1
|
Dreismickenbecker E, Fleckenstein J, Walter C, Enax-Krumova EK, Fischer MJM, Kreuzer M, Zinn S, Anders M. Nociceptive Processing of Elite Athletes Varies between Sport-Specific Loads: An EEG-Based Study Approach. Med Sci Sports Exerc 2024; 56:1046-1055. [PMID: 38227482 DOI: 10.1249/mss.0000000000003390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
INTRODUCTION For the downstream nociceptive processing of elite athletes, recent studies indicate that athletes probably tolerate more pain as compared with a normally active population. Phenotyping the nociceptive processing of athletes in different types of endurance sports can provide insight into training-specific effects, which may help in understanding the long-term effects of specific exercise. METHODS Twenty-six elite endurance athletes from the disciplines of rowing, triathlon, and running and 26 age- and sex-matched, recreationally active control subjects who participated in the subjective pain perception and processing of standardized noxious stimuli were investigated by EEG. This included standardized heat pain thresholds (HPT) and contact heat-evoked potentials from heat stimulation, measured with EEG as well as pinprick-evoked potentials from mechanical stimulation. RESULTS After noxious stimulation, athletes showed a higher activation of the event-related spectral perturbation (ERSP) patterns in the N2P2 EEG response at the Cz Electrode compared with the controls. After noxious contact heat stimulation, triathletes had a higher ERSP activation compared with the controls, whereas the rowers had a higher ERSP activation after noxious mechanical stimulation. Also, HPT in triathletes were increased despite their increased central activation after thermal stimulation. We found a correlation between increased HPT and training hours and years, although athletes did not differ within these variables. CONCLUSIONS Although we were able to identify differences between athletes of different endurance sports, the reasons and implications of these differences remain unclear. The study of sport-specific somatosensory profiles may help to understand the mechanisms of exercise-related long-term effects on pain processing and perception. Furthermore, sport-specific somatosensory effects may support the personalization of exercise interventions and identify risk factors for chronic pain in elite athletes.
Collapse
Affiliation(s)
| | - Johannes Fleckenstein
- Department of Sports Medicine and Exercise Physiology, Institute of Sports Sciences, Goethe University, Frankfurt, GERMANY
| | - Carmen Walter
- Clinical Development and Human Pain Models, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt, GERMANY
| | - Elena K Enax-Krumova
- Department of Neurology, BG University Hospital Bergmannsheil gGmbH Bochum, Ruhr University Bochum, Bochum, GERMANY
| | - Michael J M Fischer
- Center of Physiology and Pharmacology, Medical University of Vienna, Vienna, AUSTRIA
| | - Matthias Kreuzer
- Department of Anesthesiology and Intensive Care, School of Medicine, Technical University of Munich, Munich, GERMANY
| | | | - Malte Anders
- Clinical Development and Human Pain Models, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt, GERMANY
| |
Collapse
|
2
|
Sauer AK, Vigouroux M, Dougherty PM, Cata JP, Ingelmo PM. Pain Experience and Sensory Changes in Astronauts During and After Short-Lasting Commercial Spaceflight: A Proof-of-Concept Study. J Pain Res 2023; 16:4253-4266. [PMID: 38107368 PMCID: PMC10723599 DOI: 10.2147/jpr.s440630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/02/2023] [Indexed: 12/19/2023] Open
Abstract
Space travel has been associated with musculoskeletal pain, yet little is known about the nociceptive changes and pain experience during spaceflight. This preliminary study aims to investigate the pain experience and sensory alterations in astronauts following a 17-day mission to the International Space Station (ISS) on Axiom Space's AX-1 commercial space flight. Two participants were enrolled, and data were collected pre-flight, in-flight, post-flight, and three-month post-flight. Validated pain questionnaires assessed anxiety, catastrophizing, impact on physical and mental health, disability, and overall pain experience. Qualitative interviews were conducted post-landing and conditioned pain modulation (CPM) and quantitative sensory testing (QST) were performed. Both astronauts reported musculoskeletal pain during and after the flight, which was managed with anti-inflammatories and stretching techniques. Pain levels returned to baseline after three months. Pain questionnaires revealed heightened pain experiences in-flight and immediately post-flight, although their adequacy in assessing pain in space is uncertain. Qualitative interviews allowed astronauts to describe their pain experiences during the flight. Sensory changes included increased mechanical touch detection thresholds, temporal pain summation, heat pain thresholds, and differences in conditioned pain modulation post-flight. This preliminary study suggested that spaceflight may affect various aspects of sensory perception and regulation in astronauts, albeit in a variable manner. More data are needed to gain insight of on gain and loss of sensory functions during space missions. Further investigation into the multifactorial stressors affecting the somatosensory system during space travel could contribute to advancements in space and pain medicine.
Collapse
Affiliation(s)
- Andrea K Sauer
- Department of Anesthesia, University of Bonn, Bonn, Germany
| | - Marie Vigouroux
- Department of Anesthesia, McGill University, Montreal, QC, Canada
- Edwards Family Interdisciplinary Center for Complex Pain, Montreal Children’s Hospital, Montreal, QC, Canada
| | - Patrick M Dougherty
- Department of Pain Medicine, The University of Texas – MD Anderson Cancer Center, Houston, TX, USA
| | - Juan Pablo Cata
- Department of Anesthesia and Perioperative Medicine, The University of Texas – MD Anderson Cancer Center, Houston, TX, USA
- Anesthesiology and Surgical Oncology Research Group, Houston, TX, USA
| | - Pablo M Ingelmo
- Department of Anesthesia, McGill University, Montreal, QC, Canada
- Edwards Family Interdisciplinary Center for Complex Pain, Montreal Children’s Hospital, Montreal, QC, Canada
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada
- Research Institute, McGill University Health Center, Montreal, QC, Canada
| |
Collapse
|
3
|
Cruciani G, Zingaretti P, Lingiardi V, De Filippis S, Haggard P, Spitoni GF. The perception of pain, discriminative touch and affective touch in patients suffering from Borderline Personality Disorder. J Affect Disord 2023; 341:185-193. [PMID: 37657618 DOI: 10.1016/j.jad.2023.08.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/02/2023] [Accepted: 08/27/2023] [Indexed: 09/03/2023]
Abstract
Borderline Personality Disorder (BPD) is often characterized by self-injurious behaviors, with one-half to two-third of these patients reporting hypalgesic or analgesic phenomena during self-harming. Research on pain perception in BPD suggested abnormal processing of nociception either within the sensory-discriminative and/or motivational-affective systems of pain. Nevertheless, it is still unclear whether pain insensitivity could be generalized to other somatosensory submodalities. To investigate this question, 30 BPD patients and 30 matched healthy controls were enrolled in the current study and underwent a somatosensory battery composed of well-established psychophysical test assessing all the principal submodalities of somatosensation, namely pain perception (i.e., warm, cold and mechanical), discriminative touch (i.e., tactile acuity and tactile sensitivity) as well as affective touch. Results showed abnormal warm detection threshold, warm pain threshold, mechanical pain perception, and tactile sensitivity in BPD patients, but no differences emerged neither for tactile acuity nor for cold pain thresholds, cold tolerance, or for affective touch perception. Findings point to a deficit in nociception, as well as in tactile sensitivity in BPD individuals, and were discussed in relation to BPD clinical features including self-injurious behaviors.
Collapse
Affiliation(s)
- Gianluca Cruciani
- Department of Psychology, PhD Program in Behavioral Neuroscience, Sapienza University of Rome, Via dei Marsi 78, Rome, Italy.
| | - Pietro Zingaretti
- Villa von Siebenthal Neuropsychiatric Hospital and Clinic, Via della Madonnina 1, Genzano di Roma, Rome, Italy
| | - Vittorio Lingiardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Via degli Apuli 1, Rome, Italy
| | - Sergio De Filippis
- Villa von Siebenthal Neuropsychiatric Hospital and Clinic, Via della Madonnina 1, Genzano di Roma, Rome, Italy
| | - Patrick Haggard
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Grazia Fernanda Spitoni
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Via degli Apuli 1, Rome, Italy; Cognitive and Motor Rehabilitation and Neuroimaging Unit, IRCCS Fondazione Santa Lucia, Via Ardeatina 306-354, Rome, Italy
| |
Collapse
|
4
|
Yu K, Tuerlinckx F, Vanpaemel W, Zaman J. Humans display interindividual differences in the latent mechanisms underlying fear generalization behaviour. COMMUNICATIONS PSYCHOLOGY 2023; 1:5. [PMID: 39242719 PMCID: PMC11290606 DOI: 10.1038/s44271-023-00005-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 06/13/2023] [Indexed: 09/09/2024]
Abstract
Human generalization research aims to understand the processes underlying the transfer of prior experiences to new contexts. Generalization research predominantly relies on descriptive statistics, assumes a single generalization mechanism, interprets generalization from mono-source data, and disregards individual differences. Unfortunately, such an approach fails to disentangle various mechanisms underlying generalization behaviour and can readily result in biased conclusions regarding generalization tendencies. Therefore, we combined a computational model with multi-source data to mechanistically investigate human generalization behaviour. By simultaneously modelling learning, perceptual and generalization data at the individual level, we revealed meaningful variations in how different mechanisms contribute to generalization behaviour. The current research suggests the need for revising the theoretical and analytic foundations in the field to shift the attention away from forecasting group-level generalization behaviour and toward understanding how such phenomena emerge at the individual level. This raises the question for future research whether a mechanism-specific differential diagnosis may be beneficial for generalization-related psychiatric disorders.
Collapse
Affiliation(s)
| | | | | | - Jonas Zaman
- KU Leuven, Leuven, Belgium
- University of Hasselt, Hasselt, Belgium
| |
Collapse
|
5
|
Nishiyama Y, Yamashita C, Nomura S. An illusion of disownership over one's own limb is associated with pain perception. Sci Rep 2023; 13:2801. [PMID: 36859438 PMCID: PMC9977932 DOI: 10.1038/s41598-023-29993-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/14/2023] [Indexed: 03/03/2023] Open
Abstract
Viewing one's body and even a fake/virtual body experienced as one's own has been suggested to modulate pain perception. However, what happens to pain perception when one's own body part is felt as not belonging to one? We designed a paradigm to induce an illusory feeling of disownership regarding one's limb, investigating whether the feeling affects pain threshold. Participants observed right-side images of their bodies from a third-person perspective via a head-mounted display in real-time. Following instructions, they moved their left hand while keeping their left elbow behind the upper body, so that the connection of their arm to the torso was not visible (test condition), or in front of it, so they could see the arm being part of them (control condition). Then, pain threshold was tested with a thermal stimulator. We found a significantly higher strength of disownership in the test condition than in the control condition. While there was no pain modulation within and between conditions, disownership ratings negatively correlated with pain-threshold changes, where the participants reporting explicit disownership showed lower pain-threshold changes than the others. The finding suggests that while multisensory disintegration had no modulatory effect, the individual sense of disownership was associated with pain perception.
Collapse
Affiliation(s)
- Yuta Nishiyama
- Department of Information and Management Systems Engineering, Nagaoka University of Technology, Niigata, Japan.
| | - Chihiro Yamashita
- grid.260427.50000 0001 0671 2234Department of Information and Management Systems Engineering, Nagaoka University of Technology, Niigata, Japan
| | - Shusaku Nomura
- grid.260427.50000 0001 0671 2234Department of Information and Management Systems Engineering, Nagaoka University of Technology, Niigata, Japan
| |
Collapse
|
6
|
Caston RM, Davis TS, Smith EH, Rahimpour S, Rolston JD. A novel thermoelectric device integrated with a psychophysical paradigm to study pain processing in human subjects. J Neurosci Methods 2023; 386:109780. [PMID: 36586439 PMCID: PMC9892356 DOI: 10.1016/j.jneumeth.2022.109780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 12/01/2022] [Accepted: 12/24/2022] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Cerebral projections of nociceptive stimuli are of great interest as targets for neuromodulation in chronic pain. To study cerebral networks involved in processing noxious stimuli, researchers often rely on thermo-nociception to induce pain. However, various limitations exist in many pain-inducing techniques, such as not accounting for individual variations in pain and trial structure predictability. METHODS We propose an improved and reliable psychometric experimental method to evaluate human nociceptive processing to overcome some of these limitations. The developed testing paradigm leverages a custom-built, open-source, thermoelectric device (TED). The device construction and hardware are described. A maximum-likelihood adaptive algorithm is integrated into the TED software, facilitating individual psychometric functions representative of both hot and cold pain perception. In addition to testing only hot or cold thresholds, the TED may also be used to induce the thermal grill illusion (TGI), where the bars are set to alternating warm and cool temperatures. RESULTS Here, we validated the TED's capability to adjust between different temperatures and showed that the device quickly and automatically changes temperature without any experimenter input. We also validated the device and integrated psychometric pain task in 21 healthy human subjects. Hot and cold pain thresholds (HPT, CPT) were determined in human subjects with <1 °C of variation. Thresholds were anticorrelated, meaning a volunteer with a low CPT likely had a high HPT. We also showed how the TED can be used to induce the TGI. CONCLUSION The TED can induce thermo-nociception and provide probabilistic measures of hot and cold pain thresholds. Based on the findings presented, we discuss how the TED could be used to study thermo-nociceptive cerebral projections if paired with intracranial electrode monitoring.
Collapse
Affiliation(s)
- Rose M Caston
- University of Utah, Department of Biomedical Engineering, USA; University of Utah, Department of Neurosurgery, USA.
| | | | | | - Shervin Rahimpour
- University of Utah, Department of Biomedical Engineering, USA; University of Utah, Department of Neurosurgery, USA
| | - John D Rolston
- University of Utah, Department of Biomedical Engineering, USA; Brigham & Women's Hospital and Harvard Medical School, Department of Neurosurgery, USA
| |
Collapse
|
7
|
The impact of pregnancy and childbirth on pelvic sensation: a prospective cohort study. Sci Rep 2023; 13:1535. [PMID: 36707642 PMCID: PMC9883213 DOI: 10.1038/s41598-023-28323-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 01/17/2023] [Indexed: 01/29/2023] Open
Abstract
Pelvic organ prolapse, urinary, bowel and sexual dysfunction, collectively called pelvic floor dysfunction (PFD) affects 1 in 3 women and has a significant public health impact. The causes of PFD are not fully understood but involve injury to connective tissue and motor nerve during childbirth. Women with PFD also have sensory nerve impairment, and it is likely this occurs during childbirth, but this has never been investigated. In the current study 150 women underwent quantitative sensory testing for vibration sensation at the vagina and clitoris, and stretch sensation at the vagina and introitus, in the third trimester, 3 and 6 months postnatal. Antenatally vibration sensation was reduced but stretch sensation was normal. Postnatally vibration sensation deteriorated whilst stretch sensation initially deteriorated but recovered by 6 months postnatal to antenatal levels (all p < 0.001). Mode of birth had a significant impact on sensation, with caesarean section appearing neuroprotective, normal vaginal birth resulted in a transient deterioration in sensation that recovered by 6 months, whilst assisted vaginal delivery was prolonged suggesting persistent neurological impairment (all p < 0.015). Further research is required to study the clinical effect of these changes on pelvic floor dysfunction in the medium and long-term.
Collapse
|
8
|
Adler M, Taxer B. [Quantitative sensory testing for neuropathic pain and its relevance for physiotherapy]. Schmerz 2022; 36:437-446. [PMID: 34424391 PMCID: PMC9674732 DOI: 10.1007/s00482-021-00576-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Neuropathic pain syndromes are typically characterized by high chronification rates as well as long and intensive pain episodes. Early and accurate diagnosis of neuropathic pain is a basic skill of physiotherapists and other medical professionals, may allow for appropriate medical treatment and help to prevent possible consequential damage. Quantitative sensory testing (QST) can be applied as a supplement to conventional neurological bedside testing in the evaluation of neuropathic pain. Over recent decades, QST has come to hold a significant position in the field of pain research. However, despite these developments, the application of QST in clinical practice has lagged behind. OBJECTIVES What is the value of QST in the study of neuropathic pain? Have the conditions for personal clinical use of the QST been established in physiotherapy practice? Have the pathways for specific implementation of the QST been defined? METHOD Literature research as part of a Bachelor thesis in Physiotherapy. RESULTS QST constitutes a valid examination tool that is able to evaluate the complete somatosensory profile. In this way, QST may provide substantial additional benefit in the examination of neuropathic pain patients compared to other conventional testing procedures, especially when it comes to small-fibre neuropathies. These small fibres seem to be particularly affected in asymptomatic patients as well as early phases of neuropathies and cannot be investigated via conventional testing procedures. This makes the use of partial aspects of the QST a proven instrument for physiotherapists and medical staff, which was particularly useful in the decision-making process for neuropathies. DISCUSSION Nonetheless, regarding the results, there are still several limiting factors that hamper the routine use of QST. Some of these can be resolved by precisely adhering to testing protocols and taking precautions. Other highly relevant issues for clinical practice, such as the immense cost of equipment and the excessive time required for testing, have not been satisfactorily overcome as yet. Less comprehensive testing protocols as well as the innovation of handy and cost-effective testing devices might offer initial approaches to enhance the widespread use of QST. Complementing conventional bedside testing by adding thermal discrimination tests and pain detection threshold tests might prove to be another possibility to integrate the benefit of QST into clinical practice. CONCLUSION QST makes a significant contribution to the investigation and diagnosis of neuropathies. Physiotherapists are encouraged to implement partial aspects of the QST in a standard examination in order to have a positive effect on both early detection and treatment.
Collapse
Affiliation(s)
| | - Bernhard Taxer
- Fachhochschule für angewandte Wissenschaft, FH JOANNEUM Graz, Eggenberger Allee 13, 8010, Graz, Österreich.
| |
Collapse
|
9
|
Amir C, Rose-McCandlish M, Weger R, Dildine TC, Mischkowski D, Necka EA, Lee IS, Wager TD, Pine DS, Atlas LY. Test-Retest Reliability of an Adaptive Thermal Pain Calibration Procedure in Healthy Volunteers. THE JOURNAL OF PAIN 2022; 23:1543-1555. [PMID: 35189353 PMCID: PMC9644806 DOI: 10.1016/j.jpain.2022.01.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 01/14/2022] [Accepted: 01/30/2022] [Indexed: 01/02/2023]
Abstract
Quantitative sensory testing (QST) allows researchers to evaluate associations between noxious stimuli and acute pain in clinical populations and healthy participants. Despite its widespread use, our understanding of QST’s reliability is limited, as reliability studies have used small samples and restricted time windows. We examined the reliability of pain ratings in response to noxious thermal stimulation in 171 healthy volunteers (n = 99 female, n = 72 male) who completed QST on multiple visits ranging from 1 day to 952 days between visits. On each visit, participants underwent an adaptive pain calibration in which they experienced 24 heat trials and rated pain intensity after stimulus offset on a 0 to 10 Visual Analog Scale. We used linear regression to determine pain threshold, pain tolerance, and the correlation between temperature and pain for each session and examined the reliability of these measures. Threshold and tolerance were moderately reliable (Intra-class correlation = .66 and .67, respectively; P < .001), whereas temperature-pain correlations had low reliability (Intra-class correlation = .23). In addition, pain tolerance was significantly more reliable in female participants than male participants, and we observed similar trends for other pain sensitive measures. Our findings indicate that threshold and tolerance are largely consistent across visits, whereas sensitivity to changes in temperature vary over time and may be influenced by contextual factors.
Collapse
Affiliation(s)
- Carolyn Amir
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, Maryland
| | - Margaret Rose-McCandlish
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, Maryland
| | - Rachel Weger
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, Maryland
| | - Troy C Dildine
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, Maryland; Clinical Neuroscience Section, Karolinska Institutet, Solna, Sweden
| | | | - Elizabeth A Necka
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, Maryland; National Institute on Aging, National Institutes of Health, Bethesda, Maryland
| | - In-Seon Lee
- College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea; Acupuncture & Meridian Science Research Center, Kyung Hee University, Seoul, Republic of Korea
| | | | - Daniel S Pine
- National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Lauren Y Atlas
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, Maryland; National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland; National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland.
| |
Collapse
|
10
|
Swanson S, Bashmail R, Fellin CR, Luu V, Shires N, Cox PA, Nelson A, MacKenzie D, Taroc AM, Nelson LY, Seibel EJ. Prototype Development of a Temperature-Sensitive High-Adhesion Medical Tape to Reduce Medical-Adhesive-Related Skin Injury and Improve Quality of Care. Int J Mol Sci 2022; 23:7164. [PMID: 35806167 PMCID: PMC9266747 DOI: 10.3390/ijms23137164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 06/23/2022] [Accepted: 06/26/2022] [Indexed: 02/01/2023] Open
Abstract
Medical adhesives are used to secure wound care dressings and other critical devices to the skin. Without means of safe removal, these stronger adhesives are difficult to painlessly remove from the skin and may cause medical-adhesive-related skin injuries (MARSI), including skin tears and an increased risk of infection. Lower-adhesion medical tapes may be applied to avoid MARSI, leading to device dislodgement and further medical complications. This paper outlines the development of a high-adhesion medical tape designed for low skin trauma upon release. By warming the skin-attached tape for 10-30 s, a significant loss in adhesion was achieved. A C14/C18 copolymer was developed and combined with a selected pressure-sensitive adhesive (PSA) material. The addition of 1% C14/C18 copolymer yielded the largest temperature-responsive drop in surface adhesion. The adhesive film was characterized using AFM, and distinct nanodomains were identified on the exterior surface of the PSA. Our optimized formulation yielded 67% drop in adhesion when warmed to 45 °C, perhaps due to melting nanodomains weakening the adhesive-substrate boundary layer. Pilot clinical testing resulted in a significant decrease in pain when a heat pack was used for removal, giving an average pain reduction of 66%.
Collapse
Affiliation(s)
- Shawn Swanson
- Human Photonics Laboratory, Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA; (S.S.); (R.B.); (V.L.); (N.S.); (L.Y.N.)
| | - Rahaf Bashmail
- Human Photonics Laboratory, Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA; (S.S.); (R.B.); (V.L.); (N.S.); (L.Y.N.)
| | - Christopher R. Fellin
- Department of Chemistry, University of Washington, Seattle, WA 98195, USA; (C.R.F.); (A.N.)
| | - Vivian Luu
- Human Photonics Laboratory, Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA; (S.S.); (R.B.); (V.L.); (N.S.); (L.Y.N.)
| | - Nicholas Shires
- Human Photonics Laboratory, Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA; (S.S.); (R.B.); (V.L.); (N.S.); (L.Y.N.)
| | - Phillip A. Cox
- Washington Clean Energy Testbeds, University of Washington, Seattle, WA 98105, USA;
| | - Alshakim Nelson
- Department of Chemistry, University of Washington, Seattle, WA 98195, USA; (C.R.F.); (A.N.)
| | - Devin MacKenzie
- Department of Materials Science and Engineering, University of Washington, Seattle, WA 98195, USA;
| | | | - Leonard Y. Nelson
- Human Photonics Laboratory, Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA; (S.S.); (R.B.); (V.L.); (N.S.); (L.Y.N.)
| | - Eric J. Seibel
- Human Photonics Laboratory, Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA; (S.S.); (R.B.); (V.L.); (N.S.); (L.Y.N.)
| |
Collapse
|
11
|
Starling AJ, Cortez MM, Jarvis NR, Zhang N, Porreca F, Chong CD, Schwedt TJ. Cutaneous heat and light‐induced pain thresholds in post‐traumatic headache attributed to mild traumatic brain injury. Headache 2022; 62:726-736. [DOI: 10.1111/head.14318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Nicholas R. Jarvis
- Mayo Clinic Alix School of Medicine Mayo Clinic Arizona Scottsdale Arizona USA
| | - Nan Zhang
- Department of Neurology Mayo Clinic Arizona Scottsdale Arizona USA
| | - Frank Porreca
- Department of Neurology Mayo Clinic Arizona Scottsdale Arizona USA
| | | | - Todd J. Schwedt
- Department of Neurology Mayo Clinic Arizona Scottsdale Arizona USA
| |
Collapse
|
12
|
Characterization of Patients With and Without Painful Peripheral Neuropathy After Receiving Neurotoxic Chemotherapy: Traditional Quantitative Sensory Testing vs C-Fiber and Aδ-Fiber Selective Diode Laser Stimulation. THE JOURNAL OF PAIN 2022; 23:796-809. [PMID: 34896646 PMCID: PMC9086082 DOI: 10.1016/j.jpain.2021.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 11/09/2021] [Accepted: 11/12/2021] [Indexed: 11/21/2022]
Abstract
Painful chemotherapy induced peripheral neuropathy (CIPN) is a common complication of chemotherapy with drugs such as taxanes and platinum compounds. Currently, no methods are available for early detection of sensory changes that are associated with painful CIPN, nor are there biomarkers that are specific to painful CIPN. This study aimed to compare Diode Laser fiber type-selective stimulator (DLss), a method to selectively stimulate cutaneous C and Aδ fibers, to traditional quantitative sensory testing (QST) in determining psychophysical differences between patients with painful CIPN and a control group. Sensory testing was performed on the dorsal mid-foot of 20 patients with painful neuropathy after taxane- or platinum-based chemotherapy, and 20 patients who received similar neurotoxic chemotherapy, without painful CIPN. In a multivariable analysis, C-fiber to Aδ fiber detection threshold ratio, measured by DLss, was significantly different between the groups (P <.05). While QST parameters such as warmth detection threshold were different between the groups in univariate analyses, these findings were likely attributable to group differences in patient age and cumulative chemotherapy dose. PERSPECTIVE: In this study, fiber-specific DLss test showed potential in identifying sensory changes that are specific for painful neuropathy, encouraging future testing of this approach as a biomarker for early detection of painful CIPN. TRIAL REGISTRATION: The study was approved by the Washington University Institutional Review Board (#201807162) and registered at ClinicalTrials.gov (NCT03687970).
Collapse
|
13
|
Sendel M, Lienau F, Fischer D, Moll J, Koch S, Forstenpointner J, Binder A, Baron R. The descending pain modulation system predicts short term efficacy of multimodal pain therapy - an observational prospective cohort study. Postgrad Med 2022; 134:277-287. [PMID: 34895019 DOI: 10.1080/00325481.2021.2017646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Treating chronic pain patients with multimodal pain therapy (MMPT) alters perception, awareness, and processing of pain at multiple therapeutic levels. Several clinical observations suggest that the effects of therapy may go beyond the possible sum of each level of therapy and may be due to a central descending inhibitory effect measurable by conditioned pain modulation (CPM). Thus, we investigated whether CPM is able to identify a group of patients that benefit particularly from MMPT. METHODS This was an observational prospective cohort study. Patients were hospitalized on a special pain medicine ward with specially trained staff for 10 days. The patients were questioned and had investigations before and shortly after MMPT and were followed-up on 3 months post discharge. Before and after treatment, subjects were investigated via CPM and quantitative sensory testing (QST) as well as completing questionnaires. The study was registered in the German Clinical Trials Register (DRKS00006850). RESULTS During the study period of 24 months, 224 chronic pain patients were recruited. 51 percent of patients completed the study period. There was an improvement in overall groups regarding all domains assessed, lasting beyond the end of the intervention. Patients with a sufficient CPM effect, defined as a reduction in pain during the conditioning stimulus, at baseline did show a more pronounced reduction in mean pain ratings than those without. This was not the case 3 months after therapy. Furthermore, sufficient CPM was identified as a predictor for pain reduction using a linear regression model. CONCLUSION In conclusion, this study shows that while a heterogeneous group of patients with chronic pain disorders does sustainably benefit from MMPT in general, patients with a sufficient CPM effect do show a more pronounced decrease in pain ratings directly after therapy in comparison to those without.
Collapse
Affiliation(s)
- M Sendel
- Division of Neurological Pain Research and -therapy, Department of Neurology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - F Lienau
- Katholisches Marienkrankenhaus, Department. Of Neurology, Hamburg, Germany
| | - D Fischer
- Asklepios Klinik Nord, Center of Interdisciplinary Pain Therapy, Hamburg, Germany
| | - J Moll
- Asklepios Klinik Nord, Center of Interdisciplinary Pain Therapy, Hamburg, Germany
| | - S Koch
- Institute of Medical Informatics and Statistics, University Hospital Schleswig-Holstein, Kiel, Germany
| | - J Forstenpointner
- Division of Neurological Pain Research and -therapy, Department of Neurology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - A Binder
- Division of Neurological Pain Research and -therapy, Department of Neurology, University Hospital Schleswig-Holstein, Kiel, Germany.,Klinikum Saarbrücken, Department. Of Neurology
| | - R Baron
- Division of Neurological Pain Research and -therapy, Department of Neurology, University Hospital Schleswig-Holstein, Kiel, Germany
| |
Collapse
|
14
|
Zaman J, Vlaeyen JWS, Wiech K. When experience is not enough: learning-based cognitive pain modulation with or without instructions. Pain 2022; 163:137-145. [PMID: 33941752 DOI: 10.1097/j.pain.0000000000002322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 04/16/2021] [Indexed: 11/25/2022]
Abstract
ABSTRACT The effects of expectations on pain perception are often studied using large differences in pain probabilities between experimental conditions, although they may be far more subtle in clinical contexts and, therefore, more difficult to detect. The current study aimed to investigate at which point subtle differences in pain probabilities can be detected and lead to differentiable expectations and perceptions. Furthermore, we investigated whether instructions can aid learning from experience and enhance subsequent pain modulatory effects. During a predictive learning task, participants were presented with 5 different cues, followed by either a high and low noxious stimulus. They learned about the different cue-stimulus contingencies either solely through experience (LEARN, N = 40) or a combination of experience and explicit information about the cue-stimulus contingencies (INSTRUCT, N = 40). We found that without explicit information, picking up the different pain probabilities was challenging, while explicit instruction significantly improved their detection. As revealed by drift diffusion modeling, learning from experience was insufficient for the development of a bias towards low pain even when it was highly likely. By contrast, when explicit information was provided, perception became more nuanced with the direction and extent of bias, capturing the subtle differences in pain probabilities. These findings highlight that the use of instructions to foster the detection of subtle pain improvements during pain treatment to enhance their cognitive pain modulatory effects warrant further investigation.
Collapse
Affiliation(s)
- Jonas Zaman
- Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Johan W S Vlaeyen
- Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Experimental Health Psychology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Katja Wiech
- Wellcome Centre for Integrative Neuroimaging (WIN), Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
| |
Collapse
|
15
|
Dams L, Haenen V, Van der Gucht E, Devoogdt N, Smeets A, Bernar K, De Vrieze T, De Groef A, Meeus M. Absolute and relative reliability of a comprehensive quantitative sensory testing protocol in women treated for breast cancer. PAIN MEDICINE 2021; 23:1162-1175. [PMID: 34908144 DOI: 10.1093/pm/pnab343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 11/25/2021] [Accepted: 12/02/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Quantitative sensory testing (QST) are non-invasive psychophysical assessment techniques to evaluate functioning of the somatosensory nervous system. Despite the importance of reliability for correct use of QST results in research and clinical practice, the relative and absolute intra-and inter-rater reliability of a comprehensive QST protocol to evaluate the functioning of both peripheral and central somatosensory nervous system in a breast cancer population, has not yet been investigated. SETTING University Hospitals, Leuven, Belgium. SUBJECTS Thirty women at least six months after unilateral breast cancer surgery. METHODS The protocol included nine static and dynamic QST methods (mechanical detection-pain thresholds, pressure pain thresholds, thermal detection-pain thresholds for heat and cold, temporal summation and conditioned pain modulation (CPM)) performed in the surgical area and more distant regions. Absolute and relative intra (60-minutes interval) and inter-rater (one-week interval) reliability was evaluated using intraclass correlation coefficients, standard error of measurement and Bland-Altman plots. RESULTS A moderate to excellent relative intra- and inter-rater reliability was found for the evaluation of mechanical thresholds, pressure pain thresholds and temporal summation. Reliability of the CPM paradigm was considered weak. Systematic bias between raters was noticed for detection of mechanical and cold stimuli at the non-affected trunk and CPM. CONCLUSIONS Except for the evaluation of CPM, the QST protocol was found suitable for identifying differences between subjects (relative reliability) and individual follow-up after breast cancer surgery (limited systematic bias) during a one-week timeframe. Additional research is required to determine measurement properties that influence CPM test stability in order to establish a more reliable CPM test paradigm.
Collapse
Affiliation(s)
- Lore Dams
- University of Antwerp, Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, MOVANT, Antwerp, Belgium.,KU Leuven-University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium.,Pain In Motion International research group, www.paininmotion.be
| | - Vincent Haenen
- University of Antwerp, Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, MOVANT, Antwerp, Belgium.,KU Leuven-University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - Elien Van der Gucht
- University of Antwerp, Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, MOVANT, Antwerp, Belgium.,KU Leuven-University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium.,Pain In Motion International research group, www.paininmotion.be
| | - Nele Devoogdt
- KU Leuven-University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium.,Department of Vascular Surgery and Department of Physical Medicine and Rehabilitation, Center for Lymphedema, UZ Leuven-University Hospitals Leuven, Leuven, Belgium
| | - Ann Smeets
- Department of Surgical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Koen Bernar
- The Leuven Centre for Algology and Pain Management, University Hospitals Leuven, Leuven, Belgium
| | - Tessa De Vrieze
- KU Leuven-University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - An De Groef
- University of Antwerp, Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, MOVANT, Antwerp, Belgium.,KU Leuven-University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium.,Pain In Motion International research group, www.paininmotion.be
| | - Mira Meeus
- University of Antwerp, Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, MOVANT, Antwerp, Belgium.,Pain In Motion International research group, www.paininmotion.be.,Ghent University, Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, Ghent, Belgium
| |
Collapse
|
16
|
Ho JT, Krummenacher P, Lesur MR, Saetta G, Lenggenhager B. Real Bodies Not Required? Placebo Analgesia and Pain Perception in Immersive Virtual and Augmented Reality. THE JOURNAL OF PAIN 2021; 23:625-640. [PMID: 34780993 DOI: 10.1016/j.jpain.2021.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 10/13/2021] [Accepted: 10/25/2021] [Indexed: 10/19/2022]
Abstract
Pain represents an embodied experience, wherein inferences are not only drawn from external sensory inputs, but also from bodily states. Previous research has demonstrated that a placebo administered to an embodied rubber hand can effectively induce analgesia, providing first evidence that placebos can work even when applied to temporarily embodied, artificial body parts. Using a heat pain paradigm, the present study investigates placebo analgesia and pain perception during virtual embodiment. We examined whether a virtual placebo (a sham heat protective glove) can successfully induce analgesia, even when administered to a virtual body. The analgesic efficacy of the virtual placebo to the real hand (augmented reality setting) or virtual hand (virtual reality setting) was compared to a physical placebo administered to the own, physical body (physical reality setting). Furthermore, pain perception and subjective embodiment were compared between settings. In this mixed design experiment, healthy participants (n=48) were assigned to either an analgesia-expectation or control-expectation group, where subjective and objective pain was measured at pre- and post-intervention time points. Results demonstrated that pre-intervention pain intensity was lower in the virtual reality setting, and that participants in the analgesia-expectation condition, after the intervention, exhibited significantly higher pain thresholds, and lower pain intensity and unpleasantness ratings than control-expectation participants, independent of the setting. Our findings show that a virtual placebo can elicit placebo analgesia comparable to that of a physical placebo, and that administration of a placebo does not necessitate physical bodily interaction to produce analgesic responses.
Collapse
Affiliation(s)
- Jasmine T Ho
- University of Zurich, Department of Psychology, Binzmühlestrasse 14, Box 9, 8050 Zurich, Switzerland
| | - Peter Krummenacher
- University of Zurich, Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, Psychotherapy and Psychosomatics, 8032 Zurich, Switzerland
| | | | | | | |
Collapse
|
17
|
Fabig SC, Kersebaum D, Lassen J, Sendel M, Jendral S, Muntean A, Baron R, Hüllemann P. A modality-specific somatosensory evoked potential test protocol for clinical evaluation: A feasibility study. Clin Neurophysiol 2021; 132:3104-3115. [PMID: 34740042 DOI: 10.1016/j.clinph.2021.08.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/26/2021] [Accepted: 08/29/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE We aimed to establish an objective neurophysiological test protocol that can be used to assess the somatosensory nervous system. METHODS In order to assess most fiber subtypes of the somatosensory nervous system, repetitive stimuli of seven different modalities (touch, vibration, pinprick, cold, contact heat, laser, and warmth) were synchronized with the electroencephalogram (EEG) and applied on the cheek and dorsum of the hand and dorsum of the foot in 21 healthy subjects and three polyneuropathy (PNP) patients. Latencies and amplitudes of the modalities were assessed and compared. Patients received quantitative sensory testing (QST) as reference. RESULTS We found reproducible evoked potentials recordings for touch, vibration, pinprick, contact-heat, and laser stimuli. The recording of warm-evoked potentials was challenging in young healthy subjects and not applicable in patients. Latencies were shortest within Aβ-fiber-mediated signals and longest within C-fibers. The test protocol detected function loss within the Aβ-fiber and Aδ-fiber-range in PNP patients. This function loss corresponded with QST findings. CONCLUSION In this pilot study, we developed a neurophysiological test protocol that can specifically assess most of the somatosensory modalities. Despite technical challenges, initial patient data appear promising regarding a possible future clinical application. SIGNIFICANCE Established and custom-made stimulators were combined to assess different fiber subtypes of the somatosensory nervous system using modality-specific evoked potentials.
Collapse
Affiliation(s)
- Sophie-Charlotte Fabig
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital Schleswig-Holstein, Arnold-Heller-Straße 3, Haus D, 24105 Kiel, Germany.
| | - Dilara Kersebaum
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital Schleswig-Holstein, Arnold-Heller-Straße 3, Haus D, 24105 Kiel, Germany
| | - Josephine Lassen
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital Schleswig-Holstein, Arnold-Heller-Straße 3, Haus D, 24105 Kiel, Germany
| | - Manon Sendel
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital Schleswig-Holstein, Arnold-Heller-Straße 3, Haus D, 24105 Kiel, Germany
| | - Swantje Jendral
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital Schleswig-Holstein, Arnold-Heller-Straße 3, Haus D, 24105 Kiel, Germany
| | - Alexandra Muntean
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital Schleswig-Holstein, Arnold-Heller-Straße 3, Haus D, 24105 Kiel, Germany
| | - Ralf Baron
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital Schleswig-Holstein, Arnold-Heller-Straße 3, Haus D, 24105 Kiel, Germany
| | - Philipp Hüllemann
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital Schleswig-Holstein, Arnold-Heller-Straße 3, Haus D, 24105 Kiel, Germany
| |
Collapse
|
18
|
Rankin J, Rudy-Froese B, Hoyt C, Ramsahoi K, Gareau L, Howatt W, Carlesso LC. Quantitative Sensory Testing Protocols to Evaluate Central and Peripheral Sensitization in Knee OA: A Scoping Review. PAIN MEDICINE 2021; 23:526-557. [PMID: 34581816 DOI: 10.1093/pm/pnab285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 09/01/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This scoping review analyzed various quantitative sensory testing methodologies used in the assessment of sensitization and how sensitization is defined in people with knee osteoarthritis. DESIGN A scoping review. SETTING All clinical and research settings. SUBJECTS Non-surgical adults with knee osteoarthritis. METHODS This scoping review was guided by existing scoping review methodologies. Relevant studies were extracted from the following electronic databases: Medical Literature Analysis and Retrieval System Online, Excerpta Medica Database, Allied and Complementary Medicine Database and the Cumulative Index to Nursing Allied Health Literature. Abstract and full article screening and data extraction were performed in pairs. Information on quantitative sensory testing techniques and parameters was extracted and summarized in tables. General and technique specific definitions of sensitization were extracted from included texts. RESULTS Our search yielded 4199 articles, of which 50 were included in our review. The most common quantitative sensory test was pressure pain threshold. In total 28 unique testing sites were found speaking to the high degree of variability between studies. Sensitization was poorly defined with only 8 studies fully operationalizing it, 22 partially, and the remainder did not provide sufficient information to meet our criteria. CONCLUSION This scoping review has provided an overview of the most common methods of quantitative sensory testing being implemented in the assessment of nervous system sensitization to nociceptive signaling in people with knee osteoarthritis. This study provides a foundation for future development of quantitative sensory testing methodology for research and clinical practice in the osteoarthritis population.
Collapse
Affiliation(s)
- Jonathan Rankin
- McMaster University, School of Rehabilitation Sciences, Hamilton, Canada
| | | | - Curtis Hoyt
- McMaster University, School of Rehabilitation Sciences, Hamilton, Canada
| | - Keenu Ramsahoi
- McMaster University, School of Rehabilitation Sciences, Hamilton, Canada
| | - Liam Gareau
- McMaster University, School of Rehabilitation Sciences, Hamilton, Canada
| | - William Howatt
- McMaster University, School of Rehabilitation Sciences, Hamilton, Canada
| | - Lisa C Carlesso
- McMaster University, School of Rehabilitation Sciences, Hamilton, Canada.,Université de Montréal, School of Rehabilitation, Montréal, Canada
| |
Collapse
|
19
|
Sensory defunctionalization induced by 8% topical capsaicin treatment in a model of ultraviolet-B-induced cutaneous hyperalgesia. Exp Brain Res 2021; 239:2873-2886. [PMID: 34302514 DOI: 10.1007/s00221-021-06170-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 07/02/2021] [Indexed: 10/20/2022]
Abstract
Subpopulations of primary nociceptors (C- and Aδ-fibers), express the TRPV1 receptor for heat and capsaicin. During cutaneous inflammation, these afferents may become sensitized, leading to primary hyperalgesia. It is known that TRPV1+ nociceptors are involved in heat hyperalgesia; however, their involvement in mechanical hyperalgesia is unclear. This study explored the contribution of capsaicin-sensitive nociceptors in the development of mechanical and heat hyperalgesia in humans following ultraviolet-B (UVB) irradiation. Skin areas in 18 healthy volunteers were randomized to treatment with 8% capsaicin/vehicle patches for 24 h. After patches removal, one capsaicin-treated area and one vehicle area were irradiated with 2xMED (minimal erythema dose) of UVB. 1, 3 and 7 days post-UVB exposure, tests were performed to evaluate the development of UVB-induced cutaneous hyperalgesia: thermal detection and pain thresholds, pain sensitivity to supra-threshold heat stimuli, mechanical pain threshold and sensitivity, touch pleasantness, trans-epidermal water loss (TEWL), inflammatory response, pigmentation and micro-vascular reactivity. Capsaicin pre-treatment, in the UVB-irradiated area (Capsaicin + UVB area), increased heat pain thresholds (P < 0.05), and decreased supra-threshold heat pain sensitivity (P < 0.05) 1, 3 and 7 days post-UVB irradiation, while mechanical hyperalgesia resulted unchanged (P > 0.2). No effects of capsaicin were reported on touch pleasantness (P = 1), TEWL (P = 0.31), inflammatory response and pigmentation (P > 0.3) or micro-vascular reactivity (P > 0.8) in response to the UVB irradiation. 8% capsaicin ablation predominantly defunctionalizes TRPV1+-expressing cutaneous nociceptors responsible for heat pain transduction, suggesting that sensitization of these fibers is required for development of heat hyperalgesia following cutaneous UVB-induced inflammation but they are likely only partially necessary for the establishment of robust primary mechanical hyperalgesia.
Collapse
|
20
|
Kosir J, Vella D, Lukac M, Jezersek M. Towards personalized and versatile monitoring of temperature fields within heterogeneous tissues during laser therapies. BIOMEDICAL OPTICS EXPRESS 2021; 12:4530-4543. [PMID: 34457430 PMCID: PMC8367272 DOI: 10.1364/boe.428028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/07/2021] [Accepted: 06/17/2021] [Indexed: 05/05/2023]
Abstract
Advancements in medical laser technology have paved the way for its widespread acceptance in a variety of treatments and procedures. Selectively targeting particular tissue structures with minimally invasive procedures limits the damage to surrounding tissue and allows for reduced post-procedural downtime. In many treatments that are hyperthermia-based, the efficiency depends on the achieved temperature within the targeted tissues. Current approaches for monitoring subdermal temperature distributions are either invasive, complex, or offer inadequate spatial resolution. Numerical studies are often therapy-tailored and source tissue parameters from the literature, lacking versatility and a tissue-specific approach. Here, we show a protocol that estimates the temperature distribution within the tissue based on a thermographic recording of its surface temperature evolution. It couples a time-dependent matching algorithm and thermal-diffusion-based model, while recognizing tissue-specific characteristics yielded by a fast calibration process. The protocol was employed during hyperthermic laser treatment performed ex-vivo on a heterogeneous porcine tissue, and in-vivo on a human subject. In both cases the calibrated thermal parameters correlate with the range of values reported by other studies. The matching algorithm sufficiently reproduced the temperature dynamics of heterogeneous tissue. The estimated temperature distributions within ex-vivo tissue were validated by simultaneous reference measurements, and the ones estimated in-vivo reveal a distribution trend that correlates well with similar studies. The presented method is versatile, supported by the protocol for tissue-specific tailoring, and can readily be implemented for temperature monitoring of various hyperthermia-based procedures by means of recording the surface temperature evolution with a miniature thermal camera implemented within a handheld laser scanner or similar.
Collapse
Affiliation(s)
- Jure Kosir
- Faculty of Mechanical Engineering, University of Ljubljana, Askerceva 6, Ljubljana, Slovenia
| | - Daniele Vella
- Faculty of Mechanical Engineering, University of Ljubljana, Askerceva 6, Ljubljana, Slovenia
| | - Matjaz Lukac
- Department of Complex Matter, Jozef Stefan Institute, Jamova 39, Ljubljana, Slovenia
- Fotona d.o.o., Stegne 7, Ljubljana, Slovenia
| | - Matija Jezersek
- Faculty of Mechanical Engineering, University of Ljubljana, Askerceva 6, Ljubljana, Slovenia
| |
Collapse
|
21
|
Lukac M, Zorman A, Lukac N, Perhavec T, Tasic B. Characteristics of Non-Ablative Resurfacing of Soft Tissues by Repetitive Er:YAG Laser Pulse Irradiation. Lasers Surg Med 2021; 53:1266-1278. [PMID: 33792949 PMCID: PMC8518959 DOI: 10.1002/lsm.23402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 02/04/2021] [Accepted: 03/14/2021] [Indexed: 11/12/2022]
Abstract
Background and Objectives Recently, several minimally invasive gynecological, ENT and esthetic procedures have been introduced that are based on delivering “smooth” sequences of Er:YAG laser pulses to cutaneous or mucosal tissue at moderate cumulative fluences that are not only below the ablation threshold but typically also do not require local anesthesia. To explain the observed clinical results using “smooth‐resurfacing,” it has been suggested that in addition to the direct heat injury to deeper‐lying connective tissues, there is an additional mechanism based on indirect triggering of tissue regeneration through short‐exposure, intense heat shocking of epithelia. The goal of this study is to improve understanding of the complex dynamics of the exposure of tissues to a series of short Er:YAG laser pulses, during which the thermal exposure times transition from extremely short to long durations. Study Design/Materials and Methods A physical model of laser‐tissue interaction was used to calculate the temperature evolution at the irradiated surface and deeper within the tissue, in combination with a chemical model of tissue response based on the recently introduced variable heat shock (VHS) model, which assumes that the tissue damage represents a combined effect of two limiting Arrhenius′ processes, defining cell viability at extremely long and short exposure times. Superficial tissue temperature evolution was measured during smooth‐resurfacing of cutaneous and mucosal tissue, and compared with the model. Two modalities of non‐ablative resurfacing were explored: a standard “sub‐resurfacing” modality with cumulative fluences near the ablation threshold, and the “smooth‐resurfacing” modality with fluences below the patient′s pain threshold. An exemplary skin tightening clinical situation was explored by measuring pain tolerance threshold fluences for treatments on abdominal skin with and without topical anesthesia. The obtained temperature data and pain thresholds were then used to study the influence of Er:YAG laser sequence parameters on the superficial (triggering) and deep (coagulative) tissue response. Results The simulations show that for the sub‐resurfacing modality, the parameter range where no excessive damage to the tissue will occur is very narrow. On the other hand, using pain tolerance as an indicator, the smooth‐resurfacing treatments can be performed more safely and without sacrificing the treatment efficacy. Two preferred smooth‐resurfacing treatment modalities were identified. One involves using optimally long pulse sequence durations (≈1–3 seconds) with an optimal number of pulses (N ≈ 10–30), resulting in a maximal short‐exposure superficial tissue response and moderate coagulation depths. And for deeper coagulation, without significant superficial heat shocking, very long pulse sequences (>5 seconds) with a large number of delivered pulses are to be used in combination with topical anesthesia. Conclusions A comparison of the simulations with the established smooth‐resurfacing clinical protocols in gynecology, ENT, and esthetics suggests that, through clinical experience, the clinical protocols have been optimized for the maximal superficial heat shock triggering effect. Further research is needed to gain a better understanding of the proposed role of heat shock triggering in the clinically observed regeneration of cutaneous, vaginal, and oral tissues following Er:YAG laser smooth‐resurfacing. Lasers Surg. Med. © 2021 The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals LLC.
Collapse
Affiliation(s)
- Matjaz Lukac
- Institut Jozef Stefan, Jamova 39 SI-1000, Ljubljana, Slovenia
| | - Anze Zorman
- Medilase Dermatology & Laser Center, Tbilisijska 59 SI-1000, Ljubljana, Slovenia
| | - Nejc Lukac
- Faculty of Mechanical Engineering, University of Ljubljana, Askerceva 6 SI-1000, Ljubljana, Slovenia
| | | | - Blaz Tasic
- Faculty of Mechanical Engineering, University of Ljubljana, Askerceva 6 SI-1000, Ljubljana, Slovenia
| |
Collapse
|
22
|
Fischer MJM, Ciotu CI, Szallasi A. The Mysteries of Capsaicin-Sensitive Afferents. Front Physiol 2020; 11:554195. [PMID: 33391007 PMCID: PMC7772409 DOI: 10.3389/fphys.2020.554195] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 11/13/2020] [Indexed: 12/11/2022] Open
Abstract
A fundamental subdivision of nociceptive sensory neurons is named after their unique sensitivity to capsaicin, the pungent ingredient in hot chili peppers: these are the capsaicin-sensitive afferents. The initial excitation by capsaicin of these neurons manifested as burning pain sensation is followed by a lasting refractory state, traditionally referred to as "capsaicin desensitization," during which the previously excited neurons are unresponsive not only to capsaicin but a variety of unrelated stimuli including noxious heat. The long sought-after capsaicin receptor, now known as TRPV1 (transient receptor potential cation channel, subfamily V member 1), was cloned more than two decades ago. The substantial reduction of the inflammatory phenotype of Trpv1 knockout mice has spurred extensive efforts in the pharmaceutical industry to develop small molecule TRPV1 antagonists. However, adverse effects, most importantly hyperthermia and burn injuries, have so far prevented any compounds from progressing beyond Phase 2. There is increasing evidence that these limitations can be at least partially overcome by approaches outside of the mainstream pharmaceutical development, providing novel therapeutic options through TRPV1. Although ablation of the whole TRPV1-expressing nerve population by high dose capsaicin, or more selectively by intersectional genetics, has allowed researchers to investigate the functions of capsaicin-sensitive afferents in health and disease, several "mysteries" remain unsolved to date, including the molecular underpinnings of "capsaicin desensitization," and the exact role these nerves play in thermoregulation and heat sensation. This review tries to shed some light on these capsaicin mechanisms.
Collapse
Affiliation(s)
- Michael J. M. Fischer
- Center of Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Cosmin I. Ciotu
- Center of Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Arpad Szallasi
- 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| |
Collapse
|
23
|
Zenses AK, Lee JC, Plaisance V, Zaman J. Differences in perceptual memory determine generalization patterns. Behav Res Ther 2020; 136:103777. [PMID: 33271392 DOI: 10.1016/j.brat.2020.103777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 09/03/2020] [Accepted: 11/13/2020] [Indexed: 11/28/2022]
Abstract
Although memory of past experiences is crucial for the ability to transfer knowledge to new situations, surprisingly little research has directly investigated the relationship between memory and generalization. The present study sought to investigate how the perceptual memory of a trained stimulus influences generalization to similar stimuli. Forty participants underwent a fear conditioning procedure on Day 1, and separate memory recall and generalization tests on Day 2. We focused on two aspects of perceptual memory: namely memory bias (i.e., over- or underestimation of stimulus magnitude) and uncertainty. We found that memory bias predicted the pattern of generalized self-reported (expectancy ratings) and psychophysiological responses (fear-potentiated startle responses). Memory uncertainty was measured in two ways: self-reported uncertainty ratings and variability in stimulus recall. We found that higher levels of self-reported memory uncertainty corresponded with a broader generalization gradient on US expectancy, while greater variability in memory recall was associated with a broader generalization gradient on fear-potentiated startle responses. Taken together, our findings suggest that memory is an important determinant of generalized behavior and illustrate the need to account for these interindividual differences in perceptual memory when examining the generalization of learned responses.
Collapse
Affiliation(s)
- Ann-Kathrin Zenses
- Center for the Psychology of Learning and Experimental Psychopathology, Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, Box 3712, 3000, Leuven, Belgium
| | - Jessica C Lee
- University of New South Wales, Sydney, NSW, 2052, Australia
| | - Valérie Plaisance
- Center for the Psychology of Learning and Experimental Psychopathology, Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, Box 3712, 3000, Leuven, Belgium
| | - Jonas Zaman
- Center for the Psychology of Learning and Experimental Psychopathology, Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, Box 3712, 3000, Leuven, Belgium; Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, Box 3726, 3000, Leuven, Belgium; Brain and Cognition, Department of Psychology, Education & Child Studies, Erasmus School of Social and Behavioural Sciences, The Netherlands
| |
Collapse
|
24
|
New Insights into Cutaneous Laser Stimulation - Dependency on Skin and Laser Type. Neuroscience 2020; 448:71-84. [PMID: 32931847 DOI: 10.1016/j.neuroscience.2020.09.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 09/03/2020] [Accepted: 09/06/2020] [Indexed: 11/21/2022]
Abstract
Cutaneous laser stimulation is a proficient tool to investigate the function of the nociceptive system. However, variations in laser-skin interactions, causes by different skin anatomies and laser wavelength, affects the robustness of nociceptor activation. Thus, thoroughly understanding how the skin is heated by a laser pulse is important to characterize the thermal response properties of nociceptors. The study aim was to investigate how skin type and laser wavelength influences nociceptor activation during laser stimulation. Ten healthy subjects were exposed to brief CO2 (low skin penetrance) and Nd:YAP (high skin penetrance) laser stimuli delivered to the dorsum and palm of the hand, using three different intensities. Reaction times and perception intensities were recorded. A computational model simulated heat transfer in the skin and nociceptor activation in different skin types across different wavelengths and intensities. Intensity ratings were significantly lower and reaction-times significantly increased for CO2 laser stimuli in the palm compared to the dorsum. This was not the case for Nd:YAP laser stimuli. The computational model showed that these differences can be explained by the different skin absorption of CO2 and Nd:YAP lasers. For CO2 laser stimuli, the thicker stratum corneum of the glabrous skin reduces nociceptor activation, whereas the high penetrating Nd:YAP laser elicits a similar nociceptor activation, irrespective of skin type. Nociceptor activation during laser stimulation highly depends on skin composition and laser wavelength, especially for lasers having a low penetrance wavelength. A computational model showed that this difference could be explained primarily due to differences in skin composition.
Collapse
|
25
|
Kinfe T, von Willebrand N, Stadlbauer A, Buchfelder M, Yearwood TL, Muhammad S, Chaudhry SR, Gravius S, Randau T, Winder K, Maihöfner C, Gravius N, Magerl W. Quantitative sensory phenotyping in chronic neuropathic pain patients treated with unilateral L4-dorsal root ganglion stimulation. J Transl Med 2020; 18:403. [PMID: 33087129 PMCID: PMC7579938 DOI: 10.1186/s12967-020-02566-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 10/12/2020] [Indexed: 11/22/2022] Open
Abstract
Background In a previous study, we reported that selective dorsal root ganglion stimulation (DRGSTIM) at DRG level L4 promoted a favorable outcome for complex regional pain syndrome (CRPS) patients along with DRGSTIM-related changes of inflammatory biomarkers in blood and saliva. The impact on somatosensation is largely unknown. Herein, we assessed the quantitative sensory profile to quantify L4-DRGSTIM effects in CRPS patients. Methods Twelve refractory CRPS patients (4 female; 8 male; mean age 69 ± 9 years) received standardized quantitative sensory testing (QST) protocol at baseline and after 3 months of unilateral L4-DRGSTIM assessing nociceptive and non-nociceptive thermal and mechanical sensitivity of the knee affected by CRPS and the contralateral non-painful knee area. Results At baseline, CRPS subjects showed significantly increased thresholds for warmth, tactile and vibration detection (WDT, MDT and VDT) and exaggerated pain summation (WUR). After 3 months of unilateral L4-DRGSTIM all pain parameters exhibited trends towards normalization of sensitivity accumulating to a significant overall normalization for pain sensitivity (effect size: 0.91, p < 0.01), while with the one exception of WDT all non-nociceptive QST parameters remained unchanged. Overall change of non-nociceptive detection was negligible (effect size: 0.25, p > 0.40). Notably, reduction of pain summation (WUR) correlated significantly with pain reduction after 3 months of L4-DRGSTIM. Conclusions Selective L4-DRGSTIM lowered ongoing pain in CRPS patients and evoked significant normalization in the pain domain of the somatosensory profile. Thermoreception and mechanoreception remained unchanged. However, larger randomized, sham-controlled trials are highly warranted to shed more light on effects and mechanisms of dorsal root ganglion stimulation on quantitative sensory characteristics. The study protocol was registered at the 15.11.2016 on German Register for Clinical Trials (DRKS ID 00011267). https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00011267
Collapse
Affiliation(s)
- Thomas Kinfe
- Division of Functional Neurosurgery and Stereotaxy, Department of Neurosurgery, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen, Germany.
| | - Nico von Willebrand
- Department of Neurosurgery, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Andreas Stadlbauer
- Department of Neurosurgery, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Buchfelder
- Department of Neurosurgery, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Thomas L Yearwood
- Department of Pain Management, Guy's and St Thomas' Hospitals, London, UK
| | - Sajjad Muhammad
- Department of Neurosurgery, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Shafqat R Chaudhry
- Department of Basic Medical Sciences Shifa College of Pharmaceutical Sciences, Shifa Tameer-E-Millat University, Islamabad, Pakistan
| | - Sascha Gravius
- Department of Orthopedics and Trauma Surgery, University Hospital Mannheim, University Heidelberg, Heidelberg, Germany
| | - Thomas Randau
- Department of Orthopedics and Trauma Surgery, Rheinische Friedrich-Wilhelms University Bonn, Bonn, Germany
| | - Klemens Winder
- Department of Neurology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | | | - Nadine Gravius
- Department of Orthopedics and Trauma Surgery, University Hospital Mannheim, University Heidelberg, Heidelberg, Germany
| | - Walter Magerl
- Institute of Neurophysiology, Medical Faculty Mannheim, University Heidelberg, Heidelberg, Germany
| |
Collapse
|
26
|
Xiao R, Xu XZS. Temperature Sensation: From Molecular Thermosensors to Neural Circuits and Coding Principles. Annu Rev Physiol 2020; 83:205-230. [PMID: 33085927 DOI: 10.1146/annurev-physiol-031220-095215] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Temperature is a universal cue and regulates many essential processes ranging from enzymatic reactions to species migration. Due to the profound impact of temperature on physiology and behavior, animals and humans have evolved sophisticated mechanisms to detect temperature changes. Studies from animal models, such as mouse, Drosophila, and C. elegans, have revealed many exciting principles of thermosensation. For example, conserved molecular thermosensors, including thermosensitive channels and receptors, act as the initial detectors of temperature changes across taxa. Additionally, thermosensory neurons and circuits in different species appear to adopt similar logic to transduce and process temperature information. Here, we present the current understanding of thermosensation at the molecular and cellular levels. We also discuss the fundamental coding strategies of thermosensation at the circuit level. A thorough understanding of thermosensation not only provides key insights into sensory biology but also builds a foundation for developing better treatments for various sensory disorders.
Collapse
Affiliation(s)
- Rui Xiao
- Department of Aging and Geriatric Research, Institute on Aging and Center for Smell and Taste, University of Florida, Gainesville, Florida 32610, USA;
| | - X Z Shawn Xu
- Life Sciences Institute and Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, Michigan 48109, USA;
| |
Collapse
|
27
|
Thermal sensitivity mapping - warmth and cold detection thresholds of the human torso. J Therm Biol 2020; 93:102718. [PMID: 33077130 DOI: 10.1016/j.jtherbio.2020.102718] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/03/2020] [Accepted: 08/25/2020] [Indexed: 12/11/2022]
Abstract
Skin as the largest organ of the human body accomplishes many important functions, including thermoregulation. In this context, investigating cold (CDT) and warmth detection thresholds (WDT) constitutes an important research branch, and investigating thermal thresholds has a significant impact on the clothing and fabric textile industry. In this regard, not only the extremities, but also torso regions are of high relevance. However, only few examinations have conducted detailed mapping studies of the human torso. Additionally, some of these studies show certain methodological limitations. Furthermore, the issue of whether cutaneous thermal sensitivity is gender-dependent is still controversial. Therefore, the present study investigated the cutaneous thermal sensitivity (CDT, WDT) of 42 male and female young and healthy subjects. Measurements were taken at 11 anatomical regions. We found that gender plays an important role when investigating thermal thresholds: Females tended to be more sensitive than males. We also found considerable differences between the tested regions, even within the anterior torso, for example. We identified locations which were constantly sensitive (lower back), while others were consistently insensitive (e.g. scapula). We also detected greater data variability for males compared to females, and for WDT compared to CDT. Furthermore, mainly for WDT, we found a proximal-to-distal increase of thermal torso and upper arm sensitivity. In line with previous investigations, our subjects were more sensitive to cold than to warmth. The findings of this study have important implications. First, our data may complement basic research, e.g. in terms of reference data of body regional maps. Second, our data provides important insights that could be leveraged in the textile industry, and also used to optimize current broadly applicable test methods and tools, like thermal manikins and thermophysiological models.
Collapse
|
28
|
Perdue LA, Do P, David C, Chyong A, Kellner AV, Ruggieri A, Kim HR, Salaita K, Lesinski GB, Porter CC, Dreaden EC. Optical Control of Cytokine Signaling via Bioinspired, Polymer-Induced Latency. Biomacromolecules 2020; 21:2635-2644. [PMID: 32374589 DOI: 10.1021/acs.biomac.0c00264] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Cytokine signaling is challenging to study and therapeutically exploit as the effects of these proteins are often pleiotropic. A subset of cytokines can, however, achieve signal specificity via association with latency-inducing proteins, which cage the cytokine until disrupted by discreet biological stimuli. Inspired by this precision, here, we describe a strategy for synthetic induction of cytokine latency via modification with photolabile polymers that mimic latency while attached then restore protein activity in response to light, thus controlling the magnitude, duration, and location of cytokine signals. We characterize the high dynamic range of cytokine activity modulation and find that polymer-induced latency, alone, can prolong in vivo circulation and bias receptor subunit binding. We further show that protein derepression can be achieved with a near single-cell resolution and demonstrate the feasibility of transcutaneous photoactivation. Future extensions of this approach could enable multicolor, optical reprogramming of cytokine signaling networks and more precise immunotherapies.
Collapse
Affiliation(s)
- Lacey A Perdue
- Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia 30332-0002, United States
| | - Priscilla Do
- Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia 30332-0002, United States
| | - Camille David
- Department of Pediatrics, Emory School of Medicine, Atlanta, Georgia 30322, United States.,Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, Atlanta, Georgia 30322, United States.,Winship Cancer Institute of Emory University, Atlanta, Georgia 30322, United States
| | - Andrew Chyong
- Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia 30332-0002, United States
| | - Anna V Kellner
- Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia 30332-0002, United States
| | - Amanda Ruggieri
- Department of Hematology and Medical Oncology, Emory School of Medicine, Atlanta, Georgia 30322, United States.,Winship Cancer Institute of Emory University, Atlanta, Georgia 30322, United States
| | - Hye Ryong Kim
- Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia 30332-0002, United States
| | - Khalid Salaita
- Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia 30332-0002, United States.,Department of Chemistry, Emory University, Atlanta, Georgia 30322, United States
| | - Gregory B Lesinski
- Department of Hematology and Medical Oncology, Emory School of Medicine, Atlanta, Georgia 30322, United States.,Winship Cancer Institute of Emory University, Atlanta, Georgia 30322, United States
| | - Christopher C Porter
- Department of Pediatrics, Emory School of Medicine, Atlanta, Georgia 30322, United States.,Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, Atlanta, Georgia 30322, United States.,Winship Cancer Institute of Emory University, Atlanta, Georgia 30322, United States
| | - Erik C Dreaden
- Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia 30332-0002, United States.,Department of Pediatrics, Emory School of Medicine, Atlanta, Georgia 30322, United States.,Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, Atlanta, Georgia 30322, United States.,Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, Georgia 30332-0002, United States.,Winship Cancer Institute of Emory University, Atlanta, Georgia 30322, United States
| |
Collapse
|
29
|
Perceptual Decision Parameters and Their Relation to Self-Reported Pain: A Drift Diffusion Account. THE JOURNAL OF PAIN 2020; 21:324-333. [DOI: 10.1016/j.jpain.2019.06.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 06/06/2019] [Accepted: 06/13/2019] [Indexed: 01/08/2023]
|
30
|
Quantitative sensory testing of periauricular skin in healthy adults. Sci Rep 2020; 10:3728. [PMID: 32111937 PMCID: PMC7048815 DOI: 10.1038/s41598-020-60724-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/16/2020] [Indexed: 11/25/2022] Open
Abstract
The aim of this study was to investigate the test-retest reliability of quantitative sensory testing (QST) and mechanical sensitivity mapping of the periauricular skin. Twenty volunteers (10 men, 10 women) participated in two sessions at intervals of one week. Cold and warm detection threshold (CDT&WDT), cold and heat pain threshold (CPT&HPT), mechanical detection and pain threshold (MDT&MPT), pressure pain threshold (PPT) and two-point discrimination (2PD) were measured at five sites: bilateral subauricular and postauricular sites (LA, RA, LB, RB) and the dorsum of left hand (control). Pressure stimulation was applied at each of the four periauricular test sites. The test-retest reliability of the QST data implied fair to excellent agreement as evaluated by the intra-class correlation coefficients (ICC; all >0.4) for different days. There was no difference between each side in the QST parameters and mechanical sensitivity mapping (P ≥ 0.057). Significant differences between subauricular and postauricular sites were shown for WDT and PPT (P ≤ 0.028). NRS scores of mechanical sensitivity mapping showed significant effects of gender, site and point (P ≤ 0.040). QST and mechanical sensitivity mapping can be considered to be a reliable technique to assess somatosensory function of the periauricular skin.
Collapse
|
31
|
Lim SD, Svanevik CC, Fauver ME, Nelson LY, Taroc AM, Emery AF, Seibel EJ. Proof of Concept of a Surrogate High-Adhesion Medical Tape Using Photo-Thermal Release for Rapid and Less Painful Removal. J Med Device 2020. [DOI: 10.1115/1.4045298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Abstract
Medical tapes often hold critical devices to the skin so having high adhesion for the lifespan of this product is of great importance. However, the removal process is challenging for caregivers and patients alike, often a painful process that can cause medical adhesive-related skin injury (MARSI). By using an industrial thermally sensitive tape, a surrogate photosensitive tape was developed that switched from the equivalent of high-adhesion medical tape to low-adhesion medical tape. This resulted in an 86% reduction in the average peel strength when heated from 45 to 55 °C using a custom test apparatus. To photo-release the prototype tape (PT), a near-infrared (NIR) absorbing layer was painted on the visibly clear thermal-sensitive tape and an NIR optical wand using 15-LEDs (940 nm) with thermal feedback control was designed and tested. Preliminary performance of photo-to-thermal conversion was numerically modeled with transient results matching experimental measurements with 96.8% correspondence. Using the verified energy conversion model of the surrogate photosensitive tape, a new NIR optical wand was designed for rapid and noncontact release of a future medical tape at 10 deg lower than the release temperature (RTemp) of the custom adhesive, called UnTape. Numerical simulations compared to the thermal skin pain threshold of 45 °C predicts photo-release within 1.1 s of NIR exposure (85.5% absorption in PT at < 1.3 W/cm2). The unique properties of the multifunctional UnTape system (tape and portable NIR wand) may allow even stronger skin adhesion for critical medical devices while concurrently reducing the risk of MARSI upon photo release and easy removal.
Collapse
Affiliation(s)
- Saniel D. Lim
- Human Photonics Laboratory,Department of Mechanical Engineering,University of Washington, Seattle, WA 98195
| | - Carl C. Svanevik
- Human Photonics Laboratory,Department of Mechanical Engineering,University of Washington, Seattle, WA 98195
| | - Mark E. Fauver
- Human Photonics Laboratory,University of Washington, Seattle, WA 98195
| | - Leonard Y. Nelson
- Human Photonics Laboratory,University of Washington, Seattle, WA 98195
| | | | - Ashley F. Emery
- Department of Mechanical Engineering, University of Washington, Seattle, WA 98195
| | - Eric J. Seibel
- Human Photonics Laboratory,Department of Mechanical Engineering, University of Washington, UW Box 352600, Seattle, WA 98195-2600
| |
Collapse
|
32
|
Cury RG, Teixeira MJ, Galhardoni R, Silva V, Iglesio R, França C, Arnaut D, Fonoff ET, Barbosa ER, Ciampi de Andrade D. Connectivity Patterns of Subthalamic Stimulation Influence Pain Outcomes in Parkinson's Disease. Front Neurol 2020; 11:9. [PMID: 32116998 PMCID: PMC7028764 DOI: 10.3389/fneur.2020.00009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 01/07/2020] [Indexed: 12/27/2022] Open
Abstract
Background: Pain is highly prevalent in Parkinson's disease and is associated with significant reduction in health-related quality of life. Subthalamic deep brain stimulation can produce significant pain relief in a subset of patients after surgery. However, the mechanism by which deep brain stimulation modulates sensory function in Parkinson's disease remains uncertain. Objective: To describe the motor and pain outcomes of deep brain stimulation applied to a series of patients with Parkinson's disease and to determine whether the structural connectivity between the volume of tissue activated and different regions of the brain was associated with the changes of these outcomes after surgery. Methods: Data from a long-term prospective cohort of 32 Parkinson's disease patients with subthalamic stimulation were combined with available human connectome to identify connections consistently associated with clinical improvement (Unified Parkinson Disease Rating Scale), pain intensity, and experimental cold pain threshold after surgery. Results: The connectivity between the volume of tissue activated and a distributed network of sensory brain regions (prefrontal, insular and cingulate cortex, and postcentral gyrus) was inversely correlated with pain intensity improvement and reduced sensitivity to cold pain after surgery (p < 0.01). The connectivity strength with the supplementary motor area positively correlated with motor and pain threshold improvement (p < 0.05). Conclusions: These data suggest that the pattern of the connectivity between the region stimulated and specific brain cortical area might be responsible, in part, for the successful control of motor and pain symptoms by subthalamic deep brain stimulation in Parkinson's disease.
Collapse
Affiliation(s)
- Rubens Gisbert Cury
- Department of Neurology, Movement Disorders Center, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Manoel Jacobsen Teixeira
- Neurosurgery Division, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Ricardo Galhardoni
- Transcranial Magnetic Stimulation Laboratory, Psychiatry Institute, University of São Paulo, São Paulo, Brazil
| | - Valquiria Silva
- Transcranial Magnetic Stimulation Laboratory, Psychiatry Institute, University of São Paulo, São Paulo, Brazil.,Department of Neurology, Pain Center, LIM 62, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Ricardo Iglesio
- Neurosurgery Division, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Carina França
- Department of Neurology, Movement Disorders Center, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Débora Arnaut
- Department of Neurology, Pain Center, LIM 62, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Erich Talamoni Fonoff
- Neurosurgery Division, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Egberto Reis Barbosa
- Department of Neurology, Movement Disorders Center, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Daniel Ciampi de Andrade
- Department of Neurology, Pain Center, LIM 62, School of Medicine, University of São Paulo, São Paulo, Brazil.,Pain Center, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil
| |
Collapse
|
33
|
Frahm K, Mørch C, Andersen O. Directional discrimination is better for noxious laser stimuli than for innocuous laser stimuli. Eur J Pain 2019; 24:742-751. [DOI: 10.1002/ejp.1521] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 11/29/2019] [Accepted: 12/06/2019] [Indexed: 11/09/2022]
Affiliation(s)
- K.S. Frahm
- Integrative Neuroscience group, Center for Neuroplasticity and Pain (CNAP), SMI®, Dept. of Health Science & Technology Aalborg University Aalborg Denmark
| | - C.D. Mørch
- Integrative Neuroscience group, Center for Neuroplasticity and Pain (CNAP), SMI®, Dept. of Health Science & Technology Aalborg University Aalborg Denmark
| | - O.K. Andersen
- Integrative Neuroscience group, Center for Neuroplasticity and Pain (CNAP), SMI®, Dept. of Health Science & Technology Aalborg University Aalborg Denmark
| |
Collapse
|
34
|
Zaman J, Van de Pavert I, Van Oudenhove L, Van Diest I. The use of stimulus perception to account for variability in skin conductance responses to interoceptive stimuli. Psychophysiology 2019; 57:e13494. [PMID: 31608999 DOI: 10.1111/psyp.13494] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 06/05/2019] [Accepted: 07/02/2019] [Indexed: 01/27/2023]
Abstract
Activity of the electrodermal response system is customarily expressed in relation to physical stimulus properties and not to perceived features. In situations where the delivery of physically identical stimuli can be challenging, such as in interoception research, this variability might pose a challenge for contemporary SCR analyses. Therefore, we investigated the extent to which activity in the electrodermal response system triggered by the delivery of interoceptive stimuli is better predicted by perceived intensity rather than physical input. For this purpose, we reanalyzed data from the baseline phase of a previous study (n = 60) in which skin conductance responses (SCRs) to innocuous esophageal stimulations of high and low intensities were recorded in addition to categorizations based on their perceived intensity (high or low). Using both peak scoring and model inversion methods, we found that the inclusion of stimulus perception as a predictor of the magnitude of the SCR increased model fit. These findings suggest that the inclusion of perception is a promising avenue to better model variability in psychophysiological responses to interoceptive stimuli.
Collapse
Affiliation(s)
- Jonas Zaman
- Department of Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.,Center for the Psychology of Learning and Experimental Psychopathology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Iris Van de Pavert
- Department of Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Lukas Van Oudenhove
- Laboratory for Brain-Gut Axis Studies (LaBGAS), Translational Research Centre for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases, Metabolism, and Ageing, KU Leuven, Leuven, Belgium.,Consultation-Liaison Psychiatry, University Psychiatric Centre KU Leuven, Leuven, Belgium
| | - Ilse Van Diest
- Department of Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| |
Collapse
|
35
|
Abstract
OBJECTIVE The extent to which pain-related expectations, known to affect pain perception, also affect perception of nonpainful sensations remains unclear, as well as the potential role of unpredictability in this context. METHODS In a proprioceptive fear conditioning paradigm, various arm extension movements were associated with predictable and unpredictable electrocutaneous pain or its absence. During a subsequent test phase, nonpainful electrocutaneous stimuli with a high or low intensity were presented during movement execution. We used hierarchical drift diffusion modeling to examine the influence of expecting pain on the perceptual decision-making process underlying intensity perception of nonpainful sensations. In the first experiment (n = 36), the pain stimulus was never presented during the test phase after conditioning. In the second experiment (n = 39), partial reinforcement was adopted to prevent extinction of pain expectations. RESULTS In both experiments, movements that were associated with (un)predictable pain led to higher pain expectancy, self-reported fear, unpleasantness, and arousal as compared with movements that were never paired with pain (effect sizes η2 ranging from 0.119 to 0.557; all p values < .05). Only in the second experiment-when the threat of pain remained present-we found that the expectation of pain affected decision making. Compared with the no pain condition, an a priori decision-making bias toward the high-intensity decision threshold was found with the strongest bias during unpredictable pain (effect sizes η2 ranging from 0.469 to 0.504; all p-values < .001). CONCLUSIONS Thus, the expectation of pain affects inferential processes not only for subsequent painful but also for nonpainful bodily stimuli, with unpredictability moderating these effects, and only when the threat of pain remains present due to partial reinforcement.
Collapse
|
36
|
Pfau DB, Greffrath W, Schilder A, Magerl W, Ohler C, Westermann A, Maier C, Doppler K, Sommer C, Orth M, Hammes HP, Kurz J, Götz M, Treede RD, Schuh-Hofer S. Technical and clinical performance of the thermo-test device "Q-Sense" to assess small fibre function: A head-to-head comparison with the "Thermal Sensory Analyzer" TSA in diabetic patients and healthy volunteers. Eur J Pain 2019; 23:1863-1878. [PMID: 31359547 DOI: 10.1002/ejp.1461] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 07/21/2019] [Accepted: 07/22/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND Thermo-test devices are rarely used outside specialized pain centres because of high acquisition costs. Recently, a new, portable device ("Q-Sense") was introduced, which is less expensive but has reduced cooling capacity (20°C). We assessed the reliability/validity of the "Q-Sense" by comparing it with the Thermal Sensory Analyzer (TSA). METHODS Using a phantom-skin model, the physical characteristics of both devices were compared. The clinical performance was assessed in a multicentre study by performing Quantitative Sensory Testing (QST) in 121 healthy volunteers and 83 diabetic patients (Eudra-Med-No. CIV-12-05-006501). RESULTS Both device types showed ~40% slower temperature ramps for heating/cooling than nominal data. Cold/warm detection thresholds (CDT, WDT) and heat pain thresholds (HPT) of healthy subjects did not differ between device types. Cold pain thresholds (CPT) were biased for Q-Sense by a floor effect (p < .001). According to intraclass correlation coefficients (ICC), agreement between TSA and Q-Sense was good/excellent for CDT (ICC = 0.894) and WDT (ICC = 0.898), moderate for HPT (ICC = 0.525) and poor for CPT (ICC = 0.305). In diabetic patients, the sensitivity of Q-Sense to detect cold hypoesthesia was reduced in males >60 years. Moderate correlations between thermal detection thresholds and morphological data from skin biopsies (n = 51) were similar for both devices. CONCLUSIONS Physical characteristics of both thermo-test devices are similarly limited by the poor temperature conduction of the skin. The Q-Sense is useful for thermal detection thresholds but of limited use for pain thresholds. For full clinical use, the lower cut-off temperature should be set to ≤18°C. SIGNIFICANCE High purchase costs prevent a widespread use of thermo-test devices for diagnosing small fibre neuropathy. The air-cooled "Q-Sense" could be a lower cost alternative, but its technical/clinical performance needs to be assessed because of its restricted cut-off for cooling (20°C). This study provides critical information on the physical characteristics and the clinical validity/reliability of the Q-Sense compared to the "Thermal Sensory Analyzer" (TSA). We recommend lowering the cut-off value of the Q-Sense to ≤18°C for its full clinical use.
Collapse
Affiliation(s)
- Doreen B Pfau
- Department of Neurophysiology, Medical Faculty Mannheim, Center of Biomedicine and Medical Technology, University of Heidelberg, Mannheim, Germany
| | - Wolfgang Greffrath
- Department of Neurophysiology, Medical Faculty Mannheim, Center of Biomedicine and Medical Technology, University of Heidelberg, Mannheim, Germany
| | - Andreas Schilder
- Department of Neurophysiology, Medical Faculty Mannheim, Center of Biomedicine and Medical Technology, University of Heidelberg, Mannheim, Germany
| | - Walter Magerl
- Department of Neurophysiology, Medical Faculty Mannheim, Center of Biomedicine and Medical Technology, University of Heidelberg, Mannheim, Germany
| | - Carolin Ohler
- Department of Neurophysiology, Medical Faculty Mannheim, Center of Biomedicine and Medical Technology, University of Heidelberg, Mannheim, Germany
| | - Andrea Westermann
- Center for Pain Medicine, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Christoph Maier
- Center for Pain Medicine, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Kathrin Doppler
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - Claudia Sommer
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - Michael Orth
- Department of Neurology, Ulm University, Ulm, Germany
| | - Hans-Peter Hammes
- Department of Endocrinology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | | | | | - Rolf-Detlef Treede
- Department of Neurophysiology, Medical Faculty Mannheim, Center of Biomedicine and Medical Technology, University of Heidelberg, Mannheim, Germany
| | - Sigrid Schuh-Hofer
- Department of Neurophysiology, Medical Faculty Mannheim, Center of Biomedicine and Medical Technology, University of Heidelberg, Mannheim, Germany
| |
Collapse
|
37
|
Gordon C, Barbullushi A, Tombolini S, Margiotta F, Ciacci A, Yosef LS, Barker L, Martini M. Visuo-tactile stimulation, but not type of movement, modulates pain during the vision of a moving virtual limb. Pain Manag 2019; 9:449-460. [PMID: 31452455 DOI: 10.2217/pmt-2019-0019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Aim: Evidence has revealed a relationship between pain and the observation of limb movement, but it is unknown whether different types of movements have diverse modulating effects. In this immersive virtual reality study, we explored the effect of the vision of different virtual arm movements (arm vs wrist) on heat pain threshold of healthy participants. Patients & methods: 40 healthy participants underwent four conditions in virtual reality, while heat pain thresholds were measured. Visuo-tactile stimulation was used to attempt to modulate the feeling of virtual limb ownership while the participants kept their arms still. Results: Effects on pain threshold were present for type of stimulation but not type of movement. Conclusion: The type of observed movement does not appear to influence pain modulation, at least not during acute pain states.
Collapse
Affiliation(s)
- Calum Gordon
- Department of Psychology, University of East London, Water Lane, London E15 4LZ, UK
| | - Alba Barbullushi
- Department of Psychology, University of East London, Water Lane, London E15 4LZ, UK
| | - Stefano Tombolini
- Department of Psychology, University of East London, Water Lane, London E15 4LZ, UK
| | - Federica Margiotta
- Department of Psychology, University of East London, Water Lane, London E15 4LZ, UK
| | - Alessia Ciacci
- Department of Psychology, University of East London, Water Lane, London E15 4LZ, UK
| | - Lama Shekh Yosef
- Department of Psychology, University of East London, Water Lane, London E15 4LZ, UK
| | - Leon Barker
- Department of Arts & Digital Industries, University of East London, University Way, London E16 2RD, UK
| | - Matteo Martini
- Department of Psychology, University of East London, Water Lane, London E15 4LZ, UK
| |
Collapse
|
38
|
Powell-Roach KL, Yao Y, Rutherford JN, Schlaeger JM, Patil CL, Suarez ML, Shuey D, Angulo V, Carrasco J, Ezenwa MO, Fillingim RB, Wang ZJ, Molokie RE, Wilkie DJ. Thermal and mechanical quantitative sensory testing values among healthy African American adults. J Pain Res 2019; 12:2511-2527. [PMID: 31496792 PMCID: PMC6693422 DOI: 10.2147/jpr.s211855] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 07/09/2019] [Indexed: 12/26/2022] Open
Abstract
PURPOSE Only a few studies have reported quantitative sensory testing (QST) reference values for healthy African Americans, and those studies are limited in sample size and age of participants. The study purpose was to characterize QST values in healthy, pain-free African American adults and older adults whose prior pain experiences and psychological status were also measured. We examined the QST values for differences by sex, age, and body test site. PATIENTS AND METHODS A cross-sectional sample of 124 pain-free African American adults (age 18-69 years, 49% female) completed demographic and self-reported pain, fatigue and psychosocial measures. QST was performed to obtain thermal and mechanical responses and associated pain intensity levels. RESULTS We found thermal detection values at the anterior forearm were (29.2 °C±1.6) for cool detection (CD) and (34.5 °C±1.2) for warm detection (WD). At that site the sample had cold pain threshold (CPTh) (26.3 °C±5.0), heat pain threshold (HPTh) (37.8 °C±3.6), and mechanical pain thresholds (MPTH) (16.7±22.2 grams of force, gF). There was a significant between sex difference for WD, with women being more sensitive (q=0.027). Lower body sites were less sensitive than upper body sites across all thermal modalities (q<0.003), but not for the mechanical modality. CONCLUSION The QST values from this protocol at the anterior forearm indicate that the healthy African American adults had average thermal pain thresholds close to the temperature of adaptation and average MPTh under 20 gF. Differences in responses to thermal and mechanical stimuli for upper verses lower body were consistent with prior research.
Collapse
Affiliation(s)
- Keesha L Powell-Roach
- Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Yingwei Yao
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL, USA
| | - Julienne N Rutherford
- Department of Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Judith M Schlaeger
- Department of Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Crystal L Patil
- Department of Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Marie L Suarez
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - David Shuey
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Veronica Angulo
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Jesus Carrasco
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Miriam O Ezenwa
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL, USA
| | - Roger B Fillingim
- Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Zaijie J Wang
- Department of Biopharmaceutical Sciences, College of Pharmacy, Cancer Center, University of Illinois at Chicago, Chicago, IL, USA
| | - Robert E Molokie
- Department of Biopharmaceutical Sciences, College of Pharmacy, Cancer Center, University of Illinois at Chicago, Chicago, IL, USA
- Division of Hematology/Oncology, University of Illinois at Chicago College of Medicine, Chicago, IL, USA
- Department of Hematology/Oncology, Jessie Brown Veteran’s Administration Medical Center, Chicago, IL, USA
| | - Diana J Wilkie
- Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, Gainesville, FL, USA
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL, USA
| |
Collapse
|
39
|
Abstract
Behavior in novel situations is guided by similarities to previous experiences, a phenomenon known as generalization. Despite the widespread influence of generalization on healthy and pathological behavior, insight into the underlying mechanisms is lacking. It remains unclear whether a failure to notice situational changes contributes to the generalization of learned behavior. We combined a fear conditioning and generalization procedure with a perceptual decision task in humans and found that a failure to perceive a novel stimulus as different from the initial fear-evoking stimulus was associated with increased conditioned responding. These findings demonstrate the potential of a perception-centered approach to better understand (pathological) behavior and its underlying mechanism and are a promising avenue for the development of refined generalization protocols.
Collapse
|
40
|
Numerical Study of Hyper‐Thermic Laser Lipolysis With 1,064 nm Nd:YAG Laser in Human Subjects. Lasers Surg Med 2019; 51:897-909. [DOI: 10.1002/lsm.23124] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2019] [Indexed: 11/07/2022]
|
41
|
Villanueva J, Meyer AH, Rinner MTB, Firsching VJ, Benoy C, Brogli S, Walter M, Bader K, Gloster AT. "Choose change": design and methods of an acceptance and commitment therapy effectiveness trial for transdiagnostic treatment-resistant patients. BMC Psychiatry 2019; 19:173. [PMID: 31182051 PMCID: PMC6558686 DOI: 10.1186/s12888-019-2109-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 04/10/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Acceptance and Commitment Therapy (ACT) has been successfully established in hundreds of efficacy trials. It is less understood, however, how ACT works in real-world settings. Furthermore, little is known about how contextual variables such as treatment setting (inpatient vs. outpatient), social network and environment of the patient impact outcome. METHODS This paper describes the methods of the Choose Change study that compares transdiagnostic inpatients (n = 85) and outpatients (n = 85) with varying degrees of treatment experience and treatment success (i.e., no previous treatment vs. previous remission vs. treatment-resistant). Patients received ACT during an intensive treatment phase lasting approximately twelve treatment sessions, and were accompanied up to twelve months following intensive treatment. Main outcomes include symptoms, functioning, and well-being. Multiple levels of data are investigated, including treatment context, weekly assessments, a behavioral approach test, multiple follow-up phases, and ambulatory assessment using Event Sampling Methodology, to examine patients' daily context. DISCUSSION We aim to investigate antecedents, consequences, and inherent processes that contribute to the maintenance or fluctuations of psychological disorders and the efficacy of ACT treatment. Furthermore, this study intends to increase understanding of how accurately participants can report on their own experiences, in order to expand our knowledge of how to probe for such information in the future. The results of Choose Change will provide basic clinical theory and clinical care with important and meaningful insights into the effectiveness of ACT, trans diagnostically, in in- and outpatients, and in a naturalistic setting. TRIAL REGISTRATION This study was retrospectively registered in the ISRCTN Registry (registration number ISRCTN11209732 ) on May 20th 2016.
Collapse
Affiliation(s)
- Jeanette Villanueva
- Department of Psychology, Division of Clinical Psychology and Intervention Science, University of Basel, Basel, Switzerland
| | - Andrea H. Meyer
- Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland
| | - Marcia T. B. Rinner
- Department of Psychology, Division of Clinical Psychology and Intervention Science, University of Basel, Basel, Switzerland
| | - Victoria J. Firsching
- Department of Psychology, Division of Clinical Psychology and Intervention Science, University of Basel, Basel, Switzerland
| | - Charles Benoy
- Center for Psychosomatics and Psychotherapy, Psychiatric Hospital of the University of Basel, Basel, Switzerland
| | - Sandra Brogli
- Center for Psychosomatics and Psychotherapy, Psychiatric Hospital of the University of Basel, Basel, Switzerland
| | - Marc Walter
- Center for Psychosomatics and Psychotherapy, Psychiatric Hospital of the University of Basel, Basel, Switzerland
| | - Klaus Bader
- Center for Psychosomatics and Psychotherapy, Psychiatric Hospital of the University of Basel, Basel, Switzerland
| | - Andrew T. Gloster
- Department of Psychology, Division of Clinical Psychology and Intervention Science, University of Basel, Basel, Switzerland
| |
Collapse
|
42
|
Dyck PJB, Dyck PJ. Method of levels not limits for assessment of cooling detection thresholds. Muscle Nerve 2019; 60:109-110. [PMID: 31102274 DOI: 10.1002/mus.26519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 05/13/2019] [Accepted: 05/14/2019] [Indexed: 11/06/2022]
|
43
|
Wettstein M, Eich W, Bieber C, Tesarz J. Profiles of Subjective Well-being in Patients with Chronic Back Pain: Contrasting Subjective and Objective Correlates. PAIN MEDICINE 2019; 20:668-680. [PMID: 30272221 DOI: 10.1093/pm/pny162] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The detrimental impact of nonspecific chronic low back pain (CLBP) on quality of life is well known. However, patients with CLBP represent a remarkably heterogeneous group, and not all of them report compromised well-being. METHODS In this study, we investigated this heterogeneity by identifying profiles (or clusters) of well-being and their correlates in 239 CLBP patients. To take the multidimensionality of subjective well-being into account, we included multiple well-being indicators (depression, anxiety, affective distress, perceived control over life). For an in-depth characterization of the well-being profiles, we assessed 1) sociodemographic indicators (age, gender, education, marital status, occupational status), 2) pain-related measures (pain intensity, subjective and objective pain disability, number of pain locations), 3) psychosocial resources (mental health, resilience, perceived support), 4) biographical factors (trauma), and 5) somatosensory profiles based on quantitative sensory testing. RESULTS Based on two-step cluster analysis, we identified three distinct well-being profiles, characterized by either generally high well-being (cluster 1, n = 51), moderate well-being (cluster 2, n = 104), or consistently low well-being (cluster 3, n = 77), respectively. Most differences between the derived well-being profiles regarding sociodemographic, psychosocial, and biographical measures were of weak to moderate effect size. Larger effect sizes were observed for differences in pain intensity and subjective, but not objective, pain disability. Finally, the largest effects were found for differences in psychosocial resources. CONCLUSIONS Our findings suggest that not only in nonclinical samples, but also in patients with chronic pain, well-being is more closely associated with psychological resources and subjective evaluations than with objective parameters.
Collapse
Affiliation(s)
- Markus Wettstein
- Department of General Internal Medicine and Psychosomatics, Medical Hospital, Heidelberg University, Heidelberg, Germany.,German Centre of Gerontology, Berlin, Germany
| | - Wolfgang Eich
- Department of General Internal Medicine and Psychosomatics, Medical Hospital, Heidelberg University, Heidelberg, Germany
| | - Christiane Bieber
- Department of General Internal Medicine and Psychosomatics, Medical Hospital, Heidelberg University, Heidelberg, Germany
| | - Jonas Tesarz
- Department of General Internal Medicine and Psychosomatics, Medical Hospital, Heidelberg University, Heidelberg, Germany
| |
Collapse
|
44
|
ZHANG K, XU ZF, LI K, ZHAO X, CHEN B, GUO Y, WANG SJ. The analgesic effect of electroacupuncture in complete Freund's adjuvant rats—a meta analysis. WORLD JOURNAL OF ACUPUNCTURE-MOXIBUSTION 2019. [DOI: 10.1016/j.wjam.2019.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
45
|
Beck B, Peña-Vivas V, Fleming S, Haggard P. Metacognition across sensory modalities: Vision, warmth, and nociceptive pain. Cognition 2019; 186:32-41. [PMID: 30739057 PMCID: PMC6411924 DOI: 10.1016/j.cognition.2019.01.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 01/25/2019] [Accepted: 01/28/2019] [Indexed: 12/15/2022]
Abstract
The distinctive experience of pain, beyond mere processing of nociceptive inputs, is much debated in psychology and neuroscience. One aspect of perceptual experience is captured by metacognition—the ability to monitor and evaluate one’s own mental processes. We investigated confidence in judgements about nociceptive pain (i.e. pain that arises from the activation of nociceptors by a noxious stimulus) to determine whether metacognitive processes contribute to the distinctiveness of the pain experience. Our participants made intensity judgements about noxious heat, innocuous warmth, and visual contrast (first-order, perceptual decisions) and rated their confidence in those judgements (second-order, metacognitive decisions). First-order task performance between modalities was balanced using adaptive staircase procedures. For each modality, we quantified metacognitive efficiency (meta-d’/d’)—the degree to which participants’ confidence reports were informed by the same evidence that contributed to their perceptual judgements—and metacognitive bias (mean confidence)—the participant’s tendency to report higher or lower confidence overall. We found no overall differences in metacognitive efficiency or mean confidence between modalities. Mean confidence ratings were highly correlated between all three tasks, reflecting stable inter-individual variability in metacognitive bias. However, metacognitive efficiency for pain varied independently of metacognitive efficiency for warmth and visual perception. That is, those participants who had higher metacognitive efficiency in the visual task also tended to have higher metacognitive efficiency in the warmth task, but not necessarily in the pain task. We thus suggest that some distinctive and idiosyncratic aspects of the pain experience may stem from additional variability at a metacognitive level. We further speculate that this additional variability may arise from the affective or arousal aspects of pain.
Collapse
Affiliation(s)
- Brianna Beck
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom.
| | - Valentina Peña-Vivas
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - Stephen Fleming
- Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom; Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London, United Kingdom
| | - Patrick Haggard
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| |
Collapse
|
46
|
Alqarni A, Manlapaz D, Baxter D, Tumilty S, Mani R. Test procedures to assess somatosensory abnormalities in individuals with neck pain: a systematic review of psychometric properties. PHYSICAL THERAPY REVIEWS 2018. [DOI: 10.1080/10833196.2018.1512737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Abdullah Alqarni
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Donald Manlapaz
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - David Baxter
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Steve Tumilty
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Ramakrishnan Mani
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| |
Collapse
|
47
|
Davies JL, Engelstad JK, E Gove L, Linbo LK, Carter RE, Lynch C, Staff NP, Klein CJ, Dyck PJB, Herrmann DN, Dyck PJ. Somatotopic heat pain thresholds and intraepidermal nerve fibers in health. Muscle Nerve 2018; 58:509-516. [PMID: 29543981 DOI: 10.1002/mus.26128] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2018] [Indexed: 12/12/2022]
Abstract
INTRODUCTION For sequential and somatotopic assessment of small fiber neuropathy, heat pain (HP) tests of hypoalgesia might be used instead of decreased counts of epidermal nerve fibers (ENFs), but then healthy subject reference values of HP thresholds are needed. METHODS Using the Computer Assisted Sensation Evaluator IVc system, HP thresholds of hypoalgesia were estimated for 10 unilateral sites and counts of ENFs for 4 of them in healthy subjects. RESULTS In healthy subjects, small but statistically significant differences of both HP thresholds of hypoalgesia and counts of ENFs were observed among tested sites. Significant correlations between HP thresholds and counts of ENFs were not found. DISCUSSION For the studied somatotopic sites, we provide ≥95th and ≥99th percentile reference limits for HP 0.5 and 5 of 1-10 HP thresholds of hypoalgesia and decreased counts of ENFs at ≤5th and ≤1st percentile levels. Muscle Nerve 58: 509-516, 2018.
Collapse
Affiliation(s)
- Jenny L Davies
- Department of Neurology, Mayo Clinic, 200 First Street SW Rochester, Minnesota, USA, 55905
| | - Janean K Engelstad
- Department of Neurology, Mayo Clinic, 200 First Street SW Rochester, Minnesota, USA, 55905
| | - Linde E Gove
- Department of Neurology, Mayo Clinic, 200 First Street SW Rochester, Minnesota, USA, 55905
| | - Linda K Linbo
- Department of Neurology, Mayo Clinic, 200 First Street SW Rochester, Minnesota, USA, 55905
| | - Rickey E Carter
- Department of Neurology, Mayo Clinic, 200 First Street SW Rochester, Minnesota, USA, 55905
| | | | - Nathan P Staff
- Department of Neurology, Mayo Clinic, 200 First Street SW Rochester, Minnesota, USA, 55905
| | - Christopher J Klein
- Department of Neurology, Mayo Clinic, 200 First Street SW Rochester, Minnesota, USA, 55905
| | - P James B Dyck
- Department of Neurology, Mayo Clinic, 200 First Street SW Rochester, Minnesota, USA, 55905
| | | | - Peter J Dyck
- Department of Neurology, Mayo Clinic, 200 First Street SW Rochester, Minnesota, USA, 55905
| |
Collapse
|
48
|
Harris S, Sterling M, Farrell SF, Pedler A, Smith AD. The influence of isometric exercise on endogenous pain modulation: comparing exercise-induced hypoalgesia and offset analgesia in young, active adults. Scand J Pain 2018; 18:513-523. [DOI: 10.1515/sjpain-2017-0177] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 03/06/2018] [Indexed: 12/28/2022]
Abstract
Abstract
Background and aims
Impairment of endogenous analgesia has been associated with the development, maintenance and persistence of pain. Endogenous analgesia can be evaluated using exercise-induced hypoalgesia (EIH) and offset analgesia (OffA) paradigms, which measure temporal filtering of sensory information. It is not clear if these paradigms are underpinned by common mechanisms, as EIH and OffA have not previously been directly compared. A further understanding of the processes responsible for these clinically relevant phenomena may have future diagnostic and therapeutic utility in management of individuals with persistent pain conditions. The primary aim of this study was to investigate if there is a correlation between the magnitudes of EIH and OffA. The secondary aim of the study was to examine whether exercise influences OffA.
Methods
Thirty-six healthy, pain-free participants were recruited. EIH was evaluated using pressure pain thresholds (PPT) and pain ratings to suprathreshold pressure stimuli over tibialis anterior and the cervical spine. OffA evaluation utilised a three-step protocol, whereby individualised heat pain thermal stimuli [Numerical Rating Scale (NRS)=50/100] were applied (T1), before increasing 1 °C (T2), followed by 1 °C reduction (T3). The magnitude of OffA was calculated as the percentage reduction in the NRS from T2 to T3. PPT/suprathreshold pain ratings and OffA measures were recorded, before and after 5 min of isometric quadriceps exercise performed at 20–25% maximum voluntary contraction (MVC); and following a 15 min rest period. Data were analysed using repeated measures (RM) ANCOVA and correlational analyses.
Results
There was no correlation between EIH measures (PPTs or pain ratings to suprathreshold pressure stimuli over tibialis anterior or the cervical spine) and OffA (p>0.11 for all). OffA was induced and not modulated by exercise (p=0.28).
Conclusions
Five minutes of 20–25% MVC lower limb isometric exercise provided non-pharmacological pain modulation in young, active adults. Magnitude of EIH was not correlated with that of OffA, and exercise did not influence magnitude of OffA.
Implications
These results suggest that in young, pain-free individuals, separate testing of these two paradigms is required to comprehensively evaluate efficacy of endogenous analgesia. If these results are replicated in patient populations, alternative or complementary methods to exercise interventions may be required to modulate impaired OffA.
Collapse
Affiliation(s)
- Samuel Harris
- School of Allied Health Sciences , Griffith University , Gold Coast, QLD , Australia
| | - Michele Sterling
- RECOVER Injury Research Centre, NHMRC Centre for Research Excellence in Recovery Following Road Traffic Injuries , The University of Queensland , Brisbane , Australia
- Menzies Health Institute Queensland , Griffith University , Gold Coast , Australia
| | - Scott F. Farrell
- RECOVER Injury Research Centre, NHMRC Centre for Research Excellence in Recovery Following Road Traffic Injuries , The University of Queensland , Brisbane , Australia
- Menzies Health Institute Queensland , Griffith University , Gold Coast , Australia
| | - Ashley Pedler
- RECOVER Injury Research Centre, NHMRC Centre for Research Excellence in Recovery Following Road Traffic Injuries , The University of Queensland , Brisbane , Australia
| | - Ashley D. Smith
- School of Allied Health Sciences , Griffith University, 58 Parklands Dr , Southport, Gold Coast, QLD 4215 , Australia , Phone: +1 403 281 7264
| |
Collapse
|
49
|
Salame TH, Blinkhorn A, Karami Z. Neurological Assessment Using a Quantitative Sensory Test in Patients with Chronic Unilateral Orofacial Pain. Open Dent J 2018; 12:53-58. [PMID: 29492169 PMCID: PMC5815030 DOI: 10.2174/1874210601812010053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 11/06/2017] [Accepted: 11/15/2017] [Indexed: 11/22/2022] Open
Abstract
Background: Quantitative Sensory Testing (QST) has been used in clinical and experimental settings to establish sensory assessment for different types of pains, and may be a useful tool for the assessment of orofacial pain, but this premise needs to be tested. Objective: The aim of the study was to evaluate responses to thermal stimuli between painful and non-painful facial sites in subjects with orofacial pain using QST. Methods: A total of 60 participants (5o females: 28-83 years; 10 males: 44-81 years) with unilateral orofacial pain were recruited from the Orofacial Pain Clinic at the Pain Management and Research Centre, Royal North Shore Hospital, Sydney, Australia. The study followed the methods of limits of the German Research Network testing four modalities of thermal thresholds, the Warm Sensation, the Cold Sensation, the Heat Pain and the Cold Pain using a TSA-II Neurosensory Analyser. The results were compared to the results from the unaffected side of the same patient on the same area and a single t test statistical analysis was performed, where a p value of less than 0.05 was considered significant. Results: The Mean Difference for Cold Sensation between the pain side and the non-pain side was 0.48 °C ± 1.5 (t= 2.466, p=0.017), 0.68 °C ± 2.04 for Warm Sensation (t= -2.573, p= 0.013), 2.56 °C ± 2.74 for Cold Pain (t= 7.238, p<0.001) and -1.21 °C ± 2.59 for Hot Pain (t= -3.639, p=0.001). Conclusion: The study showed that QST methods using thermal stimuli could be used to evaluate sensory dysfunction in orofacial pain patients using the specific parameters of cool and warm sensation, and cold and hot pain.
Collapse
Affiliation(s)
- Talal H Salame
- Department of Prosthodontics, Faculty of Dentistry, The Lebanese University, Rafic Harriri Campus, Hadath, Lebanon
| | - Antony Blinkhorn
- Department of Population Oral Health, Faculty of Dentistry, The University of Sydney, New South Wales, Australia
| | - Zahra Karami
- Department of Oral Rehabilitation, Faculty of Dentistry, The University of Sydney, New South Wales, Australia
| |
Collapse
|
50
|
Daguet I, Bergeron-Vézina K, Harvey MP, Martel M, Léonard G. Transcutaneous electrical nerve stimulation and placebo analgesia: is the effect the same for young and older individuals? Clin Interv Aging 2018. [PMID: 29535508 PMCID: PMC5836647 DOI: 10.2147/cia.s152906] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose Placebo analgesia refers to a perceived reduction in pain intensity following the administration of a simulated or otherwise medically ineffective treatment. Previous studies have shown that many factors can influence the magnitude of placebo analgesia. However, few investigations have examined the effect of age on placebo analgesia, and none have done it in the context of electrotherapeutic interventions. The objective of this study is to compare the placebo response induced by sham transcutaneous electrical nerve stimulation (TENS) between young and older individuals, using an experimental heat-pain paradigm. Patients and methods Twenty-two young (21–39 years) and 22 older (58–76 years) healthy adults participated in this comparative study. Experimental heat pain was evoked with a thermode (2-min stimulation at a constant individually adjusted temperature) applied on the lumbar region. Participants were asked to evaluate the intensity of their pain using a computerized visual analog scale. Experimental pain was induced before and after an unconditioned placebo intervention (placebo TENS) applied for 25 min. Results In young individuals, no significant pain reductions were noted, whereas in older individuals, a statistically significant pain reduction was observed after the placebo stimulation (P<0.01). Between-group analyses revealed that placebo analgesia was greater in older individuals (40% pain reduction) compared with young individuals (15% pain reduction) (P<0.05). However, sham TENS increased heat-pain thresholds in the young group (P<0.01), but not in the older group (P=0.43). Conclusion Our results indicate that placebo analgesia is influenced by age, with older individuals showing larger placebo analgesia than young adults. Although these results should be confirmed in clinical pain populations, the current observations bear potentially important consequences for the design of future placebo-controlled trials and for healthcare professionals working with elderly patients.
Collapse
Affiliation(s)
- Inès Daguet
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada.,Research Center on Aging, Institute of Geriatrics of Sherbrooke, Sherbrooke, QC, Canada
| | - Kayla Bergeron-Vézina
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada.,Research Center on Aging, Institute of Geriatrics of Sherbrooke, Sherbrooke, QC, Canada
| | - Marie-Philippe Harvey
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada.,Research Center on Aging, Institute of Geriatrics of Sherbrooke, Sherbrooke, QC, Canada
| | - Marylie Martel
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada.,Research Center on Aging, Institute of Geriatrics of Sherbrooke, Sherbrooke, QC, Canada
| | - Guillaume Léonard
- Research Center on Aging, Institute of Geriatrics of Sherbrooke, Sherbrooke, QC, Canada.,École de réadaptation, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| |
Collapse
|