Segmental hypersensitivity and spinothalamic function in spinal cord injury pain

Finnerup, Nanna Brix; Sørensen, Leif Hovgaard; Biering‐Sørensen, Fin; Johannesen, Inger Lauge; Jensen, Troels Staehelin

doi:10.1016/j.expneurol.2007.06.001

Cited by 99 publications

(80 citation statements)

References 47 publications

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“…The latter are the hallmark of neuropathies and strongly related to the nature and severity of the nerve lesion, while they are not simply or directly correlated to the magnitude or characteristics of neuropathic pain (10,12,15). However we cannot rule out the possibility that particular combinations of positive and negative symptoms or signs would be associated with specific aetiologies or nerve lesions.…”

Section: Discussionmentioning

confidence: 99%

Neuropathic pain: Are there distinct subtypes depending on the aetiology or anatomical lesion?

Attal

Fermanian

et al. 2008

Pain

258

145

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Section: Discussionmentioning

confidence: 99%

Neuropathic pain: Are there distinct subtypes depending on the aetiology or anatomical lesion?

Attal

Fermanian

et al. 2008

Pain

258

145

View full text Add to dashboard Cite

“…Neuropathic pain impinges on quality of life, persists over time, and is often refractory to treatment. [7][8][9][10][11][12][13][14] To optimize treatments for SCI-induced neuropathic pain, it is imperative that we have valid and accurate platforms to investigate the mechanism(s) of its development and persistence. Rodent SCI models of neuropathic pain are attractive because they directly emulate the human condition, and it has been established that sensitive, accurate, and valid measures of evoked tactile and thermal sensation can be obtained throughout the period of recovery.…”

mentioning

confidence: 99%

Chronic At- and Below-Level Pain after Moderate Unilateral Cervical Spinal Cord Contusion in Rats

Detloff

Wade

Houlé

2013

Journal of Neurotrauma

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Chronic neuropathic pain is a significant consequence of spinal cord injury (SCI) that is associated with evoked pain, including allodynia and/or hyperalgesia. Allodynia is defined as a painful response to normally innocuous stimuli, and hyperalgesia occurs when there is an amplified pain response to normally noxious stimuli. We describe a model of a unilateral cervical level (C5) contusion injury where sensory recovery was assessed weekly for 6 weeks in 32 adult, female, Sprague-Dawley rats. Bilateral thermal hyperalgesia and tactile allodynia are detectable in the fore-and hindpaws as early as 7 days post-injury (dpi) and persist for at least 42 days. Paw withdrawal latency in response to a noxious thermal stimulus significantly intra-animal pre-operative values. Change in paw withdrawal latency plateaued at 21 dpi. Interestingly, bilateral forepaw allodynia develops in fewer than 40% of rats as measured by von Frey monofilament testing. Similar results occur in the hindpaws, where bilateral allodynia occurs in 46% of rats with SCI. The contralesional forepaw and both hindpaws of rats showed a slight increase in paw withdrawal threshold to tactile stimuli acutely after SCI, corresponding to ipsilesional forelimb motor deficits that resolve over time. That there is no difference among allodynic and non-allodynic groups in overall spared tissue or specifically of the dorsal column or ventrolateral white matter where ascending sensory tracts reside suggests that SCI-induced pain does not depend solely on the size or extent of the lesion, but that other mechanisms are in play. These observations provide a valid model system for future testing of therapeutic interventions to prevent the onset or to reduce the debilitating effects of chronic neuropathic pain after SCI.

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“…The underlying neurophysiological basis of these sensory complications has not yet been thoroughly characterized. Preservation of some spinothalamic tract function seems to play a crucial part in the development of central pain after SCI (Finnerup et al 2007;Wasner et al 2008), although this has largely only been confirmed by using QST approaches. In order to define the sensory deficits more precisely and to improve our understanding of its relationship to sensory complications, novel stimulation paradigms may have to be designed.…”

Section: Improved Assessment Of Segmental Sensory Functionmentioning

confidence: 99%

Refined sensory measures of neural repair in human spinal cord injury: bridging preclinical findings to clinical value

Haefeli

Curt

2012

Cell Tissue Res

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Sensory input from the periphery to the brain can be severely compromised or completely abolished after an injury to the spinal cord. Evidence from animal models suggests that endogenous repair processes in the spinal cord mediate extensive sprouting and that this might be further attenuated by targeted therapeutic interventions. However, the extent to which sprouting can contribute to spontaneous recovery after human spinal cord injury (SCI) remains largely unknown, in part because few measurement tools are available in order to non-invasively detect subtle changes in neurophysiology. The proposed application of segmental sensory evoked potentials (e.g., dermatomal contact heat evoked potentials and somatosensory evoked potentials) to assess conduction in ascending pathways (i.e., spinothalamic and dorsal column, respectively) differs from conventional approaches in that individual spinal segments adjacent to the level of lesion are examined. The adoption of these approaches into clinical research might provide improved resolution for measuring changes in sensory impairments and might determine the extent by which spontaneous recovery after SCI is mediated by similar endogenous repair mechanisms in humans as in animal models.

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Segmental hypersensitivity and spinothalamic function in spinal cord injury pain

Cited by 99 publications

References 47 publications

Neuropathic pain: Are there distinct subtypes depending on the aetiology or anatomical lesion?

Neuropathic pain: Are there distinct subtypes depending on the aetiology or anatomical lesion?

Chronic At- and Below-Level Pain after Moderate Unilateral Cervical Spinal Cord Contusion in Rats

Refined sensory measures of neural repair in human spinal cord injury: bridging preclinical findings to clinical value

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