title: Imaging the neural correlates of neuropathic pain and pleasurable relief associated with inherited erythromelalgia in a single subject with quantitative arterial spin labelling.
abstract: We identified a patient with severe inherited erythromelalgia secondary to an L858F mutation in the voltage-gated sodium channel Na(v)1.7. The patient reported severe ongoing foot pain, which was exquisitely sensitive to limb cooling. We confirmed this heat hypersensitivity using quantitative sensory testing. Additionally, we employed a novel perfusion imaging technique in a simple block design to assess her baseline erythromelalgia pain vs cooling relief. Robust activations of key pain, pain-affect, and reward-related centres were observed. This combined approach allowed us to confirm the presence of a temperature-sensitive channelopathy of peripheral neurons and to investigate the neural correlates of tonic neuropathic pain and relief in a single subject.
authors.affiliation: Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences, Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB), University of Oxford, Oxford, Oxfordshire, UK Wolfson Centre for Age-Related Disease, Kings College London, Hodgkin Building, Guys Campus, SE1 1UL London, UK.
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Segerdahl
authors.forename: Jingyi
authors.initials: J
authors.lastname: Xie
authors.forename: Kathryn
authors.initials: K
authors.lastname: Paterson
authors.forename: Juan D
authors.initials: JD
authors.lastname: Ramirez
authors.forename: Irene
authors.initials: I
authors.lastname: Tracey
authors.forename: David L H
authors.initials: DLH
authors.lastname: Bennett
mesh_terms: D000328:Adult; D001921:Brain / Q000503:physiopathology*; D004916:Erythromelalgia / Q000235:genetics / Q000503:physiopathology*; D005260:Female; D059907:Functional Neuroimaging / Q000379:methods*; D006801:Humans; D062556:NAV1.7 Voltage-Gated Sodium Channel; D009437:Neuralgia / Q000235:genetics / Q000503:physiopathology*; D057181:Pleasure / Q000502:physiology*; D012684:Sensory Thresholds / Q000502:physiology; D015222:Sodium Channels / Q000235:genetics; D013113:Spin Labels
chemical_list: D062556:NAV1.7 Voltage-Gated Sodium Channel; C486866:SCN9A protein, human; D015222:Sodium Channels; D013113:Spin Labels