Drewes AM, Gratkowski M, Sami SA, Dimcevski G, Funch-Jensen P, Arendt-Nielsen L. Is the pain in chronic pancreatitis of neuropathic origin? Support from EEG studies during experimental pain. World J Gastroenterol 2008; 14(25): 4020-4027 [PMID: 18609686 DOI: 10.3748/wjg.14.4020]
Corresponding Author of This Article
Asbjørn Mohr Drewes, Professor, MD, PhD, DMSc, Mech-Sense, Department of Medical Gastroenterology, Aalborg University Hospital, Aalborg DK-9000, Denmark. drewes@smi.auc.dk
Article-Type of This Article
Clinical Research
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World J Gastroenterol. Jul 7, 2008; 14(25): 4020-4027 Published online Jul 7, 2008. doi: 10.3748/wjg.14.4020
Is the pain in chronic pancreatitis of neuropathic origin? Support from EEG studies during experimental pain
Asbjørn M Drewes, Maciej Gratkowski, Saber AK Sami, Georg Dimcevski, Peter Funch-Jensen, Lars Arendt-Nielsen
Asbjørn M Drewes, Saber AK Sami, Department of Gastroenterology, Aalborg University Hospital, Aalborg, Aalborg DK-9000, Denmark
Asbjørn M Drewes, Maciej Gratkowski, Lars Arendt-Nielsen, Center for Sensory-Motor Interactions (SMI), Department of Health Science and Technology, Aalborg University, Aalborg DK-9000, Denmark
Maciej Gratkowski, Institute of Biomedical Engineering and Informatics, Computer Science and Automation Faculty, Technische Universität Ilmenau, Ilmenau 98684, Germany
Georg Dimcevski, Department of Gastroenterology, Haukeland University Hospital, Bergen 5021, Norway
Peter Funch-Jensen, Department of Surgical Gastroenterology L, Aarhus University Hospital, Aarhus DK-8000, Denmark
Author contributions: Drewes AM, Sami SAK and Dimcevski G conducted the experiment; Gratkowski M and Arendt-Nielsen L made the signal analysis; Funch-Jensen P included part of the patients and gave room for the experiments in Aarhus. All authors contributed to the writing process.
Correspondence to: Asbjørn Mohr Drewes, Professor, MD, PhD, DMSc, Mech-Sense, Department of Medical Gastroenterology, Aalborg University Hospital, Aalborg DK-9000, Denmark. drewes@smi.auc.dk
Telephone: +45-9-9321111
Fax: +45-9-9322503
Received: January 23, 2008 Revised: May 1, 2008 Accepted: May 8, 2008 Published online: July 7, 2008
Abstract
AIM: To prove the hypothesis that patients with chronic pancreatitis would show increased theta activity during painful visceral stimulation.
METHODS: Eight patients and 12 healthy controls underwent an experiment where the esophagus was electrically stimulated at the pain threshold using a nasal endoscope. The electroencephalogram (EEG) was recorded from 64 surface electrodes and “topographic matching pursuit” was used to extract the EEG information in the early brain activation after stimulation.
RESULTS: A major difference between controls and patients were seen in delta and theta bands, whereas there were only minor differences in other frequency bands. In the theta band, the patients showed higher activity than controls persisting throughout the 450 ms of analysis with synchronous brain activation between the channels. The main theta components oscillated with 4.4 Hz in the patients and 5.5 Hz in the controls. The energy in the delta (0.5-3.5 Hz) band was higher in the controls, whereas the patients only showed scattered activity in this band.
CONCLUSION: The differences in the theta band indicate that neuropathic pain mechanisms are involved in chronic pancreatitis. This has important implications for the understanding and treatment of pain in these patients, which should be directed against drugs with effects on neuropathic pain disorders.
