Open AccessImaging the neural correlates of neuropathic pain and pleasurable relief associated with inherited erythromelalgia in a single subject with quantitative arterial spin labelling
Author(s) -
Andrew R. Segerdahl,
Jingyi Xie,
Kathryn J. Paterson,
Juan D. Ramirez,
Irene Tracey,
David L. Bennett
Publication year - 2012
Publication title -
pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.524
H-Index - 258
eISSN - 1872-6623
pISSN - 0304-3959
DOI - 10.1016/j.pain.2011.12.012
Subject(s) - erythromelalgia , channelopathy , neuropathic pain , medicine , anesthesia , nociceptor , neuralgia , quantitative sensory testing , sensory system , neuroscience , psychology , cardiology , nociception , receptor
We identified a patient with severe inherited erythromelalgia secondary to an L858F mutation in the voltage-gated sodium channel Na(v)1.7. The patient reported severe ongoing foot pain, which was exquisitely sensitive to limb cooling. We confirmed this heat hypersensitivity using quantitative sensory testing. Additionally, we employed a novel perfusion imaging technique in a simple block design to assess her baseline erythromelalgia pain vs cooling relief. Robust activations of key pain, pain-affect, and reward-related centres were observed. This combined approach allowed us to confirm the presence of a temperature-sensitive channelopathy of peripheral neurons and to investigate the neural correlates of tonic neuropathic pain and relief in a single subject.