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Central pain in patients with Parkinson disease evaluated by pain-related evoked potentials

机译:通过疼痛相关诱发电位评估帕金森病患者的中枢性疼痛

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Pain is a well-recognized nonmotor manifestation of Parkinson disease (PD). This might be related to not only peripheral factors but also abnormal processing of nociceptive input in the central nervous system (CNS). To investigate possible dysfunction of pain pathway or of the processing of pain input in the CNS, we recorded pain-related evoked potentials induced by intra-epidermal electrical stimulation in patients with PD. Pain-related evoked potentials were recorded in 13 patients with PD and 21 healthy controls. The evoked potentials were recorded from the Cz electrode by intra-epidermal electrical stimulation, which is known to selectively stimulate A delta fibers, at the second digit on each of the 4 limbs. The amplitudes between N1 and P1, which are thought to originate from the cingulate cortex and the insula, were significantly lower in patients with PD compared with controls. Patients with PD showed no significant correlation between the severity of clinical parameters, such as Unified Parkinson's Disease Rating Scale or Hoehn and Yahr score, and the amplitudes between N1 and P1. In addition, no differences were found in mean N1 or P1 latency between the two groups. These results may reflect the existence of abnormal central processing of pain inputs in PD, which appears to be independent of the clinical expression of motor dysfunction.
机译:疼痛是帕金森病(PD)公认的非运动表现。这可能不仅与周围因素有关,而且与中枢神经系统(CNS)中伤害性输入的异常处理有关。为了研究中枢神经系统中疼痛途径或疼痛输入过程的功能障碍,我们记录了PD患者表皮内电刺激诱发的与疼痛相关的诱发电位。在13例PD患者和21例健康对照者中记录了与疼痛相关的诱发电位。通过表皮内电刺激从Cz电极记录诱发电位,已知该表皮内电刺激在4个肢体的第二个手指上选择性刺激A三角洲纤维。与对照组相比,PD患者的N1和P1之间的振幅被认为是有扣带回皮层和岛突所致。 PD患者在临床参数的严重程度(例如统一帕金森氏病评分量表或Hoehn和Yahr评分)与N1和P1之间的幅度之间没有显着相关性。此外,两组之间的平均N1或P1潜伏期均未发现差异。这些结果可能反映了PD中疼痛输入的异常中央处理的存在,这似乎与运动功能障碍的临床表达无关。

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