The influence of rate of temperature change and peak stimulus duration on pain intensity and quality

Nielsen, Jesper; Arendt‐Nielsen, Lars

doi:10.1080/08990229870781

Cited by 30 publications

(26 citation statements)

References 41 publications

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“…Whether or not such differences have any effect on the PWT-H remains unclear. In previous studies on humans, Pertovaara (Pertovaara et al, 1996) and Nielsen and Arendt-Nielsen (Nielsen and Arendt-Nielsen, 1998) found no interaction between the rates of temperature change (1–16°C/s) and pain ratings, whereas Tillman and colleagues (Tillman et al, 1995) reported decreased heat threshold in human subjects when the rate of temperature change was greater. Moreover, it has been shown that the peak rates of discharge from C-fiber nociceptors increase with higher rates of temperature increase in humans (Yarnitsky et al, 1992) and monkeys (Tillman et al, 1995).…”

Section: Discussionmentioning

confidence: 93%

A modified Hargreaves’ method for assessing threshold temperatures for heat nociception

Banik¹,

Kabadi²

2013

Journal of Neuroscience Methods

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This study describes a modified Hargreaves’ method for assessing paw withdrawal threshold temperatures for heat (PWT-H) nociception in the rat hind paws. The method utilizes applications of radiant heat to maintain controlled lamp temperatures (CLT) on a glass floor beneath the rat hind paw. An ascending series of CLTs were each applied for 10-s, with 5–10 min intervals between applications, until a characteristic withdrawal behavior was observed, or a cutoff CLT was reached. Average plantar epicutaneous temperatures measured from anesthetized rats corresponding to CLTs and withdrawal latencies were used for determining PWT-H. The mean PWT-H in 2-months old (mo) naïve Sprague-Dawley rats (n=38) was 47.6±0.2°C, and is comparable to the noxious threshold temperature for human glabrous skin (46.5±0.5°C). The PWT-H is consistent between trials and daily assessments over four consecutive days. No significant differences were observed between the PWT-H in 2 mo, 6–8 mo, and >24 mo F344 rats, but the PWT-H in 1-mo rats was significantly decreased. Three hours following plantar incision, the PWT-H decreased to 37.5±0.2°C, which correlates with previous observations of C-fiber afferents from incised glabrous skin firing at 36.7±3.6°C. Parallel testing with the current method and an electronic von Frey device illustrated similar degrees of incision-induced hyperalgesia, improvement of hyperalgesia over time, and reversals induced by morphine and gabapentin. In conclusion, the present method allows us to compare PWT-H with electrophysiological and human psychophysical studies involving thermosensation and, as a behavioral assay identical to von Frey testing in measuring threshold for nociception.

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Section: Discussionmentioning

confidence: 93%

A modified Hargreaves’ method for assessing threshold temperatures for heat nociception

Banik¹,

Kabadi²

2013

Journal of Neuroscience Methods

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“…This finding is in accordance with the results of Tillman et al [21] who evaluated how the thermal properties of the skin would affect the discharge of C fiber nociceptors (CMHs). This study concluded that due to the thermal inertia of the skin, the activation threshold temperature (at the skin surface) would increase with increasing stimulus ramp, this has been the debate of several publications [22-24]. Furthermore, the study by Tillman et al [21] also concluded that a higher stimulus ramp would produce a higher peak discharge of nociceptors (CMHs) due to the phasic properties of C fiber nociceptors.…”

Section: Discussionmentioning

confidence: 99%

Spatial temperature distribution in human hairy and glabrous skin after infrared CO2 laser radiation

et al. 2010

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BackgroundCO2 lasers have been used for several decades as an experimental non-touching pain stimulator. The laser energy is absorbed by the water content in the most superficial layers of the skin. The deeper located nociceptors are activated by passive conduction of heat from superficial to deeper skin layers.MethodsIn the current study, a 2D axial finite element model was developed and validated to describe the spatial temperature distribution in the skin after infrared CO2 laser stimulation. The geometry of the model was based on high resolution ultrasound scans. The simulations were compared to the subjective pain intensity ratings from 16 subjects and to the surface skin temperature distributions measured by an infrared camera.ResultsThe stimulations were sensed significantly slower and less intense in glabrous skin than they were in hairy skin (MANOVA, p < 0.001). The model simulations of superficial temperature correlated with the measured skin surface temperature (r > 0.90, p < 0.001). Of the 16 subjects tested; eight subjects reported pricking pain in the hairy skin following a stimulus of 0.6 J/cm2 (5 W, 0.12 s, d1/e2 = 11.4 mm) only two reported pain to glabrous skin stimulation using the same stimulus intensity. The temperature at the epidermal-dermal junction (depth 50 μm in hairy and depth 133 μm in glabrous skin) was estimated to 46°C for hairy skin stimulation and 39°C for glabrous skin stimulation.ConclusionsAs compared to previous one dimensional heat distribution models, the current two dimensional model provides new possibilities for detailed studies regarding CO2 laser stimulation intensity, temperature levels and nociceptor activation.

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“…Psychophysical thresholds for heat pain range from 40 to 49 for stimulation at glabrous and hairy skin sites with probes of different sizes and with widely varying ramp rates and stimulus durations (Hamalainen et al 1982;LaMotte 1984;LaMotte et al 1983;Morin and Bushnell 1998;Pertovaara et al 1996;Strigo et al 2000;Wahren et al 1989;Yarnitsky and Ochoa 1991). Most of the mean threshold values cluster between 43 and 46°C (Craig and Bushnell 1994;Dyck et al 1993;Hardy et al 1952;Harju 2002;Magerl and Treede 1996;Nielsen and Arendt-Nielsen 1998;Taylor et al 1993;Tillman et al 1995;Torebjork et al 1984;Verdugo and Ochoa 1992). In experiment 2 of this study, eVAS ratings of 10 represent a conservative estimate of threshold pain.…”

Section: Discussionmentioning

confidence: 99%

Relationships Between Skin Temperature and Temporal Summation of Heat and Cold Pain

Mauderli

Vierck²,

Cannon³

et al. 2003

Journal of Neurophysiology

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. Relationships between skin temperature and temporal summation of heat and cold pain. J Neurophysiol 90: 100 -109, 2003; 10.1152/jn.01066.2002. Temporal summation of heat pain during repetitive stimulation is dependent on C nociceptor activation of central N-methyl-D-aspartate (NMDA) receptor mechanisms. Moderate temporal summation is produced by sequential triangular ramps of stimulation that control skin temperature between heat pulses but do not elicit distinct first and second pain sensations. Dramatic summation of second pain is produced by repeated contact of the skin with a preheated thermode, but skin temperature between taps is not controlled by this procedure. Therefore relationships between recordings of skin temperature and psychophysical ratings of heat pain were evaluated during series of repeated skin contacts. Surface and subcutaneous recordings of skin temperatures revealed efficient thermoregulatory compensation for heat stimulation at interstimulus intervals (ISIs) ranging from 2 to 8 s. Temporal summation of heat pain was strongly influenced by the ISIs and cannot be explained by small increases in skin temperature between taps or by heat storage throughout a stimulus series. Repetitive brief contact with a precooled thermode was utilized to evaluate whether temporal summation of cold pain occurs, and if so, whether it is influenced by skin temperature. Surface and subcutaneous recordings of skin temperature revealed a sluggish thermoregulatory compensation for repetitive cold stimulation. In contrast to heat stimulation, skin temperature did not recover between cold stimuli throughout ISIs of 3-8 s. Psychophysically, repetitive cold stimulation produced an aching pain sensation that progressed gradually and radiated beyond the site of stimulation. The magnitude of aching pain was well related to skin temperature and thus appeared to be established primarily by peripheral factors. I N T R O D U C T I O NTemporal summation of pain occurs reliably when pulses of heat or electrical stimulation are delivered repetitively at rates as slow as one pulse in 3 s. Enhanced discharge of nocireceptive central neurons ("windup") can be observed under these conditions (Mendell 1966;Tommerdahl et al. 1998). Temporal summation for psychophysical and neural responses to heat is dependent on activation of unmyelinated (C) nociceptors and is dependent in part on activation of central N-methyl-D-aspartate (NMDA) receptors (Dickenson 1990;Graven-Nielsen et al. 2000;Price et al. 1994). Most investigations of heat pain summation have utilized triangular ramps from a Peltier device in constant contact with the skin. This method has the advantage of returning the skin to a baseline temperature between each ramping heat stimulus. However, because of limitations on the ramp speeds of Peltier thermodes (especially during down ramps), distinct first and second pain sensations that are attributable respectively to activation of myelinated (A-delta) and C nociceptors are not produced. Possibly because of inhibitory influe...

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The influence of rate of temperature change and peak stimulus duration on pain intensity and quality

Cited by 30 publications

References 41 publications

A modified Hargreaves’ method for assessing threshold temperatures for heat nociception

A modified Hargreaves’ method for assessing threshold temperatures for heat nociception

Spatial temperature distribution in human hairy and glabrous skin after infrared CO2 laser radiation

Relationships Between Skin Temperature and Temporal Summation of Heat and Cold Pain

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