The effect of nerve compression and capsaicin on contact heat-evoked potentials related to Aδ- and C-fibers

Madsen, Claus; Johnsen, Birger; Fuglsang-Frederiksen, Anders; Jensen, Troels Staehelin; Finnerup, Nanna Brix

doi:10.1016/j.neuroscience.2012.07.049

Cited by 27 publications

(18 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous findings from healthy subjects reported increased P2 latencies over cingulate cortex and reduced vertex amplitudes during topical capsaicin 3% application (de Tommaso et al., , ), whereas shortened N2 and P2 latencies at unchanged N2/P2 amplitudes were measured in capsaicin 5% sensitized skin (Madsen et al., ). Prolonged contact heat‐evoked potentials (CHEPs) were recorded in subjects who lost stimulus related A‐fibre activity after nerve compression (Madsen et al., ) and the authors suggested CHEPs being a useful tool for assessing sensitized pain systems (Madsen et al., ). In chronic pain patients, event related potentials also are excellent tools to assess small fibre function but it is unclear to which extent they provide additional information about the concomitant pain (Truini et al., ).…”

Section: Discussionmentioning

confidence: 99%

Short lasting transient effects of a capsaicin 8% patch on nociceptor activation in humans

Landmann

Lustenberger

Schleinzer

et al. 2016

European Journal of Pain

View full text Add to dashboard Cite

Axonal nociceptor function assessed by electrical excitability tests supplements threshold tests of nociceptive endings. The differential analgesic effects of 8% capsaicin patches may be attributed to the kinetics of capsaicin and the different depth of nociceptive nerve fibres, yet, the time course does not match the long-lasting analgesia observed in neuropathic pain patients treated with the same patch. WHAT DOES THIS STUDY ADD?: Axonal nociceptor function assessed by supra-threshold electrical excitability tests did not coincide with capsaicin-induced transduction changes supplementing threshold measures of terminal nociceptor endings. Threshold measurements do not reflect the sustained effect of pain relief seen in neuropathic pain patients. Capsaicin-sensitive nociceptors responsible for spontaneous pain are either not specifically tested with currently available sensory stimulation protocols or have higher capsaicin sensitivity or slower recovery under neuropathic conditions.

show abstract

Section: Discussionmentioning

confidence: 99%

Short lasting transient effects of a capsaicin 8% patch on nociceptor activation in humans

Landmann

Lustenberger

Schleinzer

et al. 2016

European Journal of Pain

View full text Add to dashboard Cite

show abstract

“…Contact heat‐evoked potentials (CHEPs) and cold‐evoked potentials (CEPs) are innovative noninvasive methods to assess the integrity of thinly myelinated A‐delta fibres and the spinothalamic tract. With heat or cold emitting thermodes, heat‐ or cold‐mediating fibres may be assessed selectively, providing promising noninvasive electrophysiological tools for the detection of specific small‐fibre function loss and neuropathic pain (Greffrath, Baumgartner, & Treede, ; Hullemann et al, ; De Keyser, Broeke, Courtin, Dufour, & Mouraux, ; Lagerburg et al, ; Madsen, Johnsen, Fuglsang‐Frederiksen, Jensen, & Finnerup, ,).…”

Section: Introductionmentioning

confidence: 99%

Cold‐evoked potentials versus contact heat‐evoked potentials—Methodological considerations and clinical application

Hüllemann

Nerdal

Sendel

et al. 2019

European Journal of Pain

View full text Add to dashboard Cite

Background Previous studies investigated cold‐evoked potentials (CEPs) for the assessment of the integrity of cold‐mediating A‐delta fibres and the spinothalamic tract. Nevertheless, several methodological questions remained unanswered to proceed to clinical application. How do latencies and amplitudes vary between CEPs and contact heat‐evoked potentials (CHEPs)? Are there differences between variable and fixed thermode positions or between glabrous and hairy skin? Are CEPs recordable in patients with abnormal cold processing? Methods A total of 16 healthy subjects were tested with CEPs and CHEPs at the face, hand and foot. Variable and fixed thermode positions, hairy and glabrous skin were compared. Three patients with abnormal cold processing were tested with CEPs and quantitative sensory testing. Results Compared to CEPs, CHEPs latencies were significantly longer at all locations, amplitudes were significantly larger at the face and the hand whilst comparable at the foot. CEPs and CHEPs did not differ significantly between variable and fixed thermode positions using inter stimulus intervals of 8–12 s. CEP latencies were increased by around 20% at the glabrous skin. Patients with known abnormal cold processing (central pain, polyneuropathy, Fabry's disease) showed increased N2 latencies as compared to normal controls. Conclusions Inter stimulus intervals of 8‐12 s allow the use of a fixed thermode position for reliable CEPs/CHEPs recording. Hairy skin stimulation results in faster latencies as compared to glabrous skin, without influencing EP amplitudes. In patients with abnormal cold processing, CEPs are recordable and increased latencies may be expected as compared to healthy controls and the healthy contralateral side. Significance Cold‐evoked potentials are an innovative, non‐invasive technique to assess cold detection and processing objectively. This study shows that CEP can be recorded from the hairy and glabrous skin, regardless of using fixed or variable thermode positions. Loss of A‐delta fibre function leads to an increased CEP latency, consistent with loss of cold detection in the QST.

show abstract

“…Thus, separate assessment of first and second pain can be fruitful; it has remained elusive due to the testing methodologies employed. For example, increasing levels of electrocutaneous stimulation activate A-beta and then both A-beta and A-delta afferents 19 , while cutaneous application of capsaicin preferentially activates C nociceptors 27, 30 . A direct comparison of sensitivity to these procedures is confounded by phasic vs. tonic stimulation, leaving no direct way to compare stimulus-response functions for electrical and chemical stimulation.…”

Section: Introductionmentioning

confidence: 99%

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

Eckert

Vierck

Simon

et al. 2017

The Journal of Pain

View full text Add to dashboard Cite

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.

show abstract

The effect of nerve compression and capsaicin on contact heat-evoked potentials related to Aδ- and C-fibers

Cited by 27 publications

References 57 publications

Short lasting transient effects of a capsaicin 8% patch on nociceptor activation in humans

Short lasting transient effects of a capsaicin 8% patch on nociceptor activation in humans

Cold‐evoked potentials versus contact heat‐evoked potentials—Methodological considerations and clinical application

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

Contact Info

Product

Resources

About