Depolarising Electrical Skin Stimulation in Neuropathic and Postoperative Pain

Swiss Paraplegic Research, Nottwil65 enrolled

Overview

The aim of the study is to evaluate voltage gated sodium channel (NaV1.7) dependent pain phenomena in neuropathic pain and chronic postoperative pain.

Sinus-like electrical stimulation may depolarize unmyelinated skin nociceptors involving NaV1.7 channels. In this case electrical stimulation may provoke pain already with very low currency intensity which normally not provoke pain in healthy subjects. This may be predictive for pain relief due to the sodium channel blocker lidocaine 5% patch. The study will characterize pain states in peripheral neuropathic pain as well as within the painful scar in chronic postoperative pain with regard to the involvement of NaV1.7 channels. In addition, the pain site in chronic postoperative pain (scar) will be characterized by laser-evoked potentials (LEP) and quantitative sensory testing (QST). Pain related questionnaires will be obtained.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Neuropathy;Peripheral

Interventions

neurophysiologyDIAGNOSTIC_TEST

electrophysiologic measurements of peripheral nerves

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Group (1) patients with neuropathic pain * Group (2) patients with chronic postoperative pain Exclusion Criteria (both Groups): * severe psychiatric disorder requiring hospitalisation in the past * any neurological disease other than the pain diagnosis

Locations (1)

Centre for Pain Medicine

Nottwil, Switzerland

Outcomes

Primary Outcomes

change in pain intensity

numeric rating scale (NRS), rating from 0-10, 0=no pain, 10=maximum pain imaginable

Time frame: at baseline and during electric nerve stimulation

Secondary Outcomes

heat pain threshold

Ramped stimuli (+1 degree Celsius / sec) that are terminated when the subject presses a button.

Time frame: baseline

cold pain threshold

Ramped stimuli (-1 degree Celsius / sec) that are terminated when the subject presses a button.

Time frame: baseline

mechanical detection threshold

Fine plastic hairs with different bending forces are applied to the skin to determine the mechanical detection threshold.

Time frame: baseline

mechanical pain threshold

Differently weighted pinprick stimuli are applied at a rate of 2sec on and 2sec off in an ascending order until the first percept of sharpness is reached.

Time frame: baseline

mechanical pain sensitivity

Differently weighted pinprick stimuli are applied to obtain a stimulus- response function for pinprick-evoked pain. Subjects were asked to give a pain rating for each stimulus (rating from 0-10, 0=no pain, 10=maximum pain)

Time frame: baseline

dynamic mechanical allodynia

Different stimuli, tactile and pinprick are applied with the subject giving numerical pain ratings for each stimulus (rating from 0-10, 0=no pain, maximum pain).

Time frame: baseline

Data from ClinicalTrials.gov

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