Usefulness of cyclic thermal therapy and red blood cell scintigraphy in patients with chemotherapy-induced peripheral neuropathy

Abstract

Background Pharmacological and non-pharmacological therapies have been used to treat patients with chemotherapy-induced peripheral neuropathy (CIPN). However, the effect of therapies in cancer patients has yet to be investigated comprehensively. We hypothesized that cyclic thermal therapy would improve blood flow and microcirculation and improve the symptoms driven by CIPN. Methods The criteria of assessment were blood volume in region of interest (ROI) in the images, and European Organization for Research and Treatment of Cancer–Quality of Life Questionnaire–Chemotherapy-Induced Peripheral Neuropathy 20 questionnaire scores. The blood volume was quantified by using red blood cell (RBC) scintigraphy. All patients were treated 10 times during 10 days. The thermal stimulations, between 15° and 41°, were repeatedly delivered to the patient’s hands. Results The total score of the questionnaires, the score of questions related to the upper limbs, the score of questions closely related to the upper limbs, and the score excluding the upper limbs questions was decreased. The blood volume was decreased, and the variance of blood volume was decreased. During cooling stimulation, the blood volume was decreased, and its variance was decreased. During warming stimulation, the blood volume was decreased, and its variance was decreased. Conclusions We suggest that cyclic thermal therapy is useful to alleviate CIPN symptoms by blood circulation improvement. RBC scintigraphy can provide the quantitative information on blood volume under certain conditions such as stress, as well as rest, in peripheral tissue.

Small fiber neuropathy as a complication of SARS-CoV-2 vaccinations

“…Secondary causes of SFN prevail and include, for example, diabetes, renal failure, thyroid dysfunction, hypovitaminoses, acute infections (SARS-CoV-2,[ 8 ] borreliosis[ 9 ]), vaccinations (rabies, varicella, human papillomavirus, lyme, SARS-CoV-2),[ 8 10 ] auto-immune disease,[ 11 12 ] pure autonomic failure because of alpha-synuclein deposition,[ 13 ] sarcoidosis,[ 14 ] Sjögren syndrome,[ 15 ] Parkinson’s disease,[ 16 ] and many others. [ 17 ] SFN may go along with or without affection of large motor or sensory fibers. [ 18 ] Thus, SFN can be associated with polyneuropathy (neuropathy of nerves built up of large fibers) but usually occurs without it.…”

Milnacipran Has an Antihyperalgesic Effect on Cisplatin-Induced Neuropathy

“…Cisplatin and other platinating agents, which are included as first-line therapies in many cancer treatments, are the most widely used cytotoxic drugs [ 29 , 30 ]. Neurotoxic chemotherapy drugs can induce neuropathic symptoms, typically initiated with dysesthesia and paresthesia [ 31 , 32 ]. A normal touch could also be perceived as painful, a condition referred to as allodynia [ 33 ].…”

The Efficacy of Neuromodulation Interventions for Chemotherapy-Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis

“…48 This therapy may reduce a patient's perception of discomfort by tuning sensory areas of the CIPN patient's brain, enhancing the brain's ability to filter signals such as pain or affecting pain-related neural pathways. [57][58][59] The mechanisms of peripheral neuromodulation techniques for the treatment of CIPN mainly include improving limb microcirculation, 60,61 reducing oxidative stress and inflammatory reactions, [62][63][64] inhibiting the release of pain signals through gate-control theory, [65][66][67] and regulating the release of neurotransmitters. 68,69 There was no statistically significant improvement in various indicators between the neuromodulation intervention group and the sham group.…”