• N Turgut and B U Altun.
• Neurology Department, Trakya University School of Medicine, 22030 Edirne, Turkey. nildaturgut@hotmail.com
• Acta Neurol. Scand. 2009 Dec 1;120(6):383-8.

ObjectivesMotor cortex disinhibition has a role in the mechanism of neuropathic pain. The duration of the cortical silent period (CSP) is used as a measure of excitability in cortical inhibitory circuits. We investigated cortical disinhibition in diabetic patients with and without neuropathic pain.Materials And MethodsWe studied diabetic patients with (n = 20) and without (n = 50) neuropathic pain, and control subjects (n = 30). Transcranial magnetic stimulation (TMS) was performed on the right hemisphere at rest, and surface electromyography was recorded from the left first dorsal interosseous muscle for evaluation of motor evoked potential (MEP) latency and amplitude. CSP was recorded from the left FDI, and TMS was then delivered while the subject was performing a voluntary contraction.ResultsWe showed a low resting motor threshold, a short CSP duration, and a low CSP duration/MEP amplitude ratio in patients with neuropathic pain (P < 0.0001, P < 0.0001, P < 0.0001).ConclusionsOur findings demonstrate that diabetic patients with neuropathic pain have a cortical disinhibition.

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