• Gunther Landmann, Wolfgang Dumat, Niklaus Egloff, Andreas R Gantenbein, Sibylle Matter, Roberto Pirotta, Peter S Sándor, Wolfgang Schleinzer, Burkhardt Seifert, Haiko Sprott, Lenka Stockinger, and Franz Riederer.
• *Centre for Pain Medicine, Swiss Paraplegic-Centre, Nottwil †Department of General Internal Medicine, Psychosomatic Division, C.L. Lory-Haus, Inselspital, University Hospital, Bern ‡RehaClinic, Bad Zurzach ¶Division of Biostatistics, Institute for Social and Preventive Medicine, University of Zurich Departments of §Psychiatry **Neurology, University Hospital Zurich #Medical Practice Hottingen, Zurich ∥ANNR Neurology, RehaClinic, Baden, Switzerland ††Neurological Center Rosenhuegel & Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology, Vienna, Austria.
• Clin J Pain. 2017 Aug 1; 33 (8): 746755746-755.

ObjectivesWidespread sensory deficits resembling hemihypoesthesia occur in 20% to 40% of chronic pain patients on the side of pain, independent of pain etiology, and have been termed nondermatomal sensory deficits (NDSDs). Sensory profiles have rarely been investigated in NDSDs.Materials And MethodsQuantitative sensory testing according to the protocol of the German Research Network on Neuropathic Pain (DFNS) was performed in the face, hand, and foot of the painful body side and in contralateral regions in chronic pain patients. Twenty-five patients with NDSDs and 23 without NDSDs (termed the pain-only group) were included after exclusion of neuropathic pain. Comprehensive clinical and psychiatric evaluations were carried out.ResultsNDSD in chronic pain was associated with high burden of disease and more widespread pain. Only in the NDSD group were significantly higher thresholds for mechanical and painful stimuli found in at least 2 of 3 regions ipsilateral to pain. In addition, we found a bilateral loss of function for temperature and vibration detection, and a gain of function for pressure pain in certain regions in patients with NDSD. Sensory loss and gain of function for pressure pain correlated with pain intensity in several regions.DiscussionThis may indicate a distinct sensory profile in chronic non-neuropathic pain and NDSD, probably attributable to altered central pain processing and sensitization. The presence of NDSD in chronic non-neuropathic pain may be regarded as a marker for higher burden of pain disease.

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