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Evaluation of chemotherapy-induced peripheral neuropathy using current perception threshold and clinical evaluations

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Abstract

Purpose

Chemotherapy-induced peripheral neuropathy (CIPN) is increasing with introduction of new and combination cancer pharmacotherapies. This study evaluated associations between clinical and self-report measurements and current perception threshold (CPT), a neuroselective measure of sensory nerve function that may detect asymptomatic CIPN damage.

Methods

Data for this secondary analysis were from a prospective, observational study using CPT to evaluate CIPN. Bivariate mixed models, accounting for the intraclass correlation between repeated patient assessments, were used to assess the relationship between CPT at each frequency (5, 250, and 2,000 Hz) and each subjective measure (Neuropathic Pain Scale, FACT-GOGntx) and objective measurement (quantitative sensory testing, deep tendon reflexes, and grip strength).

Results

A total of 29 chemotherapy-naïve subjects with various cancer types had a mean age of 56.7 (SD 10.4); nine subjects developed CIPN grade >1 using NCI CTC-AE criteria. Cold detection thresholds were inversely associated with CPT 5 [b(95 % CI) = −2.5(−4.5, −0.5)] and CPT 2,000 [−7.5(−11.8, −3.3)] frequencies. FACT GOG-ntx quality of life (QoL) scale and neurotoxicity and function subscales were inversely associated with CPT 2,000 [−1.8 (−3.5, −0.05), −2.2 (−4.2, −0.2), and −5.4 (−9.8, −0.9), respectively], indicating worsening QoL, impairment, and function as hypoesthesia increases.

Conclusions

CPT 2,000 may identify impending worsening of patient-reported outcomes such as QoL.

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Acknowledgments

The authors would like to acknowledge the contributions of Sharon Gordon, DDS, MPH, PhD, University of Maryland, Baltimore School of Dentistry; and Raymond Dionne, DDS, PhD, Food and Drug Administration for their critical input into study conceptualization and design. The views expressed are those of the authors and do not reflect the official policy or position of the Uniformed Services University of the Health Sciences, the Department of Defense, or the United States government. This study was funded by the National Institute of Health/National Institute of Nursing Research grant, P30 University of Maryland, Baltimore Center for Pain Studies to S.G. Dorsey (NRO11396-01).

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Authors and Affiliations

  1. University of Maryland School of Nursing, Lombard Street, Baltimore, MD, 21201, USA

    Kathleen A. Griffith, Shijun Zhu, Mary E. Johantgen, Joan M. Davenport, Cynthia L. Renn & Susan G. Dorsey

  2. Uniformed Services University of the Health Sciences, Naval Medical Center San Diego, CA, 34800 Bob Wilson Drive, San Diego, CA, 92134, USA

    Darren J. Couture

  3. MedImmune, 35 West Watkins Mill Road, Gaithersburg, MD, 20878, USA

    Naimish Pandya

  4. Experimental Neurology Unit, Department Surgery and Translational Medicine, University of Milano-Bicocca, via Cadore 48, 20900, Monza, MB, Italy

    Guido Cavaletti

  5. Department of Radiation Oncology & Molecular Sciences, Johns Hopkins Medicine, 401 North Broadway, Suite 1440, Baltimore, MD, 21231, USA

    Amanda Choflet

  6. Marlene and Stewart Greenebaum Cancer Center, University of Maryland Medical System, 22 S. Greene St., Baltimore, MD, 21201, USA

    Lori J. Tanguay, Todd Milliron & Nancy Gambill

  7. St. Agnes Cancer Institute, 900 S. Caton Ave MS 235, Baltimore, MD, 21229, USA

    Erica Glass

Authors
  1. Kathleen A. Griffith
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  2. Darren J. Couture
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  3. Shijun Zhu
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  11. Erica Glass
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  12. Nancy Gambill
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  13. Cynthia L. Renn
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  14. Susan G. Dorsey
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Corresponding authors

Correspondence to Kathleen A. Griffith or Cynthia L. Renn.

Additional information

Kathleen A. Griffith and Darren J. Couture are the co-first authors.

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Griffith, K.A., Couture, D.J., Zhu, S. et al. Evaluation of chemotherapy-induced peripheral neuropathy using current perception threshold and clinical evaluations. Support Care Cancer 22, 1161–1169 (2014). https://doi.org/10.1007/s00520-013-2068-0

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  • DOI: https://doi.org/10.1007/s00520-013-2068-0

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