Assessing the modulation of cutaneous sensory fiber excitability using a fast perception threshold tracking technique

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Abstract

Introduction: Topical application of lidocaine-and-prilocaine (LP) cream attenuates the functionality of small cutaneous nerve fibers. The aim of this human study was to measure the underlying excitability modulation of small cutaneous nerve fibers using a novel and fast perception threshold tracking (PTT) technique. Methods: Small sensory fibers were selectively blocked by 120-minute topical application of LP and confirmed by quantitative sensory testing. Excitability changes of small (activated by a specially designed pin electrode) and large (patch electrode) nerve fibers were assessed as the strength–duration relation and threshold electrotonus. Results: The excitability assessed by the strength–duration relation and threshold electrotonus was significantly modulated for the small afferents (P < 0.05, Wilcoxon's test) but not the large afferents. Discussion: This novel PTT technique was able to assess inhibition of membrane properties of small cutaneous fibers, suggesting the usefulness of the technique as a diagnostic method for assessing impairment of small fibers, as seen in many types of polyneuropathies. Muscle Nerve, 2019.

Original languageEnglish
JournalMuscle & Nerve
Volume60
Issue number4
Pages (from-to)367-375
Number of pages9
ISSN0148-639X
DOIs
Publication statusPublished - Oct 2019

Bibliographical note

DNRF121
© 2019 Wiley Periodicals, Inc.

Keywords

  • cutaneous analgesia
  • nerve fiber excitability
  • perception thresholds
  • pin electrode
  • quantitative sensory testing
  • small fiber neuropathy
  • threshold tracking

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