Modeling skin thermal pain sensation: Role of non-Fourier thermal behavior in transduction process of nociceptor

Spinal integration of hot and cold nociceptive stimuli by wide-dynamic-range neurons in anesthetized adult rats

Introduction

Early neuronal processing of thermal noxious information relies mostly on molecular detectors of the transient receptor potential family expressed by specific subpopulation of sensory neurons. This information may converge to second-order wide-dynamic-range (WDR) neurons located in the deep layer of the dorsal horn of the spinal cord.

Method

Using a micro-Peltier thermode thermal contact stimulator II delivering various cold and hot noxious stimulations, we have characterized the extracellular electrophysiological responses of mechanosensitive WDR neurons in anesthetized adult male and female Wistar rats.

Results

Most of the WDR neurons were activated after hot and cold noxious stimulations, at mean temperature thresholds corresponding to 43 and 20°C, respectively. If the production of action potential was not different in frequency between the 2 thermal modalities, the latency to observe the first action potential was significantly different (cold: 212 ms; hot: 490 ms, unpaired Student t-test: t = 8.041; df = 32; P < 0.0001), suggesting that different fiber types and circuits were involved. The temporal summation was also different because no facilitation was seen for cold noxious stimulations contrary to hot noxious ones.

Conclusion

Altogether, this study helps better understand how short-lasting and long-lasting hot or cold noxious stimuli are integrated by mechanosensitive WDR neurons. In our experimental conditions, we found WDR neurons to be nociceptive specific for C-fiber-mediated hot stimuli. We also found that cold nonnoxious and noxious information, triggered at glabrous skin areas, are likely taken in charge by A-type sensory neurons. This study will be helpful to establish working hypothesis explaining the thermal pain symptoms displayed by animal models and patients in a translational extent.

Multisine frequency modulation of intra-epidermal electric pulse sequences: A novel tool to study nociceptive processing

A sustained sensory stimulus with a periodic variation of intensity creates an electrophysiological brain response at associated frequencies, referred to as the steady-state evoked potential (SSEP). The SSEPs elicited by the periodic stimulation of nociceptors in the skin may represent activity of a brain network that is primarily involved in nociceptive processing. Exploring the behavior of this network could lead to valuable insights regarding the pathway from nociceptive stimulus to pain perception. We present a method to directly modulate the pulse rate of nociceptive afferents in the skin with a multisine waveform through intra-epidermal electric stimulation. The technique was demonstrated in healthy volunteers. Each subject was stimulated using a pulse sequence modulated by a multisine waveform of 3, 7 and 13 Hz. The EEG was analyzed for the presence of the base frequencies and associated (sub)harmonics. Topographies showed significant central and contralateral SSEP responses at 3, 7 and 13 Hz in respectively 7, 4 and 3 out of the 9 participants included for analysis. As such, we found that intra-epidermal stimulation with a multisine frequency modulated pulse sequence can generate nociceptive SSEPs. The possibility to stimulate the nociceptive system using multisine frequency modulated pulses offers novel opportunities to study the temporal dynamics of nociceptive processing.

Computational Modelling of the Bioheat Transfer Process in Human Skin Subjected to Direct Heating and/or Cooling Sources: A Systematic Review

The purpose of this systematic review is to analyze characteristics and methodologies utilized in bioheat transfer models of human skin to provide state-of-the-art knowledge on the topic. This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. PubMed, EMBASE and Web of Science databases were searched up to May 30th, 2019 for bioheat transfer models focusing on direct contact between skin and temperature (heat and/or cold) source. Ten studies were included. A 16-item checklist was used to assess their methodological quality. Four studies analyzed healthy skin and six included pathological conditions. All determined skin's thermal behavior, and studies including pathological conditions also analyzed burn damage. Studies did not present a wide variety of mathematical formulation, emphasizing on modelling equations of well-established models from the literature, such as the Pennes' bioheat transfer equation, and the Henriques and Moritz model to quantify skin damage. Reporting of modelling characteristics and formulation of the computational models is not standardized and there is shortage of implementation of validation procedures, hindering representative conclusions. The lack of validation procedures led to low methodological quality. However, all studies provided strategies and parameters as starting points for future developments in this research area.

Thermal ablation of biological tissues in disease treatment: A review of computational models and future directions

Percutaneous thermal ablation has proven to be an effective modality for treating both benign and malignant tumours in various tissues. Among these modalities, radiofrequency ablation (RFA) is the most promising and widely adopted approach that has been extensively studied in the past decades. Microwave ablation (MWA) is a newly emerging modality that is gaining rapid momentum due to its capability of inducing rapid heating and attaining larger ablation volumes, and its lesser susceptibility to the heat sink effects as compared to RFA. Although the goal of both these therapies is to attain cell death in the target tissue by virtue of heating above 50°C, their underlying mechanism of action and principles greatly differs. Computational modelling is a powerful tool for studying the effect of electromagnetic interactions within the biological tissues and predicting the treatment outcomes during thermal ablative therapies. Such a priori estimation can assist the clinical practitioners during treatment planning with the goal of attaining successful tumour destruction and preservation of the surrounding healthy tissue and critical structures. This review provides current state-of-the-art developments and associated challenges in the computational modelling of thermal ablative techniques, viz., RFA and MWA, as well as touch upon several promising avenues in the modelling of laser ablation, nanoparticles assisted magnetic hyperthermia and non-invasive RFA. The application of RFA in pain relief has been extensively reviewed from modelling point of view. Additionally, future directions have also been provided to improve these models for their successful translation and integration into the hospital work flow.

Nonlocal heat conduction approach in a bi-layer tissue during magnetic fluid hyperthermia with dual phase lag model

In this work, a nonlocal dual-phase-lag (NL DPL) model is introduced to accommodate the effects of thermomass and size-dependent thermophysical properties at nanoscale heat transport. Heat transfer at nanoscale is essentially nonlocal and quite different from that at the micro- or macro scale. To illustrate the nonlocal effect, a bi-layered structure is considered during magnetic fluid hyperthermia (MFH) treatment which is used successfully in prostate, liver, and breast tumors and the effect of size-dependent characteristic lengths is discussed in tumor and normal region of tissue. The problem is solved by using the finite difference scheme in space coordinate and Legendre wavelet Galerkin approach in time coordinate with the Dirichlet, Neumann and Robin boundary conditions. The effect of boundary conditions, characteristic lengths, phase lag parameters and nanomaterial parameters is discussed in tumor and healthy tissue domain and the results are presented graphically. This study is expected to be helpful for modeling of bioheat transfer equation at nano-scale, and may be beneficial to design nano-sized and multi-layered devices for heat transfer.

Mechanical modeling of pimple growth

Pimple is one of the most common skin diseases for humans, whose growth cause pain yet the corresponding mechanical analysis is lacking. A finite element model is developed to quantify the deformation field with the expansion of follicle, and then the mechanical stimulus is related to the sensation of pain during the development of pimple. Parametric studies show the dependence of mechanical stimulus and pain level on the pimple-surrounded structures, follicle depth and mechanical properties of the epidermis. The findings in this paper may provide useful insights on prevention or pain mitigation of pimples, as well as those related to other tissue growth and respective cosmetic concerns.

Heat treatment modelling using strongly continuous semigroups

In this paper, mathematical simulation of bioheat transfer phenomenon within the living tissue is studied using the thermal wave model. Three different sources that have therapeutic applications in laser surgery, cornea laser heating and cancer hyperthermia are used. Spatial and transient heating source, on the skin surface and inside biological body, are considered by using step heating, sinusoidal and constant heating. Mathematical simulations describe a non-Fourier process. Exact solution for the corresponding non-Fourier bioheat transfer model that has time lag in its heat flux is proposed using strongly continuous semigroup theory in conjunction with variational methods. The abstract differential equation, infinitesimal generator and corresponding strongly continuous semigroup are proposed. It is proved that related semigroup is a contraction semigroup and is exponentially stable. Mathematical simulations are done for skin burning and thermal therapy in 10 different models and the related solutions are depicted. Unlike numerical solutions, which suffer from uncertain physical results, proposed analytical solutions do not have unwanted numerical oscillations.

MATHEMATICAL MODELING FOR THE PREDICTION AND IMPROVEMENT OF TOOTH THERMAL PAIN: A REVIEW

Tooth pain, especially tooth thermal pain, is one of the most important symptoms and signs in dental clinic and daily life. As a special sensation, pain has been studied extensively in both clinic and experimental research aimed at reducing or eliminating the possible negative effects of pain. Unfortunately, the full underlying mechanism of pain is still unclear, because the pain could be influenced by many factors, including physiological, psychological, physical, chemical, and biological factors and so on. Besides, most studies on pain mechanisms in the literature are based on skin pain sensation and only few are based on tooth pain. In this paper, we present a comprehensive review on both neurophysiology of tooth pain mechanism, and corresponding thermal, mechanical, and thermomechanical behaviors of teeth. We also describe a multiscale modeling approach for quantifying tooth thermal pain by integrating the mathematic methods of engineering into the neuroscience. The mathematical model of tooth thermal pain will enable better understanding of thermal pain mechanism and optimization of existing diagnosis and treatment in dental clinic.

Fluid mechanics in dentinal microtubules provides mechanistic insights into the difference between hot and cold dental pain

Dental thermal pain is a significant health problem in daily life and dentistry. There is a long-standing question regarding the phenomenon that cold stimulation evokes sharper and more shooting pain sensations than hot stimulation. This phenomenon, however, outlives the well-known hydrodynamic theory used to explain dental thermal pain mechanism. Here, we present a mathematical model based on the hypothesis that hot or cold stimulation-induced different directions of dentinal fluid flow and the corresponding odontoblast movements in dentinal microtubules contribute to different dental pain responses. We coupled a computational fluid dynamics model, describing the fluid mechanics in dentinal microtubules, with a modified Hodgkin-Huxley model, describing the discharge behavior of intradental neuron. The simulated results agreed well with existing experimental measurements. We thence demonstrated theoretically that intradental mechano-sensitive nociceptors are not “equally sensitive” to inward (into the pulp) and outward (away from the pulp) fluid flows, providing mechanistic insights into the difference between hot and cold dental pain. The model developed here could enable better diagnosis in endodontics which requires an understanding of pulpal histology, neurology and physiology, as well as their dynamic response to the thermal stimulation used in dental practices.