Displaying Pain Sensation in Midair by Thermal Grill Illusion

Author(s):  
Mitsuru Nakajima ◽  
Yasutoshi Makino ◽  
Hiroyuki Shinoda
Pain Medicine ◽  
2021 ◽  
Author(s):  
Michal Rivel ◽  
Anat Achiron ◽  
Mark Dolev ◽  
Yael Stern ◽  
Gaby Zeilig ◽  
...  

Abstract Objective About a third of patients with multiple sclerosis (MS) suffer from chronic and excruciating central neuropathic pain (CNP). The mechanism underlying CNP in MS is not clear, since previous studies are scarce and their results are inconsistent. Our aim was to determine whether CNP in MS is associated with impairment of the spinothalamic-thalamocortical pathways (STTCs) and/or increased excitability of the pain system. Design Cross sectional study Setting General hospital Subjects 47 MS patients with CNP, 42 MS patients without CNP, and 32 healthy controls. Methods Sensory testing included the measurement of temperature, pain, and touch thresholds and the thermal grill illusion (TGI) for evaluating STTCs function, and hyperpathia and allodynia as indicators of hyperexcitability. CNP was characterized using interviews and questionnaires. Results The CNP group had higher cold and warm thresholds (p < 0.01), as well as higher TGI perception thresholds (p < 0.05), especially in painful body regions compared to controls, whereas touch and pain thresholds values were normal. The CNP group also had a significantly greater prevalence of hyperpathia and allodynia. Regression analysis revealed that whereas presence of CNP was associated with a higher cold threshold, CNP intensity, and the number of painful body regions were associated with allodynia and hyperpathia, respectively. Conclusions CNP in MS is characterized by a specific impairment of STTC function; the innocuous thermal pathways, and by pain hyperexcitability. Whereas CNP presence is associated with STTC impairment, its severity and extent are associated with pain hyperexcitability. Interventions that reduce excitability level may therefore mitigate CNP severity.


Pancreatology ◽  
2014 ◽  
Vol 14 (3) ◽  
pp. S13 ◽  
Author(s):  
Jan DHaese ◽  
Mark Hartel ◽  
Ihsan Ekin Demir ◽  
Ulf Hinz ◽  
Frank Bergmann ◽  
...  

Author(s):  
Magdalena Mackiewicz-Milewska ◽  
Małgorzata Cisowska-Adamiak ◽  
Katarzyna Sakwińska ◽  
Iwona Szymkuć-Bukowska ◽  
Iwona Głowacka-Mrotek

Diagnosis of the cause of massive edema of the lower limbs in patients after spinal cord injury (SCI) can be difficult because of loss of pain sensation, commonly occurring in this group of patients. This paper reviews several different pathologies that can lead to lower-limb edema and the associated diagnostic difficulties. We present four cases of patients with massive edemas of lower limbs at different times after SCI undergoing treatment in the Department of Rehabilitation, University Hospital in Bydgoszcz, Poland. All patients had a lack of pain sensation in the lower limbs and significantly elevated levels of D-dimer. In two cases, deep vein thrombosis (DVT) and intramuscular hematomas (IHs) were diagnosed. IHs were probably a consequence of antithrombotic treatments implemented due to the occurrence of DVT. Heterotopic ossification (HO) was diagnosed in a third case, and, in another patient, who was hospitalized for the longest period after injury, we found humeral bone fractures. Heterotopic ossification, intramuscular haematomas, and bone fractures of the lower limb can mimic DVT. Careful observation of the edema evolution is recommended, as the onset of new symptoms may indicate a different cause of edema from that initially established.


2016 ◽  
Vol 15 (2) ◽  
pp. 59-62
Author(s):  
Magdalena Sowa ◽  
Katarzyna Ciechanowska ◽  
Iwona Głowacka

Abstract Introduction. Easing labour pain is an extremely important issue in obstetric practice. Various physiotherapy methods are increasingly often applied in obstetric practice. Transcutaneous electric nerve stimulation (TENS) aiming at central and peripheral modulation of pain sensation is one of them.Aim. The aim of the study was to analyse the impact of transcutaneous electrical stimulation (TENS) on easing labour pain.Summary. The TENS method is regarded as effective since it increases both the pain threshold and secretion of endogenous opioids. Non-pharmacological methods of pain management during labour, including electrotherapy TENS methods are safe and can be used in most patients.


1989 ◽  
Vol 62 (6) ◽  
pp. 1270-1279 ◽  
Author(s):  
D. D. Price ◽  
J. G. McHaffie ◽  
M. A. Larson

1. Psychophysical experiments were initiated to determine the possible influence of increasing stimulus size on perceived pain intensity. Six trained human subjects (5 male, 1 female) made visual analogue scale (VAS) ratings for pain-sensation intensity and unpleasantness in response to nociceptive thermal stimuli. Test stimuli consisted of 5-s duration heat pulses (45-50 degrees C in 1 degrees increments) delivered by one, two, or three contact thermal probes (1 cm2 each) applied to the medial aspect of the anterior forearm. 2. The area of skin receiving noxious thermal stimuli was changed by randomly varying the number of thermodes activated. The effects of varying the distance between the thermal probes also were evaluated. In the first series of experiments, thermal-probe separation was kept close to 0; in subsequent experimental series, the thermodes were separated by either 5 or 10 cm. 3. In each experimental series, considerable spatial summation occurred in both pain-sensation intensity and unpleasantness dimensions of pain. This summation occurred throughout the nociceptive thermal range of 45-50 degrees C and was larger at suprathreshold temperatures (greater than or equal to 47 degrees C) than those near threshold (less than or equal to 46 degrees C). Unlike spatial summation of perceived warmth, that of pain was not characterized by systematic changes in power-function exponents but as approximately upward parallel displacements in double-logarithmic coordinates. 4. Thermal-probe separation over a range of 0-10 cm had no effects on spatial summation of pain-sensation intensity or pain unpleasantness. In contrast, increasing thermal-probe separation increased the subjects' ability to discriminate differences in stimulus size and their ability to detect correctly the number of thermal probes activated. 5. Because affective VAS ratings of unpleasantness were linearly related to, but distinctly and systematically less than, VAS ratings of pain-sensation intensity, it was clear that subjects responded quite differently to these two pain dimensions. Affective judgements were not additionally influenced by thermal probe separation and hence by the ability to perceive stimulus size or number of thermal probes activated. 6. The results indicate that powerful spatial-summation mechanisms exist for heat-induced pain. Spatial summation of pain is likely to be subserved both by local integration mechanisms at the level of single spinothalamic-tract neurons and by recruitment of central nociceptive neurons, because spatial summation of pain occurred to approximately equal extents under conditions of thermode separations over a distance of at least 20 cm.


1993 ◽  
Vol 76 (3_suppl) ◽  
pp. 1139-1146 ◽  
Author(s):  
Toshiteru Hatayama ◽  
Kayoko Shimizu

The present study was done to estimate rise in skin temperature during a pain reaction time (pain RT) as a means of investigating why a pricking pain threshold, produced by thermal stimulation using time method, often increases during repeated measurements. The pain RT, or the time-delay between occurrence of pain sensation and a subsequent motor response, was measured by making EMG recording on a forearm. The radiant heat stimuli were three, 200, 300, and 350 mcal/sec./cm2, each of which was given through a round radiation window of an algesiometer head. Analysis showed that the pain RTs would be too short to explain higher pain thresholds often found using the time method.


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