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Spatial acuity for pain and its relationship with somatic sensory and autonomic measures in small fiber neuropathy

Grant number: 15/25893-3
Support type:Scholarships abroad - Research Internship - Doctorate
Effective date (Start): April 01, 2016
Effective date (End): March 31, 2017
Field of knowledge:Health Sciences - Medicine
Principal researcher:Amilton Antunes Barreira
Grantee:Rodrigo Melo Conde
Supervisor abroad: Frank Birklein
Home Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil
Research place: Johannes Gutenberg University Mainz (JGU), Germany  
Associated to the scholarship:13/03150-3 - Evaluation of the sweat losses in sensory polyganglionopathy (SPG), BP.DR


Small Fiber neuropathy (SFN) is a subtype of peripheral neuropathy that specifically affects the thin fibers (somatic sensory and/or autonomic) and their functions. There is no "gold standard" for diagnosing SFN although a diagnostic criteria has been proposed based on the occurrence of at least two abnormal tests at clinical examination, quantitative sensory testing (QST) and skin biopsy. The two-point discrimination (2PD) threshold test is mostly used to evaluate tactile spatial resolution in clinical practice. Recently, it was reported for the first time a whole-body map of 2PD for pain in healthy young individuals. The authors used 2 identical Nd:YAP laser pulses to stimulate A-delta and un-myelinated C fibers without co-activating mechanoreceptors in eleven body regions. To our knowledge, the 2PD for pain and touch was never tested in multiple body regions in patients with small-fiber neuropathy. The objectives of this study are to provide a body map of the two-point discrimination threshold for pain and touch in patients with Small Fiber Neuropathy, to verify relationship among two-point discrimination threshold for pain and touch, warm and cold sensation and the sudomotor axon reflex test, and to identify whether the two-point discrimination threshold for pain is able to help diagnose patients with small fiber neuropathy. The present research project has clinical importance because the assessment of pain with lasers can quantitatively evaluate the function of small fibers and may help diagnose small fiber neuropathy. (AU)

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