Encoding of tensile stress and strain during stretch by muscle mechano-nociceptors

A quasi-experimental study on the effects of instrument assisted soft tissue mobilization on mechanosensitive neurons

[Purpose] Instrument Assisted Soft Tissue Mobilization (IASTM) is a form of manual therapy. Despite its growing popularity and an increasing number of patients receiving IASTM each year, there is a lack of high-level evidence to elucidate its therapeutic mechanisms and to support its clinical applications. The purpose of this research project was to determine the effects of IASTM on activities of mechanosensitive neurons in skin. [Subjects and Methods] Twenty-three subjects, 9 females and 14 males, mean age 25.7 (SD 6.4) years old were recruited through a convenience sampling on the university campus. The study design was a quasi-experimental study using single group pretest-posttest design. The activities of mechanosensitive neurons were measured before and after the application of IASTM. [Results] The mean 2-point discrimination was 40.2 (SD 9.4) mm before IASTM and increased to 44.9 (SD 12.0) mm after IASTM. The increase was statistically significant pre and post IASTM. The mean pain threshold was 18.2 (SD 6.6) lb and increased slightly to 18.7 (SD 6.8) lb after IASTM; however, no statistical significance was found pre and post IASTM. [Conclusion] The data indicates that IASTM changes the neural activities in 2-point discrimination but not in pain threshold.

Neuromechanical representation of fabric-evoked prickliness: a fiber-skin-neuron model

Cutaneous Aδ nociceptors encode the material and geometrical features of fiber ends evoking prickliness sensation by generating neural spikes in response to indentation of human skin, however, understanding of the underlying neuromechanism of fabric-evoked prickliness is still far from clear. This work develops and validates a fiber-skin-neuron (mechanosensitive Aδ-nociceptors) model that combines an analytical model of fiber-skin indentation, a sigmoidal function of neuronal transduction, and a leaky integrate-and-fire model of neuronal dynamics. Firstly, the model is validated to be capable of capturing the typical neurphysiological features of cutaneous Aδ nociceptors and the psychophysical phenomenon. And then, several case studies with respect to statistical features of fiber ends are carried out, and the resulting neural responses are calculated to explore the relationship between statistical features in study and evoked responses. The analysis of predicted action potentials over one second indicates that they systematically change with statistical features of fiber ends protruding above fabric surfaces, and the fitted stimulus-response relationship of Aδ nociceptors is highly similar to the stimulus-sensation relationship of prickliness rating magnitude. It follows that there might exist a linear relationship between fabric-evoked neurophysiological responses and psychophysical responses. These results provide significant new insight into the fabric-evoked prickliness sensation and raise interesting questions for further investigation, and the model described here bridges the gap between those models that transform fiber ends properties to firing rates.

Group III and IV muscle afferent discharge patterns after repeated lengthening and shortening actions

The purpose of this study was to test the hypothesis that group III and IV muscle afferent activity would differ after concentric- and eccentric-type fatiguing tasks. Tibialis anterior afferent activities from adult rats were measured in three conditions: before and after a rest period (C), and after concentric (CC) or eccentric (EC) exercise. Specific activators were used to elicit increases in afferent discharge rates, i.e., electrically induced fatigue (EIF), or potassium chloride (KCl) and lactic acid (LA) injections. After the rest period (POST-condition), the control group displayed a pattern of response to stimuli similar to that obtained in baseline condition (PRE-condition). However, responses were significantly different in the exercise groups: afferent responses were blunted in the CC group and were almost suppressed in the EC group. These results demonstrate that the type of muscular contraction involved in the fatiguing task can affect group III and IV afferent fiber activity differently and, potentially, can differentially affect the regulation of central motor command.

Nociceptive craniofacial muscle primary afferent neurons synapse in both the rostral and caudal brain stem

Limited information is available on muscle afferent neurons with fine fibers despite their presumed participation in musculoskeletal disorders, including temporomandibular disorders. To study these neurons, intracellular recordings were made from the central axons of slowly conducting muscle afferent neurons in anesthetized rats. After intraaxonal impalement, axons were characterized by masseter nerve stimulation, receptive field testing, muscle stretching and intramuscular injection of hypertonic saline. Intracellular recordings were made from 310 axons (conduction velocity: 6.5-60(M)/s, mean = 27.3(M)/s; following frequency: 27-250 Hz, mean = 110Hz). No neurons responded to cutaneous palpation or muscle stretching. Some axons (n = 34) were intracellularly stained with biotinamide. These neurons were classified as group II/III noxious mechanoreceptors because their mechanical threshold exceeded 15 mN, and conduction velocities ranged from 12 to 40.2(M)/s (mean = 25.3(M)/s). Two morphological types were recognized by using an object-based, three-dimensional colocalization methodology to locate synapses. One type (IIIHTM(Vp-Vc)) possessed axon collaterals that emerged along the entire main axon and synapsed in the trigeminal principal sensory nucleus and spinal trigeminal subnuclei oralis (Vo), interpolaris (Vi), and caudalis (Vc). A second type (IIIHTM(Vo-Vc)) possessed axon collaterals that synapsed only in caudal Vo, Vi, and Vc. Our previous studies show that muscle spindle afferent neurons are activated by innocuous stimuli and synapse in the rostral and caudal brain stem; here we demonstrate that nociceptive muscle mechanoreceptor afferent axons also synapse in rostral and caudal brain stem regions. Traditional dogma asserts that the most rostral trigeminal sensory complex exclusively processes innocuous somatosensory information, whereas caudal portions receive nociceptive sensory input; the data reported here do not support this paradigm.

A novel mouse skeletal muscle-nerve preparation and in vitro model of ischemia

The majority of patients in pain clinics are treated for muscle pain yet methods to study it in animals are relatively weak compared to methods to study skin pain. Here we describe an in vitro muscle-nerve preparation and model of muscle ischemia and contractile fatigue in mice. Timed muscle contraction is electrically evoked, while single unit activity of muscle sensory neurons and muscle contractile force are simultaneously recorded. The muscle is placed in a small (<1 mL) chamber where oxygen levels can be manipulated, drugs can be applied, and the extracellular milieu can be highly controlled. We demonstrate that we can record from sensory afferents that have the properties expected of ischemic nociceptors. This method serves for studying the neuronal and molecular mechanisms underlying ischemic pains such as angina, intermittent claudication, and sickle cell crisis.

Neural response of cervical facet joint capsule to stretch: a study of whiplash pain mechanism

Cervical facet joints are implicated as a major source of pain after whiplash injury. The purpose of this study was to investigate the proposed capsule strain injury mechanism of whiplash pain using neurophysiologic methods. Strain thresholds, threshold distribution, saturation strains and afterdischarge responses of capsule neural receptors were characterized in vivo. Goat C5-C6 facet joint capsules were used to identify and characterize capsule receptors in response to controlled uniaxial stretch by recording C6 dorsal rootlet nerve discharge. The joints were stretched at 0.5 mm/sec in a series of tests with 2 mm increments until the capsule ruptured. Ninety-two identified units were responsive to physiologic or noxious stretch while 28 were silent receptors. Among the 50 characterized responsive units, 42 showed low strain thresholds at 10.2+/-4.6% while 8 had high strain thresholds at 47.2+/-9.6%. Further, 35 of the 42 low-threshold units displayed discharge saturation at various strains (44.2+/-16.7%). A significant finding was that twelve low-threshold units exhibited afterdischarge for greater than 30 sec after stretch release at 36.6+/-12.5% strains, and displayed longer-lasting afterdischarge (greater than 4 min) at higher strains (39.0+/-14.4%) with significant difference (p = 0.019) in strains. Two high-threshold units had afterdischarges for greater than 30 sec or 4 min at 50.3+/-5.9% and 57.7+/-10.6% strains, respectively. In addition, the spatial distribution of the 42 low-threshold receptors demonstrated that the receptors on the joint gap were more strain-sensitive, with significantly lower strain thresholds compared to the rostral and caudal regions. No significant difference in strain threshold was observed in the medial-lateral direction. When compared to the reported strains that facet joint capsules experienced in whiplash (35-60%) and the reported capsule subfailure strains (35-67%), the low strain thresholds are substantially lower whereas the high thresholds and afterdischarge strains are within that range. Thus, low threshold units appear to signal proprioception within the physiologic range. High threshold units likely signal nociception (pain sensation) while afterdischarge may signal capsule strain injury and contribute to persistent pain.

Neurophysiological and biomechanical characterization of goat cervical facet joint capsules

Cervical facet joints have been implicated as a major source of pain after whiplash injury. We sought to identify facet joint capsule receptors in the cervical spine and quantify their responses to capsular deformation. The response of mechanosensitive afferents in C5-C6 facet joint capsules to craniocaudal stretch (0.5 mm/s) was examined in anaesthetized adult goats. Capsular afferents were characterized into Group III and IV based on their conduction velocity. Two-dimensional strains across the capsules during stretch were obtained by a stereoimaging technique and finite element modeling. 17 (53%) Group III and 14 (56%) Group IV afferents were identified with low strain thresholds of 0.107+/-0.033 and 0.100+/-0.046. A subpopulation of low-strain-threshold afferents had discharge rate saturation at the strains of 0.388+/-0.121 (n=9, Group III) and 0.341+/-0.159 (n=9, Group IV). Two (8%) Group IV units responded only to high strains (0.460+/-0.170). 15 (47%) Group III and 9 (36%) Group IV units could not be excited even by noxious capsular stretch. Simple linear regressions were conducted with capsular load and principal strain as independent variables and neural response of low-strain-threshold afferents as the dependent variable. Correlation coefficients (R2) were 0.73+/-0.11 with load, and 0.82+/-0.12 with principal strain. The stiffness of the C5-C6 capsules was 16.8+/-11.4 N/mm. Our results indicate that sensory receptors in cervical facet joint capsules are not only capable of signaling a graded physiological mechanical stimulus, but may also elicit pain sensation under excessive deformation.