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.