Investigating Spinally-Mediated Hyperalgesia in Small Fibre Neuropathy
Research type
Research Study
Full title
Investigation of Spinally-Mediated Hyperalgesia in Idiopathic Small Fibre Neuropathy
IRAS ID
195645
Contact name
Andrew Marshall
Contact email
Duration of Study in the UK
0 years, 6 months, 1 days
Research summary
Patients with damage to the small nerve fibres in the skin often develop nerve related pain (neuropathic pain). Why some patients develop pain and others do not is unclear. Similarly the nature of the painful symptoms varies from patient to patient, which may relate to the unpredictability of response to medication targeting neuropathic pain. It has been proposed that the generation of neuropathic pain is based on different mechanisms. Evidence is emerging that abnormalities in the way the spinal cord processes nerve signals from the peripheral tissues occur in small nerve fibre damage due to diabetes in both rodents and humans. In addition the abnormalities in the spinal cord processing appear to corrected, along with neuropathic pain, in rodents.
Here we aim to study whether abnormalities in these spinal cord processes occur in small nerve fibre damage of unknown cause and whether any such abnormality associates with particular clinical symptoms and signs. It is anticipated that the findings will help to define the mechanisms of pain generation in small nerve fibre damage and, by providing a marker of abnormalities in spinal cord processing, may lead to means of personalising treatment of neuropathic pain.
To this end we propose to perform a cross-sectional study of 20 patients with small nerve fibre damage of unknown cause with 20 age-matched healthy contols. Studies will be performed in the Clinical Neurophysiology department at the Manchester Royal Infirmary. Patients and controls will attend for a single approximately 2 hour visit. All tests are non-invasive with no side-effects and are routinely performed in clinical practice. Neuropathic pain symptoms and signs will be carefully evaluated using standardised testing of sensation. Spinal cord processing will be assessed using electrical tests on lower limb nerves.
REC name
West Midlands - Coventry & Warwickshire Research Ethics Committee
REC reference
16/WM/0016
Date of REC Opinion
19 Jan 2016
REC opinion
Further Information Favourable Opinion