Delva M. Yu., Skoryk K. S., Kryvchun A. M.

FEATURES OF THE NOCICEPTIVE FLEXOR REFLEX IN NEUROPATHIC DYSESTHETIC PAIN IN PATIENTS WITH MULTIPLE SCLEROSIS

---

Show/Download

About the author:

Delva M. Yu., Skoryk K. S., Kryvchun A. M.

Heading:

CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scientific article

Annotation:

Neuropathic dysesthetic pain (NDP) is the most common type of neuropathic pain seen in patients with multiple sclerosis (MS). The study aims to determine the characteristics of the nociceptive flexor reflex (NFR) at the onset and features of the course of NDP in patients with MS. Two hundred forty-one patients with MS were included in the prospective study. Each patient received the PainDETECT questionnaire and was instructed on the rules for filling it out. In cases of diagnosis of NDP (according to the PainDETECT questionnaire >18 points), patients were invited to the clinic for an initial examination of NFR, which tentatively corresponded to the debut of NDP. A repeated study of NFR was carried out after 1 month. Patients who reported NDP during the 1-month study were invited to the next 3-month NFR study. As a control, an NFR study was conducted in 10 MS patients who had no pain during the last month. The neurophysiological study was performed using the Neurosoft MVP-2 electroneuromyography. Among patients with MS, NDP was associated with a significant decrease in NFR pain threshold and NFR threshold compared with patients without pain. The course of NDP was accompanied by a further decrease in NFR pain and NFR threshold at 1 and 3 months compared to the initial value. In addition, at the 3-month follow-up, patients with NDP still present had a significant reduction in NFR threshold compared with patients without NDP at that time. A decrease in the NFR threshold of 20% or more 1 month after the onset of NDP appeared to be a reliable prognostic marker of future NDP chronicity.

Tags:

Bibliography:

1. Aborode AT, Pustake M, Awuah WA, Alwerdani M, Shah P, Yarlagadda R, et al. Targeting oxidative stress mechanisms to treat Alzheimer’s and Parkinson’s disease: a critical review. Oxidative medicine and cellular longevity. 2022 Jul 31;2022:7934442.
2. Delva Mlu, Skoryk KS. Chastota ta klinichni kharakterystyky neiropatychnoho boliu u patsiientiv z rossianym sklerozom. Visnyk problem biolohii ta medytsyny. 2022;1.2:149-150. [in Ukrainian].
3. Truini A, Galeotti F, Cruccu G. Treating pain in multiple sclerosis. Expert Opin Pharmacother. 2011;12(15):2355-68. DOI: http://dx.doi. org/10.1517/ 14656566. 2011.607162.
4. O’Connor AB, Schwid SR, Herrmann DN, Markman JD, Dworkin RH. Pain associated with multiple sclerosis: systematic review and proposed classification. Pain. 2008;137:96-111. DOI: 10.1016/j.pain.2007.08.024.
5. Sandrini G, Serrao M, Rossi P, Romaniello A, Cruccu G, Willer JC. The lower limb flexion reflex in humans. Progress in neurobiology. 2005 Dec 1;77(6):353-95.
6. Biurrun Manresa JA, Neziri AY, Curatolo M, Arendt-Nielsen L, Andersen OK. Test–retest reliability of the nociceptive withdrawal reflex and electrical pain thresholds after single and repeated stimulation in patients with chronic low back pain. European journal of applied physiology. 2011 Jan;111:83-92.
7. Skljarevski V, Ramadan NM: The nociceptive flexion reflex in humans – review article. Pain. 2002;96(1-2):3-8.
8. Neziri AY, Andersen OK, Petersen-Felix S, Radanov B, Dickenson AH, Scaramozzino P, et al. The nociceptive withdrawal reflex: normative values of thresholds and reflex receptive fields. European journal of pain. 2010 Feb 1;14(2):134-41.
9. Leone C, Di Lionardo A, Di Pietro G, Di Stefano G, Falco P, Blockeel AJ, et al. How different experimental models of secondary hyperalgesia change the nociceptive flexion reflex. Clinical Neurophysiology. 2021 Dec 1;132(12):2989-95.
10. Treede RD, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, et al. A classification of chronic pain for ICD-11. Pain. 2015 Jun;156(6):1003.
11. Lim EC, Sterling M, Stone A, Vicenzino B. Central hyperexcitability as measured with nociceptive flexor reflex threshold in chronic musculoskeletal pain: a systematic review. PAIN®. 2011 Aug 1;152(8):1811-20.
12. Desmeules JA, Cedraschi C, Rapiti E, Baumgartner E, Finckh A, Cohen P, et al. Neurophysiologic evidence for a central sensitization in patients with fibromyalgia. Arthritis & Rheumatism. 2003 May;48(5):1420-9.
13. Banic B, Petersen-Felix S, Andersen OK, Radanov BP, Villiger PM, Arendt-Nielsen L, et al. Evidence for spinal cord hypersensitivity in chronic pain after whiplash injury and in fibromyalgia. Pain. 2004;107:7-15.
14. Manresa JA, Neziri AY, Curatolo M, Arendt-Nielsen L, Andersen OK. Reflex receptive fields are enlarged in patients with musculoskeletal low back and neck pain. Pain®. 2013 Aug 1;154(8):1318-24.
15. Sandrini G, Antonaci F, Lanfranchi S, Milanov I, Danilov A, Nappi G. Asymmetrical reduction of the nociceptive flexion reflex threshold in cluster headache. Cephalalgia. 2000 Sep;20(7):647-52.
16. Coffin B, Bouhassira D, Sabaté JM, Barbe L, Jian R. Alteration of the spinal modulation of nociceptive processing in patients with irritable bowel syndrome. Gut. 2004;53:1465-70.

Publication of the article:

«Bulletin of problems biology and medicine», 2023 Issue 3, 170, 194-203 pages, index UDC 616.832-004.2-092-071

DOI:

10.29254/2077-4214-2023-3-170-194-203