Establishment of a therapeutic strategy based on axonal ionic pathophysiology in patients with neuropathic pain

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We investigated changes in nodal persistent Na^+currents in sensory axons of patients with neuropathic pain before and after mexiletine(Na^+channel blocker) administration, using computerized threshold tracking system. Mexiletine substantially suppressed the degree of pain associated with decreased Na^+currents. In addition, we established a recording of pain-related evoked potentials using intra-epidermal needle electrode which can selectively stimulate Aδand C fiber. The combination of evaluating peripheral ionic mechanism and studying central pathophysiology underlying neurpathic pain patients would contribute to establishment of an efficient therapeutic strategy in the future.