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| Name | Class |
|---|---|
| Swiss National Science Foundation | OTHER |
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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients with spinal cord injury with neuropathic pain |
| ||
| Patients with spinal cord injury but without neuropathic pain |
| ||
| Patients with peripheral neuropathy |
| ||
| Healthy subjects |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Neurophysiology | Diagnostic Test | Pain-related evoked potentials and nerve conduction studies |
|
| Measure | Description | Time Frame |
|---|---|---|
| Spinal cord injury patients: clinical pain phenotype including the spatial pain extent and pain intensity | Pain drawings, plus and minus signs of pain | 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 | 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 | Cross-sectional: once in a chronic stage (1 year post-injury) |
| Measure | Description | Time Frame |
|---|---|---|
| Spinal cord injury patients / healthy controls: somato-sensory evoked potentials | Amplitude in uV | Longitudinal: change from 1 month up to 12 months |
| Spinal cord injury patients / healthy controls: somato-sensory evoked potentials |
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Inclusion Criteria:
Exclusion Criteria:
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In- and outpatients of Balgrist University Hospital Zurich
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Michèle Hubli, PD Dr. | Contact | +41 44 510 72 03 | michele.hubli@balgrist.ch |
| Name | Affiliation | Role |
|---|---|---|
| Patrick Freund, Prof. Dr. Dr. | University of Zurich | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Balgrist University Hospital | Recruiting | Zurich | Canton of Zurich | 8008 | Switzerland |
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| Cardiovascular test | Diagnostic Test | Blood pressure control, orthostatic intolerance test, baro-reflex sensitivity, heart-rate variability |
|
| Experimental pain paradigms | Diagnostic Test | Temporal summation of pain, conditioned pain modulation, offset analgesia |
|
| Quantitative sensory testing | Diagnostic Test | Thermal and mechanical sensory testing |
|
| Clinical pain phenotype | Diagnostic Test | Pain drawings, plus and minus signs of pain |
|
| Pupillometry | Diagnostic Test | Pupil size changes after phasic and tonic sensory stimulation |
|
Latency in ms
| Longitudinal: change from 1 month up to 12 months |
| Spinal cord injury patients / healthy controls: contact-heat evoked potentials | Amplitude in uV | Longitudinal: change from 1 month up to 12 months |
| Spinal cord injury patients / healthy controls: contact-heat evoked potentials | Latency in ms | Longitudinal: change from 1 month up to 12 months |
| Spinal cord injury patients / healthy controls: N13 spinal potential | Amplitude in uV | Longitudinal: change from 1 month up to 12 months |
| Spinal cord injury patients / healthy controls: N13 spinal potential | Latency in ms | Longitudinal: change from 1 month up to 12 months |
| Spinal cord injury patients / healthy controls: motor neurographies | Amplitude in mV | Longitudinal: change from 1 month up to 12 months |
| Spinal cord injury patients / healthy controls: motor neurographies | Latency in ms | Longitudinal: change from 1 month up to 12 months |
| Spinal cord injury patients / healthy controls: motor neurographies | Nerve conduction velocity in m/s | Longitudinal: change from 1 month up to 12 months |
| Spinal cord injury patients / healthy controls: sensory neurography | Amplitude in mV | Longitudinal: change from 1 month up to 12 months |
| Spinal cord injury patients / healthy controls: sensory neurography | Latency in ms | Longitudinal: change from 1 month up to 12 months |
| Spinal cord injury patients / healthy controls: sensory neurography | Nerve conduction velocity in m/s | 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 | 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 | 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 | 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 | Cross-sectional: once in a chronic stage (1 year post-injury) |
| Patients with peripheral neuropathy / healthy controls: baro-reflex sensitivity | ms/mmHg | 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 | 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 | 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 | 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 | 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 | 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) | 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) | 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) | 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) | 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 | 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) | 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) | 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) | 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) | 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 | Longitudinal: change from 1 month up to 12 months |
| Spinal cord injury patients / patients with peripheral neuropathy / healthy controls: pupillometry | Change in pupil size in mm after sensory input (noxious, non-noxious) | Cross-sectional: once in a chronic stage (1 year post-injury) |
| Spinal cord injury patients / patients with peripheral neuropathy / healthy controls: offset analgesia (psychophysical) | Change in pain ratings during tonic heat stimulation (offet analgesia paradigm) in numeric rating scale (NRS, scale titel: offset analgesia, 0-100, higher score means better analgesia) | Cross-sectional: once in a chronic stage (1 year post-injury) |
| Spinal cord injury patients / patients with peripheral neuropathy / healthy controls: offset analgesia (pupillometry) | Change in pupil size in mm during tonic heat application (offseat analgesia paradigm) | Cross-sectional, once in a chronic stage (1 year post-injury) |
| ID | Term |
|---|---|
| D013119 | Spinal Cord Injuries |
| D009437 | Neuralgia |
| D059226 | Nociceptive Pain |
| ID | Term |
|---|---|
| D013118 | Spinal Cord Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D020196 | Trauma, Nervous System |
| D014947 | Wounds and Injuries |
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D059227 | Postsynaptic Potential Summation |
| ID | Term |
|---|---|
| D009435 | Synaptic Transmission |
| D015398 | Signal Transduction |
| D001669 | Biochemical Phenomena |
| D055598 | Chemical Phenomena |
| D055366 | Synaptic Potentials |
| D008564 | Membrane Potentials |
| D002468 | Cell Physiological Phenomena |
| D055724 | Electrophysiological Phenomena |
| D010829 | Physiological Phenomena |
| D009424 | Nervous System Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
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