Establishing cold-evoked potentials for clinical use

Polyneuropathy is one of the most common neurological diseases, which affects pain sensation, mobility, functionality, and quality of life in patients. Up to 16% of 70 years old human beings suffer from polyneuropathy. In the early stage of disease, common electrophysiological diagnostic procedures are not capable to assess nerve fiber alterations. Especially the integrity of small-nerve fibers and the spino-thalamic tract cannot be tested by nerve conduction studies or somatosensory evoked potentials. Nevertheless, it is essential to drive treatment decisions in the very early stage of disease in order to prevent further damage to the somatosensory system.

The majority of polyneuropathy patients suffers from cold detection loss as early sign of disease. So far, the integrity of cold mediating fibers has not been assessable by objective electrophysiological diagnostic tools.

Cold-evoked potentials (CEP) provide a valuable new diagnostic tool, which enables early detection of small-fiber function loss. This is an important prerequisite for measuring the early stage of disease, when patients report tingling sensations or quality of life affecting pain while physicians cannot detect any sensory abnormities. The early quantification of these sensory abnormalities with CEP may optimize medical treatment (such as antidiabetic drugs, vitamin substitution, avoidance of toxic agents, enzyme therapy for Fabry’s disease, etc.) and prevent further somatosensory damage.