{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T03:02:09Z","timestamp":1784257329700,"version":"3.55.0"},"reference-count":42,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,6,6]],"date-time":"2023-06-06T00:00:00Z","timestamp":1686009600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Innocuous cooling of the skin activates cold\u2010specific A\u03b4 fibres, and hence, the recording of cold\u2010evoked potentials (CEPs) may improve the objective assessment of human thermo\u2010nociceptive function. While the feasibility of CEP recordings in healthy humans has been reported, their reliability and diagnostic use in clinical conditions have not been documented.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Here, we report the results of CEP recordings in 60 consecutive patients with suspected neuropathic pain, compared with laser\u2010evoked potentials (LEPs) which are the gold standard for thermo\u2010algesic instrumental assessment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>CEP recording was a well\u2010tolerated procedure, with only ~15\u2009min of surplus in exam duration. The reproducibility and signal\u2010to\u2010noise ratio of CEPs were lower than those of LEPs, in particular for distal lower limbs (LLs). While laser responses were interpretable in all patients, CEPs interpretation was inconclusive in 5\/60 because of artefacts or lack of response on the unaffected side. Both techniques yielded concordant results in 73% of the patients. In 12 patients, CEPs yielded abnormal values while LEPs remained within normal limits; 3 of these patients had clinical symptoms limited to cold sensations, including cold\u2010heat transformation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>CEPs appear as a useful technique for exploring pain\/temperature systems. Advantages are low cost of equipment and innocuity. Disadvantages are low signal\u2010to\u2010noise ratio for LL stimulation, and sensitivity to fatigue\/habituation. Joint recording of CEPs and LEPs can increase the sensitivity of neurophysiological techniques to thin fibre\u2010 spinothalamic lesions, in particular, when abnormalities of cold perception predominate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Recording of cold\u2010evoked potentials is a well\u2010tolerated, inexpensive and easy\u2010to\u2010use procedure that can be helpful in the diagnosis of abnormalities in the thin fibre\u2010 spinothalamic pathways. Supplementing LEPs with CEPs allows consolidating the diagnosis and, for some patients suffering from symptoms limited only to cold, CEPs but not LEPs may allow the diagnosis of thin fibre pathology. Optimal CEP recording conditions are important to overcome the low signal\u2010to\u2010noise ratio and habituation phenomena, which are less favourable than with LEPs.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.2142","type":"journal-article","created":{"date-parts":[[2023,6,7]],"date-time":"2023-06-07T11:29:44Z","timestamp":1686137384000},"page":"1006-1022","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Cold\u2010evoked potentials in clinical practice: A head\u2010to\u2010head contrast with laser\u2010evoked responses"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1204-576X","authenticated-orcid":false,"given":"Caroline","family":"Perchet","sequence":"first","affiliation":[{"name":"Universit\u00e9 Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028, UMR5292, NEUROPAIN  Bron 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