Sensory Detection and Pain Thresholds in Spinal Cord Injury Patients with and without Dysesthetic Pain, and in Chronic Low Back Pain Patients

Cohen, Michael J.; Song, Z K; Schandler, Steven L.; Ho, Wun-Hong; Vulpe, Michael

doi:10.3109/08990229609028909

Cited by 20 publications

(14 citation statements)

References 15 publications

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“…Our preliminary observations of SCI patients are concordent with those of Song et al (1993) and Cohen et al (1996) suggesting that there are important alterations in cutaneous perceptual abilities far from the boundary between the anaesthetic and sentient regions of the body (SaddikiTraki et al, 1999); the threshold of light touch and the estimation of tactile stimulus intensity are altered over the entire anterior torso following a functionally complete SCI.…”

Section: Introductionsupporting

confidence: 82%

“…None reported symptoms compatible with intense chronic pain, but we did not administer a standard test such as the McGill Pain Questionnaire to obtain a more objective evaluation (M elzack and Loeser, 1978). Nevertheless, our patients did not report chronic pain and our touch thresholds are elevated as were those of patients without pain symptoms in the studies of Cohen et al (1996) andSong et al (1993).…”

Section: Differences In Tactile Sensitivity 399supporting

confidence: 43%

“…However, the elevated thresholds for touch as measured by the Semmes ± Weinstein monofilaments suggest that the explanation is not a simple release phenomenon. Also, the observations of Song et al (1993) and Cohen et al (1996) suggest that the threshold may move up or down with respect to normal according to the presence or absence of chronic pain.…”

Section: Spinal Cord Mechanismsmentioning

confidence: 90%

“…Song et al (1993) and Cohen et al (1996) showed that two-point and detection thresholds were lower than normal in SCI patients having chronic pain. Another group of SCI patients not suffering from chronic pain displayed two-point thresholds that were higher than normal.…”

Section: Differences In Tactile Sensitivity 399mentioning

confidence: 96%

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Differences between the tactile sensitivity on the anterior torso of normal individuals and those having suffered complete transection of the spinal cord

Saddiki-Traki¹,

Tremblay²,

Rw³

et al. 1999

Somatosensory & Motor Research

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Using the method of limits and a magnitude estimation procedure, the sense of touch was examined at multiple sites on the anterior torso of normal subjects. Their performance was compared with the performance of individuals having experienced a functionally complete spinal cord transection more than 6 months prior to the tests. Near the insentient regions of the spinal cord-injured patients there was a zone wherein the threshold for light touch was elevated and variable. Within this same transition zone, estimates of the magnitude of a brushing stimulus increased as a linear function of distance from the border for approximately 12 cm away from insentient skin. Throughout the rest of the thorax, spinal cord-injured patients displayed touch thresholds 67% higher than normals and, at the same test sites, spinal cord-injured patients offered estimates of the intensity of the brushing stimulus that averaged 62% higher than normal subjects. The greater intensity of the sensations experienced by spinal cord-injured patients with even very weak stimuli and the smaller range within which they were able to scale stimulus intensity, produced a situation wherein the patients made frequent errors of judgement even on skin regions far from the body parts affected by the lesion. These observations support the hypothesis that spinal cord lesions interrupt tonic modulatory mechanisms having global influences on the sense of touch. This loss produces an elevation of the touch threshold and a reduction of the normal dynamic range of tactile sensory perception for all skin surfaces on the anterior torso.

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Section: Introductionsupporting

confidence: 82%

Section: Differences In Tactile Sensitivity 399supporting

confidence: 43%

Section: Spinal Cord Mechanismsmentioning

confidence: 90%

Section: Differences In Tactile Sensitivity 399mentioning

confidence: 96%

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Differences between the tactile sensitivity on the anterior torso of normal individuals and those having suffered complete transection of the spinal cord

Saddiki-Traki¹,

Tremblay²,

Rw³

et al. 1999

Somatosensory & Motor Research

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“…Several researchers have observed that in subjects with chronic pain, electrically evoked painless sensory and pain thresholds converge. 20,21 The present multicenter study was performed to characterize CPT and PTT values from CRPS subjects and healthy controls.…”

mentioning

confidence: 99%

Painless Electrodiagnostic Current Perception Threshold and Pain Tolerance Threshold Values in CRPS Subjects and Healthy Controls: A Multicenter Study

et al. 2001

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The purpose of this study is to evaluate both painless and painful sensory transmission in patients with Complex Regional Pain Syndrome (CRPS) using the automated electrodiagnostic sensory Nerve Conduction Threshold (sNCT) test. This test generates reliable, painless Current Perception Threshold (CPT) and atraumatic Pain Tolerance Threshold (PTT) measures. Standardized CPT and PTT measures using constant alternating current sinusoid waveform stimulus at 3 different frequencies 5 Hz, 250 Hz, and 2 kHz (Neurometer CPT/C Neurotron, Inc. Baltimore, MD) were obtained from CRPS subjects at a distal phalange of the affected extremity and at an ipsilateral asymptomatic control site. Matched sites were tested on healthy subjects. Detection sensitivities for an abnormal PTT and CPT test were calculated based on specificity of 90% as determined from data obtained from healthy controls. A Spearman rank correlation was used to test for a significant association between presence of allodynia and an abnormal PTT or CPT at any frequency tested. Thirty-six CRPS subjects and 57 healthy controls were tested. The highest detection sensitivity of the PTT test from symptomatic test sites was 63% for the finger and 71% for the toe. PTT abnormalities were also detected, to a lesser degree, at the asymptomatic control site (41% finger control site, 16% toe control site). The highest CPT detection sensitivity at the symptomatic site was 37% for the finger site and 53% for the toe site. CPT abnormalities were also detected at the asymptomatic control site (29% finger control site, 37% toe control site). Eighty-six percent of the CRPS subjects had either a PTT or CPT abnormality at any frequency at the symptomatic site. There was a significant correlation between presence of allodynia and presence of an abnormal CPT and PTT, respectively (P < .01). The correlation coefficient was lower for CPT than for PTT, ie, 0.34 versus 0.6 for the finger and 0.48 versus 0.67 for the toe, respectively. In studied CRPS patients an abnormal PTT was detected with higher sensitivity than an abnormal CPT. Assessing PTT may become a useful electrodiagnostic quantitative sensory test for diagnosing and following the course of neuropathic pain conditions.

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The effects of transcranial direct current stimulation with visual illusion in neuropathic pain due to spinal cord injury: An evoked potentials and quantitative thermal testing study

Kumru

Soler

Vidal

et al. 2012

European Journal of Pain

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Sensory Detection and Pain Thresholds in Spinal Cord Injury Patients with and without Dysesthetic Pain, and in Chronic Low Back Pain Patients

Cited by 20 publications

References 15 publications

Differences between the tactile sensitivity on the anterior torso of normal individuals and those having suffered complete transection of the spinal cord

Differences between the tactile sensitivity on the anterior torso of normal individuals and those having suffered complete transection of the spinal cord

Painless Electrodiagnostic Current Perception Threshold and Pain Tolerance Threshold Values in CRPS Subjects and Healthy Controls: A Multicenter Study

The effects of transcranial direct current stimulation with visual illusion in neuropathic pain due to spinal cord injury: An evoked potentials and quantitative thermal testing study

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