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This article and any supplementary material should be cited as follows: Fischer TZ, Waxman SG. Extraterritorial temperature pain threshold abnormalities.

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Presentation on theme: "This article and any supplementary material should be cited as follows: Fischer TZ, Waxman SG. Extraterritorial temperature pain threshold abnormalities."— Presentation transcript:

1 This article and any supplementary material should be cited as follows: Fischer TZ, Waxman SG. Extraterritorial temperature pain threshold abnormalities in subjects with healed thermal injury. J Rehabil Res Dev. 2012;49(4):515–22. http://dx.doi.org/10.1682/JRRD.2011.04.0071 Slideshow Project DOI:10.1682/JRRD.2011.04.0071JSP Extraterritorial temperature pain threshold abnormalities in subjects with healed thermal injury Tanya Z. Fischer, MD, PhD; Stephen G. Waxman, MD, PhD

2 This article and any supplementary material should be cited as follows: Fischer TZ, Waxman SG. Extraterritorial temperature pain threshold abnormalities in subjects with healed thermal injury. J Rehabil Res Dev. 2012;49(4):515–22. http://dx.doi.org/10.1682/JRRD.2011.04.0071 Slideshow Project DOI:10.1682/JRRD.2011.04.0071JSP Aim – Test whether extraterritorial changes in pain thresholds, including contralateral pain-like changes, occur in humans after focal thermal injury. Relevance – Approximately 1.25 million Americans sustain burn injuries annually. – Burn pain is often refractory to current therapies, undertreated, and chronic; has lasting effect on quality of life; and is sometimes felt outside initial injury area.

3 This article and any supplementary material should be cited as follows: Fischer TZ, Waxman SG. Extraterritorial temperature pain threshold abnormalities in subjects with healed thermal injury. J Rehabil Res Dev. 2012;49(4):515–22. http://dx.doi.org/10.1682/JRRD.2011.04.0071 Slideshow Project DOI:10.1682/JRRD.2011.04.0071JSP Methods Reported quantitative sensory data from 5 subjects who had sustained external thermal limb injuries 8 wk to 11 yr prior. Assessed severity of their pain and evoked pain. Evaluated quantitative thermal sensory testing: – Assessed detection of cold, warm, cold pain, and heat pain. – Determined threshold 4 times, then averaged for each thermal modality at different locations.

4 This article and any supplementary material should be cited as follows: Fischer TZ, Waxman SG. Extraterritorial temperature pain threshold abnormalities in subjects with healed thermal injury. J Rehabil Res Dev. 2012;49(4):515–22. http://dx.doi.org/10.1682/JRRD.2011.04.0071 Slideshow Project DOI:10.1682/JRRD.2011.04.0071JSP Results Subjects demonstrated reduced thermal pain thresholds in regions outside burn injury zone, including contralateral limbs. Warm and cold detection thresholds were not significantly different from controls.

5 This article and any supplementary material should be cited as follows: Fischer TZ, Waxman SG. Extraterritorial temperature pain threshold abnormalities in subjects with healed thermal injury. J Rehabil Res Dev. 2012;49(4):515–22. http://dx.doi.org/10.1682/JRRD.2011.04.0071 Slideshow Project DOI:10.1682/JRRD.2011.04.0071JSP Conclusions Our results: – Complement data from animal models demonstrating that allodynia can develop contralateral to focal burn injury as result of changes within spinal cord. – Suggest that systemic or central mechanisms contribute to pain after burn injury.

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