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Cold‐evoked potentials – Ready for clinical use?
Author(s) -
Hüllemann P.,
Nerdal A.,
Binder A.,
Helfert S.,
Reimer M.,
Baron R.
Publication year - 2016
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1002/ejp.896
Subject(s) - spinothalamic tract , medicine , foot (prosody) , anesthesia , anatomy , nociception , linguistics , philosophy , receptor
Background Cold‐evoked potentials ( CEP s) are known to assess the integrity of A‐delta fibres and the spinothalamic tract. Nevertheless, the clinical value was not investigated previously. The aim of this study was to measure CEP s in 16 healthy subjects from the face, hand and foot sole and to investigate whether CEP s reliably detect A‐delta fibre abnormalities. Methods Swift cold stimuli were applied to the skin with a commercially available thermode, which cooled down from 30 to 25 °C in approximately 0.5 s. CEP latencies (N1, N2 and P2) and amplitudes (N1, N2/P2) were recorded with EEG . Reversible A‐fibre function loss was induced by applying a selective A‐fibre block at the superficial radial nerve. Results In all 16 subjects CEP s could be recorded from all locations; N2, P2 mean latencies were 276.4 ± 38.9 and 389.8 ± 52.5 (face), 318.6 ± 31.6 ms and 477.7 ± 43.6 (hand), and 627.6 ± 84.4 and 774.2 ± 94.0 (foot sole). N2/P2 amplitudes were 10.7 ± 4.1, 11.3 ± 4.1 and 7.5 ± 4.1 μV. During A‐fibre block no CEP s were detectable in the grand average, which restored 10 min after block removal. Conclusions CEP s were reliably recorded in healthy subjects at the hand, face and foot. Experimentally induced reversible A‐delta fibre function loss was detected by CEP s. Functional recovery was assessed as well. This study is basis for further CEP evaluation studies and might be the first step for implementing CEP s in clinical routine for the early diagnosis of small‐fibre disease. What does this study add? Cold‐evoked potentials are capable of reliably measuring A‐delta fibre integrity, loss of function and functional recovery in healthy subjects, which is an essential prerequisite for diagnostic use in patients with small‐fibre disease.