Heterotopic ischemic pain attenuates somatosensory evoked potentials induced by electrical tooth stimulation: Diffuse noxious inhibitory controls in the trigeminal nerve territory

Fujii, Keiko; Motohashi, Katsunori; Umino, Masahiro

doi:10.1016/j.ejpain.2005.07.002

Cited by 60 publications

(71 citation statements)

References 52 publications

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“…The heterotopic character of endogenous analgesia in the spinal system has been demonstrated psychophysically [26,37,53] and electrophysiologically [2,7,13,39,41,53] in healthy volunteers [18,54] and patients with neurogenic pain [4]. Decreased overall inhibition, i.e.…”

Section: Discussionmentioning

confidence: 99%

“…The cold pressor resulted in greater pain intensity than the muscle pain, and also greater DNIC suggesting that greater pain during the DNIC induction stimulus results in greater DNIC. However, the literature is not clear on whether there is a relationships between the intensity of the tonic stimulus and the magnitude of DNIC with some studies showing that the greater the pain intensity the greater the DNIC [13,29,49] while others do not show this relationship [3,38]. It is not clear if the different results can be explained by the different stimulus paradigms applied.…”

Section: Discussionmentioning

confidence: 99%

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Experimental muscle pain impairs descending inhibition

Arendt-Nielsen

Sluka

Nie

2008

Pain

121

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In chronic musculoskeletal pain conditions, the balance between supraspinal facilitation and inhibition of pain shifts towards an overall decrease in inhibition. Application of a tonic painful stimulus results in activation of diffuse noxious inhibitory controls (DNIC). The aims of the present experimental human study were (1) to compare DNIC, evoked separately, by hypertonic saline (6%)-induced muscle pain (tibialis anterior) or cold pressor pain; (2) to investigate DNIC evoked by concomitant experimental muscle pain and cold pressor pain, and (3) to analyze for gender differences. Ten males and 10 age matched females participated in two sessions. In the first session unilateral muscle pain or unilateral cold pressor pain were induced separately; in the second session unilateral muscle pain and unilateral cold pressor pain were induced concomitantly. Pressure pain thresholds (PPT) were measured around the knee joint before, during, and after DNIC induction. Cold pressor pain increased PPT in both males and females with greater increases in males. Hypertonic saline-evoked muscle pain significantly increased PPT in males but not in females. When cold pressor and muscle pain were applied concomitantly the PPT increases were smaller when compared to the individual sessions. This study showed for the first time that two concurrent conditioning tonic pain stimuli (muscle pain and cold pressor pain) cause less DNIC compared with either of the conditioning stimuli given alone; and males showed greater DNIC than females. This may explain why patients with chronic musculoskeletal pain have impaired DNIC.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Experimental muscle pain impairs descending inhibition

Arendt-Nielsen

Sluka

Nie

2008

Pain

121

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“…The effect of order was possibly due to an after-effect of conditioning stimulation. Previous research reported decreased pain and somatosensory evoked potentials 5 minutes after termination of the conditioning stimulation compared to a control condition 41. There was a 5-minute interval between the end of the last conditioning stimulation trial, and the onset of the first test stimulus alone trial.…”

Section: Discussionmentioning

confidence: 98%

Expectations of increased and decreased pain explain the effect of conditioned pain modulation in females

Bjørkedal¹,

Flaten²

2012

JPR

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ObjectiveChronic pain is believed to be related to a dysfunction of descending pain modulatory mechanisms. Functioning of descending pain modulation can be assessed by various methods, including conditioned pain modulation (CPM). CPM refers to the inhibition of one source of pain by a second noxious stimulus, termed the conditioning stimulus. This procedure can activate an endogenous pain inhibitory mechanism that inhibits early nociceptive processing. Chronic pain and anxiety disorders are more prevalent among females and it has been hypothesized that females react with more negative emotions towards unpleasant stimuli and this might be part of the explanation of greater pain sensitivity in females. The present study investigated whether expectations modulate the effect of conditioning stimulation on pain, subjective stress, and heart rate. In addition, we investigated whether the modulation of CPM by expectations differed between males and females.MethodsSeventy-two subjects (including 36 women) received six noxious heat stimuli to the forearm. During three of these stimuli, a conditioning stimulus (cold-water bath) was applied to the contralateral arm in order to activate CPM. One third of the subjects were told that this would reduce pain (analgesia group), one-third that it would increase pain (hyperalgesia group), and one third received no information about its effect (no info group).ResultsInformation that conditioning stimulation decreased or enhanced pain had the corresponding effect in females, but not in males. Conditioning stimulation increased stress, but not heart rate in females in the hyperalgesia group. A higher expectation of analgesia and lower stress during conditioning stimulation was associated with larger inhibitory CPM.ConclusionThese results suggest that reduced inhibitory CPM can be due to contextually induced cognitive and emotional factors and not necessarily a dysfunction of descending inhibitory pathways.

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“…The magnitude of CPM is measured by the change from baseline in the test stimulus to after the conditioning stimulus is applied. The CPM effect appears to peak during the application of the conditioning stimulus and fades rapidly from 5 to 10 minutes after the conditioning stimulus ceases [43, 53, 101, 102]. One report indicates that the approximate median magnitude of CPM represents about a 29% decrease in pain rating, regardless of the test stimulus used [43].…”

Section: Dynamic Quantitative Sensory Testingmentioning

confidence: 99%

Understanding Central Mechanisms of Acupuncture Analgesia Using Dynamic Quantitative Sensory Testing: A Review

Kong

Schnyer

Johnson

et al. 2013

Evidence-Based Complementary and Alternative Medicine

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We discuss the emerging translational tools for the study of acupuncture analgesia with a focus on psychophysical methods. The gap between animal mechanistic studies and human clinical trials of acupuncture analgesia calls for effective translational tools that bridge neurophysiological data with meaningful clinical outcomes. Temporal summation (TS) and conditioned pain modulation (CPM) are two promising tools yet to be widely utilized. These psychophysical measures capture the state of the ascending facilitation and the descending inhibition of nociceptive transmission, respectively. We review the basic concepts and current methodologies underlying these measures in clinical pain research, and illustrate their application to research on acupuncture analgesia. Finally, we highlight the strengths and limitations of these research methods and make recommendations on future directions. The appropriate addition of TS and CPM to our current research armamentarium will facilitate our efforts to elucidate the central analgesic mechanisms of acupuncture in clinical populations.

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Heterotopic ischemic pain attenuates somatosensory evoked potentials induced by electrical tooth stimulation: Diffuse noxious inhibitory controls in the trigeminal nerve territory

Cited by 60 publications

References 52 publications

Experimental muscle pain impairs descending inhibition

Experimental muscle pain impairs descending inhibition

Expectations of increased and decreased pain explain the effect of conditioned pain modulation in females

Understanding Central Mechanisms of Acupuncture Analgesia Using Dynamic Quantitative Sensory Testing: A Review

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