The tibial neuroma transposition (TNT) model of neuroma pain and hyperalgesia

Michael J. Dorsi, Lun Chen, Beth B Murinson, Esther M. Pogatzki-Zahn, Richard Meyer, Allan J Belzberg

Research output: Contribution to journalArticle

Abstract

Peripheral nerve injury may lead to the formation of a painful neuroma. In patients, palpating the tissue overlying a neuroma evokes paraesthesias/dysaesthesias in the distribution of the injured nerve. Previous animal models of neuropathic pain have focused on the mechanical hyperalgesia and allodynia that develops at a location distant from the site of injury and not on the pain from direct stimulation of the neuroma. We describe a new animal model of neuroma pain in which the neuroma was located in a position that is accessible to mechanical testing and outside of the innervation territory of the injured nerve. This allowed testing of pain in response to mechanical stimulation of the neuroma (which we call neuroma tenderness) independent of pain due to mechanical hyperalgesia. In the tibial neuroma transposition (TNT) model, the posterior tibial nerve was ligated and transected in the foot just proximal to the plantar bifurcation. Using a subcutaneous tunnel, the end of the ligated nerve was positioned just superior to the lateral malleolus. Mechanical stimulation of the neuroma produced a profound withdrawal behavior that could be distinguished from the hyperalgesia that developed on the hind paw. The neuroma tenderness (but not the hyperalgesia) was reversed by local lidocaine injection and by proximal transection of the tibial nerve. Afferents originating from the neuroma exhibited spontaneous activity and responses to mechanical stimulation of the neuroma. The TNT model provides a useful tool to investigate the differential mechanisms underlying the neuroma tenderness and mechanical hyperalgesia associated with neuropathic pain.

Original languageEnglish (US)
Pages (from-to)320-334
Number of pages15
JournalPain
Volume134
Issue number3
DOIs
StatePublished - Feb 2008

Fingerprint

Neuroma
Hyperalgesia
Pain
Tibial Nerve
Paresthesia
Neuralgia
Animal Models
Peripheral Nerve Injuries
Lidocaine

Keywords

  • Allodynia
  • Central sensitization
  • Hyperalgesia
  • Nerve injury
  • Neurofibroma
  • Neuroma
  • Neuropathic pain

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health
  • Neurology
  • Neuroscience(all)
  • Pharmacology
  • Clinical Psychology

Cite this

The tibial neuroma transposition (TNT) model of neuroma pain and hyperalgesia. / Dorsi, Michael J.; Chen, Lun; Murinson, Beth B; Pogatzki-Zahn, Esther M.; Meyer, Richard; Belzberg, Allan J.

In: Pain, Vol. 134, No. 3, 02.2008, p. 320-334.

Research output: Contribution to journalArticle

Dorsi, Michael J. ; Chen, Lun ; Murinson, Beth B ; Pogatzki-Zahn, Esther M. ; Meyer, Richard ; Belzberg, Allan J. / The tibial neuroma transposition (TNT) model of neuroma pain and hyperalgesia. In: Pain. 2008 ; Vol. 134, No. 3. pp. 320-334.
@article{1bbddd0984ed470c8e9597adbaf62bdb,
title = "The tibial neuroma transposition (TNT) model of neuroma pain and hyperalgesia",
abstract = "Peripheral nerve injury may lead to the formation of a painful neuroma. In patients, palpating the tissue overlying a neuroma evokes paraesthesias/dysaesthesias in the distribution of the injured nerve. Previous animal models of neuropathic pain have focused on the mechanical hyperalgesia and allodynia that develops at a location distant from the site of injury and not on the pain from direct stimulation of the neuroma. We describe a new animal model of neuroma pain in which the neuroma was located in a position that is accessible to mechanical testing and outside of the innervation territory of the injured nerve. This allowed testing of pain in response to mechanical stimulation of the neuroma (which we call neuroma tenderness) independent of pain due to mechanical hyperalgesia. In the tibial neuroma transposition (TNT) model, the posterior tibial nerve was ligated and transected in the foot just proximal to the plantar bifurcation. Using a subcutaneous tunnel, the end of the ligated nerve was positioned just superior to the lateral malleolus. Mechanical stimulation of the neuroma produced a profound withdrawal behavior that could be distinguished from the hyperalgesia that developed on the hind paw. The neuroma tenderness (but not the hyperalgesia) was reversed by local lidocaine injection and by proximal transection of the tibial nerve. Afferents originating from the neuroma exhibited spontaneous activity and responses to mechanical stimulation of the neuroma. The TNT model provides a useful tool to investigate the differential mechanisms underlying the neuroma tenderness and mechanical hyperalgesia associated with neuropathic pain.",
keywords = "Allodynia, Central sensitization, Hyperalgesia, Nerve injury, Neurofibroma, Neuroma, Neuropathic pain",
author = "Dorsi, {Michael J.} and Lun Chen and Murinson, {Beth B} and Pogatzki-Zahn, {Esther M.} and Richard Meyer and Belzberg, {Allan J}",
year = "2008",
month = "2",
doi = "10.1016/j.pain.2007.06.030",
language = "English (US)",
volume = "134",
pages = "320--334",
journal = "Pain",
issn = "0304-3959",
publisher = "Elsevier",
number = "3",

}

TY - JOUR

T1 - The tibial neuroma transposition (TNT) model of neuroma pain and hyperalgesia

AU - Dorsi, Michael J.

AU - Chen, Lun

AU - Murinson, Beth B

AU - Pogatzki-Zahn, Esther M.

AU - Meyer, Richard

AU - Belzberg, Allan J

PY - 2008/2

Y1 - 2008/2

N2 - Peripheral nerve injury may lead to the formation of a painful neuroma. In patients, palpating the tissue overlying a neuroma evokes paraesthesias/dysaesthesias in the distribution of the injured nerve. Previous animal models of neuropathic pain have focused on the mechanical hyperalgesia and allodynia that develops at a location distant from the site of injury and not on the pain from direct stimulation of the neuroma. We describe a new animal model of neuroma pain in which the neuroma was located in a position that is accessible to mechanical testing and outside of the innervation territory of the injured nerve. This allowed testing of pain in response to mechanical stimulation of the neuroma (which we call neuroma tenderness) independent of pain due to mechanical hyperalgesia. In the tibial neuroma transposition (TNT) model, the posterior tibial nerve was ligated and transected in the foot just proximal to the plantar bifurcation. Using a subcutaneous tunnel, the end of the ligated nerve was positioned just superior to the lateral malleolus. Mechanical stimulation of the neuroma produced a profound withdrawal behavior that could be distinguished from the hyperalgesia that developed on the hind paw. The neuroma tenderness (but not the hyperalgesia) was reversed by local lidocaine injection and by proximal transection of the tibial nerve. Afferents originating from the neuroma exhibited spontaneous activity and responses to mechanical stimulation of the neuroma. The TNT model provides a useful tool to investigate the differential mechanisms underlying the neuroma tenderness and mechanical hyperalgesia associated with neuropathic pain.

AB - Peripheral nerve injury may lead to the formation of a painful neuroma. In patients, palpating the tissue overlying a neuroma evokes paraesthesias/dysaesthesias in the distribution of the injured nerve. Previous animal models of neuropathic pain have focused on the mechanical hyperalgesia and allodynia that develops at a location distant from the site of injury and not on the pain from direct stimulation of the neuroma. We describe a new animal model of neuroma pain in which the neuroma was located in a position that is accessible to mechanical testing and outside of the innervation territory of the injured nerve. This allowed testing of pain in response to mechanical stimulation of the neuroma (which we call neuroma tenderness) independent of pain due to mechanical hyperalgesia. In the tibial neuroma transposition (TNT) model, the posterior tibial nerve was ligated and transected in the foot just proximal to the plantar bifurcation. Using a subcutaneous tunnel, the end of the ligated nerve was positioned just superior to the lateral malleolus. Mechanical stimulation of the neuroma produced a profound withdrawal behavior that could be distinguished from the hyperalgesia that developed on the hind paw. The neuroma tenderness (but not the hyperalgesia) was reversed by local lidocaine injection and by proximal transection of the tibial nerve. Afferents originating from the neuroma exhibited spontaneous activity and responses to mechanical stimulation of the neuroma. The TNT model provides a useful tool to investigate the differential mechanisms underlying the neuroma tenderness and mechanical hyperalgesia associated with neuropathic pain.

KW - Allodynia

KW - Central sensitization

KW - Hyperalgesia

KW - Nerve injury

KW - Neurofibroma

KW - Neuroma

KW - Neuropathic pain

UR - http://www.scopus.com/inward/record.url?scp=37848999468&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=37848999468&partnerID=8YFLogxK

U2 - 10.1016/j.pain.2007.06.030

DO - 10.1016/j.pain.2007.06.030

M3 - Article

C2 - 17720318

AN - SCOPUS:37848999468

VL - 134

SP - 320

EP - 334

JO - Pain

JF - Pain

SN - 0304-3959

IS - 3

ER -