Electrochemical Skin Conductance as a Marker of Painful Oxaliplatin-Induced Peripheral Neuropathy

Jean-Baptiste Delmotte, Abdulkarim Tutakhail, Kahina Abdallah, Pauline Reach, Marguerite D'Ussel, Gael Deplanque, Hélène Beaussier, François Coudoré, Jean-Baptiste Delmotte, Abdulkarim Tutakhail, Kahina Abdallah, Pauline Reach, Marguerite D'Ussel, Gael Deplanque, Hélène Beaussier, François Coudoré

Abstract

Purpose: Oxaliplatin is a platinum compound widely used in gastrointestinal cancer treatment but produces dose-limiting peripheral neuropathy. New insights into oxaliplatin-induced peripheral neuropathy (OIPN) assessment are needed to detect more effectively this condition. In this context, we conducted Canaloxa study, a prospective preliminary clinical trial that aimed to investigate how Electrochemical Skin Conductance (ESC), a parameter used in small fiber neuropathy assessment, could be helpful in OIPN diagnosis.

Methods: Cancer patients treated for at least three months with oxaliplatin and suffering from clinically OIPN were included. Electrochemical Skin Conductance, thermal thresholds, and neuropathic pain were assessed in all included patients.

Results: During one year, 36 patients were included. The main result was the correlation between ESC and Neuropathic Pain Symptom Inventory score for hands (rho value = -0.69, p < 0.0001) and feet (rho value = -0.79, p < 0.0001). ESC values were lower in neuropathic patients with painful symptoms than in ones without painful symptoms (p = 0.0003 and p < 0.0001 for hands and feet, respectively). No correlation was observed between ESC and thermal thresholds.

Conclusion: These preliminary data suggest that ESC could be a useful objective marker of painful oxaliplatin-induced neuropathy and could complement the use of subjective clinical scales. This study was prospectively registered on clinicaltrials.gov (NCT02827916) before patient recruitment has begun.

Figures

Figure 1
Figure 1
Distribution of the ESC values measured on hands (a) and feet (b) of oxaliplatin-treated patients (n = 36). High conductance values (ESC > 60 μS): no dysfunction of the sweat function. Intermediate conductance values (40-60 μS): first signs of a possible peripheral autonomic neuropathy. Low conductance values (ESC < 40 μS): dysfunction of the sweat function and advanced peripheral neuropathy. ESC: Electrochemical Skin Conductance. μs: microSiemens.
Figure 2
Figure 2
ESC values measured on hands and feet according to the presence or absence of a painful neuropathy. ESC values were lower in neuropathic patients with painful symptoms than in patients without painful symptoms: 55.4 ± 19.7 vs 77.6 ± 7.9 μS (p = 0.0003) and 55.0 ± 15.0 vs 78.1 ± 6.6 μS (p < 0.0001) for hands and feet, respectively.
Figure 3
Figure 3
Correlation graphs between Electrochemical Conductance (ESC) in μSiemens (μS) of hands (a) and feet (b) of treated patients and Neuropathic Pain Symptom Inventory (NPSI) scores (n = 36). ESC are correlated with NPSI score for hands (rho = -0.69, p < 0.0001) and feet (rho value = -0.79, p < 0.0001).
Figure 4
Figure 4
Receiver operating characteristics (ROC) curves for ESC of hands (a) and feet (b) using a positive NPSI score as reference. AUC = 0,86 for (a) and AUC = 0,95 for (b). (20 patients with painful symptoms and 16 patients without painful symptoms).

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