The development of neuropathic pain is one of the most debilitating sequels after a spinal cord injury (SCI). The overall aim of this study is to investigate potential underlying pathophysiological mechanisms of neuropathic pain after SCI. The functionality of the nociceptive pathway in humans as well as its plastic changes following SCI will be inferred with sophisticated sensory and pain phenotyping using quantitative sensory testing (i.e., psychophysical measures), objective neurophysiological measures of pain processing and the recording of pain-related autonomic responses (i.e., galvanic skin response, cardiovascular measures and pupil dilation). In addition, the interplay between the somatosensory and autonomic nervous system and its association with the development and maintenance of neuropathic pain after SCI will be investigated.
Study Type
OBSERVATIONAL
Enrollment
300
Pain-related evoked potentials and nerve conduction studies
Blood pressure control, orthostatic intolerance test, baro-reflex sensitivity, heart-rate variability
Temporal summation of pain, conditioned pain modulation
Thermal and mechanical sensory testing
Pain drawings, plus and minus signs of pain
Balgrist University Hospital
Zurich, Canton of Zurich, Switzerland
RECRUITINGSpinal cord injury patients: clinical pain phenotype including the spatial pain extent and pain intensity
Pain drawings, plus and minus signs of pain
Time frame: Longitudinal: change from 1 month up to 12 months
Spinal cord injury patients: clinical pain phenotype including the spatial pain extent and pain intensity
Pain drawings, plus and minus signs of pain
Time frame: Cross-sectional: once in a chronic stage (1 year post-injury)
Patients with peripheral neuropathy: clinical pain phenotype including the spatial pain extent and pain intensity
Pain drawings, plus and minus signs of pain
Time frame: Cross-sectional: once in a chronic stage (1 year post-injury)
Spinal cord injury patients / healthy controls: somato-sensory evoked potentials
Amplitude in uV
Time frame: Longitudinal: change from 1 month up to 12 months
Spinal cord injury patients / healthy controls: somato-sensory evoked potentials
Latency in ms
Time frame: Longitudinal: change from 1 month up to 12 months
Spinal cord injury patients / healthy controls: contact-heat evoked potentials
Amplitude in uV
Time frame: Longitudinal: change from 1 month up to 12 months
Spinal cord injury patients / healthy controls: contact-heat evoked potentials
Latency in ms
Time frame: Longitudinal: change from 1 month up to 12 months
Spinal cord injury patients / healthy controls: N13 spinal potential
Amplitude in uV
Time frame: Longitudinal: change from 1 month up to 12 months
Spinal cord injury patients / healthy controls: N13 spinal potential
Latency in ms
Time frame: Longitudinal: change from 1 month up to 12 months
Spinal cord injury patients / healthy controls: motor neurographies
Amplitude in mV
Time frame: Longitudinal: change from 1 month up to 12 months
Spinal cord injury patients / healthy controls: motor neurographies
Latency in ms
Time frame: Longitudinal: change from 1 month up to 12 months
Spinal cord injury patients / healthy controls: motor neurographies
Nerve conduction velocity in m/s
Time frame: Longitudinal: change from 1 month up to 12 months
Spinal cord injury patients / healthy controls: sensory neurography
Amplitude in mV
Time frame: Longitudinal: change from 1 month up to 12 months
Spinal cord injury patients / healthy controls: sensory neurography
Latency in ms
Time frame: Longitudinal: change from 1 month up to 12 months
Spinal cord injury patients / healthy controls: sensory neurography
Nerve conduction velocity in m/s
Time frame: Longitudinal: change from 1 month up to 12 months
Spinal cord injury patients / healthy controls: resting blood pressure
Systolic, diastolic and mean arterial pressure all in mmHg variability
Time frame: Cross-sectional: once in a chronic stage (1 year post-injury)
Patients with peripheral neuropathy / healthy controls: changes in blood pressure after a cold pressure test
Delta mmHg
Time frame: Cross-sectional: once in a chronic stage (1 year post-injury)
Patients with peripheral neuropathy / healthy controls: changes in blood pressure after a Valsalva maneuvre
Delta mmHg
Time frame: Cross-sectional: once in a chronic stage (1 year post-injury)
Patients with peripheral neuropathy / healthy controls: changes in blood pressure after a sit-up test
Delta mmHg
Time frame: Cross-sectional: once in a chronic stage (1 year post-injury)
Patients with peripheral neuropathy / healthy controls: baro-reflex sensitivity
ms/mmHg
Time frame: Cross-sectional: once in a chronic stage (1 year post-injury)
Patients with peripheral neuropathy / healthy controls: heart rate variability
RMSSD (root mean square of successive differences), high frequency/low frequency ratio
Time frame: Cross-sectional: once in a chronic stage (1 year post-injury)
Spinal cord injury patients / healthy controls: temporal summation of pain after repetitive application of 12 pinprick stimuli
Change in numeric rating scale of pain from the first three to the last three pinprick stimuli
Time frame: Longitudinal: change from 1 month up to 12 months
Spinal cord injury patients / healthy controls: conditioned pain modulation
Changes in pressure pain threshold (measured by an algometer in delta kg) before and during a cold water bath
Time frame: Longitudinal: change from 1 month up to 12 months
Patients with peripheral neuropathy / healthy controls: temporal summation of pain after repetitive application of 12 pinprick stimuli
Change in numeric rating scale of pain from the first three to the last three pinprick stimuli
Time frame: Longitudinal: change from 1 month up to 12 months
Patients with peripheral neuropathy / healthy controls: conditioned pain modulation
Changes in pressure pain threshold (measured by an algometer in delta kg) before and during a cold water bath
Time frame: Longitudinal: change from 1 month up to 12 months
Spinal cord injury patients / healthy controls: thermal sensory testing tested with a thermode
Warm detection threshold (°C), cold detection threshold (°C), heat pain threshold (°C), cold pain threshold (°C)
Time frame: Longitudinal: change from 1 month up to 12 months
Spinal cord injury patients / healthy controls: mechanical sensory testing tested with von Frey monofilaments/pinpricks
Mechanical detection threshold (mN)
Time frame: Longitudinal: change from 1 month up to 12 months
Spinal cord injury patients / healthy controls: mechanical sensory testing tested with von Frey monofilaments/pinpricks
Mechanical pain threshold (mN)
Time frame: Longitudinal: change from 1 month up to 12 months
Spinal cord injury patients / healthy controls: mechanical sensory testing tested with von Frey monofilaments/pinpricks
Mechanical pain sensitivity (numeric rating scale of pain 0-10)
Time frame: Longitudinal: change from 1 month up to 12 months
Spinal cord injury patients / healthy controls: mechanical sensory testing tested with von Frey monofilaments/pinpricks
Vibration detection threshold (a.u.) tested with Rydel Seiffer tuning fork
Time frame: Longitudinal: change from 1 month up to 12 months
Patients with peripheral neuropathy / healthy controls: thermal sensory testing tested with a thermode
Warm detection threshold (°C), cold detection threshold (°C), heat pain threshold (°C), cold pain threshold (°C)
Time frame: Longitudinal: change from 1 month up to 12 months
Patients with peripheral neuropathy / healthy controls: mechanical sensory testing tested with von Frey monofilaments/pinpricks
Mechanical detection threshold (mN)
Time frame: Longitudinal: change from 1 month up to 12 months
Patients with peripheral neuropathy / healthy controls: mechanical sensory testing tested with von Frey monofilaments/pinpricks
Mechanical pain threshold (mN)
Time frame: Longitudinal: change from 1 month up to 12 months
Patients with peripheral neuropathy / healthy controls: mechanical sensory testing tested with von Frey monofilaments/pinpricks
Mechanical pain sensitivity (numeric rating scale of pain 0-10)
Time frame: Longitudinal: change from 1 month up to 12 months
Patients with peripheral neuropathy / healthy controls: mechanical sensory testing tested with von Frey monofilaments/pinpricks
Vibration detection threshold (a.u.) tested with Rydel Seiffer tuning fork
Time frame: Longitudinal: change from 1 month up to 12 months
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