A new method to increase nociception specificity of the human blink reflex

Kaube, Holger; Katsarava, Zaza; Käufer, T; Diener, Hans‐Christoph; Ellrich, Jens

doi:10.1016/s1388-2457(99)00295-3

Cited by 252 publications

(286 citation statements)

References 8 publications

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“…30,31 The clinician's objective in applying manual techniques is to restore normal motion and normalize afferent input from the neuromusculoskeletal system. 29 Despite clinical evidence for the benefits of spinal mobilization, the biological mechanisms underlying the effects of spinal mobilization are not known. [32][33][34] One of the principal rationales for manual therapy intervention is that an ongoing barrage of noxious sensory input from biomechanical spinal dysfunction increases the excitability of neurons or circuits in the spinal cord.…”

Section: Discussionmentioning

confidence: 99%

“…Areas under the curve were assessed in the time window 27-87 ms after the stimulus. 28,29 Statistical Approach.-Data were analyzed using SPSS Version 16 software (SPSS, Inc., Chicago, IL, USA). Local tenderness ratings were investigated in a 2 × 4 × 2 (site [arm, neck]) × trial [trials 1-4] × time [start, end of each trial]) analysis of variance.…”

Section: Methodsmentioning

confidence: 99%

“…13,14 The nBR is a trigeminofacial brainstem reflex and has been established as a valid technique for assessing central trigeminal transmission. [15][16][17][18] Recently, the R2 component of the nBR was examined before and after unilateral GON blocks where it was found that the R2 latency increased and area under the curve (AUC) decreased after GON blockade. 13,14 This result provides empirical evidence for a functional influence on trigeminal nociceptive inputs from cervical afferents.…”

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confidence: 99%

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Cervical Referral of Head Pain in Migraineurs: Effects on the Nociceptive Blink Reflex

Watson

Drummond

2014

Headache

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Objective.-To investigate cervical, interictal reproduction of usual head pain and its effect on the nociceptive blink reflex in migraineurs.Background.-Anatomical and neurophysiological studies in animals and humans have confirmed functional convergence of trigeminal and cervical afferent pathways. Migraineurs often present with occipital and neck symptoms, and cervical pain is referred to the head in most cases, suggesting that cervical afferent information may contribute to headache. Furthermore, the effectiveness of greater occipital nerve blockade in migraine and demonstrable modulation of trigeminal transmission following greater occipital nerve blockade suggest an important role for cervical afferents in migraine. However, to what extent cervical afferents contribute actively to migraine is still unknown.Methods.-The passive accessory intervertebral movements of the atlanto-occipital and C2-3 spinal segments of 15 participants (14 females, 1 male; age 24-44 years, mean age 33.3 years) with migraine were examined interictally. During 1 session, either the atlanto-occipital or C2-3 segment was examined, resulting in referred usual head pain, while in another session, pressure was applied over the common extensor origin (lateral epicondyle of the humerus) of the ipsilateral arm. Each intervention was repeated 4 times. The nociceptive blink reflex to a supraorbital electrical stimulus was elicited ipsilaterally during both sessions before and during each intervention. The main outcome variables were the number of recorded blinks, area under the curve and latencies of the R2 components of the nociceptive blink reflex. Participants also rated the intensity of referred head pain and the supraorbital stimulus on a scale of 0-10, where 0 = "no pain" and 10 = "intolerable pain," and rated the intensity of applied pressure where 0 = "pressure but no pain" and 10 = "intolerable pain."Results.-Participants reported a significant reduction in local tenderness ratings across the 4 trials for the cervical intervention but not for the arm (P = .005). The cervical intervention evoked head pain in all participants. As the cervical intervention was sustained, head pain decreased significantly from the beginning to the end of each trial (P = .000) and from the beginning of the first trial to the end of the last (P = .000). Pain evoked by the supraorbital stimulus was consistent from baseline to across the 4 trials (P = .635) and was similar for the cervical and arm interventions (P = .072). The number of blinks decreased significantly across the experiment (P = .000) and was comparable in the cervical and arm interventions (P = .624). While the R2 area under the curve decreased irrespective of intervention (P = .000), this reduction was significantly greater for the cervical intervention than when pressure was applied to the arm (P = .037). Analysis of the R2 latencies revealed a notable increase across the experiment (P = .037). However, this increase was significantly greater following the cervical than arm intervention (P ...

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Cervical Referral of Head Pain in Migraineurs: Effects on the Nociceptive Blink Reflex

Watson

Drummond

2014

Headache

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“…Electrodes with these properties preferentially activate superficial nociceptive A-δ and C fibers (Inui et al 2002;Kaube et al 2000;Nilsson and Schouenborg 1999). The electrical detection threshold (EDT) was determined using the method of limits for 2 ascending and 2 descending sets of single pulses at 2 ms pulse width and an inter-pulse interval of 5 s. The stimulus intensity, starting at 0.1 mA, increased in steps of 0.1 mA until the participant perceived the stimulus, and then decreased in steps of 0.05 mA until the stimulus was no longer perceived.…”

Section: Conditioning Procedures (Hfs: N=50; Lfs: N=18)mentioning

confidence: 99%

Analgesia to pressure–pain develops in the ipsilateral forehead after high- and low-frequency electrical stimulation of the forearm

Drummond

2013

Exp Brain Res

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“…Klein et al 2004). The small tip diameters favor activation of superficial nociceptive afferents (Bromm and Meier 1984;Inui et al 2002;Kaube et al 2000;Nilsson and Schouenborg 1999). High-frequency stimulation (HFS) by 100 Hz (pulse width: 2 ms) was used to induce LTP (Klein et al 2004).…”

Section: Conditioning Stimuli and Experimental Settingmentioning

confidence: 99%

Psychophysical Evidence for Long-Term Potentiation of C-Fiber and Aδ-Fiber Pathways in Humans by Analysis of Pain Descriptors

Hansen¹,

Klein²,

Magerl³

et al. 2007

Journal of Neurophysiology

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. Long-term potentiation of human pain perception (nociceptive LTP) to single electrical test stimuli was induced by high-frequency stimulation (HFS) of cutaneous nociceptive afferents. Numerical pain ratings and a list of sensory pain descriptors disclosed the same magnitude of nociceptive LTP (23% increase for Ͼ60 min, P Ͻ 0.001), whereas affective pain descriptors were not significantly enhanced. Factor analysis of the sensory pain descriptors showed that facilitation was restricted to two factors characterized by hot and burning (ϩ41%) and piercing and stinging (ϩ21%, both P Ͻ 0.01), whereas a factor represented by throbbing and beating was not significantly increased (ϩ9%, P ϭ 0.47). The increased perception of the burning pain quality for Ͼ1 h after HFS is interpreted as a LTP-like facilitation of the conditioned cutaneous C-fiber pathway. Additionally, the increase of the stinging pain quality supplied evidence for facilitation of a sharpness-sensitive A␦-fiber pathway.

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A new method to increase nociception specificity of the human blink reflex

Cited by 252 publications

References 8 publications

Cervical Referral of Head Pain in Migraineurs: Effects on the Nociceptive Blink Reflex

Cervical Referral of Head Pain in Migraineurs: Effects on the Nociceptive Blink Reflex

Analgesia to pressure–pain develops in the ipsilateral forehead after high- and low-frequency electrical stimulation of the forearm

Psychophysical Evidence for Long-Term Potentiation of C-Fiber and Aδ-Fiber Pathways in Humans by Analysis of Pain Descriptors

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