title: Evaluation of nociceptive Aδ- and C-fiber dysfunction with lidocaine using intraepidermal electrical stimulation.
abstract: OBJECTIVE
  To investigate whether intraepidermal electrical stimulation (IES) can evaluate nociceptive Aδ- and C-fiber dysfunctions of an experimental model of small-fiber neuropathy (SFN) with transdermal lidocaine.
  
  
  METHODS
  Lidocaine tape or placebo was applied to the dorsum of the feet in 14 healthy subjects. Reaction time (RT), sensory threshold, and evoked potentials (EPs) were measured using IES before, and 30 and 60 min after lidocaine/placebo application.
  
  
  RESULTS
  All subjects felt pricking sensations following Aδ-fiber stimulation, and light painful sensations such as pricking, tingling, or burning following C-fiber stimulation using IES. RT was divided bimodally between Aδ- and C-fiber stimulations. At 30 min, lidocaine increased the sensory threshold and decreased the amplitude of EPs in both fiber stimulations. At 60 min, lidocaine's effects were greater for C fibers than for Aδ fibers. The sensory threshold and amplitude of EPs were unchanged among placebo sessions.
  
  
  CONCLUSIONS
  IES demonstrated differential effects of transdermal lidocaine on nociceptive Aδ and C fibers, and elucidated the pathophysiology of the experimental model of SFN.
  
  
  CONCLUSIONS
  IES has advantages in terms of cost, convenience, and invasiveness. It may have potential for a clinical tool to elucidate the pathophysiology of patients with SFN, including the differences between Aδ and C fibers.
authors.affiliation: Department of Integrative Physiology, National Institute for Physiological Sciences, Okazaki 444-8585, Japan; Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Matsumoto 390-8621, Japan. Electronic address: kodaira@nips.ac.jp.
authors.forename: Minori
authors.initials: M
authors.lastname: Kodaira
authors.affiliation: Department of Integrative Physiology, National Institute for Physiological Sciences, Okazaki 444-8585, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Inui
authors.affiliation: Department of Integrative Physiology, National Institute for Physiological Sciences, Okazaki 444-8585, Japan.
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Kakigi
mesh_terms: D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D004558:Electric Stimulation; D005071:Evoked Potentials / Q000187:drug effects; D005260:Female; D006801:Humans; D007271:Injections, Intradermal; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000187:drug effects*; D036421:Nerve Fibers, Unmyelinated / Q000187:drug effects*; D059225:Nociception / Q000187:drug effects*; D010147:Pain Measurement / Q000187:drug effects; D010523:Peripheral Nervous System Diseases / Q000503:physiopathology; D011930:Reaction Time / Q000187:drug effects; D012684:Sensory Thresholds / Q000187:drug effects; D012867:Skin / Q000294:innervation; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine
keywords: Aδ fibers; C fibers; Intraepidermal electrical stimulation; Lidocaine; Pain; Small-fiber neuropathy