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Mirror peripheral neuropathy and unilateral chronic neuropathic pain: insights from asymmetric neurological patterns in leprosy.
Raicher, Irina; Zandonai, Alexandra P; Anghinah, Isadora W; Frassetto, Mariana; Stump, Patrick R N A G; Trindade, Maria A B; Harnik, Simone; Oliveira, Rodrigo A; Macarenco, Ricardo S S; Doppler, Kathrin; Üçeyler, Nurcan; Mello, Evandro S; Sommer, Claudia; Teixeira, Manoel J; Galhardoni, Ricardo; de Andrade, Daniel C.
Afiliação
  • Raicher I; Department of Neurology, Clinics Hospital of the University of Sao Paulo Medical School, Brazil.
  • Zandonai AP; Hospital Israelita Albert Einstein, Pathology Laboratory, Sao Paulo, Brazil.
  • Anghinah IW; BP- A Beneficência Portuguesa de São Paulo, Sao Paulo, Brazil.
  • Frassetto M; Nove de Julho University, Sao Paulo, Brazil.
  • Stump PRNAG; University of Southern Santa Catarina (UNESC), Santa Catarina, Brazil.
  • Trindade MAB; Department of Neurology, Clinics Hospital of the University of Sao Paulo Medical School, Brazil.
  • Harnik S; Instituto Lauro de Souza Lima, Bauru, Brazil.
  • Oliveira RA; Department of Dermatology, Clinics Hospital of the University of Sao Paulo Medical School, Brazil.
  • Macarenco RSS; Department of Statistics of the Institute of Mathematics and Statistics of the University of Sao Paulo, Sao Paulo, Brazil.
  • Doppler K; Department of Statistics of the Institute of Mathematics and Statistics of the University of Sao Paulo, Sao Paulo, Brazil.
  • Üçeyler N; Hospital Israelita Albert Einstein, Pathology Laboratory, Sao Paulo, Brazil.
  • Mello ES; Department of Neurology, University Hospital Würzburg, Würzburg, Germany.
  • Sommer C; Department of Neurology, University Hospital Würzburg, Würzburg, Germany.
  • Teixeira MJ; Cancer Institute of Sao Paulo Octavio Frias de Oliveira, University of Sao Paulo, Brazil.
  • Galhardoni R; Department of Neurology, University Hospital Würzburg, Würzburg, Germany.
  • de Andrade DC; Pain Center, Discipline of Neurosurgery HC-FMUSP, LIM-62, University of São Paulo, Brazil.
Pain ; 164(4): 717-727, 2023 04 01.
Article em En | MEDLINE | ID: mdl-35972460
ABSTRACT: Leprosy-related multiple mononeuropathy offers a pattern of impairment where neuropathy with and without neuropathic pain (NeP) are present in the same individual, thus allowing to investigate peripheral sensory and innervation in both conditions. This cross-sectional study collected data on clinical and neurological examination, pain assessment questionnaires, quantitative sensory test, and intraepidermal nerve fiber density of patients with leprosy and divided the cohort into 2 groups: with NeP (P+) and without NeP (P-). Furthermore, we assessed mirror body areas in the same NeP individuals with bilateral neuropathy also presenting unilateral NeP. Pain-free patients having unilateral neuropathy were controls. A total of 37 P+ and 22 P- patients were evaluated. Limb areas with NeP had signs of C-fiber dysfunction and hyperesthesia on quantitative sensory testing compared with limb areas having neuropathy without NeP. Skin denervation was found in all patients with leprosy. Comparisons of limbs with and without neuropathy and with and without NeP revealed that higher heat pain thresholds (HPTs) were associated with neuropathic pain areas, whereas less altered HPT was correlated with higher fiber density. Furthermore, a relationship was found between time of leprosy treatment termination and more intense neuropathy, expressed by HPT increasing 0.03°C each month. As expected, interindividual comparisons failed to show differences in intraepidermal nerve fiber density and subepidermal plexus areas between P+ and P- patients ( P = 0.2980, P = 0.9044; respectively). Higher HPT and lower mechanical detection threshold were related to NeP. This study pointed out the relevance of intraindividual comparisons including mirror areas when assessing local changes in peripheral NeP.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hanseníase / Neuralgia Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Pain Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hanseníase / Neuralgia Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Pain Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos