgical follow-up with questionnaires and bilaterally Quantitative Sensory Testing (QST) on the thorax will be performed according to the protocol of the German Research Network on Neuropathic Pain (DFNS). Before implementing the neurophysiological measurements in humans, they have been tested in pigs. Results Neurophysiological measurements in pigs have shown that it is possible to do NCSs on both motor and sensory intercostal nerves, suggesting that measurements are possible in humans. Inclusion of patients is pending. Conclusion The preliminary results will be presented at the congress.

Reliability of orofacial quantitative sensory testing for pleasantness and unpleasantness

Cephalalgia ◽  
2020 ◽  
Vol 40 (11) ◽  
pp. 1191-1201
Author(s):  
Pankaj Taneja ◽  
Camilla Krause-Hirsch ◽  
Stine Laursen ◽  
Caroline Juul Sørensen ◽  
Håkan Olausson ◽  
...  
Keyword(s):  
Quantitative Sensory Testing ◽  
Intraclass Correlation ◽  
Research Network ◽  
Sensory Testing ◽  
German Research ◽  
Orofacial Region ◽  
The Right ◽  
Testing Protocols ◽  
Healthy Participants ◽  
Somatosensory Function

Background Quantitative sensory testing protocols for perceptions of pleasantness and unpleasantness based on the German Research Network on Neuropathic Pain protocol were recently introduced. However, there are no reliability studies yet published. Aim To evaluate the intra-examiner (test-retest) and inter-examiner reliability for orofacial pleasantness and unpleasantness quantitative sensory testing protocols. Methods Sixteen healthy participants from Aarhus University (11 women and five men, mean age 24, range 21–26 years) contributed. Two examiners were trained in performing the entire quantitative sensory testing protocols for pleasantness and unpleasantness, which included the additional dynamic tactile stimulation test using a goat-hair brush. Each participant underwent examination of both protocols by each examiner (inter-examiner reliability) on day 1. They returned at least 8 days following the testing to be re-examined by one examiner (intra-examiner reliability). All testing was performed on the skin of the right mandibular mental region. The intraclass correlation (ICC) was used to determine reliability. Results For the protocol investigating pleasantness, the majority of parameters had good to excellent intra-examiner (11/14: Intraclass correlation 0.67–0.87) and inter-examiner (13/14: Intraclass correlation 0.62–0.96) reliabilities. Similarly, the protocol investigating unpleasantness had good to excellent intra-examiner (intraclass correlation 0.63–0.99) and inter-examiner (intraclass correlation 0.65–0.98) reliabilities for most (13/15) of the parameters. Conclusion Intra and inter-examiner reliabilities in the majority of quantitative sensory testing parameters (apart from the summation ratio) investigating pleasantness and unpleasantness are acceptable when assessing somatosensory function of the orofacial region. Trial registration: NA

scholarly journals Ejaculatory Pain

2007 ◽  
Vol 107 (2) ◽  
pp. 298-304 ◽  
Author(s):  
Eske K. Aasvang ◽  
Bo Møhl ◽  
Henrik Kehlet
Keyword(s):  
Chronic Pain ◽  
Sexual Dysfunction ◽  
Quantitative Sensory Testing ◽  
Groin Hernia ◽  
Pain Treatment ◽  
Detection Threshold ◽  
Control Group ◽  
Sensory Testing ◽  
Detection Thresholds ◽  
Pain Detection

Background Sexual dysfunction due to ejaculatory and genital pain after groin hernia surgery may occur in approximately 2.5% of patients. However, the specific psychosexological and neurophysiologic characteristics have not been described, thereby precluding assessment of pathogenic mechanisms and treatment strategies. Methods Ten patients with severe pain-related sexual dysfunction and ejaculatory pain were assessed in detail by quantitative sensory testing and interviewed by a psychologist specialized in evaluating sexual functional disorders and were compared with a control group of 20 patients with chronic pain after groin hernia repair but without sexual dysfunction, to identify sensory changes associated with ejaculatory pain. Results Quantitative sensory testing showed significantly higher thermal and mechanical detection thresholds and lowered mechanical pain detection thresholds in both groups compared with the nonpainful side. Pressure pain detection threshold and tolerance were significantly lower in the ejaculatory pain group compared with the control group. 'The maximum pain was specifically located at the external inguinal annulus in all ejaculatory pain patients, but not in controls. The psychosexual interview revealed no major psychosexual disturbances and concluded that the pain was of somatic origin. All patients with ejaculatory pain had experienced major negative life changes and deterioration in their overall quality of life and sexual function as a result of the hernia operation. Conclusions Postherniotomy ejaculatory pain and pain-related sexual dysfunction is a specific chronic pain state that may be caused by pathology involving the vas deferens and/or nerve damage. Therapeutic strategies should therefore include neuropathic pain treatment and/or surgical exploration.

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