Identification of pain,intensity and P300 components in the pain evoked potential

This study examined the relationships among 3 components of the somatosensory evoked potential (SEP) to painful stimuli. Painful stimuli were produced using intracutaneous electrical stimulation of a fingertip and two levels of non-painful stimuli were produced by superficial electrical stimulation of a neighboring fingertip. SEPs were recorded from Cz-A1 and Pz-A1, and difference waves were computed for 3 components: (1) a pain component (the difference between SEPs to painful vs. strong but non-painful stimuli); (2) an intensity component that is not related to pain (the difference between SEPs to strong non-painful vs. mild non-painful stimuli); and (3) a P300 component (the difference between SEPs to the same stimuli under Target instructions vs. Standard instructions).The positive peaks in the 3 types of difference waves differed in both latency and topography, although with latency and topography overlap. The intensity component had an earlier positive peak than the pain component, and the pain component had an earlier positive peak than the P300 component. The pain and intensity components were larger at Cz than Pz, whereas the P300 component was larger at Pz than Cz. Under certain conditions, the pain evoked SEP consists of a weighted combination of the 3 components, complicating interpretation of the positive peaks in the recorded wave forms.     

Modulation of perception and neurophysiological correlates of brief CO2 laser stimuli in humans using concurrent large fiber stimulation

It has been postulated that peripheral large fiber stimulation could modulate pain perception, probably by gating the input from AS-and C-fibers. The present study examined the effects of concurrent large fiber stimulation on the perception and neurophysiological correlates of brief CO2 laser stimuli known to activate A- and C-nociceptor endings selectively. Four test stimuli of brief non-painful and painful CO2 laser pulses (duration 50 ms; diameter 5 mm; intensity range 0.116-0.212J) were delivered at random every 5-10s on the dorsum of the left forearm of ten healthy subjects. Large fiber stimulation was performed by a dynamic soft brush applied either adjacently to test stimuli (segmental brush condition) or on the dorsum of the contra-lateral foot (extrasegmental brush condition). Perception, reaction time (RT) and laser-evoked potentials (EPs) were examined for conditions with brush and without brush (control condition). The signal detection theory (SDT) was used to evaluate the discrimination performance and the decision criterion. During extrasegmental brushing, these variables were unaffected as compared with control conditions. During segmental brushing, the absolute detection threshold increased, the probability of detection decreased and the RT increased. Interestingly, the stimulus-response curve of detected stimuli and late LTPs did not change significantly. SDT analysis showed that segmental brushing did not change the discrimination performance or sensitivity but increased significantly the subject's decision criterion for reporting sensation. It was concluded that segmental brushing acted primarily at supra-spinal levels and not by gating the input from small primary afferents activated selectively by brief CO2 laser stimuli.     

Comparative psychophysical characteristics of cutaneous CO2 laser and contact heat stimulation

Psychophysical visual analog scaling can be used to reveal critical determinants of the neural processing underlying non-painful and painful heat sensations produced by radiant and contact heat stimulation. This study determined the stimulus-response (S-R) functions of cutaneous non-painful and painful heat stimuli delivered by an infra-red CO2 laser or by a contact thermode in a series of experiments in healthy volunteers. In experiment 1 ( n = 12), with the rating scale anchored at pain threshold, the S-R curve for brief (60 ms) laser pulse stimulation with a beam diameter of 10 mm was a negatively accelerating function. Transformation of laser stimulus intensity (W) into temperatures ( C) did not change the form of the S-R curve. In experiment 2 ( n=9), using the same laser stimulus parameters as in experiment 1, but without an anchored rating scale, the form of the S-R relationship did not change. In experiment 3 ( n =9), increases of the laser pulse duration up to 5 s and the beam diameter up to 18 mm produced linear S-R curves. In contrast, in experiment 4 ( n =21), the S-R curve for cutaneous contact heat stimuli applied for 5 s with an 18 mm diameter probe was best described by a positively accelerating power function with an exponent greater than 2.0. These experiments have (1) characterized the S-R functions for different parameters of infra-red laser stimulation of the skin, and (2) have shown that the form of the S-R function for innocuous and noxious heat sensation is influenced strongly by the physical conditions of heat stimulus application, including mechanical contact with the skin.     

Cerebral responses evoked by stimulation of the vesico-urethral junction in normal subjects

Following the bipolar stimulation of the vesico-urethral junction (VUJ), evoked potentials (EPs) with a late and prominent negativity (mean latency 91.4 ± 11.0 msec) were recorded from scalp in 22 male subjects. Although remarkable intersubject variations occurred, no peak variation could be seen in any given subject. Maximum amplitude of the EPs was recorded from Cz and CzP points. Stimuli with various frequencies did not lead to any differences in shape and latency of EPs.The differences between the EPs by bipolar stimulation of the VUJ and the responses elicited by distal urethal and pudendal nerve stimulation suggest that, during bipolar stimulation of VUJ, the somatic afferents were not excited. Therefore, these responses were most likely due to the excitement of the visceral afferents arising from the VUJ separately. This method may be a useful technique for evaluating the physiological condition of the afferent nerves arising from VUJ.     

Influence of segmental and extra-segmental conditioning stimuli on cortical potentials evoked by painful electrical stimulation

This study evaluated the effects of two different types of segmental/extra-segmental conditioning stimuli (tonic muscle pain and non-painful vibration) on the subjective experience (perceived pain intensity) and on the cortical evoked potentials to standardized test stimuli (cutaneous electrical stimuli). Twelve subjects participated in two separate sessions to investigate the effects of tonic muscle pain or cutaneous vibration on experimental test stimuli. The experimental protocol contained a baseline registration (test stimuli only), a registration with the test stimuli in combination with the conditioning stimuli, followed by a registration with the test stimuli only. In addition, the effects of the conditioning stimuli were examined at two anatomically separated locations (segmental and extra-segmental). Compared with the test stimulus alone, the perceived pain intensity and peak-to-peak amplitudes of the evoked potentials were unchanged in the presence of non-painful conditioning stimuli at either location. In contrast, a significant decrease of the perceived pain intensity and peak-to-peak amplitudes was found in the presence of painful conditioning stimuli at the extra-segmental sites. Moreover, the topographic maps of the 32-channel recordings suggested that the distribution of the scalp evoked potentials was almost symmetrical around the vertex Cz in the baseline registration. The evoked potentials were generally decreased during hypertonic saline infusion at the extra-segmental sites, but the distribution of the topographic maps did not appear to change. Vibration has previously been shown to inhibit pain, but in the present study the perceived intensity of phasic painful electrical stimuli was unchanged. The reduced perceived pain intensity and the smaller peak-to-peak amplitude of the evoked potential in the presence of extra-segmental conditioning pain are in accordance with the concept of diffuse noxious inhibitory control.     

Conditioned modification of viscerosensory evoked potentials during sleep and wakefulness in cats

The effects of classic conditioning on the viscerosensory evoked potentials (EPs) were studied in twenty cats during wakefulness (W), slow-wave-sleep (SWS) and paradoxical sleep (PS). Four types of the experiment were performed on four groups of animals. Weak, non-painful stimulation of the small intestine or of the left splanchnic nerve was used as conditional stimulus (CS) in all experiments. A painful or non-painful shock on the left radial nerve served as unconditional stimulus (US) which followed the CS with a delay of 500 ms. In the first and second series of experiments, the CS was paired with non-painful or painful CS during W. In the third and fourth types of experiment, weak US was used and conditioning was done during SWS or PS. The evoked responses were recorded from the primary (SI) and secondary (SII) somatosensory and associative (AS) cortex, the thalamus (VPL), hypothalamus (HPT) and dorsal hippocampus (HPC). In each experiment, the stimulus pairings resulted in a complex electrographic conditional response (CR) which included an amplitude increase of the late components of EP's (early CR) and the development of a wave of 500 ms latency (delayed CR). In the second experiment, however, a behavioural CR (limb flexion) also appeared. All these CRs proved to be extinguishable. The recall of CR established during W was successful in SWS. The traces of CS-US pairings during SWS could, however, be elicited only in SWS. Both establishment and recall of CR were unsuccessful during PS. The possible mechanism of the effects originating from an interaction of conditioning and sleep on the viscerosensory inputs of the brain are discussed.     

Cerebral evoked potentials after stimulation of the posterior urethra in man

Cerebral evoked potentials (EPs) were recorded in 25 neurologically normal subjects aged 22–73 years (mean 44.0) after stimulation of the posterior urethra (PU) and the pudendal nerve. After maximal PU stimulation 2 different configurations of the potential were found. In 12 cases a simple bi-triphasic wave form was recorded while in 12 cases there was a bifid form of the first negative wave. In 1 case identical EPs were recorded after PU and pudendal nerve stimulation.It was concluded that (1) PU stimulation excites fibres in the pudendal nerve at higher stimulation strength, resulting in a bifid wave form of the cerebral evoked potential in some individuals, (2) the most prominent negative peak, N1, with a latency of 102.1 ± 13.2 msec, is the most reproducible part of the PU-evoked potential, (3) the N1 is probably transmitted through Aδ fibres localized in the pelvic nerves, (4) there are differences between individuals concerning pudendal and pelvic nerve involvement in afferent innervation of the urethra.     

Reaction times to painless and painful CO2 and argon laser stimulation

The introduction of lasers in pain research has made it possible to activate the nociceptive system without activating mechanosensitive afferents. In the present study the reaction times to painless and painful laser stimuli were studied to investigate if the reaction time to experimental pain is reproduceable. CO2 and argon lasers were used for stimulation, and the influence of stimulus (intensity and duration) and skin parameters (temperature, thickness, and reflectance) on reaction time were investigated. When these parameters were controlled the reaction times to painful CO2 and argon laser stimulation were within the same range (350-450 ms), and the intra-individual variability minimal (6.9%). The reaction time was used to estimate peripheral conduction velocity (10 m.s-1) for the activated fibre population when distinct pain was perceived. Determination of reaction times to non-painful and painful stimuli may be suitable ways to assess the functioning of thermal and nociceptive pathways.     

Mechanisms of cutaneous-cardial interconnections

Using the method of double stimuli, some features of inhibitory influences of conditioning stimulation of cutaneous zones on the afferent transmission from the heart were studied in the experiments on cats. It has been shown that when the interval between testing and conditioning stimuli is from 50 to 150 ms, the cutaneous stimulations effectively block the appearance of evoked potentials in the rostral parts of the cerebral cortex, which were induced by the electrical stimulation of the sinoatrial nodal zone. Bilateral vagotomy completely eliminated this reaction. Stimulation of the peripheral part of the cut vagus also effectively blocked the transmission of the afferent impulses from the heart. It was concluded that inhibitory cutaneo-cardiac effects are determined by the mechanisms of presynaptic inhibition, which develop at the level of intracardiac nervous system.     

Cerebral potentials evoked by rectal distention in humans

The afferent pathways from the rectum can be stimulated and studied after mechanical distention of the rectum. We studied the rectum-brain axis in 24 healthy young adults. The rectum was stimulated with a rectal balloon using inflation volumes of 10 ml and 30 ml air at a stimulation frequency of 0.167 Hz. Additional studies were carried out with 20 ml distention volumes, random stimulation frequency, and stimulation rates of 0.08 Hz and 0.017 Hz. We found two different cortical EPs. An early onset EP was present in 21 of the 24 subjects. P1 latency shortened significantly with increasing distention volumes, but peak amplitudes did not change significantly with larger distention volumes. A late onset EP was present in all subjects with NI latency of 210 ± 15 msec, PI latency of 316 ± 24 msec, and NII latency of 444 ± 34 msec. The different EPs could be due to stimulation of two different visceral afferent pathways which are present in the same individual, due to stimulation of two different fiber populations or due to simultaneous stimulation of afferents in surrounding structures. EP recording after rectal stimulation might be useful in future studies of patients with abnormal rectal sensation.     

GABA and Prolonged Spinal Inhibition

TWO explanations have been provided for the relatively long latency and prolonged (often exceeding 100 ms) inhibition of firing of spinal motoneurones which is caused by repetitive impulses produced by electrical or natural stimulation^1–4 in muscle and cutaneous afferent fibres. This prolonged inhibitory process is exemplified by the reduction in the amplitude of monosynaptic excitatory synaptic potentials (EPSPs) and reflexes of extensor motoneurones by tetanic stimulation of group I afferents of flexor motoneurones². In contrast with “direct” inhibition, the prolonged inhibition is not reduced by strychnine but is diminished by Picrotoxin^4,6.     

Cortical correlates of perception and suppression of electrically induced pain

Two neuroimaging studies using fMRI were conducted in order to assess the cortical processes involved in the perception and suppression of pain. In the first study, 15 healthy subjects were stimulated with variable intensities of electrical pulses during a discrimination task. In the second study, the same subjects had to try to suppress the feeling of pain during tonic stimulation. The discrimination task resulted in cortical activation of contralateral SI, corresponding in extent to the intensity of the stimulus. Activation of contralateral operculum/posterior insula (SII) and non-dominant dorsolateral prefrontal cortex (DLPFC) with non-painful stimuli changed to activations of non-dominant anterior insula upon painful stimulation. In the second study, all subjects succeeded in suppressing the feeling of pain during previously painful levels of stimulation. During this suppression task, activations changed from anterior to posterior insula; also there was a suppression of activity in the anterior cingulated cortex (ACC) and caudate nucleus. Subjects seem to be able to suppress to a certain degree the feeling of pain under constant (and previously painful) stimulation. The cortical correlate seems to be a shift of cerebral activation from anterior to posterior right insula and a suppression of activity in the ACC and caudate nucleus.     

Cortical correlates of perception and suppression of electrically induced pain

Two neuroimaging studies using fMRI were conducted in order to assess the cortical processes involved in the perception and suppression of pain. In the first study, 15 healthy subjects were stimulated with variable intensities of electrical pulses during a discrimination task. In the second study, the same subjects had to try to suppress the feeling of pain during tonic stimulation. The discrimination task resulted in cortical activation of contralateral SI, corresponding in extent to the intensity of the stimulus. Activation of contralateral operculum/posterior insula (SII) and non-dominant dorsolateral prefrontal cortex (DLPFC) with non-painful stimuli changed to activations of non-dominant anterior insula upon painful stimulation. In the second study, all subjects succeeded in suppressing the feeling of pain during previously painful levels of stimulation. During this suppression task, activations changed from anterior to posterior insula; also there was a suppression of activity in the anterior cingulated cortex (ACC) and caudate nucleus. Subjects seem to be able to suppress to a certain degree the feeling of pain under constant (and previously painful) stimulation. The cortical correlate seems to be a shift of cerebral activation from anterior to posterior right insula and a suppression of activity in the ACC and caudate nucleus.     

Cortical and subcortical localization of response to pain in man using positron emission tomography.

A quantitative study of the regional cerebral responses to non-painful and painful thermal stimuli in six normal volunteers has been done by monitoring serial measurements of regional blood flow measured by positron emission tomography (PET). In comparison to a baseline of warm stimulation no statistically significant changes in blood flow were seen in relation to increasing non-painful heat. However, highly significant increases in blood flow were seen in response to painful heat in comparison to non-painful heat. These changes were in the contralateral cingulate cortex, thalamus and lenticular nucleus. These findings are discussed in relation to previous physiological observations of responses to nociceptive stimuli in man and primates.     

电刺激大鼠巨细胞网状核对小脑浦肯野细胞自发和诱发电活动的影响

本研究在麻醉并制动的大鼠上观察了电刺激巨细胞网状核(Gi)对小脑浦肯野细胞(PC)自发及诱发简单锋电位的影响。结果如下:(1)刺激Gi可使PC的简单锋电位出现潜伏期小于20ms的抑制性或兴奋性反应,并以抑制性反应为主。抑制性反应持续40-100ms,而兴奋性反应的时程可达200ms以上;(2)注射5-HT_2型受体阻断剂methysergide可以减弱或阻断电刺激Gi对PC自发简单锋电位的抑制作用;(3)条件性Gi刺激可以显著压抑或加强由刺激对侧大脑皮层感觉运动区引起的PC诱发简单锋电位反应。以上结果说明:在大鼠存在Gi-小脑通路,这一通路中的部分纤维是5-HT能的。Gi-小脑纤维可能通过突触和/或非经典突触的化学传递方式对PC的电活动产生某种调制性的影响。推测Gi-小脑传入纤维投射可能在某些小脑功能活动,如肌紧张及姿势的调节等方面发挥重要作用。     

Differential effects of painful and non-painful stimulation on tactile processing in fibromyalgia syndrome and subjects with masochistic behaviour

Background

In healthy subjects repeated tactile stimulation in a conditioning test stimulation paradigm yields attenuation of primary (S1) and secondary (S2) somatosensory cortical activation, whereas a preceding painful stimulus results in facilitation.

Methodology/Principal Findings

Since previous data suggest that cognitive processes might affect somatosensory processing in S1, the present study aims at investigating to what extent cortical reactivity is altered by the subjective estimation of pain. To this end, the effect of painful and tactile stimulation on processing of subsequently applied tactile stimuli was investigated in patients with fibromyalgia syndrome (FMS) and in subjects with masochistic behaviour (MB) by means of a 122-channel whole-head magnetoencephalography (MEG) system. Ten patients fulfilling the criteria for the diagnosis of FMS, 10 subjects with MB and 20 control subjects matched with respect to age, gender and handedness participated in the present study. Tactile or brief painful cutaneous laser stimuli were applied as conditioning stimulus (CS) followed by a tactile test stimulus (TS) 500 ms later. While in FMS patients significant attenuation following conditioning tactile stimulation was evident, no facilitation following painful stimulation was found. By contrast, in subjects with MB no attenuation but significant facilitation occurred. Attenuation as well as facilitation applied to cortical responses occurring at about 70 ms but not to early S1 or S2 responses. Additionally, in FMS patients the amount of attenuation was inversely correlated with catastrophizing tendency.

Conclusion

The present results imply altered cortical reactivity of the primary somatosensory cortex in FMS patients and MB possibly reflecting differences of individual pain experience.     

Evoked potentials and unit activity in the cat somatosensory cortex

Investigation of unit activity of the cat somatosensory cortex has shown that the principal role in the genesis of the primary response, the response to stimulation of the thalamic relay nucleus, the callosal response, and certain other forms of evoked potentials (EPs) of the somatosensory cortex is played by neurons not usually responding by spike generation during EP development. The EPs reflect what the cortical neurons received from the afferent volley, and the level of their polarization, but they are not a reliable indicator of fast nervous processes in the cerebral cortex. The EPs reflect postsynaptic potentials (PSPs) of neurons not directly participating actively in the analysis of information reaching the cortex.A. A. Bogomolets Institute of Physiology, Academy of Sciences of the Ukrainian SSR, Kiev. Translated from Neirofiziologiya, Vol. 2, No, 4, pp. 360–367, July–August, 1970.     

剌激中缝背核压抑大鼠小脑浦肯野细胞对苔状...

In anaesthetized and paralyzed rats, the effect of dorsal raphe (DR) conditioning stimulation on cerebellar Purkinje cell (PC) responses to mossy fiber and climbing fiber inputs were examined. The main results are as follows: (1) Stimulation of cerebral sensorimotor cortex elicits widespread activation of mossy and climbing fiber inputs to PCs in contralateral VI and VII lobules of the cerebellum and generates two kinds of evoked responses, i.e. the simple spike (SS) and the complex spike (CS) responses with respectively a latency 8-25 and 12-30 ms. (2) These PC responses could be markedly suppressed by stimulation of DR at intensities which by themselves were subthreshold for directly affecting PC's spontaneous SS and CS activities. (3) This DR-induced depressive effects on evoked PC's SS and CS excitations could be attenuated or blocked by systemic administration of 5-HT receptor blocker methysergide. These results demonstrate that serotonergic fiber input from DR can suppress the efficacy of mossy and climbing fiber synaptic action on PC, or decrease the responsiveness of PC itself to afferent synaptic action. The findings of this study also suggest that the raphe-cerebellar serotonergic fiber afferent system may be involved in some of the important neuronal processing in the cerebellum.     

Aδ afferent fiber stimulation activates descending noradrenergic system from the locus coeruleus

We compared the noradrenaline (NA) level in the dorsal horn following electrical stimulation of Aδ afferent nerve fibers in the peripheral nervous system between rats with bilateral lesions of the locus coeruleus (LC) and non-operated control rats by using a microdialysis technique combined with high performance liquid chromatography. Prior to Aδ afferent fiber stimulation, the NA content in the dialysate did not differ between the LC-lesioned and the control rats. During Aδ afferent fiber stimulation, in the LC-lesioned rats, the NA level did not change significantly compared to that before Aδ afferent fiber stimulation, whereas the NA level increased significantly in the control rats. There was a significant difference in the NA levels during Aδ afferent fiber stimulation between the two groups of rats. The result suggests that descending noradrenergic neurons from the LC is involved in the increase of the NA level in the spinal cord dorsal horn produced by Aδ afferent fiber stimulation.