Homotopic stimulation can reduce the area of allodynia in patients with neuropathic pain

SJ Love-Jones, M Besson, CE Steeds, P Brook, BA Chizh, AE Pickering

Research output: Contribution to journalArticle (Academic Journal)peer-review

15 Citations (Scopus)

Abstract

Allodynia is a common, troublesome feature of neuropathic pain conditions. In a previous study of postherpetic neuralgia we observed that repeated tactile stimulation appeared to reduce the size of the area of allodynia in some patients. We have undertaken a pragmatic clinical study to characterise this phenomenon in neuropathic pain patients with a range of different aetiologies. Neuropathic pain patients with a discrete area of tactile allodynia were recruited (n†=†20). We assessed the sensitive area using punctate and dynamic tactile stimuli, and thermal quantitative sensory testing. On two separate testing visits, the patients had repeated (10◊ over 1†min) noxious heat or cotton bud strokes applied to the affected site or contralaterally. Tactile stimulation of the affected area evoked pain (median 7 NRS) and a reduction (>30%) in the area of allodynia in 9/18 patients (maximum -48†±†9%, after 20†min), although the intensity of allodynic pain was unchanged. This effect persisted for over 1†h and was present the following day in all patients tested (n†=†5/5). No subjects showed an increase in area after allodynic stimulation. There was no change in heat pain threshold at a distant site following allodynic stimulation, suggesting no activation of diffuse noxious inhibitory control. Repeated thermal noxious stimulation (median NRS 7) could also elicit changes (>30%) in the area of allodynia in some patients (reductions in 7/20, increases in 3/20). Thus, we have found that a brief period of homotopic painful stimulation can reduce the area of allodynia in around half of patients with established neuropathic pains.
Translated title of the contributionHomotopic stimulation can reduce the area of allodynia in patients with neuropathic pain
Original languageEnglish
Pages (from-to)942 - 948
Number of pages6
JournalEuropean Journal of Pain
Volume13
DOIs
Publication statusPublished - Aug 2009

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