Brain, Vol. 126, No. 1, 57-70,
January 2003
© 2003 Guarantors of Brain
doi: 10.1093/brain/awg007
Sensory function in spinal cord injury patients with and without central pain
1 Department of Neurology and Danish Pain Research Centre, Aarhus University Hospital, 2 Department of Rheumatology, Viborg Hospital and 3 Department of Clinical Neurophysiology, Aarhus University Hospital, Denmark
Correspondence to: N. B. Finnerup, Danish Pain Research Centre, Building 1A, Aarhus University Hospital, Noerrebrogade 44, DK-8000 Aarhus C, Denmark E-mail: finnerup{at}akhphd.au.dk
Spinal cord injury (SCI) frequently results in neuropathic pain. However, the pathophysiology underlying this pain is unclear. In this study, we compared clinical examination, quantitative sensory testing (QST) and somatosensory evoked potentials (SEPs) in SCI patients with and without pain below spinal lesion level, with a control group of 20 subjects without injury. All patients had a traumatic SCI with a lesion above T10; 20 patients presented with spontaneous central neuropathic pain below lesion level, and 20 patients had no neuropathic pain or dysaesthesia. Patients with and without pain had a similar reduction of mechanical and thermal detection and pain thresholds, and SEPs. SCI patients with central pain more frequently had sensory hypersensitivity (brush- or cold-evoked pain, dysaesthesia or pinprick hyperalgesia) in dermatomes corresponding to lesion level than SCI patients without pain. There was no difference in intensity of pain evoked by repetitive pinprick at lesion level between patient groups. There was a significant correlation between intensity of brush-evoked dysaesthesia at lesion level and spontaneous pain below lesion level of SCI. These data suggest that lesion of the spinothalamic pathway alone cannot account for central pain in SCI patients, and that neuronal hyperexcitability at injury or higher level may be an important mechanism for pain below injury level.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  A. M. Tan, J.-S. Choi, S. G. Waxman, and B. C. Hains Dendritic Spine Remodeling After Spinal Cord Injury Alters Neuronal Signal Processing J Neurophysiol, October 1, 2009; 102(4): 2396 - 2409. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Masri, R. L. Quiton, J. M. Lucas, P. D. Murray, S. M. Thompson, and A. Keller Zona Incerta: A Role in Central Pain J Neurophysiol, July 1, 2009; 102(1): 181 - 191. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Eberle, B. Doganci, H. H. Kramer, C. Geber, M. Fechir, W. Magerl, and F. Birklein Warm and cold complex regional pain syndromes: Differences beyond skin temperature? Neurology, February 10, 2009; 72(6): 505 - 512. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J-P Lefaucheur, X Drouot, I Menard-Lefaucheur, Y Keravel, and J-P Nguyen Motor cortex rTMS in chronic neuropathic pain: pain relief is associated with thermal sensory perception improvement J. Neurol. Neurosurg. Psychiatry, September 1, 2008; 79(9): 1044 - 1049. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Wasner, B. B. Lee, S. Engel, and E. McLachlan Residual spinothalamic tract pathways predict development of central pain after spinal cord injury Brain, September 1, 2008; 131(9): 2387 - 2400. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. G. Shenker, R. C. Haigh, P. I. Mapp, N. Harris, and D. R. Blake Contralateral hyperalgesia and allodynia following intradermal capsaicin injection in man Rheumatology, September 1, 2008; 47(9): 1417 - 1421. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E A De Sousa, A P Hays, R L Chin, H W Sander, and T H Brannagan III Characteristics of patients with sensory neuropathy diagnosed with abnormal small nerve fibres on skin biopsy. J. Neurol. Neurosurg. Psychiatry, August 1, 2006; 77(8): 983 - 985. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Ducreux, N. Attal, F. Parker, and D. Bouhassira Mechanisms of central neuropathic pain: a combined psychophysical and fMRI study in syringomyelia Brain, April 1, 2006; 129(4): 963 - 976. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-X. Hao, R. C. Kupers, and X.-J. Xu Response Characteristics of Spinal Cord Dorsal Horn Neurons in Chronic Allodynic Rats After Spinal Cord Injury J Neurophysiol, September 1, 2004; 92(3): 1391 - 1399. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P D Drummond and P M Finch Persistence of pain induced by startle and forehead cooling after sympathetic blockade in patients with complex regional pain syndrome J. Neurol. Neurosurg. Psychiatry, January 1, 2004; 75(1): 98 - 102. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. B. Finnerup, C. Gyldensted, E. Nielsen, A. D. Kristensen, F. W. Bach, and T. S. Jensen MRI in chronic spinal cord injury patients with and without central pain Neurology, December 9, 2003; 61(11): 1569 - 1575. [Abstract] [Full Text] [PDF]
|
|