Microneurography to Study Nociceptive Fibre Changes in Painful Peripheral Neuropathies

Microneurography is the only neurophysiological technique that records neuronal activity directly from nerves in awake patients. The thin myelinated and unmyelinated nociceptive fibres, tested by microneurography, are not assessed by conventional nerve conduction studies and are responsible for sensing pain. Nociceptive fibres are heterogenous, they show different stimulus-response functions and some are mechanically-insensitive in the naive state. Recording from nociceptive fibres provides unrivalled insight into peripheral neuronal activity and how it can relate to chronic neuropathic pain; for example, study of nociceptive fibres in fibromyalgia patients identified hyperexcitability in C fibres and a possible new mechanisms for chronic pain in these patients.