Reduced descending itch inhibition in peripheral neuropathy patients with chronic pruritus
Background Peripheral neuropathies (PNP) cause a wide range of symptoms of which pruritus and pain are a major burden to patients. Clarifying their mechanisms will facilitate the adequate symptom management. In contrast to neuropathic pain, neuropathic pruritus has long been understudied. We investi...
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| Autori principali: | , , , , , , , , , |
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| Natura: | Article (Journal) |
| Lingua: | inglese |
| Pubblicazione: |
January 2026
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| In: |
European journal of pain
Year: 2026, Volume: 30, Fascicolo: 1, Pages: 1-11 |
| ISSN: | 1532-2149 |
| DOI: | 10.1002/ejp.70190 |
| Accesso online: | Verlag, kostenfrei, Volltext: https://doi.org/10.1002/ejp.70190 Verlag, kostenfrei, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1002/ejp.70190 
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| Note sull'autore: | Jonas Eck, Stephan Bigalke, Martin Schmelz, Daniela Constanze Rosenberger, Bruno Pradier, Frank Rutsch, Claudia Sommer, Frank Birklein, Daniel Segelcke, Esther Pogatzki-Zahn |
| Riassunto: | Background Peripheral neuropathies (PNP) cause a wide range of symptoms of which pruritus and pain are a major burden to patients. Clarifying their mechanisms will facilitate the adequate symptom management. In contrast to neuropathic pain, neuropathic pruritus has long been understudied. We investigate inhibitory pruritus mechanisms in patients with PNP. Methods A total of 39 participants (median age: 57 years [27-81], 25♀/14♂), including 16 patients with PNP and pruritus (PNPPRU) and 8 with PNP but without pruritus (PNPNO-PRU), and 15 controls, were enrolled and phenotyped using dynamic and static quantitative sensory testing, determination of intradermal nerve fibre density, and conditioned pain (CPM) and itch (CIM) modulation. For CIM, an electrically induced itch test stimulus (TS) was applied with an individual itch intensity of > 30 NRS (0-100). A cold-water bath (contralateral side) served as the conditioning stimulus (CS). Itch, pain intensity and the desire to scratch upon TS were rated before, during and after the CS was applied. Results Using our novel CIM protocol, well-controlled and stable itch was electrically induced in controls and in both PNP groups, regardless of whether or not pruritus was a symptom. Concomitant painful cold stimuli reduced electrically induced itch in all three groups to a similar degree. However, PNPPRU patients had significantly shorter itch inhibition (CIM effects) compared to controls and PNPNO-PRU, whereas CPM effects were not different between groups. Conclusions The results show reduced endogenous itch inhibition in patients with chronic itch, which represents a possible mechanism of chronic pruritus in PNP. Significance Statement Reduced itch inhibition is associated with the symptom of chronic pruritus in PNP patients, suggesting that reduced descending itch inhibition may facilitate chronic itch in peripheral neuropathy. |
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| Descrizione del documento: | Erstmals veröffentlicht: 3. Januar 2026 Gesehen am 09.03.2026 |
| Descrizione fisica: | Online Resource |
| ISSN: | 1532-2149 |
| DOI: | 10.1002/ejp.70190 |