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Normative data for Aδ contact heat evoked potentials in adult population: a multicenter study
Yelena Granovsky1, Praveen Anand, Aya Nakae
1Clinical Neurophysiology Laboratory, Technion Medical School, Haifa, Israel Department of Neurology, Rambam Health Care Campus, Haifa, Israel Department of Neurology, Imperial College London, London, United Kingdom Laboratory of Brain-Immune Interaction, WPI Immunology Frontier Research Center, Osaka University, Osaka, Japan, Department of Anesthesiology and Intensive Care, Osaka, Japan Department of Neurology, Universidade Federal Fluminense, Rio de Janeiro, Brazil Department of Neurology, Mayo Clinic, Scottsdale, AZ, USA Department of Neurology, Hospital Clinic, Barcelona, Spain.
Abstract:
There has been a significant increase over recent years in the use of contact heat evoked potentials (CHEPs) for the evaluation of small nerve fiber function. Measuring CHEP amplitude and latency has clinical utility for the diagnosis and assessment of conditions with neuropathic pain. This international multicenter study aimed to provide reference values for CHEPs to stimuli at 5 commonly examined body sites. Contact heat evoked potentials were recorded from 226 subjects (114 females), distributed per age decade between 20 and 79 years. Temperature stimuli were delivered by a thermode (32°C-51°C at a rate of 70°C/s). In phase I of the study, we investigated side-to-side differences and reported the maximum normal side-to-side difference in Aδ CHEP peak latency and amplitude for leg, forearm, and face. In phase II, we obtained normative data for 3 CHEP parameters (N2P2 amplitude, N2 latency, and P2 latency), stratified for gender and age decades from face, upper and lower limbs, and overlying cervical and lumbar spine. In general, larger CHEP amplitudes were associated with higher evoked pain scores. Females had CHEPs of larger amplitude and shorter latency than males. This substantive data set of normative values will facilitate the clinical use of CHEPs as a rapid, noninvasive, and objective technique for the assessment of patients presenting with neuropathic pain.
