Assessing the modulation of cutaneous sensory fiber excitability using a fast perception threshold tracking technique. Issue 4 (5th June 2019)

• Record Type: Journal Article
• Authors: Nielson Hoberg, Tatiana; Frahm, Steffen; Hennings, Kristian; Arendt‐Nielsen, Lars; Dahl Mørch, Carsten
• Is Part Of: Muscle & nerve. Volume 60:Issue 4(2019)
• Page Start: 367
• Page End: 375
• Publication Date: 2019-06-05
• Subjects: cutaneous analgesia -- nerve fiber excitability -- perception thresholds -- pin electrode -- quantitative sensory testing -- small fiber neuropathy -- threshold tracking; Neuromuscular diseases -- Periodicals; Muscles -- Periodicals; Nerves -- Periodicals; 616.74
• DOI: 10.1002/mus.26520
• Languages: English
• ISSNs: 0148-639X

Abstract

Abstract: Introduction: Topical application of lidocaine‐and‐prilocaine (LP) cream attenuates the functionality of small cutaneous nerve fibers. The aim of this human study was to measure the underlying excitability modulation of small cutaneous nerve fibers using a novel and fast perception threshold tracking (PTT) technique. Methods: Small sensory fibers were selectively blocked by 120‐minute topical application of LP and confirmed by quantitative sensory testing. Excitability changes of small (activated by a specially designed pin electrode) and large (patch electrode) nerve fibers were assessed as the strength–duration relation and threshold electrotonus. Results: The excitability assessed by the strength–duration relation and threshold electrotonus was significantly modulated for the small afferents ( P < 0.05, Wilcoxon's test) but not the large afferents. Discussion: This novel PTT technique was able to assess inhibition of membrane properties of small cutaneous fibers, suggesting the usefulness of the technique as a diagnostic method for assessing impairment of small fibers, as seen in many types of polyneuropathies. Abstract : See editorial on pages 345–346 in this issue .