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2. Pain catastrophizing and features of cortical response to painful stimuli in fibromyalgia
Clinical Neurophysiology 128 (2017) e415–e437
Contents lists available at ScienceDirect
Clinical Neurophysiology journal homepage: www.elsevier.com/locate/clinph
Society Proceedings
Abstracts of the 62nd National Congress of the Italian Society for Clinical Neurophysiology, Ferrara, 21–24 June 2017 Rocco Liguori SINC, Administrative Secretariat, c/o PTS, Via Nizza 45, Roma, 00198, Italy
1. Laser evoked potential in clinical practice: The diagnostic field in small fiber neuropathy—G. Devigili, S. Rinaldo, C. Lettieri, R. Eleopra (Udine, Italy) Small fiber neuropathy (SFN) is frequently encountered in clinical practice. Due to the small nerve fiber characteristics, the diagnosis requires the use of not conventional tests like skin biopsy, Quantitative sensory testing (QST) and Laser Evoked Potentials (LEPs). The aim of this study was to evaluate the diagnostic value of A-delta LEPs in clinical practice in a large cohort of patients with diagnosis of ‘‘definite” SFN. We screened 296 patients evaluated in our institution with confirmed diagnosis of sensory neuropathy. We collected 140 patients with pure SFN and 79 patients with mixed fiber neuropathy (MFN). All underwent clinical evaluation, sensory, painful thermal and mechanical detection thresholds, and quantification of somatic intraepidermal nerve fibers (IENF) by skin biopsy to define the diagnosis. Then, all SFN and MFN patients underwent LEPs. The sensitivity and specificity were calculated compared with our normative data on 67 healthy age-matched subjects. A-delta LEPs at dorsal foot showed 76% sensitivity and 80% specificity in SFN diagnosis, and, if performed bilaterally, the sensitivity and specificity increased (81% and 84%). We did not find any correlation between LEPs and entity of skin denervation, but we found good concordance with warm, heat pain thresholds and pinprick perception. doi:10.1016/j.clinph.2017.09.008
2. Pain catastrophizing and features of cortical response to painful stimuli in fibromyalgia—K. Ricci, E. Vecchio, M. Delussi, A. Montemurno, E. Gentile, M. de Tommaso (Bari, Italy) Gamma Band Oscillations (GBO) after laser stimuli are currently considered a correlate of subjective pain perception. Habituation of laser evoked potentials (LEPs) is reduced in patients with central amplification of pain stimuli. To correlate LEPs habituation and GBO induced by laser stimulation with subjective pain rating and pain catastrophizing in patients with Fibromyalgia (FM) and controls. We recorded LEPs in 30 FM patients and 15 healthy controls by stimulating the dorsum of the right hand. At the end of each series, the perceived pain was rated on a visual pain analogue scale (VAS).
All subjects were submitted to the Pain Catastrophizing Scale – Italian version (PCS-I). The FM patients showed reduced LEPs habituation and increased laser-related GBO. Both patterns correlated with the PCS-I, but not with subjective pain rating. LEPs habituation and GBO may be the expression of cortical mechanisms of nociceptive stimuli processing and exaggerated attentional orientation toward pain experiences. doi:10.1016/j.clinph.2017.09.009
3. Immunofluorescence characterization of skin nerve misfolded in different synucleinopathies: A confocal study—V. Donadio, A. Incensi, O. El-Agnaf, G. Rizzo, N. Vaikath, C. Scaglione, S. Capellari, M. Stanzani Maserati, R. Pantieri, R. Liguori (Bologna, Doha, Qatar)
a-synuclein
Intraneural misfolded a-synuclein (syn) characterized different synucleinopathies such as pure autonomic failure (PAF), idiopathic Parkinson disease (IPD) and dementia with Lewy Bodies (DLB). The aim of this study is to characterize by immunofluorescence the skin intraneural a-synuclein (syn) deposits in PAF, IPD and DLB to ascertain conformation-specific differences which may justify a different clinical phenotype. We identified a total of 21 skin intraneural abnormal syn deposits in PAF (3 patients), 22 in IPD (8 patients) and 40 in DLB (7 patients). Ten healthy subjects were used controls. Skin biopsy was performed on proximal (C7 paravertebral) and distal (thigh and leg) sites. To characterize abnormal syn deposits we used primary antibodies against native a-synuclein (NAC) and against C-terminal asynuclein epitopes involved in post-translational modifications such as phosphorylation at serine 129 (pS129) and tyrosine 125 (pY125), nitrate a-synuclein at tyr125-133 (nY125-133) and advanced glycation end products (AGEs). Furthermore, the mature amyloid asynuclein fibrils were characterized by using a non-commercial antibody (Syn-F) and ubiquitin deposits were identified by a specific antibody (UBI). Antibody raised against pS129 disclosed abnormal skin nerves syn deposits in all patients and never in the control group. Abnormal pS129 syn deposits were often (80–90% of all analysed deposits) stained by the antibody recognizing a fibril conformation, seldom (around 40%) by native antibodies and very occasionally by
Contents lists available at ScienceDirect
Clinical Neurophysiology journal homepage: www.elsevier.com/locate/clinph
Society Proceedings
Abstracts of the 62nd National Congress of the Italian Society for Clinical Neurophysiology, Ferrara, 21–24 June 2017 Rocco Liguori SINC, Administrative Secretariat, c/o PTS, Via Nizza 45, Roma, 00198, Italy
1. Laser evoked potential in clinical practice: The diagnostic field in small fiber neuropathy—G. Devigili, S. Rinaldo, C. Lettieri, R. Eleopra (Udine, Italy) Small fiber neuropathy (SFN) is frequently encountered in clinical practice. Due to the small nerve fiber characteristics, the diagnosis requires the use of not conventional tests like skin biopsy, Quantitative sensory testing (QST) and Laser Evoked Potentials (LEPs). The aim of this study was to evaluate the diagnostic value of A-delta LEPs in clinical practice in a large cohort of patients with diagnosis of ‘‘definite” SFN. We screened 296 patients evaluated in our institution with confirmed diagnosis of sensory neuropathy. We collected 140 patients with pure SFN and 79 patients with mixed fiber neuropathy (MFN). All underwent clinical evaluation, sensory, painful thermal and mechanical detection thresholds, and quantification of somatic intraepidermal nerve fibers (IENF) by skin biopsy to define the diagnosis. Then, all SFN and MFN patients underwent LEPs. The sensitivity and specificity were calculated compared with our normative data on 67 healthy age-matched subjects. A-delta LEPs at dorsal foot showed 76% sensitivity and 80% specificity in SFN diagnosis, and, if performed bilaterally, the sensitivity and specificity increased (81% and 84%). We did not find any correlation between LEPs and entity of skin denervation, but we found good concordance with warm, heat pain thresholds and pinprick perception. doi:10.1016/j.clinph.2017.09.008
2. Pain catastrophizing and features of cortical response to painful stimuli in fibromyalgia—K. Ricci, E. Vecchio, M. Delussi, A. Montemurno, E. Gentile, M. de Tommaso (Bari, Italy) Gamma Band Oscillations (GBO) after laser stimuli are currently considered a correlate of subjective pain perception. Habituation of laser evoked potentials (LEPs) is reduced in patients with central amplification of pain stimuli. To correlate LEPs habituation and GBO induced by laser stimulation with subjective pain rating and pain catastrophizing in patients with Fibromyalgia (FM) and controls. We recorded LEPs in 30 FM patients and 15 healthy controls by stimulating the dorsum of the right hand. At the end of each series, the perceived pain was rated on a visual pain analogue scale (VAS).
All subjects were submitted to the Pain Catastrophizing Scale – Italian version (PCS-I). The FM patients showed reduced LEPs habituation and increased laser-related GBO. Both patterns correlated with the PCS-I, but not with subjective pain rating. LEPs habituation and GBO may be the expression of cortical mechanisms of nociceptive stimuli processing and exaggerated attentional orientation toward pain experiences. doi:10.1016/j.clinph.2017.09.009
3. Immunofluorescence characterization of skin nerve misfolded in different synucleinopathies: A confocal study—V. Donadio, A. Incensi, O. El-Agnaf, G. Rizzo, N. Vaikath, C. Scaglione, S. Capellari, M. Stanzani Maserati, R. Pantieri, R. Liguori (Bologna, Doha, Qatar)
a-synuclein
Intraneural misfolded a-synuclein (syn) characterized different synucleinopathies such as pure autonomic failure (PAF), idiopathic Parkinson disease (IPD) and dementia with Lewy Bodies (DLB). The aim of this study is to characterize by immunofluorescence the skin intraneural a-synuclein (syn) deposits in PAF, IPD and DLB to ascertain conformation-specific differences which may justify a different clinical phenotype. We identified a total of 21 skin intraneural abnormal syn deposits in PAF (3 patients), 22 in IPD (8 patients) and 40 in DLB (7 patients). Ten healthy subjects were used controls. Skin biopsy was performed on proximal (C7 paravertebral) and distal (thigh and leg) sites. To characterize abnormal syn deposits we used primary antibodies against native a-synuclein (NAC) and against C-terminal asynuclein epitopes involved in post-translational modifications such as phosphorylation at serine 129 (pS129) and tyrosine 125 (pY125), nitrate a-synuclein at tyr125-133 (nY125-133) and advanced glycation end products (AGEs). Furthermore, the mature amyloid asynuclein fibrils were characterized by using a non-commercial antibody (Syn-F) and ubiquitin deposits were identified by a specific antibody (UBI). Antibody raised against pS129 disclosed abnormal skin nerves syn deposits in all patients and never in the control group. Abnormal pS129 syn deposits were often (80–90% of all analysed deposits) stained by the antibody recognizing a fibril conformation, seldom (around 40%) by native antibodies and very occasionally by