Reversibility of central neuronal changes in patients recovering from gallbladder stones or acute cholecystitis

Table 1 Characteristics of the 5 patients still intermittently suffering from pain

Patient (n)	Pain localization	Attack frequency	Pain duration	Physical activity	Accompanying symptoms	VAS	Pain-killers	Anti-depressive
C (4)	Epigastriel	Daily	h	Depending on activity	Feeling ill and nausea	9	Paracetamol	No
C (5)	Under the right costal margin	Every 3rd wk	20-30 s	Sitting down	No	7		SSRI
C (14)	Under the right costal margin	Approximately 3 every week	min	Sitting down	No	4	No	No
C (17)	Epigastriel and under the right costal margin	2-3/mo	h	Depending on activity	Nausea and reflux for 1-2 d	7	NSAID and paracetamol	TCA
AC (15)	Under the right costal margin	2-3/yr	min	Standing	No	6	No

C: Cholecystholithiasis study[10]; AC: Acute cholecystitis study[9]; VAS: Visual analogue scale; NSAID: Non steroid anti-inflammatory drug; SSRI: Selective serotonin reuptake inhibitor; TCA: Tricyclic anti-depressants.

Table 2 Sensory findings in the three patients showing generalized hypersensitivity

Patient (n)	Pinprick	Cold	Heat	Pinching	SES	RES	Pressure
AC (2)	-	-	-	↑	↑	-	↑
AC (24)	-	-	-	↑	↑	↑	↑
AC (30)	-	-	-	↑	↑	↑	↑

AC: Acute cholecystitis study[9]; SES: Single electrical stimulus; RES: Repeated electrical stimulus; “- ”: No difference between referred pain area (RPA) and control area (CA); “↑”: Hypersensitivity in the RPA.

Table 3 Comparison of results regarding electrical stimuli from the present study with result from the initial study, mean (range)

	Present study in mA		Initial study in mA
	RPA	CA	RPA	CA
The sensation detection threshold for single burst electrical stimuli	0.6 (0.3-2.5)	0.6 (0.2-1.4)	0.7 (0.3-1.2)	0.7 (0.4-1.5)
The pain threshold for single burst electrical stimuli	13 (0.9-56)	13.5 (0.7-46)	12.4 (2.6-30.6)	13.9 (3.7-28.6)
The sensation detection threshold for repeated burst electrical stimuli	0.6 (0.2-2.2)	0.6 (0.3-1.3)	0.7 (0.25-1.2)	0.7 (0.4-1.6)
The pain threshold for repeated burst electrical stimuli	9 (1.0-30.5)	9.3 (0.9-35.4)	7.6 (1.5-17.2)	7.7 (2.7-25)

RPA: Referred pain area; CA: Control area.