Evaluation of afferent pain pathways in adrenomyeloneuropathic patients

Publication date: March 2018
Source:Clinical Neurophysiology, Volume 129, Issue 3
Author(s): Sara Yagüe, Misericordia Veciana, Carlos Casasnovas, Montserrat Ruiz, Jordi Pedro, Josep Valls-Solé, Aurora Pujol
ObjectivePatients with adrenomyeloneuropathy may have dysfunctions of visual, auditory, motor and somatosensory pathways. We thought on examining the nociceptive pathways by means of laser evoked potentials (LEPs), to obtain additional information on the pathophysiology of this condition.MethodsIn 13 adrenomyeloneuropathic patients we examined LEPs to leg, arm and face stimulation. Normative data were obtained from 10 healthy subjects examined in the same experimental conditions. We also examined brainstem auditory evoked potentials (BAEPs), pattern reversal full-field visual evoked potentials (VEPs), motor evoked potentials (MEPs) and somatosensory evoked potentials (SEPs).ResultsUpper and lower limb MEPs and SEPs, as well as BAEPs, were abnormal in all patients, while VEPs were abnormal in 3 of them (23.1%). LEPs revealed abnormalities to stimulation of the face in 4 patients (30.7%), the forearm in 4 patients (30.7%) and the leg in 10 patients (76.9%).ConclusionsThe pathologic process of adrenomyeloneuropathy is characterized by a preferential involvement of auditory, motor and somatosensory tracts and less severely of the visual and nociceptive pathways. This non-inflammatory distal axonopathy preferably damages large myelinated spinal tracts but there is also partial involvement of small myelinated fibres.SignificanceLEPs studies can provide relevant information about afferent pain pathways involvement in adrenomyeloneuropathic patients.



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