European Heart Journal Advance Access first published online on March 24, 2005
This version published online on March 30, 2005
European Heart Journal, doi:10.1093/eurheartj/ehi229
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1 Divisione di Neurologia, Ospedale Pediatrico ‘Bambino Gesù’--IRCCS, Roma, Italy
* To whom correspondence should be addressed. Aims Previous studies suggested that an enhanced pain sensitivity is present in patients with cardiac syndrome X (SX). We investigated whether SX patients present abnormalities in the electrical cerebral signals generated by pain stimuli. Methods and results Cortical laser evoked potentials (LEPs) were recorded in 16 SX patients, in 10 patients with refractory angina due to obstructive coronary artery disease (CAD) and in 13 healthy controls. LEPs were recorded during stimulation of chest and right hand dorsum. Three sequences of painful stimuli were applied at each site. Subjective pain rating was assessed by a 0-100 mm visual analogic scale (VAS). Basal LEPs did not differ among groups and there were no differences for most LEP components across the repetitions of stimuli. However, the amplitude of the N2/P2 LEP component, specifically reflecting cortical pain processing, decreased across the three sequences of stimuli in controls and CAD patients, but not in SX patients. Compared with the first sequence, the N2/P2 amplitude during the third sequence of stimuli in the three groups was 77 ± 16, 56 ± 24, and 99 ± 34%, respectively, for chest (P = 0.001), and 63 ± 31, 72 ± 17, and 98 ± 46%, respectively, for right hand (P = 0.03) stimulation. The changes in VAS pain score across the three sequences paralleled those of N2/P2 amplitude. Conclusion Our data show that in SX patients, central handling of painful stimuli is characterized by inadequate habituation, which might play a role in determining the peculiar clinical characteristics of anginal chest pain of these patients.
Received October 25, 2004
Revised February 11, 2005
Accepted February 17, 2005
Preclinical research
Abnormal cortical pain processing in patients with cardiac syndrome X
2 Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168 Roma, Italy
3 Divisione di Riabilitazione Neuromotoria, Casa di Cura San Raffaele Pisana, IRCCS, via della Pisana 235, 00165 Roma, Italy
4 Istituto di Neurologia, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168 Roma, Italy
Gaetano Antonio Lanza, E-mail: g.a.lanza{at}inwind.it
Abstract
The originally published version of this paper was incorrect. The author affiliations for Domenica Le Pera and Liala De Armas were incorrect. The author apologizes that these were not identified earlier.
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