Monosynaptic convergence of somatic and visceral C-fiber afferents on projection and local circuit neurons in lamina I

Luz, Liliana L.; Fernandes, Elisabete C; Sivadó, Miklós; Kókai, Éva; Szûcs, Péter; Safronov, Boris V.

doi:10.1097/j.pain.0000000000000267

Cited by 59 publications

(44 citation statements)

References 49 publications

(70 reference statements)

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“…In this study, we applied LFS using a matrix electrode with high intradermal current densities to activate as many small calibre nerve fibre endings as possible and to use this afferent input to the above mentioned spinal projection neurons to reduce their excitability, hence aiming to reduce ongoing cancer pain intensity. This approach is based on the concept that somatic afferent input from stimulated nociceptive nerve fibres of the skin converges to such WDR‐neurons that receive afferent input from visceral nociceptors in the vicinity of the cancer (Jänig, ; Luz et al., ). These skin areas are called ‘Head's zones’ and represent the referred pain areas for a pain that originally stems from another visceral region or organ (Henke and Beissner, ).…”

Section: Discussionmentioning

confidence: 99%

“…approach is based on the concept that somatic afferent input from stimulated nociceptive nerve fibres of the skin converges to such WDR-neurons that receive afferent input from visceral nociceptors in the vicinity of the cancer (J€ anig, 2014;Luz et al, 2015). These skin areas are called 'Head's zones' and represent the referred pain areas for a pain that originally stems from another visceral region or organ (Henke and Beissner, 2011).…”

Section: Discussionmentioning

confidence: 99%

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Matrix stimulation in cancer pain: Methodology, safety and effectiveness

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et al. 2017

European Journal of Pain

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BackgroundThis feasibility study addresses the applicability of matrix electrodes for the reduction of ongoing pain in cancer patients via low‐frequency electrical stimulation (LFS).MethodsLow‐frequency matrix stimulation (4 Hz) was applied to the skin within the ‘Head's zones’ referring to the tumour localization of cancer pain patients. Pain at baseline was compared to a 3‐day treatment interval consisting of 5 min of matrix stimulation in the morning and evening followed by a 3‐day follow‐up period without therapy. Main outcome parameters included numeric rating scale values (rating scale 0–100), painDETECT, HADS, and German pain questionnaire, as well as the opioid intake, calculated as the oral morphine equivalent (OME).ResultsTwenty patients with cancer pain (aged 64.4 ± 10.3; 9 women) were examined. In the majority of patients, the pain was classified as nociceptive. The mean pain reduction achieved by matrix therapy was 30%, under stable daily controlled‐release opioid doses between 177 and 184 mg/day (OME). Seventeen patients (85%) were responders, defined by a pain reduction of at least 30%, while four responders experienced a pain reduction of over 50%. The only side effect was short‐term erythema.ConclusionFindings are consistent with the concept of synaptic long‐term depression in cancer pain induced after conditioning LFS. Despite the short, but well‐tolerated, treatment duration of 2 × 5 min/day, effects persisted throughout the 3‐day follow‐up.SignificanceCutaneous neuromodulation using LFS via a matrix electrode has been shown to be a safe intervention for effectively reducing cancer pain in palliative care patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Matrix stimulation in cancer pain: Methodology, safety and effectiveness

Mücke

Tils

Conrad

et al. 2017

European Journal of Pain

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“…Uitgangspunt van referred pain is het bestaan van viscerocutane reflexen. Deze theorie berust op het feit dat de viscerale zenuwen en de somatische huidzenuwen uittreden op hetzelfde niveau van de dorsale wortel en het ruggenmerg [10,11]. Dit maakt het voor onze hersenen moeilijk om onderscheid te maken tussen orgaanpijn en neuropathische pijn van de buikwand.…”

Section: Diagnostiek En Behandelingunclassified

Case report. ACNES als oorzaak van buikpijn in de urologische praktijk

2018

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SamenvattingBuikpijn kan vele oorzaken hebben en wordt vaak toegeschreven aan disfunctionerende organen (viscerale pijn). Buikklachten kunnen ook worden veroorzaakt door afwijkingen in de buikwand zelf. Een voorbeeld hiervan is het anterior cutaneous nerve entrapment syndrome (ACNES). ACNES wordt echter in de hedendaagse kliniek vaak niet (h)erkend als oorzaak van (chronische) buikpijn. Urologen zien geregeld patiënten met buik-en flankpijnen zonder een duidelijk urologisch substraat. Aan de hand van deze casuïstiek willen wij de diagnose ACNES bij urologen onder de aandacht brengen om zodoende onnodig delay en frustrerend negatief onderzoek bij deze patiëntengroep te voorkomen.Trefwoorden anterior cutaneous nerve entrapment syndrome (ACNES) · chronische buikpijn · flankpijn · neurectomie Case report. ACNES as cause of abdominal pain in a urology clinic Abstract Abdominal pain can have many causes and is often attributed to dysfunctional organs (visceral pain). Abdominal complaints can also be caused by abnormalities in the abdominal wall itself. Anterior cutaneous nerve entrapment syndrome (ACNES) is a common but relatively unknown source of abdominal wall pain. Urology specialists regularly see patients with abdominal and flank pain without any urological substrate. We present a case report of two patients seen at the urology outpatient clinic, who were eventually diagnosed with ACNES. Our cases illustrate the importance of considering ACNES in the differential diagnosis. Early diagnosis can avoid unnecessary investigations, treatment and considerable cost.Keywords anterior cutaneous nerve entrapment syndrome (ACNES) · chronic abdominal pain · flank pain · neurectomy

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“…At the spinal level of the central neuron another important mechanism of pain can be elicited, referred pain [95]. This is a result of 'convergence' of afferent fibers from superficial bodily neurons, as well as from deeper, visceral fibers, into a lesser number of ascending central neurons.…”

Section: Referred Painmentioning

confidence: 99%