Journal
PAIN
Volume 153, Issue 5, Pages 1122-1127Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1016/j.pain.2011.12.012
Keywords
Neuropathic pain; Erythromelalgia; Arterial spin labelling; FMRI
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Funding
- Wellcome Trust
- London Pain Consortium
- Medical Research Council (FMRIB Centre)
- Medical Research Council [G0700399] Funding Source: researchfish
- MRC [G0700399] Funding Source: UKRI
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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. (C) 2012 Published by Elsevier B.V. on behalf of International Association for the Study of Pain.
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