Somatotopic heat pain thresholds and intraepidermal nerve fibers in health

Jenny L. Davies, Janean K. Engelstad, Linde E. Gove, Linda K. Linbo, Rickey E. Carter, Christopher Lynch, Nathan P Staff, Christopher Jon Klein, P. James B Dyck, David N. Herrmann, Peter J Dyck

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3 Scopus citations


Introduction: For sequential and somatotopic assessment of small fiber neuropathy, heat pain (HP) tests of hypoalgesia might be used instead of decreased counts of epidermal nerve fibers (ENFs), but then healthy subject reference values of HP thresholds are needed. Methods: Using the Computer Assisted Sensation Evaluator IVc system, HP thresholds of hypoalgesia were estimated for 10 unilateral sites and counts of ENFs for 4 of them in healthy subjects. Results: In healthy subjects, small but statistically significant differences of both HP thresholds of hypoalgesia and counts of ENFs were observed among tested sites. Significant correlations between HP thresholds and counts of ENFs were not found. Discussion: For the studied somatotopic sites, we provide ≥95th and ≥99th percentile reference limits for HP 0.5 and 5 of 1–10 HP thresholds of hypoalgesia and decreased counts of ENFs at ≤5th and ≤1st percentile levels. Muscle Nerve 58: 509–516, 2018.

Original languageEnglish (US)
Pages (from-to)509-516
Number of pages8
JournalMuscle and Nerve
Issue number4
StatePublished - Oct 1 2018



  • distal polyneuropathy
  • epidermal nerve fibers
  • heat pain tests of hypoalgesia
  • heat pain thresholds
  • small fiber neuropathy
  • somatotopic sites

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Physiology (medical)

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