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Assessing Aδ fiber function with lidocaine using intraepidermal electrical stimulation
Naofumi Otsuru1, Koji Inui, Koya Yamashiro
1Department of Integrative Physiology, National Institute for Physiological Sciences, Okazaki, Japan. ootsuru@nips.ac.jp
The Journal of Pain
|January 16, 2010
Summary
Intraepidermal stimulation (IES) effectively assesses Adelta fiber function by measuring pain thresholds. This sensitive, non-invasive method shows promise as a screening tool for peripheral neuropathies.
Area of Science:
- Neuroscience
- Clinical Electrophysiology
Background:
- Peripheral neuropathies often impair small nerve fiber function.
- Clinical screening tools are needed to assess these functional changes.
Purpose of the Study:
- To evaluate intraepidermal stimulation (IES) for assessing Adelta fiber function.
- To determine if IES can detect functional changes in superficial cutaneous Adelta fibers.
Main Methods:
- Investigated sensory thresholds and evoked cortical responses in healthy volunteers.
- Used transdermal lidocaine to induce local anesthesia.
- Compared IES with transcutaneous electrical stimulation (TS) for pain and tactile thresholds.
- Recorded cortical potentials evoked by IES and TS before and after anesthesia.
Main Results:
- Local anesthesia significantly increased pain thresholds with IES.
- Local anesthesia abolished evoked cortical potentials with IES.
- Local anesthesia did not affect tactile thresholds or evoked potentials with TS.
Conclusions:
- IES is a sensitive tool for detecting functional changes in cutaneous Adelta fibers.
- The IES method is easy to apply, minimally invasive, and versatile for body site stimulation.
- IES shows potential as a valuable screening test for patients with neuropathy.
