Cited by 83Pain Mechanisms and TreatmentsPain Management and TreatmentPeripheral Nerve Disorders

Neurophysiological studies of pain pathways in peripheral and central nervous system disorders

Treede, Rolf-Detlef·2003·Journal of Neurology

Abstract

Standard clinical neurophysiological assessment of somatosensory pathways by sensory evoked potentials (SEPs) is limited to the tactile and proprioceptive systems consisting of large fibers in the peripheral nerve, the dorsal columns of the spinal cord and the medial lemniscus in the brainstem. This limitation means that about half of the lesions in the somatosensory system will not be detectable. In recent years, many clinical studies have confirmed that laser evoked potentials (LEPs) allow the assessment of the other half of the somatosensory system. Rapid heating of the skin by infrared laser pulses specifically activates the nociceptive and thermoreceptive pathways consisting of small fibers in the peripheral nerve and the anterolateral spinothalamic tract in the spinal cord and brainstem. Owing to the large degree of convergence of the somatosensory pathways on to common thalamic nuclei, the differential use of LEP vs. SEP is less evident for thalamocortical lesions. In contrast to standard SEPs, the LEP technique can be applied to non-glabrous skin in any dermatome. This review summarizes the principles of clinical neurophysiological studies of pain pathways and the findings obtained in patients with peripheral and central nervous system disorders. These data provide a rational basis for developing clinical indications for LEP testing.

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Crossref · 10.1007/s00415-003-0237-7

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Authors
Treede, R.-D.
Affiliations
Johannes Gutenberg University Mainz (DE)
Corresponding author
Treede, Rolf-Detlef
Venue
Journal of Neurology
Published
2003-10-01
Volume
250
Issue
10
Pages
1152-1161
ISSN
  • 0012-1037 (ISSN-L)
  • 0340-5354
  • 1432-1459
OpenAlex
W2007507727
Cited by
83
References
84
Citations by year
2026: 1 · 2025: 3 · 2024: 3 · 2022: 2 · 2021: 1 · 2020: 2 · 2019: 3 · 2018: 1 · 2017: 3 · 2016: 4 · 2015: 3 · 2014: 4 · 2013: 4 · 2012: 10
FWCI
1.15
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Neurology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Peripheral Nerve Disorders
Keywords
laser-evoked potentials, sensory evoked potentials, pain pathways, somatosensory pathways, nociceptive pathways, small fiber neuropathy, peripheral nerve disorders, central nervous system disorders, infrared laser stimulation
MeSH terms
Central Nervous System Diseases, Evoked Potentials, Somatosensory, Humans, Lasers, Pain, Peripheral Nervous System Diseases, Temperature, Touch

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