Pain-related magnetic fields following painful CO2 laser stimulation in man

Laser-evoked potentials after painful hand and foot stimulation in humans: evidence for generation of the middle-latency component in the secondary somatosensory cortex

The vertex potential (N2, P2) of the laser-evoked potential (LEP) is preceded by a small negativity (N1). The role of the secondary somatosensory cortex (SII) in generation of the N1 is established for the upper but not for the lower limb. We therefore investigated the N1 after painful radiant heat stimulation of hand and foot dorsum in 22 subjects. LEPs were recorded from the scalp with midline and temporal electrodes. After hand stimulation N1 was maximal in the contralateral temporal lead (mean peak latency 156 +/- 23 ms). After foot stimulation N1 was maximal in the same lead (200 +/- 22 ms). In the ipsilateral temporal lead, N1 appeared significantly smaller and later. N2 and P2 were maximal in midline electrodes for both stimulus sites. The latency shift between hand and foot stimulation was identical for all three components. These results suggest a contribution of temporo-parietal cortex (e.g. SII) to the N1 generation for stimulation of upper and lower limb.

Scalp topography and dipolar source modelling of potentials evoked by CO2 laser stimulation of the hand

CO2 laser evoked potentials to hand stimulation recorded using a scalp 19-channel montage in 11 normal subjects consistently showed early N1/P1 dipolar field distribution peaking at a mean latency of 159 ms. The N1 negativity was distributed in the temporoparietal region contralateral to stimulation and the P1 positivity in the frontal region. The N1/P1 response was followed by 3 distinct components: (1) N2a reaching its maximal amplitude at the vertex and ipsilaterally to the stimulated hand, (2) N2b mostly distributed in the frontal region, and (3) P2 with a mid-central topography. Brain electrical source analysis showed that this sequence was explained, with a residual variance below 5%, by a model including two dipoles in the upper bank of the Sylvian fissure of each hemisphere, a frontal dipole close to the midline, and two anterior medial temporal dipoles, thus suggesting a sequential activation of the two second somatosensory areas, anterior cingulate gyrus and the amygdalar nuclei or the hippocampal formations, respectively. This model fitted well with the scalp field topography of grand average responses to stimulation of left and right hand obtained across all subjects as well as when applied to individual data. Our findings suggest that the second somatosensory area contralateral to the stimulation is the first involved in the building of pain-related responses, followed by ipsilateral second somatosensory area and limbic areas receiving noxious inputs from the periphery.

Somatosensory evoked magnetic fields following stimulation of the lip in humans

The topography of somatosensory evoked magnetic fields (SEFs) following stimulation of the upper and lower lips was investigated in 6 normal subjects. When the lateral side of the upper lip was stimulated, P20m and its counterpart, N20m, were identified in the hemisphere contralateral to the stimulated side. The equivalent current dipoles (ECDs) of N20m-P20m were considered to be located in lip area of the primary sensory cortex (SI). Middle latency deflections (N40m-P40m, N60m-P60m, and N80m-P80m) were identified in bilateral hemispheres. Their ECDs were located in the SI in both hemispheres. Long latency deflections (P110m-N110m) were recognized in both hemispheres, and their ECDs were located inferior to the SI, in an area considered to be the secondary sensory cortex (SII). When the midline of the lip was stimulated, similar short and middle latency deflections was also identified, but SII deflections (P110m-N110m) were decreased in amplitude. When the lower lip was stimulated, the ECDs of short and middle latency deflections were located at a site in the SI inferior to or near those elicited by upper lip stimulation. The ECDs of P110m-N110m were located in an area of the SII similar to that upon stimulation of the upper lip, but their orientations were different.

Effects of noxious cooling of the skin on pain perception in man

By means of somatosensory evoked brain potentials following painful CO2 laser stimulation (pain SEPs) and a pain visual analogue scale (VAS), we investigated changes in pain perception caused by noxious cooling of the skin in normal subjects. Pain SEPs were recorded from scalp electrodes following laser stimulation applied to the leg under various conditions as follows: (1) control (without any interference); (2) 46 degrees C foot (dipping the foot ipsilateral to the stimulated leg in hot water at 46 degrees C); (3) 0 degrees C foot (dipping the foot ipsilateral to the stimulated leg in ice water at 0 degrees C); and (4) 0 degrees C hand (dipping the hand contralateral to the stimulated leg in ice water at 0 degrees C). Marked decreases in amplitude of pain SEPs and VAS were observed under all conditions as compared with the control (P < 0.001); the degree of pain relief was significantly correlated with changes in pain SEPs. These changes were greatest in the '0 degrees C hand' condition, followed in decreasing order by '0 degrees C foot' and '46 degrees C foot', and there was a significant difference between '0 degrees C hand' and the '46 degrees C foot' condition. We considered that the decrease in pain is due to the diffuse noxious inhibitory control (DNIC). The reason why the degree of pain relief in '0 degrees C foot' condition was less than that in '0 degrees C hand' condition is unclear, but some particular spatial summation of two kinds of nociceptive impulses mediated by the same pathway might take place.

Pain-related somatosensory evoked magnetic fields

Somatosensory evoked magnetic fields (SEFs) following painful electrical stimulation of the finger were investigated in 5 normal subjects. Equivalent current dipoles (ECDs) of deflections shorter than 100 msec in latency were located in the primary sensory cortex (SI) in the hemisphere contralateral to the stimulated finger following either non-painful or painful stimulation. Two main deflections, N100m-P100m and N250m-P250m, were independently identified following painful stimulation, although they were not found in SEFs following non-painful weak stimulation. ECDs of the N100m-P100m were considered to be located in the bilateral second sensory cortices (SII). ECDs of the N250m-P250m were identified in the bilateral cingulate cortices and SII, but the intersubject difference was large. Therefore, we considered that contralateral SI and bilateral SII were initially activated by painful noxious stimulation, and then multiple areas including bilateral SII and cingulate cortices were activated. In EEG recordings (evoked potentials), no potential corresponding to N100m-P100m was found, probably because it was difficult to record activation in SII by EEG recordings. The P250 potential which corresponded to the N250m-P250m was clearly identified, probably because activation of multiple areas generated large long-duration EEG potentials which were maximal around the vertex, unlike MEG recordings.