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Functional characterization of at-level hypersensitivity in patients with spinal cord injury

Research paper by Carola Vogel, Roman Rukwied, Lenka Stockinger, Marcus Schley, Martin Schmelz, Wolfgang Schleinzer, Christoph Konrad

Indexed on: 24 Oct '16Published on: 22 Oct '16Published in: The Journal of Pain



Abstract

At-level and above-level hypersensitivity was assessed in patients with chronic complete thoracic spinal cord injury (SCI). Patients were classified by somatosensory mapping (brush, cold, pinprick) and assigned into two groups, i.e. patients i) with at-level hypersensitivity (SCIHs, n=8) and ii) without at-level hypersensitivity (SCINHs, n=7). Gender and age-matched healthy subjects served as controls. Quantitative sensory testing (QST), electrically- and histamine-induced pain and itch, laser Doppler imaging and laser-evoked potentials (LEP) were recorded at-level and above-level in SCI-patients. Six of 8 SCIHs-patients, but 0/7 SCINHs-patients suffered from neuropathic below-level pain. Clinical sensory mapping revealed spreading of hypersensitivity to more cranial areas (above-level) in 3 SCIHs-patients. Cold pain threshold measures confirmed clinical hypersensitivity at-level in SCIHs-patients. At-level and above-level hypersensitivity to electrical stimulation did not differ significantly between SCIHs- and SCINHs-patients. Mechanical allodynia, cold and pin-prick hypersensitivity did not relate to impaired sensory function (QST), axon reflex flare or LEP’s.

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