Ann Rehabil Med.  2015 Feb;39(1):108-115. 10.5535/arm.2015.39.1.108.

Pain-Related Evoked Potential in Healthy Adults

• Oh KJ
• Kim SH
• Lee YH
• Kim JH
• Jung HS
• Park TJ
• Park J
• Shinn JM

• KMID: 2273026
• DOI: http://doi.org/10.5535/arm.2015.39.1.108

Abstract

OBJECTIVE
To investigate the normal data of pain-related evoked potentials (PREP) elicited with a concentric surface electrode among normal, healthy adults and the relationship between PREP and pain intensity.
METHODS
Sixty healthy volunteers (22 men and 38 women; aged 36.4+/-10.7 years; height, 165.4+/-7.8 cm) were enrolled. Routine nerve conduction study (NCS) was done to measure PREP following electrical stimulation of hands (C7 dermatome) and feet (L5 dermatome). Negative peak (N), positive peak (P) latencies, peak to peak (NP) amplitudes, conduction velocity (CV), and verbal rating scale (VRS) score were obtained. Linear regression analysis tested for significant relevance between variables of PREP and VRS score.
RESULTS
Normal NCS results were obtained in all subjects. N latency of hand PREP was 163.8 +/-40.0 ms (right) and 161.0+/-39.9 ms (left). N latency of foot PREP was 178.0+/-43.9 ms (right), 180.4+/-43.4 ms (left). NP amplitude of hands was 20.6+/-10.6 microV (right) and 21.9+/-11.6 microV (left). NP amplitude of feet was 18.8+/-8.3 microV (right) and 19.0+/-8.4 microV (left). The calculated CV was 13.2+/-4.7 m/s and VRS score was 3.8+/-1.0. A highly significant positive correlation was evident between VRS score and NP amplitude (y=0.1069x+1.781, r=0.877, n=60, p<0.0001).
CONCLUSION
PREP among normal, healthy adults revealed a statistically significant correlation between PREP amplitude and VRS score.

Keyword

Evoked potentials; Pain measurement; Nociceptive pain; Electrodes

MeSH Terms

Adult*
Electric Stimulation
Electrodes
Evoked Potentials*
Female
Foot
Hand
Healthy Volunteers
Humans
Linear Models
Male
Neural Conduction
Nociceptive Pain
Pain Measurement

Figure

• 

  Fig. 1 The custom-built concentric surface electrode. The design of this planar concentric electrode was previously described. Central cathode (diameter 0.5 mm) and external anode ring (diameter 6 mm) were assembled. A medical engineering company (Hurev Co. Ltd., Wonju, Korea) contractually produced the first sample electrode according. Then we tested and confirmed final production. This custom-built electrode use conventional carbon wire cable and socket that fits well with a portable electromyography system.

• 

  Fig. 2 Stimulation site of pain-related evoked potential. (A) In upper limb stimulation, the stimulating electrode was placed on the middle phalanx of the second digit of the hand (C7 dermatome). (B) In lower limb stimulation, the stimulating electrode was placed on the middle phalanx of the second toe of the foot (L5 dermatome). (C) For calculating upper extremity conduction velocity, distal N latency was measured by stimulating the middle phalanx of the second digit. Proximal N latency was measured by stimulating the point where it measured from 20 cm proximal from the middle phalanx of the second digit. The 20-cm distance between distal and proximal stimulation sites was divided by the difference between the distal N latency and the proximal N latency. (D) The same method was used for calculating lower extremity conduction velocity.

• 

  Fig. 3 Representative acquired graph of C7 dermatomal stimulation of pain-related evoked potential (PREP). Initially negative peak (N) and subsequently positive peak (P) were identified in the averaged waveforms of PREP. Negative-positive peaks were clearly recognized in four different stimulation sites.

• 

  Fig. 4 Correlation between verbal rating scale (VRS) scores and pain-related evoked potential (PREP). VRS score for each of the subject was plotted against the amplitude of PREP. Linear regression analysis was used to determine the relation between VRS scores (y-axis) and amplitude of PREP (x-axis), which revealed a highly significant positive correlation (y=0.1069x+1.781, r=0.877, n=60, p<0.0001).

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