Neuropathic Pain Clinical Trial
Official title:
Evaluation of Patients With Neuropathic Pain in the Context of Clinical Symptoms, Quantitative Sensory Tests and Imaging With FMRI
This study is planned to evaluate patients with upper extremity neuropathic pain due to cervical radiculopathy with clinical symptoms, Quantitative Sensory Testing(QST) and Functional Magnetic Resonance Imaging(fMRI). Patients with similar charactheristics will be grouped and comparisons will be conducted in fMRI results, as well as QST.
Neuropathic pain is a type of pain which usually accompanies injuries or conduction defects
in the central or peripheral nervous system, as well as receptors. Unlike the other types of
pain, neuropathic ones are more resistant to therapy and prone to be chronic.
In recent years, there are many novel techiques to assess the neurological status and create
standardized test protocols. One of these techiques is QST(Quantitative Sensory Testing). QST
is a specific type of sensory examination, usually done through computerized stimuli of heat,
cold or vibration, or specific test equipment. There are many types of QST protocols around
the world, and their results can also be expressed as phenotypes through statistics. While
there are 3 types of pain phenotypes with the 13 item QST protocol suggested by German
Neuropathic Pain Research group(DFNS), all patient groups can be classified differently as
well, according to the common findings they express. These different phenotypes are also
shown to have different responses to the different pain treatments. Such differences are
usually attributed to the different mechanisms and fibers underlying the pathogenesis.
While patients show differences in QST results, evidence for the correlation between these
variables and clinical symptoms of the patients are still scarce. Moreover, it is still yet
to be known if these differences have a central origin as well as the peripheral mechanisms.
Functional Magnetic Resonance Imaging(fMRI) is a method to evaluate cerebral functions. It is
mainly based on the blood flow changes that occur locally in regions that are in function[5].
As a result of the increased blood flow, the oxygen concentration also increases, creating a
signal response called BOLD(Blood Oxygen Level Dependent) response. Since different types of
pain are conducted through different fibers and pathways, it is also probable that they might
show changes in cortical response as well.
In this study, the aim is to find whether QST results are correlated to clinical symptoms and
pain properties of the patients, and these changes are related to the changes in the central
nervous system
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