Professor Robert Chen
Editor-in-Chief, Clinical Neurophysiology
Caterina M. Leone, Giuseppe di Pietro, Giulia di Stefano, Charles Quesada, Charbel Salameh, Caroline Perchet, Luis Garcia-Larrea, André Mouraux, Louisien Lebrun, Solenn Gousset, Niko Möller-Grell, Anna V. Kostenko, Nanna B. Finnerup, Ombretta Caspani, Bo Jiang, Thomas Li, Clarence Rong, Bernd Genser, Rolf-Detlef Treede, Andrea Truini.
Despite the use of pharmacological and non-pharmacological measures, many patients with chronic pain remains treatment refractory. Clinical neurophysiology methods play an important role in the assessment of pain. The RIII flexion reflex elicited by peripheral nerve stimulation is a nociceptive, polysynaptic reflex that measures lower limb withdrawal to pain. In this volume of Clinical Neurophysiology, Leone et al. examined in effects of three analgesic drug on spinal pain biomarkers in healthy subjects in a randomized, placebo-controlled study. The results showed that tapentadol and pregabalin reduced RIII flexion reflex areas, although the results were not significant, likely due to limited sample size. Both drugs and lacosamide increased RIII threshold. N13 SEP, which assessed large fiber functions, were unchanged. These results highlight the role of clinical neurophysiology measures such as RIII flexion reflex as an objective biomarker of pain, and their potential utility to assess the efficacy of treatment.