Neurophysiological evaluation of pain

Bromm, B.; Lorenz, Jürgen

doi:10.1016/s0013-4694(98)00075-3

Cited by 376 publications

(274 citation statements)

References 196 publications

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“…This corresponds to the wellestablished relationship between perceived measures of pain and stimulation intensity (i.e., trunk stimulation was rated as more painful) [Bromm and Lorenz, 1998;Coghill et al, 2003].…”

Section: Cortical Processing Of Nociceptive Stimuli Between Cervical supporting

confidence: 54%

Differences in cortical coding of heat evoked pain beyond the perceived intensity: An fMRI and EEG study

Haefeli

Freund

Kramer

et al. 2013

Human Brain Mapping

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Imaging studies have identified a wide network of brain areas activated by nociceptive stimuli and revealed differences in somatotopic representation of highly distinct stimulation sites (foot vs. hand) in the primary (S1) and secondary (S2) somatosensory cortices. Somatotopic organization between adjacent dermatomes and differences in cortical coding of similarly perceived nociceptive stimulation are less well studied. Here, cortical processing following contact heat nociceptive stimulation of cervical (C4, C6, and C8) and trunk (T10) dermatomes were recorded in 20 healthy subjects using functional magnetic resonance imaging (fMRI) and electroencephalography (EEG). Stimulation of T10 compared with the C6 and C8 revealed significant higher response intensity in the left S1 (contralateral) and the right S2 (ipsilateral) even when the perceived pain was equal between stimulation sites. Accordingly, contact heat evoked potentials following stimulation of T10 showed significantly higher N2P2 amplitudes compared to C6 and C8. Adjacent dermatomes did not reveal a distinct somatotopical representation. Within the assessed cervical and trunk dermatomes, nociceptive cortical processing to heat differs significantly in magnitude even when controlling for pain perception. This study provides evidence that controlling for pain perception is not sufficient to compare directly the magnitude of cortical processing [blood oxygen level dependence (BOLD) response and amplitude of evoked potentials] between body sites. Hum Brain Mapp 35:1379-1389,

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Section: Cortical Processing Of Nociceptive Stimuli Between Cervical supporting

confidence: 54%

Differences in cortical coding of heat evoked pain beyond the perceived intensity: An fMRI and EEG study

Haefeli

Freund

Kramer

et al. 2013

Human Brain Mapping

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“…in patients with central neuropathic syndromes, LEP latency is less sensitive due to the importance of inter-individual variability [7]. The fact that only extremely high amplitude changes (z scores [10) indicated persistent dorsal root impairment in our study likely reflects the well-known properties of long-latency-evoked potentials across all sensory modalities that they critically depend on a variety of factors, such as brain morphology, artifacts, averaging techniques, electrode impedance, vigilance, and habituation [2,12]. The high amplitude changes are nearly comparable to an LEP loss indicating a severe conduction block.…”

Section: Discussionmentioning

confidence: 70%

“…The laser was shifted after each stimulus within the dermatome to avoid receptor habituation. Each test side was examined twice by blocks of 40 stimuli (10 min) in a balanced sequence (control-affected-affected-control) to minimize a decrement of vigilance over the session [2]. The electroencephalogram (EEG) was recorded over Fz, Cz, Pz, T3 and T4 according to the 10-20 electrode positioning system and referenced against linked ear lobes using a Nicolet Ò amplifier with a CED 1401 AD converter.…”

Section: Laser Methodsmentioning

confidence: 99%

“…The resulting dermatomal LEP were evaluated for latency [mean latency of the large vertex negativity (N 2 ) and the following positivity (P 2 )] and the corresponding amplitude (differences between N 2 and P 2 ) in channel Cz, where pain related LEP are known to be maximal [2]. A representative LEP curve is presented in Fig.…”

Section: Laser Methodsmentioning

confidence: 99%

“…Dermatomal laser-evoked potentials (LEP) elicited by slightly painful infrared laser stimuli proved to be a useful tool to examine pain pathways [2]. Previously, our group has shown that LEP yield a significantly higher sensitivity than the standard electrical SEP when probing the function of a single dorsal root [13,18].…”

Section: Introductionmentioning

confidence: 99%

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Laser-evoked potentials: prognostic relevance of pain pathway defects in patients with acute radiculopathy

2009

Self Cite

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The radicular pain syndrome is a major problem in public health care that can lead to chronic back and leg pain in 30%. Ischalgia and back pain are the most prominent signs of dorsal root affection. Until now, no clinical or neurophysiological test procedure exists that evaluates the function of the dorsal root and predicts the prognosis of patients suffering from RPS. We have recently demonstrated that laser-evoked potentials (LEP) are able to demonstrate dorsal root damage. With this study, we investigated 54 patients with acute radicular symptoms and compared LEP parameters (side to side difference of latency and amplitude, transformed to a z-score) with their state of health after 3 months to calculate their predictive value for outcome prognosis. Most significantly, the latency difference between the LEP of the affected dermatome relative to the contralateral healthy dermatome was able to predict the prognosis. Latency z score above two demonstrates a 91% specificity (33% sensitivity) for a poor outcome at 3 months. A significant relation between amplitude changes and the main outcome measure could not be shown. Only extreme changes (z score [10) in amplitude show a high specificity for the persistence of ischialgia in particular (specificity 0.94; sensitivity 0.35). All other parameters, such as clinical scores or other LEP parameters, were not able to predict the outcome of patients. We propose that clinical testing using LEP with latency analysis is a useful tool for estimating the course of disease, so that patients with poor predictive parameters can be treated more invasively at early disease stages to avoid persistence of radiculopathy.

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Mapping of early and late human somatosensory evoked brain potentials to phasic galvanic painful stimulation

Babiloni

Carducci

et al. 2001

Hum. Brain Mapp.

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Neurophysiological evaluation of pain

Cited by 376 publications

References 196 publications

Differences in cortical coding of heat evoked pain beyond the perceived intensity: An fMRI and EEG study

Differences in cortical coding of heat evoked pain beyond the perceived intensity: An fMRI and EEG study

Laser-evoked potentials: prognostic relevance of pain pathway defects in patients with acute radiculopathy

Mapping of early and late human somatosensory evoked brain potentials to phasic galvanic painful stimulation

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