Quick Discrimination of Adelta and C Fiber Mediated Pain Based on Three Verbal Descriptors

Beißner, Florian; Brandau, Amadeus; Henke, Christian; Felden, Lisa; Baumgärtner, Ulf; Treede, Rolf‐Detlef; Oertel, B.; Lötsch, Jörn

doi:10.1371/journal.pone.0012944

Cited by 107 publications

(113 citation statements)

References 38 publications

(45 reference statements)

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“…With clear instructions subjects were able to separately rate first and second pain sensations in response to thermal heat stimuli of one-second duration, similar to previous reports 4, 13 . This investigation provides the basis for direct comparison of first and second pain sensations within and across upper-limb testing sites.…”

Section: Discussionsupporting

confidence: 81%

Testing Assumptions in Human Pain Models: Psychophysical Differences Between First and Second Pain

Eckert

Vierck

Simon

et al. 2017

The Journal of Pain

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Acute pain arises from activation of myelinated (A delta) and unmyelinated (C) nociceptive afferents, leading to 1st (A-fiber) or 2nd (C-fiber) pain sensations. The current study sought to investigate first and second pain within glabrous and hairy skin sites in human upper-limbs. Fifty healthy adults (25 males/25 females, 18-30 yrs: mean = 20.5 ± 1.4) participated in a psychophysical study investigating electronically rated, thermal first and second pain sensations within the glabrous skin at the palm and hairy skin of the forearm. Repeated measures ANOVA indicated that the threshold for first pain was lower (more sensitive) than for second pain (p = .004), for both glabrous and hairy skin, and thresholds at glabrous skin were higher than for hairy skin (p = .001). Hairy skin presented a steeper slope for testing, whereas there were no differences in slope between first and second pain. The study findings support assumptions associated with mechanistic differences between first and second pain sensations, while offering a novel method for producing first and second pain with the same thermal stimulus. Efforts to understand abnormalities among people with clinical pain and development of new therapeutic agents will benefit from specific psychophysical methods.

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Section: Discussionsupporting

confidence: 81%

Testing Assumptions in Human Pain Models: Psychophysical Differences Between First and Second Pain

Eckert

Vierck

Simon

et al. 2017

The Journal of Pain

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“…Furthermore, pain quality was assessed by the verbal descriptors of "pricking," "dull" and "pressing." These three descriptors have demonstrated discriminative properties to distinguish between Aδ-and C-fiber-mediated pain (Beissner et al, 2010). 0.6 ml Articaine was subsequently injected at the left mental foramen according to the technique described by Schwenzer & Ehrenfeld (Schwenzer, 2009).…”

Section: Pretest 3-6 Weeks Prior To the Fmri Experimentsmentioning

confidence: 99%

“…All subjects included in the final analysis reported a pricking pain experience during the entire pain phase, indicating predominantly Aδ-fiber-mediated pain (Beissner et al, 2010). Following the articaine injection, pain stopped at 2.8 min (SD = 3.73 min).…”

Section: Stimulus Perception and Pain Reliefmentioning

confidence: 99%

The Human Brain Response to Dental Pain Relief

et al. 2015

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Local anesthesia has made dental treatment more comfortable since 1884, but little is known about associated brain mechanisms. Functional magnetic resonance imaging is a modern neuroimaging tool widely used for investigating human brain activity related to sensory perceptions, including pain. Most brain regions that respond to experimental noxious stimuli have recently been found to react not only to nociception alone, but also to visual, auditory, and other stimuli. Thus, presumed functional attributions have come under scrutiny regarding selective pain processing in the brain. Evidently, innovative approaches are warranted to identify cerebral regions that are nociceptive specific. In this study, we aimed at circumventing known methodological confounders by applying a novel paradigm in 14 volunteers: rather than varying the intensity and thus the salience of painful stimuli, we applied repetitive noxious dental stimuli at constant intensity to the left mandibular canine. During the functional magnetic resonance imaging paradigm, we suppressed the nociceptive barrage by a mental nerve block. Brain activity before and after injection of 4% articaine was compared intraindividually on a group level. Dental pain extinction was observed to correspond to activity reduction in a discrete region of the left posterior insular cortex. These results confirm previous reports demonstrating that direct electrical stimulation of this brain region-but not of others-evokes bodily pain sensations. Hence, our investigation adds further evidence to the notion that the posterior insula plays a unique role in nociceptive processing. The human brain response to dental pain relief AbstractLocal anesthesia has made dental treatment more comfortable since 1884, but little is known about associated brain mechanisms. Functional magnetic resonance imaging (fMRI) is a modern neuroimaging tool widely used for investigating human brain activity related to sensory perceptions, including pain. Recently, most brain regions that respond to experimental noxious stimuli have been found to react not only to nociception alone, but also to visual, auditory and other stimuli. Thus, presumed functional attributions have come under scrutiny regarding selective pain processing in the brain. Evidently, innovative approaches are warranted to identify cerebral regions that are nociceptivespecific. In this study, we aimed at circumventing known methodological confounders by applying a novel paradigm in 14 volunteers: rather than varying the intensity and thus the salience of painful stimuli, we applied repetitive noxious dental stimuli at constant intensity to the left mandibular canine.During the fMRI paradigm we suppressed the nociceptive barrage by a mental nerve block. Brain activity before and after injection of 4% articaine was compared intra-individually on a group level.Dental pain extinction was observed to correspond to activity reduction in a discrete region of the left posterior insular cortex. These results confirm previous reports dem...

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“…In all experiments, we delivered slow-rising CO 2 laser stimuli of increasing temperature (1 °C/sec). Participants were asked to press a button as soon as they felt a pinprick sensation, reflecting the activation of Aδ afferents49. The temperature at which the button was pressed defined the pinprick detection threshold.…”

Section: Methodsmentioning

confidence: 99%

Perceptual learning to discriminate the intensity and spatial location of nociceptive stimuli

Mancini

Dolgevica

Steckelmacher

et al. 2016

Sci Rep

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Accurate discrimination of the intensity and spatial location of nociceptive stimuli is essential to guide appropriate behaviour. The ability to discriminate the attributes of sensory stimuli is continuously refined by practice, even throughout adulthood - a phenomenon called perceptual learning. In the visual domain, perceptual learning to discriminate one of the features that define a visual stimulus (e.g., its orientation) can transfer to a different feature of the same stimulus (e.g., its contrast). Here, we performed two experiments on 48 volunteers to characterize perceptual learning in nociception, which has been rarely studied. We investigated whether learning to discriminate either the intensity or the location of nociceptive stimuli (1) occurs during practice and is subsequently maintained, (2) requires feedback on performance, and (3) transfers to the other, unpractised stimulus feature. First, we found clear evidence that perceptual learning in discriminating both the intensity and the location of nociceptive stimuli occurs, and is maintained for at least 3 hours after practice. Second, learning occurs only when feedback is provided during practice. Finally, learning is largely confined to the feature for which feedback was provided. We discuss these effects in a predictive coding framework, and consider implications for future studies.

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Quick Discrimination of Adelta and C Fiber Mediated Pain Based on Three Verbal Descriptors

Cited by 107 publications

References 38 publications

Testing Assumptions in Human Pain Models: Psychophysical Differences Between First and Second Pain

Testing Assumptions in Human Pain Models: Psychophysical Differences Between First and Second Pain

The Human Brain Response to Dental Pain Relief

Perceptual learning to discriminate the intensity and spatial location of nociceptive stimuli

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