A Novel Method of Eliciting Pain‐Related Potentials by Transcutaneous Electrical Stimulation

Katsarava, Zaza; Ayzenberg, Ilya; Sack, Florian; Limmroth, Volker; Diener, Hans‐Christoph; Kaube, Holger

doi:10.1111/j.1526-4610.2006.00446.x

Cited by 117 publications

(120 citation statements)

References 23 publications

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“…1A) (Biurrun Manresa et al, 2010). This electrode has been verified to induce a sensation of pain at a lower stimulation intensity compared with conventional cutaneous nerve stimulation because the diameter of the cathodes is smaller so a high current density is achieved in the epidermal layers where the nociceptive Aδ-and C fibers terminate (Kaube et al, 2000;Katsarava et al, 2006;Mouraux et al, 2010;Mørch et al, 2011). The individual electrical detection threshold (DTh) was determined according to the method of limits: a series of electrical pulses increasing and decreasing at step sizes of 3% of the stimulation intensity was repeated three times in each session.…”

Section: Conditioning Electrical Stimulation (Ces)mentioning

confidence: 99%

Exploration of the conditioning electrical stimulation frequencies for induction of long-term potentiation-like pain amplification in humans

2016

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Background: Spinal nociceptive long-term potentiation (LTP) can be induced by high or low frequency conditioning electrical stimulation (CES) in rodent preparations in vitro. However, there is still sparse information on the effect of different conditioning frequencies inducing LTP-like pain amplification in humans. In this study we tested two other paradigms aiming to explore the CES frequency effect inducing pain amplification in healthy humans.Methods: Cutaneous LTP-like pain amplification induced by three different paradigms (10 Hz, 100 Hz, and 200 Hz CES) was assessed in fifteen volunteers in a cross-over design. Perceptual intensity ratings to single electrical stimulation at the conditioned site and to mechanical stimuli (pinprick and light stroking) in the immediate vicinity were recorded; superficial blood flow was also measured. The short-form of the McGill Pain Questionnaire (SF-MPQ) was used for characterizing the perception induced by CES. Results:Compared with the control session, pain perception to pinprick stimuli and area of allodynia significantly increased after all three CES paradigms. In the 10 Hz and 200 Hz sessions, the superficial blood flow 10 min after CES was significantly higher than in the control session reaching a plateau after 20 min and 10 min, respectively; for the 100 Hz paradigm a stable level was found without significant differences compared with CES and control sessions. 10 Hz CES caused a lower SF-MPQ score than 100 Hz. Conclusions:High frequency (200 Hz) and low frequency (10 Hz) paradigms can induce heterotopic pain amplification similar to the traditional 100 Hz paradigm. The 10 Hz paradigm can be an appealing alternative paradigm in future studies due to its specific association with low-level discharging of C-fibers during inflammation.

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Section: Conditioning Electrical Stimulation (Ces)mentioning

confidence: 99%

Exploration of the conditioning electrical stimulation frequencies for induction of long-term potentiation-like pain amplification in humans

2016

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“…Laserevoked potentials and contact heat-evoked potentials are based on activation of Aδ-fibres and C-fibres, although seem to have limited clinical applicability. Pain-related evoked potentials are based on preferential electrical stimulation of Aδ-fibres 177 , and intraepidermal electrical stimulation has been developed most recently to provide functional information about Aδ-fibres and C-fibres 178,179 . Pain-related evoked potentials seem to hold some promise for clinical evaluation of SFNs.…”

Section: Small-fibre-related Evoked Potentialsmentioning

confidence: 99%

“…Pain-related evoked potentials are induced by electrical stimulation of the skin at the threshold at which the subject feels the stimulus as painful 177 . Stimulation is delivered via a concentric planar electrode and is limited to the superficial layer of the dermis.…”

Section: Pain-related Evoked Potentialsmentioning

confidence: 99%

“…A pushpin-like electrode with a length of 0.2 mm can be used for intraepidermal stimulation. Pain-related evoked potentials reflect early depolarization of superficial Aδ-fibres; deeper, non-nociceptive skin fibres are not activated 177 . Some evidence suggests that altered pain-related evoked potentials correlate with low IENF density in patients with HIV-related SFN 193 , and that abnormal pain-related evoked potentials can aid early diagnosis of diabetic neuropathy 194 .…”

Section: Pain-related Evoked Potentialsmentioning

confidence: 99%

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New technologies for the assessment of neuropathies

et al. 2017

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Peripheral neuropathies are among the most common neurological disorders 1 . In routine clinical practice, diagnosis of peripheral neuropathies is typically based on clinical assessment, nerve conduction studies and needle electromyography, which can determine whether symptoms are caused by primary axonal damage or demyelinating damage. This distinction is often relevant to therapeutic choices and to prognosis, as axonal damage typically reflects an inflammatory (for example, vasculitic) or degenerative (for example, hereditary or idiopathic) process that correlates with disability, whereas demyelinating damage can reflect a hereditary neuro pathy, but more often reflects an acquired immunemediated neuropathy. Besides metabolic, inflammatory or primary degenerative neuropathies, peripheral nerves can also be damaged by compression from adjacent tissue structures, such as tendons, cysts or haematomas. In this case, proper identification of the site, nature and degree of the lesion might be challenging, but is relevant to treatment and prognosis. Moreover, some patients present with symptoms that suggest damage to small nerve fibres, which nerve conduction studies cannot be used to detect.In the past 15 years, several techniques have become available to investigate focal and diffuse peripheral neuropathies, and their reliability has widened the spectrum of diagnostic tools for clinicians and improved assessment of neuropathies. In this Review, we provide an overview of these new and emerging technologies. We first discuss peripheral nerve imaging with MRI and ultrasonography, which can provide information about the precise localization of neuro pathies and the pathological processes involved in large-fibre neuropathies, and can complement clinical and electrophysiological evaluation. We then consider techniques that can provide diagnostic information when the pathological process is restricted to small nerve fibres and is consequently not detectable with nerve conduction studies or neuroimaging. These include skin biopsy, which is established in clinical practice, and the emerging techniques of corneal confocal microscopy, laser-evoked potentials and heat-related and pain-related evoked potentials, and microneurography.Nerve imaging technology Advances in imaging techniques have made it possible to gain great insight into nerve pathology with magnetic resonance and ultrasound. Each approach offers distinct advantages, and can provide different information about damage to large myelinated fibres. Abstract | Technical advances are rapidly changing the clinical and instrumental approach to peripheral nerve diseases. Magnetic resonance neurography, diffusion tensor imaging and nerve ultrasonography are increasingly entering the diagnostic workup of peripheral neuropathies as tools that complement neurophysiology and enable investigation of proximal structures, such as plexuses and roots. Progress in the design of magnetic resonance scanners and sequences, and the development of high-frequency ultrasound probes mean th...

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“…Most temporal summation studies to date use superficial or intra-operative sources of stimulation-typically in the form of electrical or thermal energy-to study this phenomenon (Arendt-Nielsen et al, 1994;Arendt-Nielsen et al, 2000;Katsarava et al, 2006). Others use focal mechanical pressure applied at the skin to stimulate deep muscular structures (Nie et al, 2005).…”

mentioning

confidence: 99%

Rapid ultrasonic stimulation of inflamed tissue with diagnostic intent

McClintic

Dickey

Illian

et al. 2013

The Journal of the Acoustical Society of America

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Previous studies have observed that individual pulses of intense focused ultrasound (iFU) applied to inflamed and normal tissue can generate sensations, where inflamed tissue responds at a lower intensity than normal tissue. It was hypothesized that successively applied iFU pulses will generate sensation in inflamed tissue at a lower intensity and dose than application of a single iFU pulse. This hypothesis was tested using an animal model of chronic inflammatory pain, created by injecting an irritant into the rat hind paw. Ultrasound pulses were applied in rapid succession or individually to rats' rear paws beginning at low peak intensities and progressing to higher peak intensities, until the rats withdrew their paws immediately after iFU application. Focused ultrasound protocols consisting of successively and rapidly applied pulses elicited inflamed paw withdrawal at lower intensity and estimated tissue displacement values than single pulse protocols. However, both successively applied pulses and single pulses produced comparable threshold acoustic dose values and estimates of temperature increases. This raises the possibility that temperature increase contributed to paw withdrawal after rapid iFU stimulation. While iFU-induction of temporal summation may also play a role, electrophysiological studies are necessary to tease out these potential contributors to iFU stimulation.

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A Novel Method of Eliciting Pain‐Related Potentials by Transcutaneous Electrical Stimulation

Abstract: The technique is noninvasive, affordable, and easy to perform and allows quantitative assessment of human nociceptive pathways.

Cited by 117 publications

References 23 publications

Exploration of the conditioning electrical stimulation frequencies for induction of long-term potentiation-like pain amplification in humans

Exploration of the conditioning electrical stimulation frequencies for induction of long-term potentiation-like pain amplification in humans

New technologies for the assessment of neuropathies

Rapid ultrasonic stimulation of inflamed tissue with diagnostic intent

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