European Journal of Pain, 2022 · DOI: 10.1002/ejp.2028 · Published: October 1, 2022
This study investigates central sensitization, a key mechanism in neuropathic pain (NP) after spinal cord injury (SCI). It explores two novel proxies: temporal summation of pain (TSP) and sympathetic skin responses (SSR). The study compares SCI subjects with and without NP to healthy controls (HC). Temporal summation of pain (TSP) was assessed by measuring pain ratings during a 2-minute heat application. Sympathetic skin responses (SSR) were recorded to examine pain-autonomic interactions. Pain extent was measured by the affected body area. The study found enhanced TSP in SCI subjects with NP compared to those without and healthy controls. Pain extent was positively correlated with deficient SSR habituation. These findings support using TSP and SSRs as indicators of central sensitization.
The study suggests an improved way to assess neuronal hyperexcitability potentially enabling mechanism-based treatment.
Measures of pain-autonomic interaction emerged as a promising tool for the objective investigation of sensitized neuronal states in chronic pain conditions.
The findings have implications for clinical practice, particularly in improving the assessment of increased nociceptive sensitivity at the individual level.