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Tuning in C-nocicep...
Tuning in C-nociceptors to reveal mechanisms in chronic neuropathic pain
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- Jonas, Robin (författare)
- Heidelberg Univ, Med Fac Mannheim, Dept Expt Pain Res, Theodor Kutzer Ufer 1-3, D-68167 Mannheim, Germany;Stanford Univ, Dept Anesthesiol, Stanford, CA 94305 USA
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- Namer, Barbara (författare)
- Friedrich Alexander Univ Erlangen Nuremberg, Dept Physiol 1, Nurnberg, Germany
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- Stockinger, Lenka (författare)
- Swiss Parapleg Ctr, Ctr Pain Med, Nottwil, Switzerland
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- Chisholm, Kim (författare)
- Kings Coll London, London Pain Consortium, Neurorestorat Grp, London, England
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- Schnakenberg, Mark (författare)
- Heidelberg Univ, Med Fac Mannheim, Dept Expt Pain Res, Theodor Kutzer Ufer 1-3, D-68167 Mannheim, Germany
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- Landmann, Gunther (författare)
- Swiss Parapleg Ctr, Ctr Pain Med, Nottwil, Switzerland
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- Kucharczyk, Mateusz (författare)
- Kings Coll London, London Pain Consortium, Neurorestorat Grp, London, England
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- Konrad, Christoph (författare)
- Kantonsspital Lucerne, Dept Anaesthesiol, Luzern, Switzerland
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- Schmidt, Roland (författare)
- Uppsala universitet,Klinisk neurofysiologi
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- Carr, Richard (författare)
- Heidelberg Univ, Med Fac Mannheim, Dept Expt Pain Res, Theodor Kutzer Ufer 1-3, D-68167 Mannheim, Germany
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- McMahon, Stephen (författare)
- Kings Coll London, London Pain Consortium, Neurorestorat Grp, London, England
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- Schmelz, Martin (författare)
- Heidelberg Univ, Med Fac Mannheim, Dept Expt Pain Res, Theodor Kutzer Ufer 1-3, D-68167 Mannheim, Germany
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- Rukwied, Roman (författare)
- Heidelberg Univ, Med Fac Mannheim, Dept Expt Pain Res, Theodor Kutzer Ufer 1-3, D-68167 Mannheim, Germany
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(creator_code:org_t)
- 2018-05-11
- 2018
- Engelska.
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Ingår i: Annals of Neurology. - : WILEY. - 0364-5134 .- 1531-8249. ; 83:5, s. 945-957
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- ObjectiveDevelop and validate a low‐intensity sinusoidal electrical stimulation paradigm to preferentially activate C‐fibers in human skin.MethodsSinusoidal transcutaneous stimulation (4Hz) was assessed psychophysically in healthy volunteers (n = 14) and neuropathic pain patients (n = 9). Pursuing laser Doppler imaging and single nociceptor recordings in vivo in humans (microneurography) and pigs confirmed the activation of “silent” C‐nociceptors. Synchronized C‐fiber compound action potentials were evoked in isolated human nerve fascicles in vitro. Live cell imaging of L4 dorsal root ganglia in anesthetized mice verified the recruitment of small‐diameter neurons during transcutaneous 4‐Hz stimulation of the hindpaw (0.4mA).ResultsTranscutaneous sinusoidal current (0.05–0.4mA, 4Hz) activated “polymodal” C‐fibers (50% at ∼0.03mA) and “silent” nociceptors (50% at ∼0.04mA), intensities substantially lower than that required with transcutaneous 1‐ms rectangular pulses (“polymodal” ∼3mA, “silent” ∼50mA). The stimulation induced delayed burning (nonpulsating) pain and a pronounced axon‐reflex erythema, both indicative of C‐nociceptor activation. Pain ratings to repetitive stimulation (1 minute, 4Hz) adapted in healthy volunteers by Numeric Rating Scale (NRS) –3 and nonpainful skin sites of neuropathic pain patients by NRS –0.5, whereas pain even increased in painful neuropathic skin by approximately NRS +2.InterpretationSinusoidal electrical stimulation at 4Hz enables preferential activation of C‐nociceptors in pig and human skin that accommodates during ongoing (1‐minute) stimulation. Absence of such accommodation in neuropathic pain patients suggest axonal hyperexcitability that could be predictive of alterations in peripheral nociceptor encoding and offer a potential therapeutic entry point for topical analgesic treatment.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
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Jonas, Robin
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Namer, Barbara
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Stockinger, Lenk ...
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Chisholm, Kim
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Schnakenberg, Ma ...
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Landmann, Gunthe ...
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visa fler...
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Kucharczyk, Mate ...
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Konrad, Christop ...
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Schmidt, Roland
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Carr, Richard
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McMahon, Stephen
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Schmelz, Martin
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Rukwied, Roman
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