Palmitoylethanolamide restores myelinated-fibre function in patients with chemotherapy-induced painful neuropathy.
We assessed the effect of palmitoylethanolamide (PEA) on pain and nerve function in patients with chemotherapy-induced painful neuropathy, in 20 patients undergoing thalidomide and bortezomib treatment for multiple myeloma. All patients were evaluated before and after a two-month treatment with PEA 300 mg BID using pain and warmth thresholds; blinded examiners measured motor and sensory nerve fibre function and laser-evoked potentials. Although no variables returned to normal values, pain and all neurophysiological measures � assessing Aα, Aβ, and Aδ  fibres � significantly improved (P < 0.05). In contrast, warmth thresholds, assessing unmyelinated afferents, remained unchanged (P > 0.50). Although a placebo effect might play a role in the reported pain relief, the changes in neurophysiological measures indicate that PEA exerted a positive action on myelinated fibre groups. PEA, possibly by moderating mast cell hyperactivity, relieved conduction blocks secondary to endoneural edema. In a severe condition such as painful neuropathy associated with multiple myeloma and chemotherapy, a safe substance such as PEA provides significant restoration of nerve function.
Dip. Neurologia e Psichiatria, Sapienza Universita di Roma, Roma, Italy.
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Truini
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Biasiotta
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Di Stefano
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La Cesa
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Leone
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Cartoni
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Federico
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Petrucci
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Cruccu
D000368:Aged; D000369:Aged, 80 and over; D000577:Amides; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D063388:Endocannabinoids; D004983:Ethanolamines; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000187:drug effects* / Q000502:physiology*; D010146:Pain / Q000139:chemically induced / Q000188:drug therapy* / Q000473:pathology; D010169:Palmitic Acids / Q000627:therapeutic use*; D011115:Polyneuropathies / Q000139:chemically induced / Q000188:drug therapy* / Q000473:pathology
D000577:Amides; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000970:Antineoplastic Agents; D063388:Endocannabinoids; D004983:Ethanolamines; D010169:Palmitic Acids; C005958:palmidrol