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Maestrini I, Viganò A, Di Stefano G, Toscano M, Di Piero V. Neurophysiological investigations in a case of primary paroxysmal hemicrania-tic syndrome. Neurol Sci 2024; 45:3917-3921. [PMID: 38523207 DOI: 10.1007/s10072-024-07470-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/13/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND The association between paroxysmal hemicrania (PH) and trigeminal neuralgia-the so-called PH-tic syndrome-has rarely been described. However, a correct diagnosis is crucial since both disorders require specific treatments. Little is known about pathophysiological mechanisms, and, to date, there are no electrophysiological studies in patients with PH-tic syndrome. CASE We describe the case of a 52-year-old man with a PH-tic syndrome successfully treated with an association of carbamazepine (1200 mg/day) and indomethacin (150 mg/die). Patient underwent trigeminal reflex testing, including blink and masseter inhibitory reflex, and laser-evoked potential (LEP) recording after supraorbital region stimulation in the affected and unaffected side. Both neurophysiological investigations resulted normal; LEPs failed to detect any latency asymmetry between both sides. CONCLUSIONS Neurophysiological findings demonstrate for the first time the integrity of somatosensory system in a primary PH-tic syndrome case. Central pathophysiological mechanisms and hypothalamic dysregulation may contribute to the development of this rare syndrome.
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Affiliation(s)
- Ilaria Maestrini
- Department of Systems Medicine, University Hospital of Rome "Tor Vergata", Rome, Italy.
- Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy.
| | - Alessandro Viganò
- Rehabilitation Neurology Unit, I.R.C.C.S. Fondazione Don Carlo Gnocchi, Via Alfonso Capecelatro 66, 20148, Milan, Italy
| | - Giulia Di Stefano
- Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy
| | - Massimiliano Toscano
- Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy
- Department of Neurology, Fatebenefratelli Hospital-Gemelli Isola, Rome, Italy
| | - Vittorio Di Piero
- Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy
- University Consortium for Adaptive Disorders and Head Pain (UCADH), Pavia, Italy
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Coppi S, Jensen KB, Ehrsson HH. Eliciting the rubber hand illusion by the activation of nociceptive C and Aδ fibers. Pain 2024:00006396-990000000-00611. [PMID: 38787634 DOI: 10.1097/j.pain.0000000000003245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 02/12/2024] [Indexed: 05/26/2024]
Abstract
ABSTRACT The coherent perceptual experience of one's own body depends on the processing and integration of signals from multiple sensory modalities, including vision, touch, and proprioception. Although nociception provides critical information about damage to the tissues of one's body, little is known about how nociception contributes to own-body perception. A classic experimental approach to investigate the perceptual and neural mechanisms involved in the multisensory experience of one's own body is the rubber hand illusion (RHI). During the RHI, people experience a rubber hand as part of their own body (sense of body ownership) caused by synchronized stroking of the rubber hand in the participant's view and the hidden participant's real hand. We examined whether the RHI can be elicited by visual and "pure" nociceptive stimulation, ie, without tactile costimulation, and if so, whether it follows the basic perceptual rules of the illusion. In 6 separate experiments involving a total of 180 healthy participants, we used a Nd:YAP laser stimulator to specifically target C and Aδ fibers in the skin and compared the illusion condition (congruent visuonociceptive stimulation) to control conditions of incongruent visuonociceptive, incongruent visuoproprioceptive, and no nociceptive stimulation. The illusion was quantified through direct (questionnaire) and indirect (proprioceptive drift) behavioral measures. We found that a nociceptive rubber hand illusion (N-RHI) could be elicited and that depended on the spatiotemporal congruence of visuonociceptive signals, consistent with basic principles of multisensory integration. Our results suggest that nociceptive information shapes multisensory bodily awareness and contributes to the sense of body ownership.
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Affiliation(s)
| | - Karin B Jensen
- Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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3
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Perchet C, Hagiwara K, Salameh C, Garcia-Larrea L. Cold-evoked potentials in clinical practice: A head-to-head contrast with laser-evoked responses. Eur J Pain 2023; 27:1006-1022. [PMID: 37278358 DOI: 10.1002/ejp.2142] [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: 12/27/2022] [Revised: 05/17/2023] [Accepted: 05/21/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND Innocuous cooling of the skin activates cold-specific Aδ fibres, and hence, the recording of cold-evoked potentials (CEPs) may improve the objective assessment of human thermo-nociceptive function. While the feasibility of CEP recordings in healthy humans has been reported, their reliability and diagnostic use in clinical conditions have not been documented. METHODS Here, we report the results of CEP recordings in 60 consecutive patients with suspected neuropathic pain, compared with laser-evoked potentials (LEPs) which are the gold standard for thermo-algesic instrumental assessment. RESULTS CEP recording was a well-tolerated procedure, with only ~15 min of surplus in exam duration. The reproducibility and signal-to-noise ratio of CEPs were lower than those of LEPs, in particular for distal lower limbs (LLs). While laser responses were interpretable in all patients, CEPs interpretation was inconclusive in 5/60 because of artefacts or lack of response on the unaffected side. Both techniques yielded concordant results in 73% of the patients. In 12 patients, CEPs yielded abnormal values while LEPs remained within normal limits; 3 of these patients had clinical symptoms limited to cold sensations, including cold-heat transformation. CONCLUSIONS CEPs appear as a useful technique for exploring pain/temperature systems. Advantages are low cost of equipment and innocuity. Disadvantages are low signal-to-noise ratio for LL stimulation, and sensitivity to fatigue/habituation. Joint recording of CEPs and LEPs can increase the sensitivity of neurophysiological techniques to thin fibre- spinothalamic lesions, in particular, when abnormalities of cold perception predominate. SIGNIFICANCE Recording of cold-evoked potentials is a well-tolerated, inexpensive and easy-to-use procedure that can be helpful in the diagnosis of abnormalities in the thin fibre- spinothalamic pathways. Supplementing LEPs with CEPs allows consolidating the diagnosis and, for some patients suffering from symptoms limited only to cold, CEPs but not LEPs may allow the diagnosis of thin fibre pathology. Optimal CEP recording conditions are important to overcome the low signal-to-noise ratio and habituation phenomena, which are less favourable than with LEPs.
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Affiliation(s)
- Caroline Perchet
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028, UMR5292, NEUROPAIN, Bron, France
| | - Koichi Hagiwara
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028, UMR5292, NEUROPAIN, Bron, France
- Fukuoka International University of Health and Welfare, Fukuoka, Japan
| | - Charbel Salameh
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028, UMR5292, NEUROPAIN, Bron, France
| | - Luis Garcia-Larrea
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028, UMR5292, NEUROPAIN, Bron, France
- Centre D'évaluation et de Traitement de la Douleur, Hôpital Neurologique, Lyon, France
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Assessment of C Fibers Evoked Potentials in Healthy Subjects by Nd : YAP Laser. Pain Res Manag 2022; 2022:7737251. [PMID: 36601434 PMCID: PMC9807303 DOI: 10.1155/2022/7737251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/11/2022] [Accepted: 12/03/2022] [Indexed: 12/28/2022]
Abstract
Introduction Although laser stimuli activate both Ad- and C-fibres, the corresponding laser evoked potentials (LEPs) remain restricted to the Ad-fibers input, while the C-fibers related potential is hardly detectable. Aims To evaluate multichannel ultralate LEPs (U-LEPs) by using Nd : Yap laser pulses in healthy volunteers to stimulation of face and lower and upper limbs, in order to estimate the reliability of C-LEPs elicited from both trigeminal and somatic sites. Methods Twenty healthy volunteers participated in two stimulation sessions to record Aδ-LEPs and C-LEPs. We used a Nd : YAP Laser and 62 EEG recording electrodes. Stimuli parameters were set to activate either small myelinated (Aδ), eliciting purely warmth sensations, or unmyelinated (C) afferents, and eliciting pinprick sensations. Results At the trigeminal level, we obtained a negative-positive complex in a time interval compatible with the C fibers activation. In the somatic districts, the averaged responses consisted of an earlier negative-positive complex, followed by a later one. Single trials analysis of U-LEPs showed a maximal positive peak in a time interval in the range of C fibers. Topographical analysis of U-LEPs resembled that of LEPs. All subjects exhibited readable U-LEPs in at least 2 stimulated sites. Discussion. A purely warmth sensation seems to correspond to Aδ and C-fibers coactivation, at least in the somatic districts. While the related cortical waves seem hardly readable, their total absence could be a sign of systemic involvement of warm related C-fibers in specific clinical conditions.
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Sympathetic skin response as an objective tool to estimate stimulus-associated arousal in a human model of hyperalgesia. Neurophysiol Clin 2022; 52:436-445. [DOI: 10.1016/j.neucli.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 08/02/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022] Open
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Cambieri C, Libonati L, Moret F, Tartaglia G, Garibaldi M, Chimenti C, Inghilleri M, Ceccanti M. The Silent Period for Small Fiber Sensory Neuropathy Assessment in a Mixed Cohort of Transthyretin-Mediated Amyloidosis. Biomedicines 2022; 10:biomedicines10092073. [PMID: 36140174 PMCID: PMC9495326 DOI: 10.3390/biomedicines10092073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/20/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Transthyretin-mediated amyloidosis (ATTR) is a rare multisystemic disease involving the peripheral nervous system and heart. Autonomic and small fiber involvement is one of the hallmarks of ATTR, and many tools have been proposed to assess this aspect. Aim: The aim of this study was to investigate cutaneous and mixed nerve silent periods (CSP and MnSP) as instruments for small fiber assessment. Methods: A total of 21 ATTR patients, 20 healthy controls, and 18 asymptomatic carriers underwent a sensory conduction study from the right sural and non-dominant ulnar nerves. A motor conduction study from the right deep peroneal and non-dominant ulnar nerves, with their F waves, CSPs, and MnSPs, was performed. Results: The amplitudes of the sural and ulnar sensory nerves and of the peroneal and ulnar motor nerves were reduced in ATTR patients compared to the other groups. F waves from the ulnar and peroneal nerves showed no differences between the three groups. The CSP and MnSP latency, but not amplitude, were increased in both the ulnar and peroneal nerves of ATTR patients. Conclusions: ATTR patients showed axonal involvement of large sensory and motor nerve fibers and demyelinating features of small sensory fibers.
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Affiliation(s)
- Chiara Cambieri
- Center for Rare Neuromuscular Diseases, Department of Human Neuroscience, Policlinico Umberto I, Sapienza University of Rome, 00185 Rome, Italy
| | - Laura Libonati
- Center for Rare Neuromuscular Diseases, Department of Human Neuroscience, Policlinico Umberto I, Sapienza University of Rome, 00185 Rome, Italy
| | - Federica Moret
- Center for Rare Neuromuscular Diseases, Department of Human Neuroscience, Policlinico Umberto I, Sapienza University of Rome, 00185 Rome, Italy
| | - Giorgio Tartaglia
- Center for Rare Neuromuscular Diseases, Department of Human Neuroscience, Policlinico Umberto I, Sapienza University of Rome, 00185 Rome, Italy
| | - Matteo Garibaldi
- Neuromuscular and Rare Disease Center, Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sant’Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy
| | - Cristina Chimenti
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, Sapienza University, 00185 Rome, Italy
- Cellular and Molecular Cardiology Lab, IRCCS Lazzaro Spallanzani, 00149 Rome, Italy
| | - Maurizio Inghilleri
- Center for Rare Neuromuscular Diseases, Department of Human Neuroscience, Policlinico Umberto I, Sapienza University of Rome, 00185 Rome, Italy
| | - Marco Ceccanti
- Center for Rare Neuromuscular Diseases, Department of Human Neuroscience, Policlinico Umberto I, Sapienza University of Rome, 00185 Rome, Italy
- Correspondence:
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7
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De Stefano G, Leone C, Di Pietro G, Esposito N, Falco P, Galosi E, Litewczuk D, Mollica C, Truini A, Di Stefano G. Unravelling the role of unmyelinated nerve fibres in trigeminal neuralgia with concomitant continuous pain. Clin Neurophysiol 2022; 142:52-58. [DOI: 10.1016/j.clinph.2022.07.502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 06/13/2022] [Accepted: 07/22/2022] [Indexed: 11/03/2022]
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8
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Verdugo RJ, Matamala JM, Inui K, Kakigi R, Valls-Solé J, Hansson P, Bernhard Nilsen K, Lombardi R, Lauria G, Petropoulos IN, Malik RA, Treede RD, Baumgärtner U, Jara PA, Campero M. Review of techniques useful for the assessment of sensory small fiber neuropathies: Report from an IFCN expert group. Clin Neurophysiol 2022; 136:13-38. [DOI: 10.1016/j.clinph.2022.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 02/09/2023]
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9
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Hadizadeh M, Rahimi A, Javaherian M, Velayati M, Dommerholt J. The efficacy of intramuscular electrical stimulation in the management of patients with myofascial pain syndrome: a systematic review. Chiropr Man Therap 2021; 29:40. [PMID: 34579747 PMCID: PMC8477566 DOI: 10.1186/s12998-021-00396-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 09/07/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Myofascial pain syndrome (MPS) is one of the most common disorders causing chronic muscle pain. Almost one-third of patients with musculoskeletal complaints meet the MPS criteria. The aim of this study is to evaluate the effectiveness of intramuscular electrical stimulation (IMES) in patients with MPS through a systematic review method. Methods PubMed, Scopus, Embase, ProQuest, PEDro, Web of Science, and CINAHL were systematically searched to find out the eligible articles without language limitations from 1990 to December 30, 2020. All relevant randomized controlled trials that compared the effectiveness of IMES with sham-IMES, dry needling, or exercise therapy in patients with MPS were included. Full texts of the selected studies were critically appraised using Revised Cochrane risk-of-bias tool for randomized trials (RoB2). Results Six studies (out of 397) had met our inclusion criteria (involving 158 patients) and were entered to the systematic review. Outcome measures examined in these studies included pain, range of motion, pressure pain threshold, biochemical factors, disability, and amount of analgesic use. In the most studies, it has been shown that IMES is more effective than the control group in improving some outcome measurements such as pain. Conclusion There is preliminary evidence from a few small trials suggesting the efficacy of IMES for the care of myofascial pain syndrome. The data support the conduct of larger trials investigating the efficacy of IMES. Supplementary Information The online version contains supplementary material available at 10.1186/s12998-021-00396-z.
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Affiliation(s)
- Monavar Hadizadeh
- Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, # Damavand Ave, Zip code:16169-13111, Tehran, Iran
| | - Abbas Rahimi
- Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, # Damavand Ave, Zip code:16169-13111, Tehran, Iran.
| | - Mohammad Javaherian
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Meysam Velayati
- Musculoskeletal RadiologistDepartment of Radiology, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Jan Dommerholt
- Bethesda Physiocare, Bethesda, MD, USA.,Myopain Seminars, Bethesda, MD, USA.,Department of Physical Therapy and Rehabilitation Science, School of Medicine, University of Maryland, Baltimore, MD, USA
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10
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Teng G, Zhang F, Li Z, Zhang C, Zhang L, Chen L, Zhou T, Yue L, Zhang J. Quantitative Electrophysiological Evaluation of the Analgesic Efficacy of Two Lappaconitine Derivatives: A Window into Antinociceptive Drug Mechanisms. Neurosci Bull 2021; 37:1555-1569. [PMID: 34550562 DOI: 10.1007/s12264-021-00774-w] [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: 02/21/2021] [Accepted: 06/16/2021] [Indexed: 10/20/2022] Open
Abstract
Quantitative evaluation of analgesic efficacy improves understanding of the antinociceptive mechanisms of new analgesics and provides important guidance for their development. Lappaconitine (LA), a potent analgesic drug extracted from the root of natural Aconitum species, has been clinically used for years because of its effective analgesic and non-addictive properties. However, being limited to ethological experiments, previous studies have mainly investigated the analgesic effect of LA at the behavioral level, and the associated antinociceptive mechanisms are still unclear. In this study, electrocorticogram (ECoG) technology was used to investigate the analgesic effects of two homologous derivatives of LA, Lappaconitine hydrobromide (LAH) and Lappaconitine trifluoroacetate (LAF), on Sprague-Dawley rats subjected to nociceptive laser stimuli, and to further explore their antinociceptive mechanisms. We found that both LAH and LAF were effective in reducing pain, as manifested in the remarkable reduction of nocifensive behaviors and laser-evoked potentials (LEPs) amplitudes (N2 and P2 waves, and gamma-band oscillations), and significantly prolonged latencies of the LEP-N2/P2. These changes in LEPs reflect the similar antinociceptive mechanism of LAF and LAH, i.e., inhibition of the fast signaling pathways. In addition, there were no changes in the auditory-evoked potential (AEP-N1 component) before and after LAF or LAH treatment, suggesting that neither drug had a central anesthetic effect. Importantly, compared with LAH, LAF was superior in its effects on the magnitudes of gamma-band oscillations and the resting-state spectra, which may be associated with their differences in the octanol/water partition coefficient, degree of dissociation, toxicity, and glycine receptor regulation. Altogether, jointly applying nociceptive laser stimuli and ECoG recordings in rats, we provide solid neural evidence for the analgesic efficacy and antinociceptive mechanisms of derivatives of LA.
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Affiliation(s)
- Guixiang Teng
- College of Life Science, Northwest Normal University, Lanzhou, 730070, China.,The Rural Development Academy, Northwest Normal University, Lanzhou, 730070, China
| | - Fengrui Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China.,Department of Psychology, University of the Chinese Academy of Sciences, Beijing, 100049, China
| | - Zhenjiang Li
- School of Psychology, Jiangxi Normal University, Nanchang, 330022, China
| | - Chun Zhang
- School of Chemical and Biological Engineering, Lanzhou Jiaotong University, Lanzhou, 730070, China
| | - Libo Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China.,Department of Psychology, University of the Chinese Academy of Sciences, Beijing, 100049, China
| | - Lele Chen
- College of Life Science, Northwest Normal University, Lanzhou, 730070, China.,The Rural Development Academy, Northwest Normal University, Lanzhou, 730070, China
| | - Tao Zhou
- College of Life Science, Northwest Normal University, Lanzhou, 730070, China.,The Rural Development Academy, Northwest Normal University, Lanzhou, 730070, China
| | - Lupeng Yue
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China. .,Department of Psychology, University of the Chinese Academy of Sciences, Beijing, 100049, China.
| | - Ji Zhang
- College of Life Science, Northwest Normal University, Lanzhou, 730070, China. .,The Rural Development Academy, Northwest Normal University, Lanzhou, 730070, China.
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11
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Lefaucheur JP, Abbas SA, Lefaucheur-Ménard I, Rouie D, Tebbal D, Bismuth J, Nordine T. Small nerve fiber selectivity of laser and intraepidermal electrical stimulation: A comparative study between glabrous and hairy skin. Neurophysiol Clin 2021; 51:357-374. [PMID: 34304975 DOI: 10.1016/j.neucli.2021.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 06/20/2021] [Accepted: 06/20/2021] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES In clinical neurophysiology practice, various methods of stimulation can be used to activate small-diameter nociceptive cutaneous afferents located in the epidermis. These methods include different types of laser and intraepidermal electrical stimulation techniques. The diffusion of the stimulation in the skin, inside or under the epidermis, depends on laser wavelength and electrode design, in particular. The aim of this study was to compare several of these techniques in their ability to selectively stimulate small nerve fibers. METHODS In 8 healthy subjects, laser stimulation (using a CO2 or Nd:YAP laser) and intraepidermal electrical stimulation (using a micropatterned, concentric planar, or concentric needle electrode), were applied at increasing energy or intensity on the dorsal or volar aspect of the right hand or foot. The subjects were asked to define the perceived sensation (warm, pinprick, or electric shock sensation, corresponding to the activation of C fibers, Aδ fibers, or Aβ fibers, respectively) after each stimulation. Depending on the difference in the sensations perceived between dorsal (hairy skin with thin stratum corneum) and volar (glabrous skin with thick stratum corneum) stimulations, the diffusion of the stimulation inside or under the epidermis and the nature of the activated afferents were determined. RESULTS Regarding laser stimulation, the perceived sensations turned from warm to pinprick with increasing energies of stimulation, in particular with the Nd:YAP laser, of which pulse could penetrate deep in the skin according to its short wavelength. In contrast, CO2 laser stimulation produced only warm sensations and no pricking sensation when applied to the glabrous skin, perhaps due to a thicker stratum corneum and the shallow penetration of the CO2 laser pulse. Regarding intraepidermal electrical stimulation using concentric electrodes, the perceived sensations turned from pinprick to a combination of pinprick and electrical shocks with increasing intensities. Using the concentric planar electrode, the sensations perceived at high stimulation intensity even consisted of electric shocks without concomitant pinprick. In contrast, using the micropatterned electrode, only pinprick sensations were produced by the stimulation of the hairy skin, while the stimulation of the glabrous skin produced no sensation at all within the limits of stimulation intensities used in this study. CONCLUSIONS Using the CO2 laser or the micropatterned electrode, pinprick sensations were selectively produced by the stimulation of hairy skin, while only warm sensation or no sensation at all were produced by the stimulation of glabrous skin. These two techniques appear to be more selective with a limited diffusion of the stimulation into the skin, restricting the activation of sensory afferents to the most superficial and smallest intraepidermal nerve fibers.
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Affiliation(s)
- Jean-Pascal Lefaucheur
- Univ Paris Est Creteil, EA4391, ENT, F-94010 Creteil, France; AP-HP, Henri Mondor University Hospital, Clinical Neurophysiology Unit, F-94010 Creteil, France.
| | - Samar A Abbas
- AP-HP, Henri Mondor University Hospital, Clinical Neurophysiology Unit, F-94010 Creteil, France
| | | | - Denis Rouie
- AP-HP, Henri Mondor University Hospital, Clinical Neurophysiology Unit, F-94010 Creteil, France
| | - Denise Tebbal
- AP-HP, Henri Mondor University Hospital, Clinical Neurophysiology Unit, F-94010 Creteil, France
| | - Julie Bismuth
- AP-HP, Henri Mondor University Hospital, Clinical Neurophysiology Unit, F-94010 Creteil, France
| | - Tarik Nordine
- Univ Paris Est Creteil, EA4391, ENT, F-94010 Creteil, France; AP-HP, Henri Mondor University Hospital, Clinical Neurophysiology Unit, F-94010 Creteil, France
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12
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Song Y, Su Q, Yang Q, Zhao R, Yin G, Qin W, Iannetti GD, Yu C, Liang M. Feedforward and feedback pathways of nociceptive and tactile processing in human somatosensory system: A study of dynamic causal modeling of fMRI data. Neuroimage 2021; 234:117957. [PMID: 33744457 DOI: 10.1016/j.neuroimage.2021.117957] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 03/07/2021] [Accepted: 03/09/2021] [Indexed: 11/30/2022] Open
Abstract
Nociceptive and tactile information is processed in the somatosensory system via reciprocal (i.e., feedforward and feedback) projections between the thalamus, the primary (S1) and secondary (S2) somatosensory cortices. The exact hierarchy of nociceptive and tactile information processing within this 'thalamus-S1-S2' network and whether the processing hierarchy differs between the two somatosensory submodalities remains unclear. In particular, two questions related to the ascending and descending pathways have not been addressed. For the ascending pathways, whether tactile or nociceptive information is processed in parallel (i.e., 'thalamus-S1' and 'thalamus-S2') or in serial (i.e., 'thalamus-S1-S2') remains controversial. For the descending pathways, how corticothalamic feedback regulates nociceptive and tactile processing also remains elusive. Here, we aimed to investigate the hierarchical organization for the processing of nociceptive and tactile information in the 'thalamus-S1-S2' network using dynamic causal modeling (DCM) combined with high-temporal-resolution fMRI. We found that, for both nociceptive and tactile information processing, both S1 and S2 received inputs from thalamus, indicating a parallel structure of ascending pathways for nociceptive and tactile information processing. Furthermore, we observed distinct corticothalamic feedback regulations from S1 and S2, showing that S1 generally exerts inhibitory feedback regulation independent of external stimulation whereas S2 provides additional inhibition to the thalamic activity during nociceptive and tactile information processing in humans. These findings revealed that nociceptive and tactile information processing have similar hierarchical organization within the somatosensory system in the human brain.
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Affiliation(s)
- Yingchao Song
- School of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University, Tianjin, China
| | - Qian Su
- Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for China, Tianjin, China
| | - Qingqing Yang
- School of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University, Tianjin, China
| | - Rui Zhao
- School of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University, Tianjin, China; Department of Orthopedics Surgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Guotao Yin
- Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for China, Tianjin, China
| | - Wen Qin
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Gian Domenico Iannetti
- Neuroscience and Behaviour Laboratory, Italian Institute of Technology, Rome, Italy; Department of Neuroscience, Physiology and Pharmacology, University College London, London, United Kingdom
| | - Chunshui Yu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China; Chinese Academy of Sciences (CAS) Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China
| | - Meng Liang
- School of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University, Tianjin, China.
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13
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Mahmutoglu MA, Baumgärtner U, Rupp A. Posterior insular activity contributes to the late laser-evoked potential component in EEG recordings. Clin Neurophysiol 2021; 132:770-781. [PMID: 33571885 DOI: 10.1016/j.clinph.2020.11.042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 11/13/2020] [Accepted: 11/24/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Nociceptive activity in some brain areas has concordantly been reported in EEG source models, such as the anterior/mid-cingulate cortex and the parasylvian area. Whereas the posterior insula has been constantly reported to be active in intracortical and fMRI studies, non-invasive EEG and MEG recordings mostly failed to detect activity in this region. This study aimed to determine an appropriate inverse modeling approach in EEG recordings to model posterior insular activity, assuming the late LEP (laser evoked potential) time window to yield a better separation from other ongoing cortical activity. METHODS In 12 healthy volunteers, nociceptive stimuli of three intensities were applied. LEP were recorded using 32-channel EEG recordings. Source analysis was performed in specific time windows defined in the grand-average dataset. Two distinct dipole-pairs located close to the operculo-insular area were compared. RESULTS Our results show that posterior insular activity yields a substantial contribution to the latest part (positive component) of the LEP. CONCLUSIONS Even though the initial insular activity onset is in the early LEP time window,modelingthe insular activity in the late LEP time window might result in better separation from other ongoing cortical activity. SIGNIFICANCE Modeling the late LEP activity might enable to distinguish posterior insular activity.
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Affiliation(s)
- Mustafa Ahmed Mahmutoglu
- Section of Biomagnetism, Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany; Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
| | - Ulf Baumgärtner
- Chair of Neurophysiology, Centre for Biomedicine and Medical Technology Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Department of Physiology/Physics, University of Applied Sciences and Medical University, Medical School Hamburg, Hamburg, Germany
| | - André Rupp
- Section of Biomagnetism, Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
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14
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Valeriani M, Liguori S, Vollono C, Testani E, Bangrazi S, Petti F, Liguori A, Germanotta M, Padua L, Pazzaglia C. Homotopic reduction in laser-evoked potential amplitude and laser-pain rating by abdominal acupuncture. Eur J Pain 2020; 25:659-667. [PMID: 33259079 DOI: 10.1002/ejp.1701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The neural mechanism underlying the analgesic effect of acupuncture is largely unknown. We aimed at investigating the effect of abdominal acupuncture (AA) on the laser-evoked potential (LEP) amplitude and laser-pain rating to stimulation of body parts either homotopic or heterotopic to the treated acupoint. METHODS Laser-evoked potentials were recorded from 13 healthy subjects to stimulation of the right wrist (RW), left wrist (LW) and right foot (RF). LEPs were obtained before, during and after the AA stimulation of an abdominal area corresponding to the representation of the RW. Subjective laser-pain rating was collected after each LEP recording. RESULTS The amplitude of the N2/P2 LEP component was significantly reduced during AA and 15 min after needle removal to both RW (F = 4.14, p = .02) and LW (F = 5.48, p = .008) stimulation, while the N2/P2 amplitude to RF stimulation (F = 0.94, p = .4) remained unchanged. Laser-pain rating was reduced during AA and 15 min after needle removal only to RW stimulation (F = 5.67, p = .007). CONCLUSION Our findings showing an AA effect on LEP components to both the ipsilateral and contralateral region homotopic to the treated area, without any LEP change to stimulation of a heterotopic region, suggest that the AA analgesia is mediated by a segmental spinal mechanism. SIGNIFICANCE Although abdominal acupuncture has demonstrated to be effective in the reduction in laser-evoked potential (LEP) amplitude and laser-pain rating, the exact mechanism of this analgesic effect is not known. In the current study, we found that treatment of an area in the "turtle representation" of the body led to a topographical pattern of LEP amplitude inhibition that can be mediated by a segmental spinal mechanism.
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Affiliation(s)
- Massimiliano Valeriani
- Department of Neuroscience, Pediatric Hospital Bambino Gesù, IRCCS, Rome, Italy.,Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark
| | | | - Catello Vollono
- Neurofisiopatologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | | | | | | | | | | | - Luca Padua
- Department of Geriatrics and Orthopaedics, Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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15
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Leone C, Di Lionardo A, Diotallevi G, Mollica C, Di Pietro G, Di Stefano G, La Cesa S, Cruccu G, Truini A. Conduction velocity of the cold spinal pathway in healthy humans. Eur J Pain 2020; 24:1923-1931. [PMID: 32735696 DOI: 10.1002/ejp.1640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 07/19/2020] [Accepted: 07/25/2020] [Indexed: 11/05/2022]
Abstract
OBJECTIVES We aimed to investigate the conduction velocity of the cold spinal pathway in healthy humans. METHODS Using a cold stimulator consisting of micro-Peltier elements that was able to produce steep cooling ramps up to -300°C/s, we recorded cold-evoked potentials after stimulation of the dorsal midline at C5, T2, T6 and T10 vertebral levels and calculated the conduction velocity of the cold spinal pathway. In all participants, we used laser stimulation to deliver painful heat (Aδ-fibres-mediated) and warm (C-fibres-mediated) stimuli to the same sites in order to compare the conduction velocity of the cold spinal pathway with that of the nociceptive and warm spinal pathways. RESULTS Cold stimulation evoked large-amplitude vertex potentials from all stimulation sites. The mean conduction velocity of the cold spinal pathway was 12.0 m/s, which did not differ from that of the nociceptive spinal pathway (10.5 m/s). The mean conduction velocity of the warm spinal pathway was 2.0 m/s. DISCUSSION This study provides previously unreported findings regarding cold spinal pathway conduction velocity in humans that may be useful in the assessment of spinal cord lesions as well as in intraoperative monitoring during spinal surgery. SIGNIFICANCE This neurophysiological study provides previously unreported findings on cold spinal pathway conduction velocity in healthy humans. Cold-evoked potentials may represent an alternative to laser-evoked potential recording, useful to assess spinothalamic tract in patients with spinal cord lesions and monitor patients during spinal surgery.
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Affiliation(s)
- Caterina Leone
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | | | | | - Cristina Mollica
- Department of Methods and Models for Economics, Territory and Finance, Sapienza University, Rome, Italy
| | | | | | - Silvia La Cesa
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - Giorgio Cruccu
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - Andrea Truini
- Department of Human Neuroscience, Sapienza University, Rome, Italy
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16
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van Neerven SGA, Mouraux A. Capsaicin-Induced Skin Desensitization Differentially Affects A-Delta and C-Fiber-Mediated Heat Sensitivity. Front Pharmacol 2020; 11:615. [PMID: 32508630 PMCID: PMC7248294 DOI: 10.3389/fphar.2020.00615] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 04/20/2020] [Indexed: 12/19/2022] Open
Abstract
Localized neuropathic pain can be relieved following the topical application of high-concentration capsaicin. This clinical effect is thought to be related to the temporary desensitization of capsaicin- and heat-sensitive epidermal nociceptors. The objective of the present study was to examine whether the changes in thermal sensitivity induced by high-concentration topical capsaicin can be explained entirely by desensitization of capsaicin-sensitive afferents. For this purpose, we characterized, in 20 healthy human volunteers, the time course and spatial extent of the changes in sensitivity to thermal stimuli preferentially activating heat-sensitive A-fiber nociceptors, heat-sensitive C-fiber afferents, and cool-sensitive A-fiber afferents. The volar forearm was treated with a high-concentration capsaicin patch for 1 h. Transient heat, warm and cold stimuli designed to activate Aδ- and C-fiber thermonociceptors, C-fiber warm receptors, and Aδ-fiber cold receptors were applied to the skin before and after treatment at days 1, 3, and 7. Reaction times, intensity ratings, and quality descriptors were collected. The stimuli were applied both within the capsaicin-treated skin and around the capsaicin-treated skin to map the changes in thermal sensitivity. We found that topical capsaicin selectively impairs heat sensitivity without any concomitant changes in cold sensitivity. Most interestingly, we observed a differential effect on the sensitivity to thermal inputs conveyed by Aδ- and C-fibers. Reduced sensitivity to Aδ-fiber-mediated heat was restricted to the capsaicin-treated skin, whereas reduced sensitivity to C-fiber-mediated heat extended well beyond the treated skin. Moreover, the time course of the reduced sensitivity to C-fiber-mediated input was more prolonged than the reduced sensitivity to Aδ-fiber-mediated input.
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Affiliation(s)
| | - André Mouraux
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
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17
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Su Q, Song Y, Zhao R, Liang M. A review on the ongoing quest for a pain signature in the human brain. BRAIN SCIENCE ADVANCES 2020. [DOI: 10.26599/bsa.2019.9050024] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Developing an objective biomarker for pain assessment is crucial for understanding neural coding mechanisms of pain in the human brain as well as for effective treatment of pain disorders. Neuroimaging techniques have been proven to be powerful tools in the ongoing quest for a pain signature in the human brain. Although there is still a long way to go before achieving a truly successful pain signature based on neuroimaging techniques, important progresses have been made through great efforts in the last two decades by the Pain Society. Here, we focus on neural responses to transient painful stimuli in healthy people, and review the relevant studies on the identification of a neuroimaging signature for pain.
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Affiliation(s)
- Qian Su
- Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for China, Tianjin 300060, China
- These authors contributed equally to this work
| | - Yingchao Song
- School of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University, Tianjin 300070, China
- These authors contributed equally to this work
| | - Rui Zhao
- Department of Orthopedics Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Meng Liang
- School of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University, Tianjin 300070, China
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18
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de Tommaso M, Betti V, Bocci T, Bolognini N, Di Russo F, Fattapposta F, Ferri R, Invitto S, Koch G, Miniussi C, Piccione F, Ragazzoni A, Sartucci F, Rossi S, Arcara G, Berchicci M, Bianco V, Delussi M, Gentile E, Giovannelli F, Mannarelli D, Marino M, Mussini E, Pauletti C, Pellicciari MC, Pisoni A, Raggi A, Valeriani M. Pearls and pitfalls in brain functional analysis by event-related potentials: a narrative review by the Italian Psychophysiology and Cognitive Neuroscience Society on methodological limits and clinical reliability-part I. Neurol Sci 2020; 41:2711-2735. [PMID: 32388645 DOI: 10.1007/s10072-020-04420-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 04/13/2020] [Indexed: 12/14/2022]
Abstract
Event-related potentials (ERPs) are obtained from the electroencephalogram (EEG) or the magnetoencephalogram (MEG, event-related fields (ERF)), extracting the activity that is time-locked to an event. Despite the potential utility of ERP/ERF in cognitive domain, the clinical standardization of their use is presently undefined for most of procedures. The aim of the present review is to establish limits and reliability of ERP medical application, summarize main methodological issues, and present evidence of clinical application and future improvement. The present section of the review focuses on well-standardized ERP methods, including P300, Contingent Negative Variation (CNV), Mismatch Negativity (MMN), and N400, with a chapter dedicated to laser-evoked potentials (LEPs). One section is dedicated to proactive preparatory brain activity as the Bereitschaftspotential and the prefrontal negativity (BP and pN). The P300 and the MMN potentials have a limited but recognized role in the diagnosis of cognitive impairment and consciousness disorders. LEPs have a well-documented usefulness in the diagnosis of neuropathic pain, with low application in clinical assessment of psychophysiological basis of pain. The other ERP components mentioned here, though largely applied in normal and pathological cases and well standardized, are still confined to the research field. CNV, BP, and pN deserve to be largely tested in movement disorders, just to explain possible functional changes in motor preparation circuits subtending different clinical pictures and responses to treatments.
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Affiliation(s)
- Marina de Tommaso
- Applied Neurophysiology and Pain Unit-AnpLab-University of Bari Aldo Moro, Bari, Italy
| | - Viviana Betti
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,IRCCS Fondazione Santa Lucia (Santa Lucia Foundation), Rome, Italy
| | - Tommaso Bocci
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Nadia Bolognini
- Department of Psychology & NeuroMi, University of Milano Bicocca, Milan, Italy.,Laboratory of Neuropsychology, IRCCS Istituto Auxologico, Milan, Italy
| | - Francesco Di Russo
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | | | | | - Sara Invitto
- INSPIRE - Laboratory of Cognitive and Psychophysiological Olfactory Processes, University of Salento, Lecce, Italy
| | - Giacomo Koch
- IRCCS Fondazione Santa Lucia (Santa Lucia Foundation), Rome, Italy.,Department of Neuroscience, Policlinico Tor Vergata, Rome, Italy
| | - Carlo Miniussi
- Center for Mind/Brain Sciences - CIMeC, University of Trento, Rovereto, Italy.,Cognitive Neuroscience Section, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Francesco Piccione
- Brain Imaging and Neural Dynamics Research Group, IRCCS San Camillo Hospital, Venice, Italy
| | - Aldo Ragazzoni
- Unit of Neurology and Clinical Neurophysiology, Fondazione PAS, Scandicci, Florence, Italy
| | - Ferdinando Sartucci
- Section of Neurophysiopathology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.,CNR Institute of Neuroscience, Pisa, Italy
| | - Simone Rossi
- Department of Medicine, Surgery and Neuroscience Siena Brain Investigation and Neuromodulation Lab (SI-BIN Lab), University of Siena, Siena, Italy
| | - Giorgio Arcara
- Brain Imaging and Neural Dynamics Research Group, IRCCS San Camillo Hospital, Venice, Italy
| | - Marika Berchicci
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Valentina Bianco
- IRCCS Fondazione Santa Lucia (Santa Lucia Foundation), Rome, Italy.,Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Marianna Delussi
- Applied Neurophysiology and Pain Unit-AnpLab-University of Bari Aldo Moro, Bari, Italy
| | - Eleonora Gentile
- Applied Neurophysiology and Pain Unit-AnpLab-University of Bari Aldo Moro, Bari, Italy
| | - Fabio Giovannelli
- Section of Psychology - Department of Neuroscience, Psychology, Drug Research, Child Health, University of Florence, Florence, Italy
| | - Daniela Mannarelli
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Marco Marino
- Brain Imaging and Neural Dynamics Research Group, IRCCS San Camillo Hospital, Venice, Italy
| | - Elena Mussini
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Caterina Pauletti
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | | | - Alberto Pisoni
- Department of Psychology & NeuroMi, University of Milano Bicocca, Milan, Italy
| | - Alberto Raggi
- Unit of Neurology, G.B. Morgagni - L. Pierantoni Hospital, Forlì, Italy
| | - Massimiliano Valeriani
- Neurology Ward Unit, Bambino Gesù Hospital, Rome, Italy. .,Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark.
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19
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Efficacy of low-level laser therapy on management of Bell's palsy: a systematic review. Lasers Med Sci 2020; 35:1245-1252. [PMID: 32318918 DOI: 10.1007/s10103-020-02996-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 03/09/2020] [Indexed: 10/24/2022]
Abstract
The aim of this study is to evaluate the efficacy of low-level laser therapy (LLLT) in patients with Bell's palsy (BP) through a systematic review method. We systematically searched international databases including PubMed, Scopus, and Web of Science to find eligible articles without language limitation. All relevant randomized controlled trials (RCTs) that compared the efficacy of the LLLT with placebo laser, exercise, massage, or no intervention on BP patients were included. Four studies (out of 259) had met our inclusion criteria involving 171 patients and were entered to the systematic review. Full texts of the selected studies were retrieved and critically appraised using Physiotherapy Evidence Database (PEDro) scale. The patients of all trials were in sub-acute (less than 1 week) stage. Both of LLLT and control groups showed significant improvement after trials. Two authors reported significant differences between the groups after 6 weeks of laser application (830 nm, 100 mW). In converse, two other authors did not identify any effectiveness following 4 weeks and 15 days of LLLT application with 670 and 830 nm wavelength, sequentially. There is clear lack of information lead to get and evidence-based suggestion for the LLLT application on Bells' palsy; however, the LLLT irradiation with 830 nm and 100 mW power for a period of 6 weeks might be beneficial on recovery for the patients with sub-acute Bell's palsy. There were no reported adverse effects during treatment and/or follow-up sessions.
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20
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Di Stefano G, Di Lionardo A, La Cesa S, Di Pietro G, Fasolino A, Galosi E, Leone C, Cruccu G, Marinelli L, Leandri M, Truini A. The new micropatterned interdigitated electrode for selective assessment of the nociceptive system. Eur J Pain 2020; 24:956-966. [DOI: 10.1002/ejp.1545] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 01/20/2020] [Accepted: 02/11/2020] [Indexed: 11/08/2022]
Affiliation(s)
| | | | - Silvia La Cesa
- Department of Human Neuroscience Sapienza University Rome Italy
| | | | | | - Eleonora Galosi
- Department of Human Neuroscience Sapienza University Rome Italy
| | - Caterina Leone
- Department of Human Neuroscience Sapienza University Rome Italy
| | - Giorgio Cruccu
- Department of Human Neuroscience Sapienza University Rome Italy
| | - Lucio Marinelli
- Department of Neuroscience Genetics, Maternal and Child Health (DINOGMI) University of Genova Genova Italy
- Department of Neuroscience Ospedale Policlinico San Martino Genova Italy
| | - Massimo Leandri
- Department of Neuroscience Genetics, Maternal and Child Health (DINOGMI) University of Genova Genova Italy
| | - Andrea Truini
- Department of Human Neuroscience Sapienza University Rome Italy
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21
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Murtaza M, Chacko A, Delbaz A, Reshamwala R, Rayfield A, McMonagle B, St John JA, Ekberg JAK. Why are olfactory ensheathing cell tumors so rare? Cancer Cell Int 2019; 19:260. [PMID: 31632194 PMCID: PMC6788004 DOI: 10.1186/s12935-019-0989-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 10/01/2019] [Indexed: 01/08/2023] Open
Abstract
The glial cells of the primary olfactory nervous system, olfactory ensheathing cells (OECs), are unusual in that they rarely form tumors. Only 11 cases, all of which were benign, have been reported to date. In fact, the existence of OEC tumors has been debated as the tumors closely resemble schwannomas (Schwann cell tumors), and there is no definite method for distinguishing the two tumor types. OEC transplantation is a promising therapeutic approach for nervous system injuries, and the fact that OECs are not prone to tumorigenesis is therefore vital. However, why OECs are so resistant to neoplastic transformation remains unknown. The primary olfactory nervous system is a highly dynamic region which continuously undergoes regeneration and neurogenesis throughout life. OECs have key roles in this process, providing structural and neurotrophic support as well as phagocytosing the axonal debris resulting from turnover of neurons. The olfactory mucosa and underlying tissue is also frequently exposed to infectious agents, and OECs have key innate immune roles preventing microbes from invading the central nervous system. It is possible that the unique biological functions of OECs, as well as the dynamic nature of the primary olfactory nervous system, relate to the low incidence of OEC tumors. Here, we summarize the known case reports of OEC tumors, discuss the difficulties of correctly diagnosing them, and examine the possible reasons for their rare incidence. Understanding why OECs rarely form tumors may open avenues for new strategies to combat tumorigenesis in other regions of the nervous system.
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Affiliation(s)
- Mariyam Murtaza
- 1Griffith Institute for Drug Discovery, Griffith University, Brisbane, QLD 4111 Australia.,2Menzies Health Institute Queensland, Griffith University, Southport, QLD 4222 Australia.,3Clem Jones Centre for Neurobiology and Stem Cell Research, Griffith University, Nathan, 4111 Australia
| | - Anu Chacko
- 1Griffith Institute for Drug Discovery, Griffith University, Brisbane, QLD 4111 Australia.,2Menzies Health Institute Queensland, Griffith University, Southport, QLD 4222 Australia.,3Clem Jones Centre for Neurobiology and Stem Cell Research, Griffith University, Nathan, 4111 Australia
| | - Ali Delbaz
- 1Griffith Institute for Drug Discovery, Griffith University, Brisbane, QLD 4111 Australia.,2Menzies Health Institute Queensland, Griffith University, Southport, QLD 4222 Australia.,3Clem Jones Centre for Neurobiology and Stem Cell Research, Griffith University, Nathan, 4111 Australia
| | - Ronak Reshamwala
- 1Griffith Institute for Drug Discovery, Griffith University, Brisbane, QLD 4111 Australia.,2Menzies Health Institute Queensland, Griffith University, Southport, QLD 4222 Australia.,3Clem Jones Centre for Neurobiology and Stem Cell Research, Griffith University, Nathan, 4111 Australia
| | - Andrew Rayfield
- 1Griffith Institute for Drug Discovery, Griffith University, Brisbane, QLD 4111 Australia.,2Menzies Health Institute Queensland, Griffith University, Southport, QLD 4222 Australia.,3Clem Jones Centre for Neurobiology and Stem Cell Research, Griffith University, Nathan, 4111 Australia
| | - Brent McMonagle
- 4Department of Otolaryngology-Head and Neck Surgery, Gold Coast University Hospital, 1 Hospital Boulevard, Southport, QLD 4215 Australia
| | - James A St John
- 1Griffith Institute for Drug Discovery, Griffith University, Brisbane, QLD 4111 Australia.,2Menzies Health Institute Queensland, Griffith University, Southport, QLD 4222 Australia.,3Clem Jones Centre for Neurobiology and Stem Cell Research, Griffith University, Nathan, 4111 Australia
| | - Jenny A K Ekberg
- 1Griffith Institute for Drug Discovery, Griffith University, Brisbane, QLD 4111 Australia.,2Menzies Health Institute Queensland, Griffith University, Southport, QLD 4222 Australia.,3Clem Jones Centre for Neurobiology and Stem Cell Research, Griffith University, Nathan, 4111 Australia
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22
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Engskov AS, Rubin AT, Åkeson J. Single and double pain responses to individually titrated ultra-short laser stimulation in humans. BMC Anesthesiol 2019; 19:29. [PMID: 30832563 PMCID: PMC6399816 DOI: 10.1186/s12871-019-0702-1] [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: 11/22/2018] [Accepted: 02/21/2019] [Indexed: 11/10/2022] Open
Abstract
Background This preclinical study in humans was designed to selectively induce delayed nociceptive pain responses to individually titrated laser stimulation, enabling separate bedside intensity scoring of both immediate and delayed pain. Methods Forty-four (fourteen female) healthy volunteers were subjected to repeated nociceptive dermal stimulation in the plantar arc, based on ultra-short carbon dioxide laser with individually titrated energy levels associated with mild pain. Results Data was analysed in 42 (12 female) subjects, and 29 of them (11 females) consistently reported immediate and delayed pain responses at second-long intervals to each nociceptive stimulus. All single pain responses were delayed and associated with lower levels (p = 0.003) of laser energy density (median 61; IQR 54–71 mJ/mm2), compared with double pain responses (88; 64–110 mJ/mm2). Pain intensity levels associated with either kind of response were readily assessable at bedside. Conclusions This study is the first one to show in humans that individually titrated ultra-short pulses of laser stimulation, enabling separate pain intensity scoring of immediate and delayed responses at bedside, can be used to selectively induce and evaluate delayed nociceptive pain, most likely reflecting C-fibre-mediated transmission. These findings might facilitate future research on perception and management of C-fibre-mediated pain in humans.
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Affiliation(s)
- Anna Sellgren Engskov
- Department of Clinical Sciences Malmö, Anaesthesiology and Intensive Care Medicine, Lund University, Skåne University Hospital, Carl Bertil Laurells gata 9, 3rd floor, SE-20502, Malmö, Sweden.
| | | | - Jonas Åkeson
- Department of Clinical Sciences Malmö, Anaesthesiology and Intensive Care Medicine, Lund University, Skåne University Hospital, Carl Bertil Laurells gata 9, 3rd floor, SE-20502, Malmö, Sweden
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Abstract
Clinical neurophysiologic investigation of pain pathways in humans is based on specific techniques and approaches, since conventional methods of nerve conduction studies and somatosensory evoked potentials do not explore these pathways. The proposed techniques use various types of painful stimuli (thermal, laser, mechanical, or electrical) and various types of assessments (measurement of sensory thresholds, study of nerve fiber excitability, or recording of electromyographic reflexes or cortical potentials). The two main tests used in clinical practice are quantitative sensory testing and pain-related evoked potentials (PREPs). In particular, PREPs offer the possibility of an objective assessment of nociceptive pathways. Three types of PREPs can be distinguished depending on the type of stimulation used to evoke pain: laser-evoked potentials, contact heat evoked potentials, and intraepidermal electrical stimulation evoked potentials (IEEPs). These three techniques investigate both small-diameter peripheral nociceptive afferents (mainly Aδ nerve fibers) and spinothalamic tracts without theoretically being able to differentiate the level of lesion in the case of abnormal results. In routine clinical practice, PREP recording is a reliable method of investigation for objectifying the existence of a peripheral or central lesion or loss of function concerning the nociceptive pathways, but not the existence of pain. Other methods, such as nerve fiber excitability studies using microneurography, more directly reflect the activities of nociceptive axons in response to provoked pain, but without detecting or quantifying the presence of spontaneous pain. These methods are more often used in research or experimental study design. Thus, it should be kept in mind that most of the results of neurophysiologic investigation performed in clinical practice assess small fiber or spinothalamic tract lesions rather than the neuronal mechanisms directly at the origin of pain and they do not provide objective quantification of pain.
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Affiliation(s)
- Jean-Pascal Lefaucheur
- Excitabilité Nerveuse et Thérapeutique, Faculté de Médecine de Créteil, Université Paris-Est-Créteil, Hôpital Henri Mondor, Créteil, France; Service de Physiologie-Explorations Fonctionnelles, Hôpital Henri Mondor, Créteil, France.
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24
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Pazzaglia C, Vollono C, Testani E, Coraci D, Granata G, Padua L, Valeriani M. Low-Frequency rTMS of the Primary Motor Area Does Not Modify the Response of the Cerebral Cortex to Phasic Nociceptive Stimuli. Front Neurosci 2018; 12:878. [PMID: 30555294 PMCID: PMC6281959 DOI: 10.3389/fnins.2018.00878] [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: 09/03/2018] [Accepted: 11/12/2018] [Indexed: 01/12/2023] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive technique of cortical stimulation. Although the exact mechanism of action is not clearly understood, it has been postulated that rTMS action on pain depends most on stimulation sites and stimulation parameters. Most studies concern high-frequency rTMS of the primary motor cortex (M1). High-frequency rTMS over motor cortex seems to induce an analgesic effect while contrasting results were reported after low-frequency rTMS. The aim of the current study was to investigate the effects of 1 Hz rTMS stimulation over the left primary motor cortex on subjective laser pain rating and laser evoked potential (LEP) amplitudes in healthy subjects. Subjects underwent two different sessions (real and sham rTMS) according to a cross-sectional design. In each session, LEPs and laser-pain rating to stimulation of both right and left hand dorsum were collected before 1 Hz rTMS over the left M1 area (baseline), which lasted 20 min. Then, LEPs and laser-pain rating were measured immediately after rTMS (T0), after 20 min from T0 (T0+20), and after 40 min from T0 (T0+40). We could not find any modification of both laser-pain rating and LEP parameters (latencies and amplitudes) following 1 Hz rTMS. Therefore, our results show that the low-frequency rTMS of the M1 area does not change the response of the cerebral cortex to pain.
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Affiliation(s)
- Costanza Pazzaglia
- Unit of High Intensity Neurorehabilitation, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Catello Vollono
- Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Elisa Testani
- Department of Neurological and Neurosensory Sciences, University Hospital of Siena, Siena, Italy
| | | | - Giuseppe Granata
- Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Luca Padua
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.,Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - Massimiliano Valeriani
- Department of Neuroscience, Pediatric Hospital Bambino Gesù, Rome, Italy.,Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark
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Need for Thorough Standardization of CO2 Laser Evoked Potential Procedure. J Clin Neurophysiol 2018; 35:485-489. [DOI: 10.1097/wnp.0000000000000502] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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An K, Lim S, Lee HJ, Kwon H, Kim M, Gohel B, Kim J, Kim K. Magnetoencephalographic study of event-related fields and cortical oscillatory changes during cutaneous warmth processing. Hum Brain Mapp 2018; 39:1972-1981. [PMID: 29363226 PMCID: PMC5947665 DOI: 10.1002/hbm.23977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Revised: 01/09/2018] [Accepted: 01/09/2018] [Indexed: 01/13/2023] Open
Abstract
Thermoreception is an important cutaneous sense, which plays a role in the maintenance of our body temperature and in the detection of potential noxious heat stimulation. In this study, we investigated event‐related fields (ERFs) and neural oscillatory activities, which were modulated by warmth stimulation. We developed a warmth stimulator that could elicit a warmth sensation, without pain or tactile sensation, by using a deep‐penetrating 980‐nm diode laser. The index finger of each participant (n = 24) was irradiated with the laser warmth stimulus, and the cortical responses were measured using magnetoencephalography (MEG). The ERFs and oscillatory responses had late latencies (∼1.3 s and 1.0–1.5 s for ERFs and oscillatory responses, respectively), which could be explained by a slow conduction velocity of warmth‐specific C‐fibers. Cortical sources of warmth‐related ERFs were seen in the bilateral primary and secondary somatosensory cortices (SI and SII), posterior part of the anterior cingulate cortex (pACC), ipsilateral primary motor, and premotor cortex. Thus, we suggested that SI, SII, and pACC play a role in processing the warmth sensation. Time–frequency analysis demonstrated the suppression of the alpha (8–13 Hz) and beta (18–23 Hz) band power in the bilateral sensorimotor cortex. We proposed that the suppressions in alpha and beta band power are involved in the automatic response to the input of warmth stimulation and sensorimotor interactions. The delta band power (1–4 Hz) increased in the frontal, temporal, and cingulate cortices. The power changes in delta band might be related with the attentional processes during the warmth stimulation.
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Affiliation(s)
- Kyung‐min An
- Center for Biosignals, Korea Research Institute of Standards and Science (KRISS)DaejeonRepublic of Korea
| | - Sanghyun Lim
- Center for Biosignals, Korea Research Institute of Standards and Science (KRISS)DaejeonRepublic of Korea
- Department of Medical PhysicsUniversity of Science and Technology (UST)DaejeonRepublic of Korea
| | - Hyun Joon Lee
- Center for Biosignals, Korea Research Institute of Standards and Science (KRISS)DaejeonRepublic of Korea
- Department of PhysicsPusan National UniversityBusanRepublic of Korea
| | - Hyukchan Kwon
- Center for Biosignals, Korea Research Institute of Standards and Science (KRISS)DaejeonRepublic of Korea
| | - Min‐Young Kim
- Center for Biosignals, Korea Research Institute of Standards and Science (KRISS)DaejeonRepublic of Korea
| | - Bakul Gohel
- Center for Biosignals, Korea Research Institute of Standards and Science (KRISS)DaejeonRepublic of Korea
| | - Ji‐Eun Kim
- Center for Biosignals, Korea Research Institute of Standards and Science (KRISS)DaejeonRepublic of Korea
- Department of Medical PhysicsUniversity of Science and Technology (UST)DaejeonRepublic of Korea
| | - Kiwoong Kim
- Center for Biosignals, Korea Research Institute of Standards and Science (KRISS)DaejeonRepublic of Korea
- Department of Medical PhysicsUniversity of Science and Technology (UST)DaejeonRepublic of Korea
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Xu G, Zhou C, Liu S, Li W, Tang W. Electrophysiological characteristics of the frontal nerve in patients with herpetic ophthalmic neuralgia. Muscle Nerve 2018; 57:973-980. [PMID: 29314073 DOI: 10.1002/mus.26057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2017] [Indexed: 11/06/2022]
Abstract
INTRODUCTION The aim of this study was to explore a method for obtaining sensory nerve action potentials (SNAPs) of the supratrochlear (STN) and supraorbital (SON) nerves and evaluate the function of affected nerves in patients with herpetic ophthalmic neuralgia (HON). METHODS Thirty healthy volunteers and 40 subjects with subacute HON participated in this study. RESULTS The amplitudes and sensory conduction velocities (SCVs) that predicted HON were identified. The corresponding cutoff values for the amplitudes ranged from 11.10 μV to 12.45 μV. The corresponding cutoff values for the SCVs ranged from 43.14 m/s to 44.64 m/s. SCVs were markedly lower on the affected side compared with healthy volunteers (P < 0.05), and the amplitudes of SNAPs on the affected side were decreased by 36% compared with healthy volunteers (P < 0.05). DISCUSSION SCVs of STN and SONs can be obtained with the 3-channel method and used to evaluate myelinated fibers in patients with HON. Muscle Nerve 57: 973-980, 2018.
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Affiliation(s)
- Gang Xu
- Department of Rehabilitation Medicine, Affiliated Tenth People's Hospital of Tongji University, Shanghai Tenth People's Hospital, 301 Middle Yanchang Road Shanghai, 200072, China
| | - Chaosheng Zhou
- Department of Rehabilitation Medicine, Affiliated Tenth People's Hospital of Tongji University, Shanghai Tenth People's Hospital, 301 Middle Yanchang Road Shanghai, 200072, China
| | - Shasha Liu
- Department of Rehabilitation Medicine, Affiliated Tenth People's Hospital of Tongji University, Shanghai Tenth People's Hospital, 301 Middle Yanchang Road Shanghai, 200072, China
| | - Wen Li
- Department of Rehabilitation Medicine, Affiliated Tenth People's Hospital of Tongji University, Shanghai Tenth People's Hospital, 301 Middle Yanchang Road Shanghai, 200072, China
| | - Weizhen Tang
- Department of Rehabilitation Medicine, Affiliated Tenth People's Hospital of Tongji University, Shanghai Tenth People's Hospital, 301 Middle Yanchang Road Shanghai, 200072, China
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Valentini E, Nicolardi V, Aglioti SM. Visual reminders of death enhance nociceptive-related cortical responses and event-related alpha desynchronisation. Biol Psychol 2017; 129:121-130. [PMID: 28859860 DOI: 10.1016/j.biopsycho.2017.08.055] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 08/18/2017] [Accepted: 08/27/2017] [Indexed: 11/18/2022]
Abstract
Previous research suggests that prompting individuals to think on their own mortality affects their perception of painful somatic stimuli and related brain activity. Grounded on the assumption that reminders of mortality may recruit threat-defence mechanisms similar to the ones activated by painful nociceptive stimuli, we hypothesize that the effects exerted by linguistic reminders of death on pain perception and brain activity would be elicited by passive observation of death-related pictures vs. more generic threat-related pictures. Results showed an increase of the laser evoked P2 amplitude and oscillatory theta activity when participants observed death-related images. However, no change in pain ratings was found. Moreover, observation of death-related content was linked to increased oscillatory alpha desynchronisation but not to variations of visual evoked potentials amplitude. Our findings indicate that pairing potentially noxious stimuli with death-related images exerts a preferential modulation of nociceptive and visual cortical representations.
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Affiliation(s)
- Elia Valentini
- Department of Psychology and Centre for Brain Science, University of Essex, England, UK; Sapienza Università di Roma, Dipartimento di Psicologia, Italy; Fondazione Santa Lucia, Istituto di Ricovero e Cura a Carattere Scientifico, Italy.
| | - Valentina Nicolardi
- Sapienza Università di Roma, Dipartimento di Psicologia, Italy; Fondazione Santa Lucia, Istituto di Ricovero e Cura a Carattere Scientifico, Italy
| | - Salvatore Maria Aglioti
- Sapienza Università di Roma, Dipartimento di Psicologia, Italy; Fondazione Santa Lucia, Istituto di Ricovero e Cura a Carattere Scientifico, Italy
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Valentini E, Nicolardi V, Aglioti SM. Painful engrams: Oscillatory correlates of working memory for phasic nociceptive laser stimuli. Brain Cogn 2017; 115:21-32. [PMID: 28390217 DOI: 10.1016/j.bandc.2017.03.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 01/28/2017] [Accepted: 03/23/2017] [Indexed: 11/15/2022]
Abstract
Research suggests that working memory (WM) is impaired in chronic pain. Yet, information on how potentially noxious stimuli are maintained in memory is limited in patients as well as in healthy people. We recorded electroencephalography (EEG) in healthy volunteers during a modified delayed match-to-sample task where maintenance in memory of relevant attributes of nociceptive laser stimuli was essential for subsequent cued-discrimination. Participants performed in high and low load conditions (i.e. three vs. two stimuli to keep in WM). Modulation of EEG oscillations in the beta band during the retention interval and in the alpha band during the pre-retention interval reflected performance in the WM task. Importantly, both a non-verbal and a verbal neuropsychological WM test predicted oscillatory modulations. Moreover, these two neuropsychological tests and self-reported personality measures predicted the performance in the nociceptive WM task. Results demonstrate (i) that beta and alpha EEG oscillations can represent WM for nociceptive stimuli; (ii) the association between neuropsychological measures of WM and the brain representation of phasic nociceptive painful stimuli; and (iii) that personality factors can predict memory for nociceptive stimuli at the behavioural level. Altogether, our findings offer a promising approach for investigating cortical correlates of nociceptive memory in clinical pain conditions.
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Affiliation(s)
- Elia Valentini
- Department of Psychology and Centre for Brain Science, University of Essex, England, UK; Sapienza Università di Roma, Dipartimento di Psicologia, Italy; Fondazione Santa Lucia, Istituto di Ricovero e Cura a Carattere Scientifico, Italy.
| | - Valentina Nicolardi
- Department of Psychology and Centre for Brain Science, University of Essex, England, UK; Sapienza Università di Roma, Dipartimento di Psicologia, Italy
| | - Salvatore Maria Aglioti
- Department of Psychology and Centre for Brain Science, University of Essex, England, UK; Sapienza Università di Roma, Dipartimento di Psicologia, Italy
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31
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Orenius TI, Raij TT, Nuortimo A, Näätänen P, Lipsanen J, Karlsson H. The interaction of emotion and pain in the insula and secondary somatosensory cortex. Neuroscience 2017; 349:185-194. [PMID: 28259800 DOI: 10.1016/j.neuroscience.2017.02.047] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 02/21/2017] [Indexed: 11/24/2022]
Abstract
Pain is processed in a large neural network that partially overlaps structures involved in emotion processing. Despite the fact that pain and emotion are known to share neural regions and interact in numerous clinical conditions, relatively little is known about the interaction of pain and emotion at the neural level. This study on healthy adults aimed to investigate the interaction between negative and positive emotional stimuli and experimental pain in an essential pain processing network. Sixteen healthy young adult subjects were exposed to pictures from the International Affective Picture System (IAPS) with negative, neutral or positive valence, along with laser pain stimuli. The stimuli were pseudo-randomly arranged in three 15-min experiment series comprising 49 stimuli each (picture, laser or simultaneous picture and laser stimuli). The whole-brain blood-oxygen-level-dependent (BOLD) signal was acquired using 3T functional magnetic resonance imaging (fMRI). As expected, the pain stimulus elicited activation in the secondary somatosensory cortex (SII), insula and anterior cingulate cortex (ACC) when compared to the baseline. The interaction of negative emotion and laser stimuli related to the activation of the left SII. The interaction of positive emotion and pain stimuli led to bilateral activation of the SII and left insula. These findings reveal interaction in parts of the pain processing network during simultaneous emotion and physical pain. We demonstrated a valence-independent interaction of emotion and pain in SII.
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Affiliation(s)
- Tage I Orenius
- ORTON Orthopaedic Hospital Ltd., ORTON Foundation, Helsinki, Finland.
| | - Tuukka T Raij
- Department of Psychiatry, Helsinki University Hospital, Finland; Department of Neuroscience and Biomedical Engineering and Advanced Magnetic Imaging Centre, Aalto Neuroimaging, Aalto University School of Science, Espoo, Finland.
| | - Antti Nuortimo
- Institute of Behavioural Sciences, University of Helsinki, Finland.
| | | | - Jari Lipsanen
- Institute of Behavioural Sciences, University of Helsinki, Finland.
| | - Hasse Karlsson
- Department of Psychiatry and Turku Brain and Mind Centre, University of Turku and Turku University Hospital, Finland.
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Peng WW, Guo XL, Jin QQ, Wei H, Xia XL, Zhang Y, Huang PC, Wang WC, Li SL, Wang JS, Chen J, Hu L. Biological mechanism of post-herpetic neuralgia: Evidence from multiple patho-psychophysiological measures. Eur J Pain 2016; 21:827-842. [PMID: 27977069 DOI: 10.1002/ejp.985] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND Post-herpetic neuralgia (PHN), which develops after the resolution of a herpes zoster eruption, is an exceptionally drug-resistant neuropathic pain. The unsatisfactory management of PHN partly results from the difficulty in dissecting out its contributing factors due to the complexity of PHN mechanism. METHODS Here, to elaborate our understanding of the PHN mechanism and to establish a basis for effective therapeutic strategies, we comprehensively investigated the contributions of multiple factors to PHN severity. RESULTS Based on the comparison of somatosensory detection thresholds (C, Aδ and Aβ fibre thresholds) between affected and unaffected sides, 16 PHN patients with significant sensory deficits and 13 PHN patients without significant sensory deficits were identified and assigned to different groups. The different extents of lesions in the nociceptive system between patients with and without sensory deficits were confirmed using laser-evoked brain responses. Moreover, patients with sensory deficits had more severe pain and psychological disorders, e.g. anxiety and depression. Importantly, chronic pain severity was significantly influenced by various psychophysiological factors (sleep disturbances, psychological disorders and hypothalamic-pituitary-adrenal axis dysfunction) for patients with sensory deficits. CONCLUSIONS Our findings demonstrated the contribution of multiple patho-psychophysiological factors to PHN severity, which could help establish a basis for the development of a rational, patient-centred therapeutic strategy. SIGNIFICANCE This study revealed the contribution of multiple patho-psychophysiological factors to PHN severity, which expanded our understanding of the underlying PHN mechanism, and helped develop a rational, patient-centred therapeutic strategy targeting towards the corresponding etiology and psychophysiological disorders for individual patient.
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Affiliation(s)
- W W Peng
- Brain Function and Psychological Science Research Center, Shenzhen University, Shenzhen, China
| | - X L Guo
- Department of Pain Medicine, Daping Hospital & Research Institute of Surgery, The Third Military Medical University, Chongqing, China
| | - Q Q Jin
- Key Laboratory of Cognition and Personality (Ministry of Education) and School of Psychology, Southwest University, Chongqing, China
| | - H Wei
- Key Laboratory of Cognition and Personality (Ministry of Education) and School of Psychology, Southwest University, Chongqing, China
| | - X L Xia
- Key Laboratory of Cognition and Personality (Ministry of Education) and School of Psychology, Southwest University, Chongqing, China
| | - Y Zhang
- Key Laboratory of Cognition and Personality (Ministry of Education) and School of Psychology, Southwest University, Chongqing, China
| | - P C Huang
- Department of Pain Medicine, Daping Hospital & Research Institute of Surgery, The Third Military Medical University, Chongqing, China
| | - W C Wang
- Department of Pain Medicine, Daping Hospital & Research Institute of Surgery, The Third Military Medical University, Chongqing, China
| | - S L Li
- Department of Pain Medicine, Daping Hospital & Research Institute of Surgery, The Third Military Medical University, Chongqing, China
| | - J S Wang
- Department of Pain Medicine, Guangzhou Red Cross Hospital of Jinan University, Guangzhou, China
| | - J Chen
- Institute for Biomedical Sciences of Pain, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - L Hu
- Key Laboratory of Cognition and Personality (Ministry of Education) and School of Psychology, Southwest University, Chongqing, China.,CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
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Cutaneous silent period evoked in human first dorsal interosseous muscle motor units by laser stimulation. J Electromyogr Kinesiol 2016; 31:104-110. [DOI: 10.1016/j.jelekin.2016.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Revised: 09/28/2016] [Accepted: 10/10/2016] [Indexed: 11/27/2022] Open
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González-Roldán AM, Bomba IC, Diesch E, Montoya P, Flor H, Kamping S. Controllability and hippocampal activation during pain expectation in fibromyalgia syndrome. Biol Psychol 2016; 121:39-48. [PMID: 27678310 DOI: 10.1016/j.biopsycho.2016.09.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 08/23/2016] [Accepted: 09/23/2016] [Indexed: 10/20/2022]
Abstract
To examine the role of perceived control in pain perception, fibromyalgia patients and healthy controls participated in a reaction time experiment under different conditions of pain controllability. No significant differences between groups were found in pain intensity and unpleasantness ratings. However, during the expectation of uncontrollable pain, patients compared to controls showed higher hippocampal activation. In addition, hippocampal activity during the pain expectation period predicted activation of the posterior cingulate cortex (PCC), precuneus and hippocampus during pain stimulation in fibromyalgia patients. The increased activation of the hippocampus during pain expectation and subsequent activation of the PCC/precuneus during the lack of control phase points towards an influence of pain perception through heightening of alertness and anxiety responses to pain in fibromyalgia patients.
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Affiliation(s)
- Ana María González-Roldán
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany; Research Institute on Health Sciences (IUNICS), University of Balearic Islands, 07122 Palma, Spain
| | - Isabelle C Bomba
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany
| | - Eugen Diesch
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany
| | - Pedro Montoya
- Research Institute on Health Sciences (IUNICS), University of Balearic Islands, 07122 Palma, Spain
| | - Herta Flor
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany.
| | - Sandra Kamping
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany; Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Section Pain Medicine and Pain Psychology, 20246 Hamburg, Germany
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Abstract
Natural selection has shaped the physiological properties of sensory systems across species, yielding large variations in their sensitivity. Here, we used laser stimulation of skin nociceptors, a widely used technique to investigate pain in rats and humans, to provide a vivid example of how ignoring these variations can lead to serious misconceptions in sensory neuroscience. In 6 experiments, we characterized and compared the physiological properties of the electrocortical responses elicited by laser stimulation in rats and humans. We recorded the electroencephalogram from the surface of the brain in freely moving rats and from the scalp in healthy humans. Laser stimuli elicited 2 temporally distinct responses, traditionally interpreted as reflecting the concomitant activation of different populations of nociceptors with different conduction velocities: small-myelinated Aδ-fibres and unmyelinated C-fibres. Our results show that this interpretation is valid in humans, but not in rats. Indeed, the early response recorded in rats does not reflect the activation of the somatosensory system, but of the auditory system by laser-generated ultrasounds. These results have wide implications: retrospectively, as they prompt for a reconsideration of a large number of previous interpretations of electrocortical rat recordings in basic, preclinical, and pharmacological research, and prospectively, as they will allow recording truly pain-related cortical responses in rats.
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Pazzaglia C, Testani E, Giordano R, Padua L, Valeriani M. Expectation to feel more pain disrupts the habituation of laser-pain rating and laser-evoked potential amplitudes. Neuroscience 2016; 333:244-51. [PMID: 27461877 DOI: 10.1016/j.neuroscience.2016.07.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 07/16/2016] [Accepted: 07/18/2016] [Indexed: 11/28/2022]
Abstract
Increased pain perception due to the expectation to feel more pain is called nocebo effect. The present study aimed at investigating whether: (1) the mere expectation to feel more pain after the administration of an inert drug can affect the laser-pain rating and the laser-evoked potential (LEP) amplitude, and (2) the learning potentiates the nocebo effect. Eighteen healthy volunteers were told that an inert cream, applied on the right hand, would increase the laser pain and LEP amplitude to right hand stimulation. They were randomly assigned to either "verbal session" or "conditioning session". In the "verbal session", LEPs to both right and left hand stimulation were recorded at the same intensity before (baseline) and after cream application. In the "conditioning session", after an initial cream application the laser stimulus intensity was increased surreptitiously to make the subjects believe that the treatment really increased the pain sensation. Then, the cream was reapplied, and LEPs were recorded at the same stimulus intensity as at the baseline. It was found that the verbal suggestion to feel more pain disrupted the physiological habituation of the laser-pain rating and LEP amplitude to treated (right) hand stimulation. Unlike previously demonstrated for the placebo effect, the learning did not potentiate the nocebo effect.
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Affiliation(s)
- Costanza Pazzaglia
- Department of Neurology, Don Carlo Gnocchi Onlus Foundation, Via Alfonso Capecelatro, 66, 20148 Milan, Italy.
| | - Elisa Testani
- Institute of Neurology, Catholic University of the Sacred Heart, Largo Francesco Vito, 1, 00168 Rome, Italy.
| | - Rocco Giordano
- Institute of Neurology, Catholic University of the Sacred Heart, Largo Francesco Vito, 1, 00168 Rome, Italy.
| | - Luca Padua
- Department of Neurology, Don Carlo Gnocchi Onlus Foundation, Via Alfonso Capecelatro, 66, 20148 Milan, Italy; Institute of Neurology, Catholic University of the Sacred Heart, Largo Francesco Vito, 1, 00168 Rome, Italy.
| | - Massimiliano Valeriani
- Department of Neuroscience, Pediatric Hospital Bambino Gesù, Piazza Sant'Onofrio, 4, 00146 Rome, Italy; Center for Sensory-Motor Interaction, Aalborg University, Fredrik Bajers Vej 5, 9100 Aalborg, Denmark.
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Quattrini C, Jeziorska M, Malik RA. Small Fiber Neuropathy in Diabetes: Clinical Consequence and Assessment. INT J LOW EXTR WOUND 2016; 3:16-21. [PMID: 15866784 DOI: 10.1177/1534734603262483] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Recent findings have shed new light on the role of peripheral nerves in the skin and have established a modern concept of cutaneous neurobiology. There is bidirectional rather than unidirectional (conveying information from the periphery) signaling between central and peripheral nerves and the endocrine and immune systems. This interaction is mediated principally by cutaneous small nerve fibers and will influence a variety of physiologic and pathophysiologic functions central to wound healing, which include cellular development, growth, differentiation, immunity, vasoregulation, and leukocyte recruitment. Thus, disease of the small fibers in diabetic patients is frequent and may have a considerable impact on the predisposition and subsequent wound-healing response to foot ulceration. The authors review the basic pathophysiology, clinical consequences, and current methods to evaluate somatic and autonomic nerve fiber dysfunction and damage.
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Affiliation(s)
- C Quattrini
- Department of Medicine, Manchester Royal Infirmary, UK
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Abstract
Craniofacial nociceptive processing in patients ( n = 25) suffering from unilateral cluster headache was assessed by laser-evoked cortical potentials (LEPs). Latencies and amplitudes of late (N2, P2) and middle-latency (N1) LEPs were measured in chronic (CCH, n = 9) and episodic cluster headache (ECH, n = 17). In CCH patients on headache side N1c occurred later and P2 amplitude was smaller than on the healthy control side. In active periods of ECH patients P2 latency was shorter on the headache side. In remission periods of ECH patients the N2P2 ratio was lower on the headache side. In 19 out of 26 examinations in 25 headache patients LEP deviated from normative data in healthy controls ( n = 10) without any specific pattern of altered parameters. LEPs document pathological changes in craniofacial nociception in cluster headache. However, there seems to be no pathognomonic deviation pattern that enables reliable diagnosis of cluster headache and application of LEPs in further studies of pathophysiological mechanisms.
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Affiliation(s)
- J Ellrich
- Department of Neurosurgery, Experimental Neurosurgery Section, RWTH Aachen University, Aachen, Germany.
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Azevedo E, Silva A, Martins R, Andersen ML, Tufik S, Manzano GM. Activation of C-fiber nociceptors by low-power diode laser. ARQUIVOS DE NEURO-PSIQUIATRIA 2016; 74:223-7. [DOI: 10.1590/0004-282x20160018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 10/28/2015] [Indexed: 11/21/2022]
Abstract
ABSTRACT Objective The evaluation of selective activation of C-fibers to record evoked potentials using the association of low-power diode laser (810 nm), tiny-area stimulation and skin-blackening. Method Laser-evoked potentials (LEPs) were obtained from 20 healthy young subjects. An aluminum plate with one thin hole was attached to the laser probe to provide tiny-area stimulation of the hand dorsum and the stimulated area was covered with black ink. Results The mean intensity used for eliciting the ultra-late laser-evoked potential (ULEP) was 70 ± 32 mW. All subjects showed a clear biphasic potential that comprised a negative peak (806 ± 61 ms) and a positive deflection (1033 ± 60 ms), corresponding to the ULEP related to C-fiber activation. Conclusion C-fiber-evoked responses can be obtained using a very low-power diode laser when stimulation is applied to tiny areas of darkened skin. This strategy offers a non-invasive and easy methodology that minimizes damage to the tissue.
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Pazzaglia C, Camerota F, Celletti C, Minciotti I, Testani E, Padua L, Valeriani M. Focal Mechanical Vibration Does not Change Laser-Pain Perception and Laser-Evoked Potentials: A Pilot Study. Pain Pract 2016; 17:25-31. [PMID: 26892176 DOI: 10.1111/papr.12417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 10/13/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Nonpainful tactile and electrical stimulation of the large myelinated fibers reduces spontaneous pain and the amplitude of laser-evoked potentials (LEPs), which represent the most reliable technique to assess the nociceptive pathway function. Focal mechanical vibration stimulates the Aβ afferents selectively; thus, it is conceivable its action on nociceptive pathways. AIM The aim of this study was to investigate the effect of vibratory stimuli, activating either both muscle and skin receptors or cutaneous afferents only on the LEPs and subjective laser-pain rating. METHODS Ten healthy volunteers were studied. The subjects were evaluated in two different sessions to test muscle and skin receptors or cutaneous afferents only. In each session, LEPs were recorded to stimulation of the dorsal hand skin in radial and ulnar territory bilaterally, while the vibratory stimulus was delivered on the radial territory of the right forearm. RESULTS The results showed a substantial stability of the potential N1 and N2/P2 after the two protocols, with a declining trend from the initial to the last test of the same session, probably due to habituation. Accordingly, the laser-pain perception did not change during the experimental setting. CONCLUSIONS We conclude that a vibratory stimulus is ineffective in reducing the laser-evoked potentials and laser-pain perception.
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Affiliation(s)
- Costanza Pazzaglia
- Department of Neurorehabilitation, Don Carlo Gnocchi Onlus Foundation, Milan, Italy
| | - Filippo Camerota
- Physical Medicine and Rehabilitation Division, Umberto I Hospital, Sapienza University, Rome, Italy
| | - Claudia Celletti
- Physical Medicine and Rehabilitation Division, Umberto I Hospital, Sapienza University, Rome, Italy
| | - Ileana Minciotti
- Department of Geriatric, Neuroscience and Orthopaedic, Catholic University of the Sacred Heart, Rome, Italy
| | - Elisa Testani
- Department of Geriatric, Neuroscience and Orthopaedic, Catholic University of the Sacred Heart, Rome, Italy
| | - Luca Padua
- Department of Neurorehabilitation, Don Carlo Gnocchi Onlus Foundation, Milan, Italy.,Department of Geriatric, Neuroscience and Orthopaedic, Catholic University of the Sacred Heart, Rome, Italy
| | - Massimiliano Valeriani
- Department of Neurology, Pediatric Hospital Bambino Gesù, Rome, Italy.,Center for Sensory-motor Interaction, Aalborg University, Aalborg, Denmark
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Madden VJ, Catley MJ, Grabherr L, Mazzola F, Shohag M, Moseley GL. The effect of repeated laser stimuli to ink-marked skin on skin temperature-recommendations for a safe experimental protocol in humans. PeerJ 2016; 4:e1577. [PMID: 26793428 PMCID: PMC4715456 DOI: 10.7717/peerj.1577] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 12/16/2015] [Indexed: 11/20/2022] Open
Abstract
Background. Nd:YAP laser is widely used to investigate the nociceptive and pain systems, generating perpetual and laser-evoked neurophysiological responses. A major procedural concern for the use of Nd:YAP laser stimuli in experimental research is the risk of skin damage. The absorption of Nd:YAP laser stimuli is greater in darker skin, or in pale skin that has been darkened with ink, prompting some ethics boards to refuse approval to experimenters wishing to track stimulus location by marking the skin with ink. Some research questions, however, require laser stimuli to be delivered at particular locations or within particular zones, a requirement that is very difficult to achieve if marking the skin is not possible. We thoroughly searched the literature for experimental evidence and protocol recommendations for safe delivery of Nd:YAP laser stimuli over marked skin, but found nothing. Methods. We designed an experimental protocol to define safe parameters for the use of Nd:YAP laser stimuli over skin that has been marked with black dots, and used thermal imaging to assess the safety of the procedure at the forearm and the back. Results. Using thermal imaging and repeated laser stimulation to ink-marked skin, we demonstrated that skin temperature did not increase progressively across the course of the experiment, and that the small change in temperature seen at the forearm was reversed during the rest periods between blocks. Furthermore, no participant experienced skin damage due to the procedure. Conclusion. This protocol offers parameters for safe, confident and effective experimentation using repeated Nd:YAP laser on skin marked with ink, thus paving the way for investigations that depend on it.
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Affiliation(s)
- Victoria J Madden
- Sansom Institute for Health Research, University of South Australia , Adelaide, South Australia , Australia
| | - Mark J Catley
- Sansom Institute for Health Research, University of South Australia , Adelaide, South Australia , Australia
| | - Luzia Grabherr
- Sansom Institute for Health Research, University of South Australia , Adelaide, South Australia , Australia
| | - Francesca Mazzola
- Sansom Institute for Health Research, University of South Australia , Adelaide, South Australia , Australia
| | - Mohammad Shohag
- Sansom Institute for Health Research, University of South Australia , Adelaide, South Australia , Australia
| | - G Lorimer Moseley
- Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia; Neuroscience Research Australia, Sydney, Australia
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Cortical Responsiveness to Nociceptive Stimuli in Patients with Chronic Disorders of Consciousness: Do C-Fiber Laser Evoked Potentials Have a Role? PLoS One 2015; 10:e0144713. [PMID: 26674634 PMCID: PMC4684218 DOI: 10.1371/journal.pone.0144713] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 11/23/2015] [Indexed: 01/18/2023] Open
Abstract
It has been shown that the presence of Aδ-fiber laser evoked potentials (Aδ-LEP) in patients suffering from chronic disorders of consciousness (DOC), such as vegetative state (VS) and minimally conscious state (MCS), may be the expression of a residual cortical pain arousal. Interestingly, the study of C-fiber LEP (C-LEP) could be useful in the assessment of cortical pain arousal in the DOC individuals who lack of Aδ-LEP. To this end, we enrolled 38 DOC patients following post-anoxic or post-traumatic brain injury, who met the international criteria for VS and MCS diagnosis. Each subject was clinically evaluated, through the coma recovery scale-revised (CRS-R) and the nociceptive coma scale-revised (NCS-R), and electrophysiologically tested by means of a solid-state laser for Aδ-LEP and C-LEP. VS individuals showed increased latencies and reduced amplitudes of both the Aδ-LEP and C-LEP components in comparison to MCS patients. Although nearly all of the patients had both the LEP components, some VS individuals showed only the C-LEP ones. Notably, such patients had a similar NCS-R score to those having both the LEP components. Hence, we could hypothesize that C-LEP generators may be rearranged or partially spared in order to still guarantee cortical pain arousal when Aδ-LEP generators are damaged. Therefore, the residual presence of C-LEP should be assessed when Aδ-LEP are missing, since a potential pain experience should be still present in some patients, so to properly initiate, or adapt, the most appropriate pain treatment.
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Hansen N, Kahn AK, Zeller D, Katsarava Z, Sommer C, Üçeyler N. Amplitudes of Pain-Related Evoked Potentials Are Useful to Detect Small Fiber Involvement in Painful Mixed Fiber Neuropathies in Addition to Quantitative Sensory Testing - An Electrophysiological Study. Front Neurol 2015; 6:244. [PMID: 26696950 PMCID: PMC4670913 DOI: 10.3389/fneur.2015.00244] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 11/09/2015] [Indexed: 01/22/2023] Open
Abstract
To investigate the usefulness of pain-related evoked potentials (PREP) elicited by electrical stimulation for the identification of small fiber involvement in patients with mixed fiber neuropathy (MFN). Eleven MFN patients with clinical signs of large fiber impairment and neuropathic pain and ten healthy controls underwent clinical and electrophysiological evaluation. Small fiber function, electrical conductivity and morphology were examined by quantitative sensory testing (QST), PREP, and skin punch biopsy. MFN was diagnosed following clinical and electrophysiological examination (chronic inflammatory demyelinating neuropathy: n = 6; vasculitic neuropathy: n = 3; chronic axonal neuropathy: n = 2). The majority of patients with MFN characterized their pain by descriptors that mainly represent C-fiber-mediated pain. In QST, patients displayed elevated cold, warm, mechanical, and vibration detection thresholds and cold pain thresholds indicative of MFN. PREP amplitudes in patients correlated with cold (p < 0.05) and warm detection thresholds (p < 0.05). Burning pain and the presence of par-/dysesthesias correlated negatively with PREP amplitudes (p < 0.05). PREP amplitudes correlating with cold and warm detection thresholds, burning pain, and par-/dysesthesias support employing PREP amplitudes as an additional tool in conjunction with QST for detecting small fiber impairment in patients with MFN.
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Affiliation(s)
- Niels Hansen
- Department of Neurology, University of Würzburg , Würzburg , Germany ; Department of Neurophysiology, Ruhr-University Bochum , Bochum , Germany ; Department of Epileptology, University of Bonn , Bonn , Germany
| | - Ann-Kathrin Kahn
- Department of Neurology, University of Würzburg , Würzburg , Germany
| | - Daniel Zeller
- Department of Neurology, University of Würzburg , Würzburg , Germany
| | - Zaza Katsarava
- Department of Neurology, Evangelisches Krankenhaus , Unna , Germany
| | - Claudia Sommer
- Department of Neurology, University of Würzburg , Würzburg , Germany
| | - Nurcan Üçeyler
- Department of Neurology, University of Würzburg , Würzburg , Germany
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Valentini E, Koch K, Nicolardi V, Aglioti SM. Mortality salience modulates cortical responses to painful somatosensory stimulation: Evidence from slow wave and delta band activity. Neuroimage 2015; 120:12-24. [PMID: 26188186 DOI: 10.1016/j.neuroimage.2015.07.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Revised: 06/18/2015] [Accepted: 07/03/2015] [Indexed: 10/23/2022] Open
Abstract
Social psychology studies show that awareness of one's eventual death profoundly influences human cognition and behaviour by inducing defensive reactions against end-of-life-related anxiety. Much less is known about the impact of reminders of mortality on brain activity. Here we tested whether reminders of mortality can induce a modulation of the slow electroencephalographic activity triggered by somatosensory nociceptive or auditory threatening stimulation and if this modulation is related to mood and anxiety as well as personality traits. We found a specific slow wave (SW) modulation only for nociceptive stimulation and only following mortality salience induction (compared to reminders of an important failed exam). The enhancement of SW negativity at the scalp vertex was associated with increased state anxiety and negative mood, whereas higher self-esteem was associated with reduced SW amplitude. In addition, mortality salience was linked to an increased amplitude of frontal delta band, which was correlated also with increased positive mood and higher self-esteem. The results indicate that SW and delta spectral activity may represent both proximal and distal defences associated with reminders of death and that neurophysiological correlates of somatosensory representation of painful and threatening stimuli may be useful for existential neuroscience studies.
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Affiliation(s)
- Elia Valentini
- Sapienza Università di Roma, Dipartimento di Psicologia, Rome, Italy; Fondazione Santa Lucia, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy.
| | - Katharina Koch
- Sapienza Università di Roma, Dipartimento di Psicologia, Rome, Italy; Fondazione Santa Lucia, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Valentina Nicolardi
- Sapienza Università di Roma, Dipartimento di Psicologia, Rome, Italy; Fondazione Santa Lucia, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Salvatore Maria Aglioti
- Sapienza Università di Roma, Dipartimento di Psicologia, Rome, Italy; Fondazione Santa Lucia, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
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Pazzaglia C, Liguori S, Minciotti I, Testani E, Tozzi A, Liguori A, Petti F, Padua L, Valeriani M. Abdominal acupuncture reduces laser-evoked potentials in healthy subjects. Clin Neurophysiol 2015; 126:1761-8. [DOI: 10.1016/j.clinph.2014.11.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 11/12/2014] [Accepted: 11/21/2014] [Indexed: 01/14/2023]
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Hüllemann P, Shao Y, Manthey G, Binder A, Baron R. Central habituation and distraction alter C-fibre-mediated laser-evoked potential amplitudes. Eur J Pain 2015; 20:377-85. [DOI: 10.1002/ejp.735] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2015] [Indexed: 11/10/2022]
Affiliation(s)
- P. Hüllemann
- Division of Neurological Pain Research and Therapy; Department of Neurology; University Clinic Schleswig-Holstein; Kiel Germany
| | - Y.Q. Shao
- Division of Neurological Pain Research and Therapy; Department of Neurology; University Clinic Schleswig-Holstein; Kiel Germany
| | - G. Manthey
- Division of Neurological Pain Research and Therapy; Department of Neurology; University Clinic Schleswig-Holstein; Kiel Germany
| | - A. Binder
- Division of Neurological Pain Research and Therapy; Department of Neurology; University Clinic Schleswig-Holstein; Kiel Germany
| | - R. Baron
- Division of Neurological Pain Research and Therapy; Department of Neurology; University Clinic Schleswig-Holstein; Kiel Germany
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Mochizuki H, Kakigi R. Itch and brain. J Dermatol 2015; 42:761-7. [DOI: 10.1111/1346-8138.12956] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 04/16/2015] [Indexed: 01/23/2023]
Affiliation(s)
- Hideki Mochizuki
- Department of Dermatology; Temple University School of Medicine; Temple Itch Center; Philadelphia Pennsylvania USA
| | - Ryusuke Kakigi
- Department of Integrative Physiology; National Institute for Physiological Sciences; Okazaki Japan
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Lencioni T, Piscosquito G, Rabuffetti M, Bovi G, Calabrese D, Aiello A, Di Sipio E, Padua L, Diverio M, Pareyson D, Ferrarin M. The influence of somatosensory and muscular deficits on postural stabilization: Insights from an instrumented analysis of subjects affected by different types of Charcot-Marie-Tooth disease. Neuromuscul Disord 2015; 25:640-5. [PMID: 26028275 PMCID: PMC4553554 DOI: 10.1016/j.nmd.2015.05.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 05/06/2015] [Accepted: 05/07/2015] [Indexed: 11/21/2022]
Abstract
We studied the role of sensory and muscular deficits in balance impairments in CMT. Large sensory fibers and dorsi-flexor muscles affect the dynamic phase of stabilization. Small sensory fibers and plantar-flexor muscles influence the static phase of balance. Residual sensory and muscle functions must be evaluated for a proper rehabilitation.
Charcot–Marie–Tooth (CMT) disease is the most common hereditary neuromuscular disorder. CMT1 is primarily demyelinating, CMT2 is primarily axonal, and CMTX1 is characterized by both axonal and demyelinating abnormalities. We investigated the role of somatosensory and muscular deficits on quiet standing and postural stabilization in patients affected by different forms of CMT, comparing their performances with those of healthy subjects. Seventy-six CMT subjects (CMT1A, CMT2 and CMTX1) and 41 healthy controls were evaluated during a sit-to-stand transition and the subsequent quiet upright posture by means of a dynamometric platform. All CMT patients showed altered balance and postural stabilization compared to controls. Multivariate analysis showed that in CMT patients worsening of postural stabilization was related to vibration sense deficit and to dorsi-flexor's weakness, while quiet standing instability was related to the reduction of pinprick sensibility and to plantar-flexor's weakness. Our results show that specific sensory and muscular deficits play different roles in balance impairment of CMT patients, both during postural stabilization and in static posture. An accurate evaluation of residual sensory and muscular functions is therefore necessary to plan for the appropriate balance rehabilitation treatment for each patient, besides the CMT type.
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Affiliation(s)
- Tiziana Lencioni
- Biomedical Technology Department, IRCCS Foundation Don Gnocchi Onlus, Milan, Italy.
| | - Giuseppe Piscosquito
- Unit of Clinic of Central and Peripheral Degenerative Neuropathies, IRCCS Foundation, C. Besta Neurological Institute, Milan, Italy
| | - Marco Rabuffetti
- Biomedical Technology Department, IRCCS Foundation Don Gnocchi Onlus, Milan, Italy
| | - Gabriele Bovi
- Biomedical Technology Department, IRCCS Foundation Don Gnocchi Onlus, Milan, Italy
| | - Daniela Calabrese
- Unit of Clinic of Central and Peripheral Degenerative Neuropathies, IRCCS Foundation, C. Besta Neurological Institute, Milan, Italy
| | - Alessia Aiello
- Department of Neuroscience, Ophthalmology and Genetics, University of Genoa, Genoa, Italy
| | - Enrica Di Sipio
- Centro S. Maria della Pace, Foundation Don Gnocchi Onlus, Rome, Italy
| | - Luca Padua
- Centro S. Maria della Pace, Foundation Don Gnocchi Onlus, Rome, Italy
| | - Manuela Diverio
- Polo Riabilitativo del Levante Ligure, Foundation Don Gnocchi Onlus, Sarzana, Italy
| | - Davide Pareyson
- Unit of Clinic of Central and Peripheral Degenerative Neuropathies, IRCCS Foundation, C. Besta Neurological Institute, Milan, Italy
| | - Maurizio Ferrarin
- Biomedical Technology Department, IRCCS Foundation Don Gnocchi Onlus, Milan, Italy
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Henrich F, Magerl W, Klein T, Greffrath W, Treede RD. Capsaicin-sensitive C- and A-fibre nociceptors control long-term potentiation-like pain amplification in humans. Brain 2015; 138:2505-20. [DOI: 10.1093/brain/awv108] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 02/24/2015] [Indexed: 01/08/2023] Open
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Valentini E, Koch K, Aglioti SM. Seeing One's Own Painful Hand Positioned in the Contralateral Space Reduces Subjective Reports of Pain and Modulates Laser Evoked Potentials. THE JOURNAL OF PAIN 2015; 16:499-507. [PMID: 25724316 DOI: 10.1016/j.jpain.2015.02.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 12/17/2014] [Accepted: 02/04/2015] [Indexed: 01/31/2023]
Abstract
UNLABELLED Studies report that viewing the body or keeping one's arms crossed while receiving painful stimuli may have an analgesic effect. Interestingly, changes in ratings of pain are accompanied by a reduction of brain metabolism or of laser evoked potentials amplitude. What remains unknown is the link between visual analgesia and crossed-arms related analgesia. Here, we investigated pain perception and laser evoked potentials in 3 visual contexts while participants kept their arms in a crossed or uncrossed position during vision of 1) one's own hand, 2) a neutral object in the same spatial location, and 3) a fixation cross placed in front of the participant. We found that having vision of the affected body part in the crossed-arms position was associated with a significant reduction in pain reports. However, no analgesic effect of having vision of the hand in an uncrossed position or of crossing the arms alone was found. The increase of the late vertex laser evoked potential P2 amplitude indexed a general effect of vision of the hand. Our results hint at a complex interaction between cross-modal input and body representation in different spatial frames of reference and at the same time question the effect of visual analgesia and crossed-arms analgesia alone. PERSPECTIVE We found that nociceptive stimuli delivered to the hand in a crossed-arms position evoke less pain than in a canonical anatomic position. Yet we report no significant analgesic effect of vision or crossing the arms on their own. These findings foster the integration of visuospatial and proprioceptive information in rehabilitation protocols.
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Affiliation(s)
- Elia Valentini
- Psychology Department, Sapienza University of Rome, Rome, Italy; Santa Lucia Foundation, Scientific Institute for Research, Hospitalization and Health Care, Rome, Italy.
| | - Katharina Koch
- Psychology Department, Sapienza University of Rome, Rome, Italy; Santa Lucia Foundation, Scientific Institute for Research, Hospitalization and Health Care, Rome, Italy
| | - Salvatore Maria Aglioti
- Psychology Department, Sapienza University of Rome, Rome, Italy; Santa Lucia Foundation, Scientific Institute for Research, Hospitalization and Health Care, Rome, Italy
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