Effect of conditioned pain modulation on long-term potentiation-like pain amplification in humans

2016 ◽  
Vol 12 (1) ◽  
pp. 124
Author(s):  
Weiwei Xia ◽  
Carsten Dahl Mørch ◽  
Dagfinn Matre ◽  
Ole Kæseler Andersen
Keyword(s):  
Electrical Stimulation ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Long Term Potentiation ◽  
Pain Modulation ◽  
Conditioned Pain Modulation ◽  
Control Session ◽  
Mechanical Stimuli ◽  
Term Potentiation

AbstractAimThe current study aimed to explore the effect of conditioned pain modulation (CPM) on the long-term potentiation (LTP)-like pain amplification induced by peripheral 10 Hz conditioning electrical stimulation (CES).MethodsSensory changes and neurogenic inflammatory vas-cular reactions induced by 10 Hz CES were assessed in twenty subjects in a randomized crossover design involving two experimental days separated by at least one week. The CPM effect was activated by cold pressor test (CPT) (4 °C) which was applied immediately before the 10 Hz CES in the active session and 32 °C water was used in the control session. Perceptual intensity ratings to single electrical stimulation (SES) at the conditioned skin site and to mechanical stimuli (pinprick and light stroking) in the immediate vicinity of the electrode for CES were recorded. Superficial blood flow (SBF), skin temperature (ST), and heat pain threshold (HPT) were also measured. The pain intensities during the CES process were recorded and the short-form McGill Pain Questionnaire (SF-MPQ) was used for assessing the pain experience.ResultsCPT reduced the pain perception increments to pin-prick (12.8 g) and light stroking stimuli after 10 Hz CES compared to the control session. Moreover, CPT resulted in lower pain intensity ratings during the CES process but without significant changes in the SF-MPQ scores between the two sessions. The SBF and ST were found to increase after CES and then gradually decline but without differences between the CPT and the control sessions. No CPM effect was found for HPT and pain intensity increments to SES.ConclusionsThe cold pressor test inhibited heterotopic perception amplification to mechanical stimuli after conditioning electrical stimulation. The results indicate that endogenous descending inhibitory systems may affect pain-amplificatory mechanisms.

Neurophysiological Correlates of Nociceptive Heterosynaptic Long-Term Potentiation in Humans

2010 ◽  
Vol 103 (4) ◽  
pp. 2107-2113 ◽  
Author(s):  
Emanuel N. van den Broeke ◽  
Clementina M. van Rijn ◽  
José A. Biurrun Manresa ◽  
Ole K. Andersen ◽  
Lars Arendt-Nielsen ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Pain Perception ◽  
Event Related Potentials ◽  
Long Term Potentiation ◽  
P300 Amplitude ◽  
Experimental Conditions ◽  
Term Potentiation ◽  
Before And After ◽  
Related Potentials

Long-term potentiation (LTP) is a cellular model of synaptic plasticity and reflects an increase of synaptic strength. LTP is also present in the nociceptive system and is believed to be one of the key mechanisms involved in the manifestations of chronic pain. LTP manifested as an increased response in pain perception can be induced in humans using high-frequency electrical stimulation (HFS). The aim of this study was to induce spinal heterosynaptic LTP using HFS and investigate its heterotopic effects on event-related potentials (ERPs) to repeated nonpainful cutaneous stimuli as a possible electrophysiological cortical correlate of sensitization. Twenty-two healthy subjects were randomly assigned to one of the two experimental conditions: HFS and control stimulation. Before and after the stimulation, both conditions received heterotopic mechanical (pinprick) and paired nonpainful electrical test stimuli to quantify and confirm the effects of HFS on the behavioral level. ERPs to paired nonpainful electrical stimulation were measured simultaneously. Conditioning HFS resulted in significant heterotopic effects after 30 min, including increased perceived intensity in response to (pinprick) mechanical and paired nonpainful electrical stimulation compared with control. The paired nonpainful electrical stimuli were accompanied by significantly enhanced responses regarding the ERP N1-P2 peak-to-peak and P300 amplitude compared with control. These findings suggest that HFS is capable of producing heterosynaptic spinal LTP that can be measured not only behaviorally but also using ERPs.

Effects of conditioned pain modulation on the withdrawal pattern to nociceptive stimulation in humans – Preliminary results

2017 ◽  
Vol 16 (1) ◽  
pp. 176-177
Author(s):  
F.A. Jure ◽  
F.G. Arguissain ◽  
J.A. Biurrun Manresa ◽  
O.K. Andersen
Keyword(s):  
Cold Water ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Biceps Femoris ◽  
Pain Modulation ◽  
Wilcoxon Test ◽  
Conditioned Pain Modulation ◽  
Stimulus Interval ◽  
Biceps Femoris Muscle ◽  
Femoris Muscle

AbstractAimsConditioned pain modulation (CPM) is a paradigm employed to assess descending control of spinal nociception. Previous studies have shown that CPM affects the nociceptive withdrawal reflex (NWR) threshold (RTh), typically assessed in one muscle. However, the NWR activates not one but a group of synergistic muscles, which are recruited by common neural commands to achieve the limb withdrawal. In this regard, synergy analysis can provide the minimum coordinated recruitment of groups of muscles with specific activation balances that describe a movement. The aim was to assess how CPM modulate the global withdrawal strategy of the lower limb expressed by synergy analysis.MethodsSixteen healthy subjects received electrical stimulation in the arch of the foot at 2 × RTh intensity assessed at the biceps femoris muscle, to elicit the NWR at three time points: before, during and after immersion of the hand in cold water at 2.6 ± 0.4° (cold pressor test, CPT) to trigger CPM. Electromyographic signals (EMG) were recorded from 2 distal muscles (tibialis anterior, soleus) and 2 proximal muscles (biceps femoris, rectus femoris). Muscle synergies were identified by a non-negative matrix factorization algorithm for the EMG envelope in the 60–180 ms post-stimulus interval. Data were analyzed by a point-by-point Wilcoxon test using a permutation strategy.ResultsThe overall withdrawal pattern was explained by two main synergies (Syn1 and Syn2). Syn1 mainly contributes to EMG of distal muscles, whereas Syn2 contributes to EMG of proximal muscles. During CPT, the magnitude of Syn2 was reduced in the 160–180ms post-stimulus interval (p < 0.05), whereas no changes were found for Syn1.ConclusionsAt least two synergies are required to explain the NWR. Furthermore, results suggest that CPM might differentially affect proximal and distal muscles. Further analysis is needed to provide additional information about the behavior of the individual muscles.

scholarly journals Reliability of the Conditioned Pain Modulation Paradigm to Assess Endogenous Inhibitory Pain Pathways

2012 ◽  
Vol 17 (2) ◽  
pp. 98-102 ◽  
Author(s):  
Gwyn N Lewis ◽  
Heales Luke ◽  
David A Rice ◽  
Keith Rome ◽  
Peter J McNair
Keyword(s):  
Pain Threshold ◽  
Intraclass Correlation ◽  
Cold Pressor Test ◽  
Pressure Pain Threshold ◽  
Cold Pressor ◽  
Pain Modulation ◽  
Conditioned Pain Modulation ◽  
Pressure Pain ◽  
Pressor Test ◽  
Conditioning Stimuli

BACKGROUND: Conditioned pain modulation paradigms are often used to assess the diffuse noxious inhibitory control (DNIC) system. DNICs provide one of the main supraspinal pain inhibitory pathways and are impaired in several chronic pain populations. Only one previous study has examined the psychometric properties of the conditioned pain modulation technique and this study did not evaluate intersession reliability.OBJECTIVES: To evaluate and compare the intra- and intersession reliability of two conditioned pain modulation paradigms using different conditioning stimuli, and to determine the time course of conditioned pain inhibition following stimulus removal.METHODS: An electronic pressure transducer was used to determine the pressure-pain threshold at the knee during painful conditioning of the opposite hand using the ischemic arm test and the cold pressor test. Assessments were completed twice on one day and repeated once approximately three days later.RESULTS: The two conditioning stimuli resulted in a similar increase in the pressure-pain threshold at the knee, reflecting presumed activation of the DNIC system. Intrasession intraclass correlation coefficients for the cold pressor (0.85) and ischemic arm tests (0.75) were excellent. The intersession intraclass correlation coefficient for the cold pressor test was good (0.66) but was poor for the ischemic arm test (−0.4). Inhibition of the pressure-pain threshold remained significant at 10 min following conditioning, but returned to baseline by 15 min.CONCLUSIONS: Within-session reliability of DNIC assessment using conditioned pain modulation paradigms was excellent, but the applicability of assessing pain modulation over multiple sessions was influenced by the conditioning stimulus. The cold pressor test was the superior technique.

scholarly journals Comparison of Thermal and Electrical Modalities in the Assessment of Temporal Summation of Pain and Conditioned Pain Modulation

2021 ◽  
Vol 2 ◽  
Author(s):  
Monica Sean ◽  
Alexia Coulombe-Lévêque ◽  
Martine Bordeleau ◽  
Matthieu Vincenot ◽  
Louis Gendron ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Temporal Summation ◽  
Cold Pressor Test ◽  
Conditioning Stimulus ◽  
Cold Pressor ◽  
Pain Modulation ◽  
Conditioned Pain Modulation ◽  
Electrical Nerve Stimulation ◽  
Clinical Assessments ◽  
Healthy Participants

Temporal summation of pain (TSP) and conditioned pain modulation (CPM) can be measured using a thermode and a cold pressor test (CPT). Unfortunately, these tools are complex, expensive, and are ill-suited for routine clinical assessments. Building on the results from an exploratory study that attempted to use transcutaneous electrical nerve stimulation (TENS) to measure CPM and TSP, the present study assesses whether a “new” TENS protocol can be used instead of the thermode and CPT to measure CPM and TSP. The objective of this study was to compare the thermode/CPT protocol with the new TENS protocol, by (1) measuring the association between the TSP evoked by the two protocols; (2) measuring the association between the CPM evoked by the two protocols; and by (3) assessing whether the two protocols successfully trigger TSP and CPM in a similar number of participants. We assessed TSP and CPM in 50 healthy participants, using our new TENS protocol and a thermode/CPT protocol (repeated measures and randomized order). In the TENS protocol, both the test stimulus (TS) and the conditioning stimulus (CS) were delivered using TENS; in the thermode/CPT protocol, the TS was delivered using a thermode and the CS consisted of a CPT. There was no association between the response evoked by the two protocols, neither for TSP nor for CPM. The number of participants showing TSP [49 with TENS and 29 with thermode (p &lt; 0.001)] and CPM [16 with TENS and 30 with thermode (p = 0.01)] was different in both protocols. Our results suggest that response to one modality does not predict response to the other; as such, TENS cannot be used instead of a thermode/CPT protocol to assess TSP and CPM without significantly affecting the results. Moreover, while at first glance it appears that TENS is more effective than the thermode/CPT protocol to induce TSP, but less so to induce CPM, these results should be interpreted carefully. Indeed, TSP and CPM response appear to be modality-dependent as opposed to an absolute phenomenon, and the two protocols may tap into entirely different mechanisms, especially in the case of TSP.

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