Differences in perception and brain activation following stimulation by large versus small area cutaneous surface electrodes

Lelic, Dina; Mørch, Carsten Dahl; Hennings, Kristian; Andersen, Ole Kæseler; Drewes, Asbjørn Mohr

doi:10.1002/j.1532-2149.2011.00063.x

Cited by 25 publications

(56 citation statements)

References 37 publications

(48 reference statements)

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“…Several studies have demonstrated selective activation of small fibers using intraepidermal and small surface electrical stimulation and large fibers using large surface electrical stimulation . Previously, Lelic et al . found that, when stimulating with this cutaneous pin electrode at up to 10 times the perception threshold, the brain areas processing nociceptive input were activated to a greater extent than when compared with stimulation with a large area surface electrode.…”

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

“…Diagnostic tools for small‐fiber neuropathy (SFN) are scarce, because activation and assessment of small nerve fibers remain difficult. Small cutaneous fibers have a higher activation threshold than large fibers when electrical stimulation is applied through ordinary large surface patch electrodes . To change this recruitment order of electrical stimulation, alternative pin electrode configurations have been introduced, for example, as an array of small‐diameter surface cathodes that generates higher current densities in the epidermis close to the free nerve endings .…”

mentioning

confidence: 99%

“…Small cutaneous fibers have a higher activation threshold than large fibers when electrical stimulation is applied through ordinary large surface patch electrodes . To change this recruitment order of electrical stimulation, alternative pin electrode configurations have been introduced, for example, as an array of small‐diameter surface cathodes that generates higher current densities in the epidermis close to the free nerve endings . Therefore, the nerve endings of small fibers may be activated at lower intensities than larger fibers as the small nerve fiber endings protrude into the epidermis, whereas the large fibers predominantly terminate in dermis …”

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confidence: 99%

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Assessing the modulation of cutaneous sensory fiber excitability using a fast perception threshold tracking technique

et al. 2019

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Introduction Topical application of lidocaine‐and‐prilocaine (LP) cream attenuates the functionality of small cutaneous nerve fibers. The aim of this human study was to measure the underlying excitability modulation of small cutaneous nerve fibers using a novel and fast perception threshold tracking (PTT) technique. Methods Small sensory fibers were selectively blocked by 120‐minute topical application of LP and confirmed by quantitative sensory testing. Excitability changes of small (activated by a specially designed pin electrode) and large (patch electrode) nerve fibers were assessed as the strength–duration relation and threshold electrotonus. Results The excitability assessed by the strength–duration relation and threshold electrotonus was significantly modulated for the small afferents (P < 0.05, Wilcoxon's test) but not the large afferents. Discussion This novel PTT technique was able to assess inhibition of membrane properties of small cutaneous fibers, suggesting the usefulness of the technique as a diagnostic method for assessing impairment of small fibers, as seen in many types of polyneuropathies.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Assessing the modulation of cutaneous sensory fiber excitability using a fast perception threshold tracking technique

et al. 2019

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“…Subjectively, this induces a more localized, sharp and painful sensation. In a recent study we showed that brain sources generating the EPs were more nociceptive‐like for the intracutaneous electrode as compared with surface electrodes . Yet it can still be argued that intracutaneous electrical stimulation will likely stimulate an unselective spectrum of nerve fibres in a similar fashion to transcutaneous electrical stimulation .…”

Section: Discussionmentioning

confidence: 99%

Electroencephalography and analgesics

Malver

Brokjær

Staahl

et al. 2013

Brit J Clinical Pharma

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To assess centrally mediated analgesic mechanisms in clinical trials with pain patients, objective standardized methods such as electroencephalography (EEG) has many advantages. The aim of this review is to provide the reader with an overview of present findings in analgesics assessed with spontaneous EEG and evoked brain potentials (EPs) in humans. Furthermore, EEG methodologies will be discussed with respect to translation from animals to humans and future perspectives in predicting analgesic efficacy. We searched PubMed with MeSH terms 'analgesics' , 'electroencephalography' and 'evoked potentials' for relevant articles. Combined with a search in their reference lists 15 articles on spontaneous EEG and 55 papers on EPs were identified. Overall, opioids produced increased activity in the delta band in the spontaneous EEG, but increases in higher frequency bands were also seen. The EP amplitudes decreased in the majority of studies. Anticonvulsants used as analgesics showed inconsistent results. The N-methyl-D-aspartate receptor antagonist ketamine showed an increase in the theta band in spontaneous EEG and decreases in EP amplitudes. Tricyclic antidepressants increased the activity in the delta, theta and beta bands in the spontaneous EEG while EPs were inconsistently affected. Weak analgesics were mainly investigated with EPs and a decrease in amplitudes was generally observed. This review reveals that both spontaneous EEG and EPs are widely used as biomarkers for analgesic drug effects. Methodological differences are common and a more uniform approach will further enhance the value of such biomarkers for drug development and prediction of treatment response in individual patients.

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Frequency‐dependent current perception threshold in healthy Japanese adults

Nakatani-Enomoto

Yamazaki

Kamimura

et al. 2019

Bioelectromagnetics

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The purpose of the study involves measuring the threshold for electric currents (i.e., current perception threshold or CPT) under several stimulating current frequencies. Specifically, current perception threshold (CPT) was measured in 53 healthy volunteers between the ages of 21 and 67. The stimulation currents were applied on the right index finger with stimulus frequencies in the range of 50 Hz À 300 kHz. The method of limits and method of constant stimuli were combined to measure the CPT. In a manner consistent with the findings obtained by previous studies, the results indicated that CPT was higher in men than in women and in older individuals than in young subjects. Bioelectromagnetics. 40:150-159, 2019.

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Differences in perception and brain activation following stimulation by large versus small area cutaneous surface electrodes

Abstract: The current study gives evidence that CPE activates the nociceptive brain areas to a greater extent than conventional surface electrode. Therefore, CPE should preferentially be utilized in future studies where electrical stimuli are used to study nociception.

Cited by 25 publications

References 37 publications

Assessing the modulation of cutaneous sensory fiber excitability using a fast perception threshold tracking technique

Assessing the modulation of cutaneous sensory fiber excitability using a fast perception threshold tracking technique

Electroencephalography and analgesics

Frequency‐dependent current perception threshold in healthy Japanese adults

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