Mechanisms of neuropathic pain in patients with Charcot-Marie-Tooth 1 A: A laser-evoked potential study

Costanza Pazzaglia, Catello Vollono, Diana Ferraro, Daniela Virdis, Valentina Lupi, Domenica Le Pera, Pietro Tonali, Luca Padua, Massimiliano Valeriani

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Charcot-Marie-Tooth (CMT) disease is the most common inherited neuropathy. The CMT1A type can be considered the typical phenotype of this disease. Although pain is not considered a relevant symptom in CMT patients by physicians and no study assessed it comprehensively, this symptom is frequently complained by patients. The objective of the present study was to investigate the nociceptive system in a sample of CMT1A patients suffering from pain by laser-evoked potentials (LEPs). Moreover, we also used a pain specific questionnaire in order to obtain patient-oriented data about their painful symptoms, the Neuropathic Pain Diagnostic Questionnaire (DN4). We evaluated 16 patients affected by CMT1A and 14 controls. All subjects underwent a standard LEP recording session (foot, hand, and face stimulation) and filled in the DN4. While the N2/P2 amplitude to foot stimulation was lower in CMT patients than in controls (p = 0.003), no difference in LEP amplitude to both hand and face stimulation was found between patients and healthy subjects (p > 0.05). This result is probably due to a length-dependent Aδ-fiber loss which involves mostly the longer fibers coming from the lower limb. In our patients, there was a significant association between a reduced N2/P2 amplitude to foot stimulation and a high DN4 score (p = 0.03), meaning that patients with highly probable neuropathic pain had also low N2/P2 amplitude values to painful foot stimulation. This suggests that in our CMT1A patients neuropathic pain is probably related to a reduction of the Aδ afferents.

Original languageEnglish
Pages (from-to)379-385
Number of pages7
JournalPain
Volume149
Issue number2
DOIs
Publication statusPublished - May 2010

Fingerprint

Neuralgia
Tooth
Foot
Pain
Hand
Laser-Evoked Potentials
Charcot-Marie-Tooth Disease
Myelinated Nerve Fibers
Lower Extremity
Healthy Volunteers
Physicians
Phenotype

Keywords

  • Charcot-Marie-Tooth
  • Laser-evoked potentials
  • Neuropathic pain
  • Pain specific questionnaire

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine
  • Neurology
  • Pharmacology

Cite this

Mechanisms of neuropathic pain in patients with Charcot-Marie-Tooth 1 A : A laser-evoked potential study. / Pazzaglia, Costanza; Vollono, Catello; Ferraro, Diana; Virdis, Daniela; Lupi, Valentina; Le Pera, Domenica; Tonali, Pietro; Padua, Luca; Valeriani, Massimiliano.

In: Pain, Vol. 149, No. 2, 05.2010, p. 379-385.

Research output: Contribution to journalArticle

Pazzaglia, Costanza ; Vollono, Catello ; Ferraro, Diana ; Virdis, Daniela ; Lupi, Valentina ; Le Pera, Domenica ; Tonali, Pietro ; Padua, Luca ; Valeriani, Massimiliano. / Mechanisms of neuropathic pain in patients with Charcot-Marie-Tooth 1 A : A laser-evoked potential study. In: Pain. 2010 ; Vol. 149, No. 2. pp. 379-385.
@article{1952e41c32494a43bfa2aef677292761,
title = "Mechanisms of neuropathic pain in patients with Charcot-Marie-Tooth 1 A: A laser-evoked potential study",
abstract = "Charcot-Marie-Tooth (CMT) disease is the most common inherited neuropathy. The CMT1A type can be considered the typical phenotype of this disease. Although pain is not considered a relevant symptom in CMT patients by physicians and no study assessed it comprehensively, this symptom is frequently complained by patients. The objective of the present study was to investigate the nociceptive system in a sample of CMT1A patients suffering from pain by laser-evoked potentials (LEPs). Moreover, we also used a pain specific questionnaire in order to obtain patient-oriented data about their painful symptoms, the Neuropathic Pain Diagnostic Questionnaire (DN4). We evaluated 16 patients affected by CMT1A and 14 controls. All subjects underwent a standard LEP recording session (foot, hand, and face stimulation) and filled in the DN4. While the N2/P2 amplitude to foot stimulation was lower in CMT patients than in controls (p = 0.003), no difference in LEP amplitude to both hand and face stimulation was found between patients and healthy subjects (p > 0.05). This result is probably due to a length-dependent Aδ-fiber loss which involves mostly the longer fibers coming from the lower limb. In our patients, there was a significant association between a reduced N2/P2 amplitude to foot stimulation and a high DN4 score (p = 0.03), meaning that patients with highly probable neuropathic pain had also low N2/P2 amplitude values to painful foot stimulation. This suggests that in our CMT1A patients neuropathic pain is probably related to a reduction of the Aδ afferents.",
keywords = "Charcot-Marie-Tooth, Laser-evoked potentials, Neuropathic pain, Pain specific questionnaire",
author = "Costanza Pazzaglia and Catello Vollono and Diana Ferraro and Daniela Virdis and Valentina Lupi and {Le Pera}, Domenica and Pietro Tonali and Luca Padua and Massimiliano Valeriani",
year = "2010",
month = "5",
doi = "10.1016/j.pain.2010.03.001",
language = "English",
volume = "149",
pages = "379--385",
journal = "Pain",
issn = "0304-3959",
publisher = "Elsevier",
number = "2",

}

TY - JOUR

T1 - Mechanisms of neuropathic pain in patients with Charcot-Marie-Tooth 1 A

T2 - A laser-evoked potential study

AU - Pazzaglia, Costanza

AU - Vollono, Catello

AU - Ferraro, Diana

AU - Virdis, Daniela

AU - Lupi, Valentina

AU - Le Pera, Domenica

AU - Tonali, Pietro

AU - Padua, Luca

AU - Valeriani, Massimiliano

PY - 2010/5

Y1 - 2010/5

N2 - Charcot-Marie-Tooth (CMT) disease is the most common inherited neuropathy. The CMT1A type can be considered the typical phenotype of this disease. Although pain is not considered a relevant symptom in CMT patients by physicians and no study assessed it comprehensively, this symptom is frequently complained by patients. The objective of the present study was to investigate the nociceptive system in a sample of CMT1A patients suffering from pain by laser-evoked potentials (LEPs). Moreover, we also used a pain specific questionnaire in order to obtain patient-oriented data about their painful symptoms, the Neuropathic Pain Diagnostic Questionnaire (DN4). We evaluated 16 patients affected by CMT1A and 14 controls. All subjects underwent a standard LEP recording session (foot, hand, and face stimulation) and filled in the DN4. While the N2/P2 amplitude to foot stimulation was lower in CMT patients than in controls (p = 0.003), no difference in LEP amplitude to both hand and face stimulation was found between patients and healthy subjects (p > 0.05). This result is probably due to a length-dependent Aδ-fiber loss which involves mostly the longer fibers coming from the lower limb. In our patients, there was a significant association between a reduced N2/P2 amplitude to foot stimulation and a high DN4 score (p = 0.03), meaning that patients with highly probable neuropathic pain had also low N2/P2 amplitude values to painful foot stimulation. This suggests that in our CMT1A patients neuropathic pain is probably related to a reduction of the Aδ afferents.

AB - Charcot-Marie-Tooth (CMT) disease is the most common inherited neuropathy. The CMT1A type can be considered the typical phenotype of this disease. Although pain is not considered a relevant symptom in CMT patients by physicians and no study assessed it comprehensively, this symptom is frequently complained by patients. The objective of the present study was to investigate the nociceptive system in a sample of CMT1A patients suffering from pain by laser-evoked potentials (LEPs). Moreover, we also used a pain specific questionnaire in order to obtain patient-oriented data about their painful symptoms, the Neuropathic Pain Diagnostic Questionnaire (DN4). We evaluated 16 patients affected by CMT1A and 14 controls. All subjects underwent a standard LEP recording session (foot, hand, and face stimulation) and filled in the DN4. While the N2/P2 amplitude to foot stimulation was lower in CMT patients than in controls (p = 0.003), no difference in LEP amplitude to both hand and face stimulation was found between patients and healthy subjects (p > 0.05). This result is probably due to a length-dependent Aδ-fiber loss which involves mostly the longer fibers coming from the lower limb. In our patients, there was a significant association between a reduced N2/P2 amplitude to foot stimulation and a high DN4 score (p = 0.03), meaning that patients with highly probable neuropathic pain had also low N2/P2 amplitude values to painful foot stimulation. This suggests that in our CMT1A patients neuropathic pain is probably related to a reduction of the Aδ afferents.

KW - Charcot-Marie-Tooth

KW - Laser-evoked potentials

KW - Neuropathic pain

KW - Pain specific questionnaire

UR - http://www.scopus.com/inward/record.url?scp=77951878933&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77951878933&partnerID=8YFLogxK

U2 - 10.1016/j.pain.2010.03.001

DO - 10.1016/j.pain.2010.03.001

M3 - Article

C2 - 20334975

AN - SCOPUS:77951878933

VL - 149

SP - 379

EP - 385

JO - Pain

JF - Pain

SN - 0304-3959

IS - 2

ER -