Hyperpathia: A potential biomarker of spinally-driven pain in people with diabetic neuropathy

  • There is increasing recognition that processes within the spinal cord are key to modulating neuropathic pain, through amplification or suppression of peripheral nociceptive inputs.
  • This study aimed to determine whether impaired rate-dependent depression of the Hoffmann reflex was associated with painful diabetic neuropathy. Compared to patients with diabetic neuropathy without pain, those with pain experienced impaired Hoffmann reflex rate-dependent depression at 1, 2 and 3 Hz (P≤0.001). Spinal disinhibition in the painful diabetic neuropathy group was greatly associated with mechanical pain sensitivity, heat hyperalgesia and higher ratings of spontaneous burning pain. In addition, the authors indicate a link between hyperpathia as a putative biomarker with spinal disinhibition.  
  • According to the authors, spinal disinhibition plays a role in pain amplification in people with painful diabetic neuropathy.