Clinical neurophysiology of pain

Lefaucheur, Jean‐Pascal

doi:10.1016/b978-0-444-64142-7.00045-x

Cited by 29 publications

(23 citation statements)

References 358 publications

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“…To assess an individual's sensitivity to pain, standardized painful stimuli that activate the A and C fibers in the human body are applied to the surface of the skin. A variety of techniques, including thermal, laser, mechanical (e.g., flat tip probes), or electrical stimulation are commonly used to evoke pain responses in the subject's brain (Iannetti et al, 2013;Oh et al, 2015;Wulf et al, 2017;Albu and Meagher, 2019;Lefaucheur, 2019). The extent of the response strongly correlates with how ''painful'' the individual subjectively rates the applied stimulus; a good correlation between a visual analog scale (VAS) pain score communicated by the subject and the amplitude of the noxious contact heat evoked potentials (CHEPS) can usually be detected (Roberts et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

Application of Referencing Techniques in EEG-Based Recordings of Contact Heat Evoked Potentials (CHEPS)

Anders

Kreuzer

et al. 2020

Front. Hum. Neurosci.

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Evoked potentials in the amplitude-time spectrum of the electroencephalogram are commonly used to assess the extent of brain responses to stimulation with noxious contact heat. The magnitude of the N- and P-waves are used as a semi-objective measure of the response to the painful stimulus: the higher the magnitude, the more painful the stimulus has been perceived. The strength of the N-P-wave response is also largely dependent on the chosen reference electrode site. The goal of this study was to examine which reference technique excels both in practical and theoretical terms when analyzing noxious contact heat evoked potentials (CHEPS) in the amplitude-time spectrum. We recruited 21 subjects (10 male, 11 female, mean age of 55.79 years). We applied seven noxious contact heat stimuli using two temperatures, 51°C, and 54°C, to each subject. During EEG analysis, we aimed to identify the referencing technique which produces the highest N-wave and P-wave amplitudes with as little artifactual influence as possible. For this purpose, we applied the following six referencing techniques: mathematically linked A1/A2 (earlobes), average reference, REST, AFz, Pz, and mathematically linked PO7/PO8. We evaluated how these techniques impact the N-P amplitudes of CHEPS based on our data from healthy subjects. Considering all factors, we found that mathematically linked earlobes to be the ideal referencing site to use when displaying and evaluating CHEPS in the amplitude-time spectrum.

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Section: Introductionmentioning

confidence: 99%

Application of Referencing Techniques in EEG-Based Recordings of Contact Heat Evoked Potentials (CHEPS)

Anders

Kreuzer

et al. 2020

Front. Hum. Neurosci.

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“…Laser, contact-heat, and intraepidermal electrical stimulation are the three main types of stimuli that can be used reliably. Thermal modalities primarily investigate small-diameter Að* fiber dysfunction (rather than C-fibers), and the central lesions involving the spinothalamic tract ( 44 ). Intraepidermal electrical stimulation preferentially activates large-diameter AB fibers rather than small-diameter Að* or C fibers ( 44 ).…”

Section: Discussionmentioning

confidence: 99%

Modified Sensory Testing in Non-verbal Patients Receiving Novel Intrathecal Therapies for Neurological Disorders

Cornelissen

Donado

et al. 2022

Front. Neurol.

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Several neurological disorders may be amenable to treatment with gene-targeting therapies such as antisense oligonucleotides (ASOs) or viral vector-based gene therapy. The US FDA has approved several of these treatments; many others are in clinical trials. Preclinical toxicity studies of ASO candidates have identified dose-dependent neurotoxicity patterns. These include degeneration of dorsal root ganglia, the cell bodies of peripheral sensory neurons. Quantitative sensory testing (QST) refers to a series of standardized mechanical and/or thermal measures that complement clinical neurologic examination in detecting sensory dysfunction. QST primarily relies on patient self-report or task performance (i.e., button-pushing). This brief report illustrates individualized pragmatic approaches to QST in non-verbal subjects receiving early phase investigational intrathecal drug therapies as a component of clinical trial safety protocols. Three children with neurodevelopmental disorders that include Neuronal Ceroid Lipofuscinosis Type 7, Ataxia-Telangiectasia, and Epilepsy of Infancy with Migrating Focal Seizures are presented. These case studies discuss individualized testing protocols, accounting for disease presentation, cognitive and motor function. We outline specific considerations for developing assessments for detecting changes in sensory processing in diverse patient groups and safety monitoring trials of early phase investigational intrathecal drug therapies. QST may complement information obtained from the standard neurologic examination, electrophysiologic studies, skin biopsies, and imaging. QST has limitations and challenges, especially in non-verbal subjects, as shown in the three cases discussed in this report. Future directions call for collaborative efforts to generate sensory datasets and share data registries in the pediatric neurology field.

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“…They may be of large amplitude, but are extremely variable in both amplitude and latency (for a review see Lefaucheur, 2019). In addition, most of these late potentials have similar waveshapes to artefacts caused by muscular potentials which are often not automatically rejected because they have similar amplitudes as the genuine signal components.…”

Section: Discussionmentioning

confidence: 99%

Using correlation analysis to assess the reliability of evoked potential components identified by signal averaging

Campbell

Leandri

2020

Journal of Neuroscience Methods

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Clinical neurophysiology of pain

Cited by 29 publications

References 358 publications

Application of Referencing Techniques in EEG-Based Recordings of Contact Heat Evoked Potentials (CHEPS)

Application of Referencing Techniques in EEG-Based Recordings of Contact Heat Evoked Potentials (CHEPS)

Modified Sensory Testing in Non-verbal Patients Receiving Novel Intrathecal Therapies for Neurological Disorders

Using correlation analysis to assess the reliability of evoked potential components identified by signal averaging

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