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Kutafina E, Becker S, Namer B. Measuring pain and nociception: Through the glasses of a computational scientist. Transdisciplinary overview of methods. FRONTIERS IN NETWORK PHYSIOLOGY 2023; 3:1099282. [PMID: 36926544 PMCID: PMC10013045 DOI: 10.3389/fnetp.2023.1099282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/04/2023] [Indexed: 02/12/2023]
Abstract
In a healthy state, pain plays an important role in natural biofeedback loops and helps to detect and prevent potentially harmful stimuli and situations. However, pain can become chronic and as such a pathological condition, losing its informative and adaptive function. Efficient pain treatment remains a largely unmet clinical need. One promising route to improve the characterization of pain, and with that the potential for more effective pain therapies, is the integration of different data modalities through cutting edge computational methods. Using these methods, multiscale, complex, and network models of pain signaling can be created and utilized for the benefit of patients. Such models require collaborative work of experts from different research domains such as medicine, biology, physiology, psychology as well as mathematics and data science. Efficient work of collaborative teams requires developing of a common language and common level of understanding as a prerequisite. One of ways to meet this need is to provide easy to comprehend overviews of certain topics within the pain research domain. Here, we propose such an overview on the topic of pain assessment in humans for computational researchers. Quantifications related to pain are necessary for building computational models. However, as defined by the International Association of the Study of Pain (IASP), pain is a sensory and emotional experience and thus, it cannot be measured and quantified objectively. This results in a need for clear distinctions between nociception, pain and correlates of pain. Therefore, here we review methods to assess pain as a percept and nociception as a biological basis for this percept in humans, with the goal of creating a roadmap of modelling options.
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Affiliation(s)
- Ekaterina Kutafina
- Institute of Medical Informatics, Medical Faculty, RWTH Aachen University, Aachen, Germany
- Faculty of Applied Mathematics, AGH University of Science and Technology, Krakow, Poland
| | - Susanne Becker
- Clinical Psychology, Department of Experimental Psychology, Heinrich Heine University, Düsseldorf, Germany
- Integrative Spinal Research, Department of Chiropractic Medicine, University Hospital Balgrist, University of Zurich, Zurich, Switzerland
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Barbara Namer
- Junior Research Group Neuroscience, Interdisciplinary Center for Clinical Research Within the Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- Institute of Physiology, Medical Faculty, RWTH Aachen University, Aachen, Germany
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van den Berg B, Manoochehri M, Schouten AC, van der Helm FCT, Buitenweg JR. Nociceptive Intra-epidermal Electric Stimulation Evokes Steady-State Responses in the Secondary Somatosensory Cortex. Brain Topogr 2022; 35:169-181. [PMID: 35050427 PMCID: PMC8860817 DOI: 10.1007/s10548-022-00888-y] [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: 06/07/2021] [Accepted: 01/05/2022] [Indexed: 11/16/2022]
Abstract
Recent studies have established the presence of nociceptive steady-state evoked potentials (SSEPs), generated in response to thermal or intra-epidermal electric stimuli. This study explores cortical sources and generation mechanisms of nociceptive SSEPs in response to intra-epidermal electric stimuli. Our method was to stimulate healthy volunteers (n = 22, all men) with 100 intra-epidermal pulse sequences. Each sequence had a duration of 8.5 s, and consisted of pulses with a pulse rate between 20 and 200 Hz, which was frequency modulated with a multisine waveform of 3, 7 and 13 Hz (n = 10, 1 excluded) or 3 and 7 Hz (n = 12, 1 excluded). As a result, evoked potentials in response to stimulation onset and contralateral SSEPs at 3 and 7 Hz were observed. The SSEPs at 3 and 7 Hz had an average time delay of 137 ms and 143 ms respectively. The evoked potential in response to stimulation onset had a contralateral minimum (N1) at 115 ms and a central maximum (P2) at 300 ms. Sources for the multisine SSEP at 3 and 7 Hz were found through beamforming near the primary and secondary somatosensory cortex. Sources for the N1 were found near the primary and secondary somatosensory cortex. Sources for the N2-P2 were found near the supplementary motor area. Harmonic and intermodulation frequencies in the SSEP power spectrum remained below a detectable level and no evidence for nonlinearity of nociceptive processing, i.e. processing of peripheral firing rate into cortical evoked potentials, was found.
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Affiliation(s)
- Boudewijn van den Berg
- Biomedical Signals and Systems, Technical Medical Centre, University of Twente, PO Box 217, 7500 AE, Enschede, The Netherlands.
| | - Mana Manoochehri
- Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, The Netherlands
| | - Alfred C Schouten
- Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, The Netherlands.,Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, USA.,Biomechanical Engineering, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Frans C T van der Helm
- Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, The Netherlands.,Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Jan R Buitenweg
- Biomedical Signals and Systems, Technical Medical Centre, University of Twente, PO Box 217, 7500 AE, Enschede, The Netherlands
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Poulsen AH, van den Berg B, Arguissain FG, Tigerholm J, Buitenweg JR, Andersen OK, Mørch CD. Novel surface electrode design for preferential activation of cutaneous nociceptors. J Neural Eng 2022; 19. [PMID: 34996054 DOI: 10.1088/1741-2552/ac4950] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 01/07/2022] [Indexed: 11/11/2022]
Abstract
Objective Small area electrodes enable preferential activation of nociceptive fibers. It is debated, however, whether co-activation of large fibers still occurs for the existing electrode designs. Moreover, existing electrodes are limited to low stimulation intensities, for which behavioral and physiological responses may be considered less reliable. A recent optimization study showed that there is a potential for improving electrode performance and increase the range of possible stimulation intensities. Based on those results, the present study introduces and tests a novel planar concentric array electrode design for small fiber activation in healthy volunteers. Approach Volunteers received electrical stimulation with the planar concentric array electrode and a regular patch electrode. Perception thresholds were estimated at the beginning and the end of the experiment. Evoked cortical potentials were recorded in blocks of 30 stimuli. For the patch, stimulation intensity was set to two times perception threshold (PT), while three intensities, 2, 5, and 10 times PT, were applied with the planar concentric array electrode. Sensation quality, numerical-rating scores, and reaction times were obtained for each PT estimation and during each block of evoked potential recordings. Main results Stimulation with the patch electrode was characterized as dull, while stimulation with the planar concentric array electrode was characterized as sharp, with increased sharpness for increasing stimulus intensity. Likewise, NRS scores were higher for the planar concentric array electrode compared to the patch and increased with increasing stimulation intensity. Reaction times and ERP latencies were longer for the planar concentric array electrode compared to the patch. Significance The presented novel planar concentric array electrode is a small, non-invasive, and single-use electrode that has the potential to investigate small fiber neuropathy and pain mechanisms, as it is small fiber preferential for a wide range of stimulation intensities.
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Affiliation(s)
- Aida Hejlskov Poulsen
- Department of Health science and technology, Aalborg Universitet Det Sundhedsvidenskabelige Fakultet, Fredrik bajers vej, 7 A1, 208, Aalborg, Nordjylland, 9220, DENMARK
| | - Boudewijn van den Berg
- University of Twente Technical Medical Centre, PO box 217, 7500 AE Enschede, The Netherlands, Enschede, 7500, NETHERLANDS
| | - Federico G Arguissain
- Department of Health Science and Technology, Aalborg Universitet Det Sundhedsvidenskabelige Fakultet, Fredrik Bajers Vej 7A, Aalborg, 9220, DENMARK
| | - Jenny Tigerholm
- Health Science and Technology, Aalborg University, Fredrik Bajers vej 7A, Aalborg, 9220, DENMARK
| | - Jan R Buitenweg
- EWI - TST, University of Twente, PO Box 217, 7500 AE Enchende, The Netherlands, Enschende, 7500, NETHERLANDS
| | - Ole Kaeseler Andersen
- Department of Health Science and Technology, Aalborg Universitet Det Sundhedsvidenskabelige Fakultet, Fredrik Bajers Vej 7, 9220 Aalborg, Aalborg, 9220, DENMARK
| | - Carsten Dahl Mørch
- Department of Health Science and Technology, Aalborg Universitet Det Sundhedsvidenskabelige Fakultet, Fredrik Bajers Vej 7 A, Aalborg, 9220, DENMARK
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