Factors influencing pricking pain threshold using a CO2 laser

Aerobic Exercise Reduces Pressure More Than Heat Pain Sensitivity in Healthy Adults

OBJECTIVES

The hypoalgesic effects of exercise are well described, but there are conflicting findings for different modalities of pain; in particular for mechanical vs thermal noxious stimuli, which are the most commonly used in studies of exercise-induced hypoalgesia. The aims of this study were 1) to investigate the effect of aerobic exercise on pressure and heat pain thresholds that were well equated with regard to their temporal and spatial profile and 2) to identify whether changes in the excitability of nociceptive pathways-measured using laser-evoked potentials-accompany exercise-induced hypoalgesia.

SUBJECTS

Sixteen healthy adults recruited from the University of New South Wales.

METHODS

Pressure and heat pain thresholds and pain ratings to laser stimulation and laser-evoked potentials were measured before and after aerobic cycling exercise and an equivalent period of light activity.

RESULTS

Pressure pain thresholds increased substantially after exercise (rectus femoris: 29.6%, d = 0.82, P < 0.001; tibialis anterior: 26.9%, d = 0.61, P < 0.001), whereas heat pain thresholds did not (tibialis anterior: 4.2%, d = 0.30, P = 0.27; foot: 0.44%, d = 0.02, P = 1). Laser-evoked potentials and laser heat pain ratings also changed minimally after exercise (d = -0.59 to 0.3, P > 0.06).

CONCLUSIONS

This is the first investigation to compare the effects of exercise on pressure and heat pain using the same stimulation site and pattern. The results show that aerobic exercise reduces mechanical pain sensitivity more than thermal pain sensitivity.

Discrepancies between cortical and behavioural long-term readouts of hyperalgesia in awake freely moving rats

BACKGROUND

It is still unclear to what extent the most common animal models of pain and analgesia, based on indirect measures such as nocifensive behaviours, provide valid measures of pain perception.

METHODS

To address this issue, we developed a novel animal model comprising a more direct readout via chronically (>1 month) implanted multichannel electrodes (MCE) in rat primary somatosensory cortex (S1; known to be involved in pain perception in humans) and compared this readout to commonly used behavioural pain-related measures during development of hyperalgesia. A translational method to induce hyperalgesia, UVB irradiation of the skin, was used. Localized CO2 laser stimulation was made of twenty skin sites (20 stimulations/site/observation day) on the plantar hind paw, before and during the time period when enhanced pain perception is reported in humans after UVB irradiation.

RESULTS

We demonstrate a 2-10 fold significant enhancement of cortical activity evoked from both irradiated and adjacent skin and a time course that corresponds to previously reported enhancement of pain magnitude during development of primary and secondary hyperalgesia in humans. In contrast, withdrawal reflexes were only significantly potentiated from the irradiated skin area and this potentiation was significantly delayed as compared to activity in S1.

CONCLUSIONS

The present findings provide direct evidence that chronic recordings in S1 in awake animals can offer a powerful, and much sought for, translational model of the perception of pain magnitude during hyperalgesia. WHAT DOES THIS STUDY ADD?: In a novel animal model, chronic recordings of nociceptive activity in primary somatosensory cortex (S1) in awake freely moving rats are compared to behavioural readouts during UVB-induced hyperalgesia. Evoked activity in rat S1 replicates altered pain perception in humans during development of hyperalgesia, but withdrawal reflexes do not.

Laser-induced withdrawal test for electrophysiological recordings of nociception

CO(2) lasers are often used in pain research. However, the stimulation parameters of the CO(2) lasers, such as beam diameter, laser power, etc., used for these animal nociceptive studies vary across laboratories. The differences of the parameters usually make novices who want to reproduce the laser-evoked responses confused to follow. In this study, we quantitatively measured the laser-withdrawal reflex of the rat to ascertain the individual laser-withdrawal threshold and then found the thresholds were diverse among the rats we adopted. Furthermore, the optimal stimulation distance, the most conveniently modified stimulation parameter of CO(2) laser stimuli, was also determined. We suggest that laser-withdrawal tests should be applied before the electrophysiological recordings in order to verify the efficiency of the induced nociception and substantiate the operational parameters of the CO(2) laser device.

Flattop laser irradiance profile for stimulation of cutaneous nociceptors

OBJECTIVE

A nerve stimulator based on a CO2 laser has been developed for use in human pain research. A flattened irradiance profile was generated for safer and more uniform pain stimulation. The pain evoked by the flattened profile was compared to a TEM00 profile.

BACKGROUND DATA

The CO2 laser normally operates in TEM00 mode. This is not ideal for thermal stimulation, since the beam will generate a temperature that has a peak in the center of the irradiance profile. This will result in non-uniform activation of nerve fibers.

MATERIALS AND METHODS

A lens system has been designed to redistribute the energy of the beam to produce a flattened supergaussian irradiance profile for uniform heating of the skin. The lenses work by refracting the more intense central part of the beam towards the periphery. Psychophysical techniques were used to compare the pain evoked with a flattop irradiance profile and a TEM00 profile.

RESULTS

It was found that the supergaussian beam evokes pain at a lower energy level than a TEM00 beam.

CONCLUSION

A flattop irradiance profile is a safer source than a gaussian beam for evoking pain in human pain studies.