Pre-perceptual pain sensory responses (N1 component) in type 1 diabetes mellitus

Neuroreport. 2002 Jun 12;13(8):1009-12. doi: 10.1097/00001756-200206120-00005.

Abstract

We investigated the integrity of the ascending pathways for pain sensitivity in the early stage of type 1 diabetes mellitus, by measuring the N1 component and the conventional N2/P2 vertex potentials of laser evoked potentials (LEPs). Brain responses to laser stimuli were obtained in 21 healthy volunteers and 21 type 1 diabetic patients, without either clinical neuropathy or electrophysiological evidence of large-fiber damage. In diabetic patients N1 and P2 latencies were prolonged and the N1 and N2/P2 amplitudes were decreased after foot stimulation. A significant reduction of the conduction velocity of Adelta fibers in the lower limbs was also observed. LEPs reveal an early, subclinical and selective damage of pain sensation in diabetic patients. N1 and P2 potentials are delayed and decreased in parallel giving evidence that LEP abnormalities are not secondary to a cognitive dysfunction and mostly reflect a small-fiber dysfunction.

MeSH terms

  • Afferent Pathways / pathology
  • Afferent Pathways / physiopathology*
  • Diabetes Mellitus, Type 1 / pathology
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Diabetic Neuropathies / pathology
  • Diabetic Neuropathies / physiopathology*
  • Evoked Potentials, Somatosensory / physiology
  • Female
  • Humans
  • Lasers
  • Male
  • Nerve Fibers, Myelinated / pathology
  • Nerve Fibers, Myelinated / physiology*
  • Neural Conduction / physiology
  • Nociceptors / pathology
  • Nociceptors / physiology*
  • Pain / etiology
  • Pain / pathology
  • Pain / physiopathology*
  • Peripheral Nerves / pathology
  • Peripheral Nerves / physiopathology*
  • Physical Stimulation
  • Reaction Time / physiology