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Cold aggravates abnormal excitability of motor axons in oxaliplatin‐treated patients
Author(s) -
Bennedsgaard Kristine,
Ventzel Lise,
Grafe Peter,
Tigerholm Jenny,
Themistocleous Andreas C.,
Bennett David L.,
Tankisi Hatice,
Finnerup Nanna B.
Publication year - 2020
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.26852
Subject(s) - oxaliplatin , allodynia , medicine , refractory period , motor nerve , anesthesia , hyperalgesia , colorectal cancer , nociception , cancer , receptor , psychiatry
Cold allodynia is often seen in the acute phase of oxaliplatin treatment, but the underlying pathophysiology remains unclear. Methods Patients scheduled for adjuvant oxaliplatin for colorectal cancer were examined with quantitative sensory testing and nerve excitability tests at baseline and after the second or third oxaliplatin cycle at different skin temperatures. Results Seven patients were eligible for examination. All patients felt evoked pain and tingling when touching something cold after oxaliplatin infusion. Oxaliplatin decreased motor nerve superexcitability ( P < .001), increased relative refractory period ( P = .011), and caused neuromyotonia‐like after‐activity. Cooling exacerbated these changes and prolonged the accommodation half‐time. Discussion The findings suggest that a combined effect of oxaliplatin and cooling facilitates nerve excitability changes and neuromyotonia‐like after‐activity in peripheral nerve axons. A possible mechanism is the slowing in gating of voltage‐dependent fast sodium and slow potassium channels, which results in symptoms of cold allodynia.