Tracking Changes in Neuropathic Pain After Acute Spinal Cord Injury

Frontiers in Neurology, 2019 · DOI: 10.3389/fneur.2019.00090 · Published: February 14, 2019

Spinal Cord Injury Neurology Pain Management

Simple Explanation

This study investigates the link between how people respond to a constant heat sensation and their neuropathic pain levels after a spinal cord injury. Subjects rated their pain during a 2-minute heat exposure upon entering and leaving rehabilitation, and researchers analyzed how their pain perception changed over time. The study found that changes in how people modulate pain (balancing adaptation and temporal summation) were related to changes in their neuropathic pain severity.

Study Duration

Not specified

Participants

27 subjects with acute spinal cord injury

Evidence Level

Not specified

Key Findings

1
There was no initial correlation between responses to tonic heat and neuropathic pain severity upon admission to rehabilitation.
2
The degree of adaptation and temporal summation of pain did not significantly change between admission and discharge.
3
Changes in modulation profiles between admission and discharge were significantly correlated with changes in neuropathic pain severity.

Research Summary

The study examined the relationship between behavioral changes to tonic heat and changes in neuropathic pain severity in patients with spinal cord injury. The primary finding was that changes in the severity of neuropathic pain corresponded with changes in the modulation profile. The modulation profile, an aggregate of adaptation and temporal summation of pain, was demonstrated to be a valuable metric to quantify changes in response to tonic heat stimulation.

Practical Implications

Pain Management

Tonic heat stimulation may be a valuable quantitative method to objectively track changes related to the severity of neuropathic pain in patients with spinal cord injury.

Research

Additional studies are warranted to investigate the application of modulation profiles as an objective outcome to evaluate interventions aimed at relieving chronic neuropathic pain.

Therapeutic interventions

Changes in the modulation proﬁle may represent an effective measure to track changes in neuropathic pain severity from early to later stages of spinal cord injury.

Study Limitations

1
The total sample size is small.
2
Nine subjects were lost to follow up examination of tonic heat at discharge.
3
Our analysis did not take into account medications, which could have independently impacted adaptation and temporal summation of pain

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