Thoefner M S, Westrup U, Toft N, Bjerrum O J, Berendt M
Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlaegevej 16, 1870 Frederiksberg C, Denmark.
Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlaegevej 16, 1870 Frederiksberg C, Denmark.
Vet J. 2019 Apr;246:92-97. doi: 10.1016/j.tvjl.2019.01.011. Epub 2019 Feb 1.
It is assumed that Cavalier King Charles spaniels with Chiari-like malformation and syringomyelia experience central neuropathic pain. An association between spinal cord parenchymal lesions and specific clinical signs (e.g. spontaneous and evoked scratching, withdrawal, and paroxysmal pain manifestations with vocalisation) has been suggested. This led to the hypothesis that mechanical sensory threshold is altered in clinical cases. The aim of this study was to quantify the cervical mechanical sensory threshold using Semmes-Weinstein monofilaments in nine Cavalier King Charles spaniels with Chiari-like malformation and assumed syringomyelia-associated central neuropathic pain compared to eight control dogs. Clinical and neurological examination including magnetic resonance imaging was undertaken. Mean mechanical sensory threshold was not significantly different between case and control dogs (t-test on log10 transformed data; P=0.25). Substantial variation within and between dogs was seen, with individual thresholds ranging from 0.04 to 26g in case dogs and from 0.02 to 10g in control dogs. Based on these results, it is unlikely that Cavalier King Charles spaniels with Chiari-like malformation and syringomyelia have increased mechanical sensation characterised by lower mechanical sensory threshold when quantified with Semmes-Weinstein monofilaments. Whether clinical cases experience central neuropathic pain remains unknown. The assessment of sensory function in dogs with assumed central neuropathic pain should be multimodal and include not only mechanical but also tactile and thermal threshold quantification. The use of threshold quantification in a clinical setting is challenging due to an insufficient signal relative to the biological background noise within and between dogs.
人们认为,患有 Chiari 样畸形和脊髓空洞症的查理士王小猎犬会经历中枢神经性疼痛。有研究表明脊髓实质病变与特定临床症状(如自发和诱发的抓挠、退缩以及伴有发声的阵发性疼痛表现)之间存在关联。这引发了一个假设,即临床病例的机械感觉阈值会发生改变。本研究的目的是使用 Semmes-Weinstein 单丝量化九只患有 Chiari 样畸形且假定患有与脊髓空洞症相关的中枢神经性疼痛的查理士王小猎犬的颈部机械感觉阈值,并与八只对照犬进行比较。进行了包括磁共振成像在内的临床和神经学检查。病例犬和对照犬之间的平均机械感觉阈值没有显著差异(对 log10 转换后的数据进行 t 检验;P = 0.25)。在犬只内部和之间都观察到了很大的差异,病例犬的个体阈值范围为 0.04 至 26 克,对照犬的个体阈值范围为 0.02 至 10 克。基于这些结果,当用 Semmes-Weinstein 单丝进行量化时,患有 Chiari 样畸形和脊髓空洞症的查理士王小猎犬不太可能具有以较低机械感觉阈值为特征的机械感觉增强。临床病例是否经历中枢神经性疼痛仍然未知。对假定患有中枢神经性疼痛的犬只进行感觉功能评估应采用多模式,不仅包括机械感觉阈值,还应包括触觉和热感觉阈值的量化。由于相对于犬只内部和之间的生物背景噪声而言信号不足,在临床环境中使用阈值量化具有挑战性。