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A Method for Tracking the Time Evolution of Steady-State Evoked Potentials
Published on: May 25, 2019
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Cold-evoked potentials versus contact heat-evoked potentials-Methodological considerations and clinical application
Philipp Hüllemann1, Annika Nerdal1, Manon Sendel1
1Division of Neurological Pain Research and Therapy, Department of Neurology, University clinic Schleswig-Holstein, Kiel, Germany.
European Journal of Pain (London, England)
|March 9, 2019
Summary
Cold-evoked potentials (CEPs) offer an objective method for assessing cold sensation. This study confirms CEPs are reliable across different skin types and thermode positions, with increased latencies indicating impaired cold processing.
Area of Science:
- Neuroscience
- Sensory Physiology
- Clinical Electrophysiology
Background:
- Previous studies utilized cold-evoked potentials (CEPs) to evaluate cold-mediating A-delta fibers and the spinothalamic tract.
- Methodological questions regarding CEPs and contact heat-evoked potentials (CHEPs) clinical application remained.
- Variations in latency, amplitude, thermode position, and skin type needed clarification.
Purpose of the Study:
- To compare latencies and amplitudes between CEPs and CHEPs.
- To investigate the impact of variable vs. fixed thermode positions on CEPs and CHEPs.
- To determine if CEPs are recordable in patients with abnormal cold processing.
Main Methods:
- 16 healthy subjects underwent CEP and CHEP testing on the face, hand, and foot.
- Variable and fixed thermode positions on hairy and glabrous skin were compared.
- Three patients with abnormal cold processing were assessed using CEPs and quantitative sensory testing (QST).
Main Results:
- CHEPs exhibited significantly longer latencies and larger amplitudes (face/hand) compared to CEPs.
- No significant differences in CEPs/CHEPs were found between variable and fixed thermode positions with 8-12s intervals.
- Glabrous skin stimulation increased CEP latencies by ~20%; patients with abnormal cold processing showed increased N2 latencies.
Conclusions:
- Fixed thermode positions are reliable for CEPs/CHEPs recording with 8-12s intervals.
- Hairy skin stimulation yields faster CEP latencies than glabrous skin.
- CEPs are recordable in patients with abnormal cold processing, showing increased latencies indicative of impaired cold detection.
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