Contact heat evoked potentials as a valid means to study nociceptive pathways in human subjects

Chen, Andrew C. N.; Niddam, David M.; Arendt‐Nielsen, Lars

doi:10.1016/s0304-3940(01)02374-6

Cited by 146 publications

(98 citation statements)

References 13 publications

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“…6,10 The responses from A␦ fibers, maximally recorded at the vertex and presumably originating from the middle cingular area, 19,35 are better defined and consistent compared with those from C fibers. 10,40 This new recording technique provides a non-invasive assessment for investigating thermal pathways and can specifically determine the physiological changes that underlie the perception of, for example, intensity of pain.…”

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confidence: 89%

Effects of aging on contact heat‐evoked potentials: The physiological assessment of thermal perception

et al. 2007

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Age significantly influences the detection thresholds to noxious heat; such thresholds depend on responses in the cerebral cortex to thermal stimuli and the psychophysical perception of such responses. To understand the influence of age on cerebral responses, we used contact heat-evoked potentials (CHEPs) to investigate the physiology of cerebral responses to thermal stimuli in 70 healthy subjects (33 men and 37 women, 39.56 +/- 12.12 years of age). With heat stimulation of fixed intensity (51 degrees C) on the distal forearm and distal leg, CHEPs revealed consistent waveforms with an initial negative peak (N1 latency: 398.63 +/- 28.55 and 449.03 +/- 32.21 ms for upper and lower limbs) and a later positive peak (P1 latency: 541.63 +/- 37.92 and 595.41 +/- 39.24 ms for upper and lower limbs) with N1-P1 interpeak amplitude of 42.30 +/- 12.57 microV in the upper limb and 39.67 +/- 12.03 microV in the lower limb. On analyses with models of multiple linear regression, N1-P1 amplitudes were negatively correlated with age and N1 latencies were correlated with gender, with females having shorter latencies. The verbal rating scale (VRS) for pain perception was higher in females than males, and decreased with aging. In addition, VRS paralleled changes in N1-P1 amplitude and N1 latency; the higher the VRS, the shorter the N1 latency and the higher the N1-P1 amplitude. These results provide evidence that CHEPs are influenced significantly by aging, corresponding to aging-related changes in thermal pain perception.

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confidence: 89%

Effects of aging on contact heat‐evoked potentials: The physiological assessment of thermal perception

et al. 2007

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“…However, one of the main challenges in the interpretation of these results is to differentiate findings consistent with a general pain response from those that might be specific to migraine [11,12]. Nevertheless, a noxious stimulation paradigm, using a contact thermode [26], has been extensively used in different BOLD-fMRI studies to elucidate mechanisms underlying pain processing in migraine subjects. Moulton and colleagues [27] have measured brainstem fMRI responses to noxious heat in migraine subjects, showing a reduced activity at the level of the nucleus cuneiformis, a component of brainstem pain modulatory circuits.…”

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confidence: 99%

The role of BOLD-fMRI in elucidating migraine pathophysiology

et al. 2013

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Migraine is a neurologic disorder characterized by disabling attacks of throbbing headache with specific features and associated symptoms. Despite the recent discoveries in basic neurosciences, migraine pathophysiology is not completely understood. Nevertheless, in the last decades, advances in functional magnetic resonance imaging (fMRI) have significantly provided new insights into migraine mechanisms. Blood oxygen level dependent (BOLD) fMRI technique is the most commonly used method to explore brain function and connectivity due to high temporal and spatial resolution. The purpose of this review is to present a synthesis of recent BOLD-fMRI studies which have allowed us to elucidate the complex process involved in migraine pathophysiology.

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“…The stimulus can be easily controlled 187,189 , and the risk of skin irritation is lower than with lasers 190 . Contact heatevoked potentials enable recording of late and ultra-late potentials associated with activation of Aδ-fibres and C-fibres, respectively 187,191 . Standard reference values were published in 2014 (REF.…”

Section: Small-fibre-related Evoked Potentialsmentioning

confidence: 99%

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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Contact heat evoked potentials as a valid means to study nociceptive pathways in human subjects

Cited by 146 publications

References 13 publications

Effects of aging on contact heat‐evoked potentials: The physiological assessment of thermal perception

Effects of aging on contact heat‐evoked potentials: The physiological assessment of thermal perception

The role of BOLD-fMRI in elucidating migraine pathophysiology

New technologies for the assessment of neuropathies

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