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Persistent Spinal Pain Syndrome: A Study of Contact Heat-Evoked Potentials
Bruno Lima Pessôa1, Eduardo Davidovich2, Osvaldo Nascimento2
1Neurosurgery, Fluminense Federal University, Niterói, BRA.
Cureus
|April 7, 2025
Summary
Persistent spinal pain syndrome (PSPS) involves altered central pain processing. Contact heat-evoked potentials (CHEPs) show dysfunction in PSPS patients, suggesting spinothalamic tract involvement and potential diagnostic value.
Area of Science:
- Neuroscience
- Pain Research
- Electrophysiology
Background:
- Persistent spinal pain syndrome (PSPS) type 2 is a chronic condition following spinal surgery.
- Its pathophysiology is unclear, potentially involving altered central pain processing.
Purpose of the Study:
- Investigate central sensitization in PSPS using contact heat-evoked potentials (CHEPs).
- Assess spinothalamic tract integrity and central pain processing in PSPS patients.
Main Methods:
- Compared CHEP parameters (N2-P2 amplitude, N2 latency, P2 latency) between 15 PSPS patients and 36 healthy controls.
- Stimulation applied to the L1 dermatome, with neuropathic pain localized to L4, L5, S1.
Main Results:
- PSPS patients showed prolonged N2 and P2 latencies and reduced N2-P2 amplitude.
- N2 latency was the most reliable diagnostic parameter (AUC=0.81).
- Abnormal CHEP values found in 68% of PSPS patients, indicating spinothalamic tract dysfunction.
Conclusions:
- Findings support altered central pain processing in PSPS, linked to central sensitization.
- CHEPs are a valuable non-invasive tool for studying PSPS central pain mechanisms.
- Further research is needed due to limitations like small sample size.
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