Differential involvement of A-delta and A-beta fibres in neuropathic pain related to carpal tunnel syndrome

Luca Padua, Pietro Caliandro, Costanza Pazzaglia, A. Truini, A. Biasiotta, F. Galeotti, M. Inghilleri, G. Cruccu

Risultato della ricerca: Contributo in rivistaArticolo in rivista

77 Citazioni (Scopus)

Abstract

Carpal tunnel syndrome (CTS), a common entrapment neuropathy involving the median nerve at the wrist, frequently manifests with neuropathic pain. We sought information on pain mechanisms in CTS. We studied 70 patients with a diagnosis of CTS (117 CTS hands). We used the DN4 questionnaire to select patients with neuropathic pain, and the Neuropathic Pain Symptom Inventory (NPSI) to assess the intensity of the various qualities of neuropathic pain. All patients underwent a standard nerve conduction study (NCS) to assess the function of non-nociceptive Abeta-fibres, and the cutaneous silent period (CSP) after stimulation of the IIIrd and Vth digits, to assess the function of nociceptive Adelta-fibres. In 40 patients (75 CTS hands) we also recorded laser-evoked potentials (LEPs) in response to stimuli delivered to the median nerve territory and mediated by nociceptive Adelta-fibres. We sought possible correlations between neurophysiological data and the various qualities of neuropathic pain as assessed by the NPSI. We found that the median nerve sensory conduction velocity correlated with paroxysmal pain and abnormal sensations, whereas LEP amplitude correlated with spontaneous constant pain. Our findings suggest that whereas paroxysmal pain and abnormal sensations reflect demyelination of non-nociceptive Abeta-fibres, spontaneous constant pain arises from damage to nociceptive Adelta-fibres.
Lingua originaleEnglish
pagine (da-a)105-109
Numero di pagine5
RivistaPain
Volume145
DOI
Stato di pubblicazionePubblicato - 2009

Keywords

  • Carpal tunnel syndrome
  • Laser-evoked potentials
  • Neuropathic pain
  • Standard nerve conduction study

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