Subthalamic deep brain stimulation modulates small fiber-dependent sensory thresholds in Parkinson's disease

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.author ANDRADE, Daniel Ciampi de FMUSP-HC
LEFAUCHEUR, Jean-Pascal
GALHARDONI, Ricardo
FERREIRA, Karine S. L.
PAIVA, Anderson Rodrigues Brandao
BOR-SENG-SHU, Edson FMUSP-HC
ALVARENGA, Luciana FMUSP-HC
MYCZKOWSKI, Martin L. FMUSP-HC
MARCOLIN, Marco Antonio FMUSP-HC
SIQUEIRA, Silvia R. D. T. de FMUSP-HC
FONOFF, Erich FMUSP-HC
BARBOSA, Egberto Reis FMUSP-HC
TEIXEIRA, Manoel Jacobsen FMUSP-HC
dc.date.issued 2012
dc.identifier.citation PAIN, v.153, n.5, p.1107-1113, 2012
dc.identifier.issn 0304-3959
dc.identifier.uri http://observatorio.fm.usp.br/handle/OPI/396
dc.description.abstract The effects of deep brain stimulation of the subthalamic nucleus on nonmotor symptoms of Parkinson's disease (PD) rarely have been investigated. Among these, sensory disturbances, including chronic pain (CP), are frequent in these patients. The aim of this study was to evaluate the changes induced by deep brain stimulation in the perception of sensory stimuli, either noxious or innocuous, mediated by small or large nerve fibers. Sensory detection and pain thresholds were assessed in 25 PD patients all in the off-medication condition with the stimulator turned on or off (on- and off-stimulation conditions, respectively). The relationship between the changes induced by surgery on quantitative sensory testing, spontaneous CP, and motor abilities were studied. Quantitative sensory test results obtained in PD patients were compared with those of age-matched healthy subjects. Chronic pain was present in 72% of patients before vs 36% after surgery (P = .019). Compared with healthy subjects, PD patients had an increased sensitivity to innocuous thermal stimuli and mechanical pain, but a reduced sensitivity to innocuous mechanical stimuli. In addition, they had an increased pain rating when painful thermal stimuli were applied, particularly in the off-stimulation condition. In the on-stimulation condition, there was an increased sensitivity to innocuous thermal stimuli but a reduced sensitivity to mechanical or thermal pain. Pain provoked by thermal stimuli was reduced when the stimulator was turned on. Motor improvement positively correlated with changes in warm detection and heat pain thresholds. Subthalamic nucleus deep brain stimulation contributes to relieve pain associated with PD and specifically modulates small fiber-mediated sensations.
dc.description.sponsorship · FAPESP (Fundacao de Amparo a Pesquisa do Estado de Sao Paulo) [10/19392-8]
· Department of Neurology, University of Sao Paulo, Sao Paulo, Brazil (FMUSP)
dc.language.iso eng
dc.publisher ELSEVIER SCIENCE BV
dc.relation.ispartof Pain
dc.rights restrictedAccess
dc.subject Chronic pain; Parkinson's disease; Deep brain stimulation; Sensory thresholds; Subthalamic nucleus
dc.subject.other pain sensitivity; dopamine-receptors; denervation; levodopa; nucleus; basal; rat
dc.title Subthalamic deep brain stimulation modulates small fiber-dependent sensory thresholds in Parkinson's disease
dc.type article
dc.rights.holder Copyright ELSEVIER SCIENCE BV
dc.description.group LIM/26
dc.description.group LIM/45
dc.identifier.doi 10.1016/j.pain.2012.02.016
dc.identifier.pmid 22456108
dc.type.category original article
dc.type.version publishedVersion
hcfmusp.author ANDRADE, Daniel Ciampi de:HC:ICHC
hcfmusp.author BOR-SENG-SHU, Edson:HC:ICHC
hcfmusp.author ALVARENGA, Luciana:FM:
hcfmusp.author MYCZKOWSKI, Martin L.:HC:IPQ
hcfmusp.author MARCOLIN, Marco Antonio:HC:IPQ
hcfmusp.author SIQUEIRA, Silvia R. D. T. de:FM:
hcfmusp.author FONOFF, Erich:HC:IPQ
hcfmusp.author BARBOSA, Egberto Reis:HC:ICHC
hcfmusp.author TEIXEIRA, Manoel Jacobsen:FM:MNE
hcfmusp.author.external · LEFAUCHEUR, Jean-Pascal:Univ Paris Est Creteil, Fac Med, EA 4391, Creteil, France; Hop Henri Mondor, AP HP, Serv Physiol Explorat Fonct, F-94010 Creteil, France
· GALHARDONI, Ricardo:Inst Canc Estado Sao Paulo, Pain Ctr, Sao Paulo, Brazil
· FERREIRA, Karine S. L.:Inst Canc Estado Sao Paulo, Pain Ctr, Sao Paulo, Brazil
· PAIVA, Anderson Rodrigues Brandao:Univ Sao Paulo, Sch Med, Hosp Clin, Div Neurol, BR-05403900 Sao Paulo, Brazil
hcfmusp.origem.id 2-s2.0-84859882571
hcfmusp.origem.id WOS:000302996200024
hcfmusp.publisher.city AMSTERDAM
hcfmusp.publisher.country NETHERLANDS
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dc.description.index MEDLINE
hcfmusp.citation.scopus 40
hcfmusp.citation.wos 41
hcfmusp.affiliation.country Brasil
hcfmusp.affiliation.country França


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