Contribution of Loss of Large Fiber Function to Pain in Two Samples of Oncology Patients

Christine Miaskowski, Steven M. Paul, Judy Mastick, Gary Abrams, Kimberly Topp, Betty Smoot, Kord M. Kober, Margaret Chesney, Mark Schumacher, Yvette P. Conley, Marilyn Hammer, Steven Cheung, David Borsook, Jon D. Levine

Research output: Contribution to journalArticle

Abstract

Numbness associated with neuropathic pain suggests the loss of function in myelinated, large diameter sensory neurons. The purpose of this study was to examine the relationships between pain severity and subjective (i.e., severity of numbness) and objective (i.e., loss of light touch sensations, vibration thresholds) measures of loss of large fiber function in adult survivors with chemotherapy-induced peripheral neuropathy (CIN, n=426) and breast cancer patients with persistent post-surgical pain (n=80). For both samples, average pain and numbness were evaluated using a 0 to 10 numeric rating scale (NRS). Loss of light touch sensations in the hands and feet of patients with CIN and in the upper arm of patients at 5 and 6 months following breast cancer surgery were assessed using Semmes Weinstein monofilaments. Loss of vibration in the hands and feet of patients with CIN was assessed using a biothesiometer. Pearson Product Moment correlation coefficients were calculated between average pain and the number or percentage of sites with loss of light touch sensations, mean vibration thresholds, and the severity of numbness. For both pain conditions, average pain scores were significantly correlated with objective measures of large fiber function (r=0.12 to 0.34; all, P<0.05) and numbness (r=0.22 to 0.52; all, P<0.008). Our findings, in two independent samples of oncology patients, suggest that loss of function of myelinated, large diameter fibers contributes to the severity of neuropathic pain.

Original languageEnglish (US)
JournalClinical Journal of Pain
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Hypesthesia
Pain
Touch
Vibration
Neuralgia
Foot
Hand
Breast Neoplasms
Peripheral Nervous System Diseases
Sensory Receptor Cells
Survivors
Arm
Drug Therapy

Keywords

  • breast cancer
  • chemotherapy-induced peripheral neuropathy
  • large myelinated fibers
  • neuropathic pain
  • numbness
  • post-surgical pain
  • vibration

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

Miaskowski, C., Paul, S. M., Mastick, J., Abrams, G., Topp, K., Smoot, B., ... Levine, J. D. (Accepted/In press). Contribution of Loss of Large Fiber Function to Pain in Two Samples of Oncology Patients. Clinical Journal of Pain. https://doi.org/10.1097/AJP.0000000000000649

Contribution of Loss of Large Fiber Function to Pain in Two Samples of Oncology Patients. / Miaskowski, Christine; Paul, Steven M.; Mastick, Judy; Abrams, Gary; Topp, Kimberly; Smoot, Betty; Kober, Kord M.; Chesney, Margaret; Schumacher, Mark; Conley, Yvette P.; Hammer, Marilyn; Cheung, Steven; Borsook, David; Levine, Jon D.

In: Clinical Journal of Pain, 01.01.2018.

Research output: Contribution to journalArticle

Miaskowski, C, Paul, SM, Mastick, J, Abrams, G, Topp, K, Smoot, B, Kober, KM, Chesney, M, Schumacher, M, Conley, YP, Hammer, M, Cheung, S, Borsook, D & Levine, JD 2018, 'Contribution of Loss of Large Fiber Function to Pain in Two Samples of Oncology Patients', Clinical Journal of Pain. https://doi.org/10.1097/AJP.0000000000000649
Miaskowski, Christine ; Paul, Steven M. ; Mastick, Judy ; Abrams, Gary ; Topp, Kimberly ; Smoot, Betty ; Kober, Kord M. ; Chesney, Margaret ; Schumacher, Mark ; Conley, Yvette P. ; Hammer, Marilyn ; Cheung, Steven ; Borsook, David ; Levine, Jon D. / Contribution of Loss of Large Fiber Function to Pain in Two Samples of Oncology Patients. In: Clinical Journal of Pain. 2018.
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