Contact heat evoked potentials: normal values and use in small-fiber neuropathy

Muscle Nerve. 2015 May;51(5):743-9. doi: 10.1002/mus.24465. Epub 2015 Mar 31.

Abstract

Introduction: Contact heat evoked potentials (CHEPs) may be an objective, non-invasive diagnostic tool in small-fiber neuropathy (SFN). This study establishes normal CHEP values and examines their applicability in SFN patients.

Methods: Standardized CHEPs were administered at the wrist and ankle. The N2 and P2 latencies and N2 -P2 peak-peak amplitude were recorded by electroencephalography. We examined healthy subjects (n = 97), stratified by age and gender, and SFN patients with abnormal intraepidermal nerve fiber density (n = 42). CHEP reproducibility and interobserver values were also investigated.

Results: CHEP normative values were determined. There was a 9-16% increase in latency per centimeter of height with increasing age. Amplitudes were higher in women than men, and decreased (17-71%) with aging. Test-retest reproducibility and interobserver values were >0.61 and >0.96, respectively. CHEPs were abnormal in 73.8% of the patients.

Conclusion: In this study we have established normal values, reliability, and clinical applicability of CHEPs in SFN.

Keywords: contact heat evoked potentials; polyneuropathy; quantitative sensory testing; reference values; small-fiber neuropathy.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aging / physiology
  • Ankle
  • Erythromelalgia / diagnosis*
  • Erythromelalgia / physiopathology*
  • Evoked Potentials, Somatosensory / physiology*
  • Female
  • Hot Temperature*
  • Humans
  • Male
  • Middle Aged
  • Observer Variation
  • Reaction Time / physiology*
  • Reference Values
  • Reproducibility of Results
  • Retrospective Studies
  • Sex Factors
  • Skin / innervation*
  • Wrist