Evaluation of c-fibre function pre/post cordotomy

• Research type

  Research Study

• Full title

  Evaluation of c-fibre function pre/post cordotomy: an investigation into the roles of C-tactile afferents in affective touch

• IRAS ID

  105405

• Contact name

  Manohar Sharma

• Contact email

  manohar.sharma@thewaltoncentre.nhs.uk

• Sponsor organisation

  The walton centre NHS trust

• Research summary

  The skin is innervated by different types of nerve fibres coding for touch, temperature, pain and itch that differ in their speed of conduction and fibre diameter. The thinnest and slowest nerve fibres send pain and temperature messages to the brain via a specific pathway in the spinal cord, the spinothalamic tract. Recent research has identified another class of thin slowly conducting skin nerve that does not signal pain/itch, but respond optimally to gentle, stroking touch - C-tactile (CT) afferents. These nerves are understood to code for the pleasant properties of touch.
  Indirect evidence from both imaging in humans and animal studies support the possibility that CT afferents also transmit information to the brain via the spinothalamic tract. However, direct evidence is lacking. Additionally there is no direct proof that itch sensitive nerves transmit by this pathway in humans. In chronic intractable cancer pain a surgical procedure is often used that cuts the spinothalamic tract in the neck region, thus rendering these patients pain free on the contralateral (opposite) side of the body. This procedure – cordotomy – is usually only used in patients with a matter of months to live as the pain can return. By gently brushing the skin on the lesioned side of these patients, and recording their responses as to whether it is pleasant or not, we aim to find out if CTs afferents ascend in the spinothalamic tract – an important step in defining their role in body sensations. A non-invasive bedside test of itch will also be assessed following cordotomy to assess whether information about itch is transmitted to the brain by this pathway.
  

• REC name

  North West - Preston Research Ethics Committee

• REC reference

  14/NW/1247

• Date of REC Opinion

  3 Oct 2014

• REC opinion

  Favourable Opinion