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https://observatorio.fm.usp.br/handle/OPI/41468
Title: | Abnormal sensory thresholds of dystonic patients are not affected by deep brain stimulation |
Authors: | LISTIK, Clarice; CURY, Rubens Gisbert; SILVA, Valquiria Aparecida da; CASAGRANDE, Sara Carvalho Barbosa; LISTIK, Eduardo; LINK, Naira; GALHARDONI, Ricardo; BARBOSA, Egberto Reis; TEIXEIRA, Manoel Jacobsen; ANDRADE, Daniel Ciampi de |
Citation: | EUROPEAN JOURNAL OF PAIN, v.25, n.6, p.1355-1366, 2021 |
Abstract: | Background Unlike motor symptoms, the effects of deep brain stimulation (DBS) on non-motor symptoms associated with dystonia remain unknown. Methods The objective of this study was to assess the effects of DBS on evoked experimental pain and cutaneous sensory thresholds in a crossover, double-blind on/off study and compare these results with those of healthy volunteers (HV). Results Sixteen patients with idiopathic dystonia (39.9 +/- 13 years old, n = 14 generalized) with DBS of the globus pallidus internus underwent a battery of quantitative sensory testing and assessment using a pain top-down modulation system (conditioned pain modulation, CPM). Results for the more and less dystonic body regions were compared in on and off stimulation. The patients' results were compared to age- and sex-matched HV. Descending pain modulation CPM responses in dystonic patients (on-DBS, 11.8 +/- 40.7; off-DBS, 1.8 +/- 22.1) was abnormally low (defective) compared to HV (-15.6 +/- 23.5, respectively p = .006 and p = .042). Cold pain threshold and cold hyperalgesia were 54.8% and 95.7% higher in dystonic patients compared to HV. On-DBS CPM correlated with higher Burke-Fahn-Marsden disability score (r = 0.598; p = .014). While sensory and pain thresholds were not affected by DBS on/off condition, pain modulation was abnormal in dystonic patients and tended to be aggravated by DBS. Conclusion The analgesic effects after DBS do not seem to depend on short-duration changes in cutaneous sensory thresholds in dystonic patients and may be related to changes in the central processing of nociceptive inputs. |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - FM/MNE Artigos e Materiais de Revistas Científicas - HC/ICESP Artigos e Materiais de Revistas Científicas - HC/ICHC Artigos e Materiais de Revistas Científicas - HC/IPq Artigos e Materiais de Revistas Científicas - LIM/45 Artigos e Materiais de Revistas Científicas - LIM/62 |
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