Dependence of thermal thresholds in man on the rate of temperature change

Swerup, C.; Nilsson, Bengt

doi:10.1111/j.1748-1716.1987.tb08284.x

Cited by 35 publications

(15 citation statements)

References 4 publications

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“…If one considers data related to the hand with a ∼10 cm 2 area of stimulation, the detectable changes of temperature were found to be in the 1–5°C range [19]–[20], [38]–[42]. The measured warm thresholds were related directly to the rate of temperature changes, being in fact apparent thresholds as defined in the present paper; accordingly, the differences were generally attributed to the reaction time artifact [19], [39]–[40], [43]–[44]. On the other hand, the forced choice method of levels applied in similar conditions provided remarkably reproducible detectable changes of temperature in the 0.6–0.7°C range [19], [38], [40], [45].…”

Section: Discussionsupporting

confidence: 57%

The Fine Tuning of Pain Thresholds: A Sophisticated Double Alarm System

et al. 2010

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Two distinctive features characterize the way in which sensations including pain, are evoked by heat: (1) a thermal stimulus is always progressive; (2) a painful stimulus activates two different types of nociceptors, connected to peripheral afferent fibers with medium and slow conduction velocities, namely Aδ- and C-fibers. In the light of a recent study in the rat, our objective was to develop an experimental paradigm in humans, based on the joint analysis of the stimulus and the response of the subject, to measure the thermal thresholds and latencies of pain elicited by Aδ- and C-fibers. For comparison, the same approach was applied to the sensation of warmth elicited by thermoreceptors. A CO2 laser beam raised the temperature of the skin filmed by an infrared camera. The subject stopped the beam when he/she perceived pain. The thermal images were analyzed to provide four variables: true thresholds and latencies of pain triggered by heat via Aδ- and C-fibers. The psychophysical threshold of pain triggered by Aδ-fibers was always higher (2.5–3°C) than that triggered by C-fibers. The initial skin temperature did not influence these thresholds. The mean conduction velocities of the corresponding fibers were 13 and 0.8 m/s, respectively. The triggering of pain either by C- or by Aδ-fibers was piloted by several factors including the low/high rate of stimulation, the low/high base temperature of the skin, the short/long peripheral nerve path and some pharmacological manipulations (e.g. Capsaicin). Warming a large skin area increased the pain thresholds. Considering the warmth detection gave a different picture: the threshold was strongly influenced by the initial skin temperature and the subjects detected an average variation of 2.7°C, whatever the initial temperature. This is the first time that thresholds and latencies for pain elicited by both Aδ- and C-fibers from a given body region have been measured in the same experimental run. Such an approach illustrates the role of nociception as a “double level” and “double release” alarm system based on level detectors. By contrast, warmth detection was found to be based on difference detectors. It is hypothesized that pain results from a CNS build-up process resulting from population coding and strongly influenced by the background temperatures surrounding at large the stimulation site. We propose an alternative solution to the conventional methods that only measure a single “threshold of pain”, without knowing which of the two systems is involved.

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Section: Discussionsupporting

confidence: 57%

The Fine Tuning of Pain Thresholds: A Sophisticated Double Alarm System

et al. 2010

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“…A clinical examination included inspection of the hands, blood pressure, touch sensation, and Adson, Allen, Tinel, and Phalen tests. The objective tests were performed in the following order ( a ) grip strength, ( b ) a modified Moberg pickup test,11 ( c ) aesthesiometry as described by Renfrew and modified by Carlson,12-14( d ) vibrotactile threshold with an HVLab vibrometer,15 16 ( e ) measurement of the thermal neutral zones and thermal pain thresholds with the Sonemedic Thermotest,17 18 and ( f ) a controlled cold provocation test 15°C for 5 minutes 19…”

Section: Methodsmentioning

confidence: 99%

Cross sectional study of a workforce exposed to hand-arm vibration: with objective tests and the Stockholm workshop scales

Wh²

2000

Occup Environ Med

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Objectives-Medical surveillance of workforces exposed to vibration has been recommended with the Stockholm workshop scales. The aims of this study were (a) to evaluate how the results of the objective tests individually and jointly associated with the final Stockholm workshop staging, (b) how this staging related to the history of exposure to vibration, and (c) how diVerent trades were aVected by the hazards from vibrating tools. Methods-All workers exposed to vibration in a heavy engineering company were examined with a questionnaire and a battery of tests. (Occup Environ Med 2000;57:35-42)

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“…Habituation occurs with repeated stimuli, especially when testing heat pain (Agostinho et al, 2009). The rate of temperature change during testing affects thresholds (higher rate results in higher thresholds) in the reaction time-dependent test algorithm (limits) (Croze and Duclaux, 1978;Pertovaara and Kojo, 1985;Swerup and Nilsson, 1987;Yarnitsky and Ochoa, 1990;Yarnitsky and Ochoa, 1991;Hilz et al, 1995b;1996;Pertovaara et al, 1996;Palmer et al, 2000;Maeda and Sakakibara, 2002). Higher rates may also increase intra-subject variability (Hilz et al, 1995a;Nielsen and Arendt-Nielsen, 1998).…”

Section: Settings Variablesmentioning

confidence: 99%

Temperature threshold testing: a systematic review

Bakkers

Faber

Peters

et al. 2013

J Peripheral Nervous Sys

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The diagnosis of small fiber neuropathy (SFN) has been recently defined as typical symptoms due to small nerve fiber dysfunction accompanied by reduced intraepidermal nerve fiber density (IENFD) or abnormal temperature threshold testing (TTT). Guidelines have been published for the assessment of IENFD. However, international guidelines for TTT are lacking. This paper presents a systematic literature review on reported TTT methods and provides recommendations for its future use in studies evaluating patients. A total of 164 papers fulfilled pre-defined requirements and were selected for review. Over 15 types of instruments are currently being used with a variety of methodological approaches for location, stimulus application, and sensation qualities examined. Consensus is needed to standardize the use of TTT as a diagnostic and follow-up tool in patients.

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Dependence of thermal thresholds in man on the rate of temperature change

Cited by 35 publications

References 4 publications

The Fine Tuning of Pain Thresholds: A Sophisticated Double Alarm System

The Fine Tuning of Pain Thresholds: A Sophisticated Double Alarm System

Cross sectional study of a workforce exposed to hand-arm vibration: with objective tests and the Stockholm workshop scales

Temperature threshold testing: a systematic review

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