scholarly journals Direct Anterior Insular Cortex Stimulation Increases Heat Pain Threshold: A Case Report

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Chang-Chia Liu ◽  
Shayan Moosa ◽  
Mark Quigg ◽  
W Jeffrey Elias
Keyword(s):  
Pain Threshold ◽  
Pain Treatment ◽  
Insular Cortex ◽  
Heat Pain ◽  
Posterior Portion ◽  
Thermal Pain ◽  
Depth Electrodes ◽  
Bipolar Mode ◽  
Heat Pain Threshold ◽  
Cerebral Processing

Abstract INTRODUCTION The insular cortex is thought to be involved in the cerebral processing of three dissociable dimensions of pain: sensory-discriminative, affective-motivational, and cognitive-evaluative. The posterior portion of the insular cortex (pIC) has greater connectivity to the primary and secondary somatosensory cortices and is likely related to the sensory-discriminative dimension of pain. The anterior portion the of insular cortex (aIC) has greater connectivity to the ventrolateral prefrontal and orbitofrontal cortices and is involved in the affective-motivational and cognitive-evaluative aspects of pain. While direct pIC stimulation has been demonstrated to increase thermal pain threshold, direct aIC stimulation has never been attempted in humans. We hypothesize that direct aIC stimulation will induce an inhibitory effect upon cerebral processing of the affective components of pain and therefore will result in a significant increase in thermal pain threshold. METHODS A 31-yr-old female patient undergoing epileptic focus localization with depth electrodes implanted in the aIC was recruited for this study. The locations of the aIC electrodes were determined by postoperative T2-weighted MRI. Direct aIC stimulation was performed with the following settings: bipolar mode, 3 trains of 10 s stimulations at a frequency of 50 Hz, pulse width of 250 μs, and interstimulus train intervals of 5 s. The intensity of stimulation was set to 2 mA and 4 mA. Thermal pain thresholds were measured on the contralateral forearm following direct aIC stimulation. RESULTS Direct aIC stimulation increased the heat pain threshold by 2°C, and the magnitude of this effect was positively correlated with the intensity of stimulation (P = .011). No evoked sensations were reported. CONCLUSION This case suggests that direct aIC stimulation decreases thermal nociception and provides evidence that the aIC may be a neuromodulation target for chronic pain treatment.

Repeatability of cold pain and heat pain thresholds: The application of sensory testing in migraine research

Cephalalgia ◽  
2010 ◽  
Vol 30 (8) ◽  
pp. 904-909 ◽  
Author(s):  
Trond Sand ◽  
Kristian Bernhard Nilsen ◽  
Knut Hagen ◽  
Lars Jacob Stovner
Keyword(s):  
Pain Threshold ◽  
Heat Pain ◽  
Cold Pain ◽  
Pain Thresholds ◽  
Thermal Pain ◽  
Normal Limits ◽  
Normal Test ◽  
Heat Pain Threshold ◽  
The Face ◽  
Repeatability Limit

Normal heat pain threshold (HPT) and cold pain threshold (CPT) repeatability should be estimated in order to identify thermal allodynia in longitudinal studies, but such data are scarce in the literature. The aim of our study was to estimate normal HPT and CPT repeatability in the face, forehead, neck and hand. In addition, we reviewed briefly normative studies of thermal pain thresholds relevant for headache research. Thermal pain thresholds were measured on three different days in 31 healthy headache-free subjects. Coefficients of repeatability and normal limits were calculated. HPT and CPT were lowest in the face. Pooled across regions, the lower repeatability limit for the test/retest ratio was 63% for HPT and 55% for CPT. The upper normal CPT limit varied between 24.5°C and 29.7°C. Lower HPT limits ranged between 35.5°C and 40.8°C. Quantitative sensory methods provide useful information about headache and pain pathophysiology, and it is important to estimate the normal test/retest repeatability range in follow-up studies.

The association between selected genetic variants and individual differences in experimental pain

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Marie Udnesseter Lie ◽  
Bendik Winsvold ◽  
Johannes Gjerstad ◽  
Dagfinn Matre ◽  
Linda M. Pedersen ◽  
...  
Keyword(s):  
Individual Differences ◽  
Genetic Variants ◽  
Pain Threshold ◽  
Experimental Pain ◽  
Pain Tolerance ◽  
Heat Pain ◽  
Low Back ◽  
Secondary Hyperalgesia ◽  
Heat Pain Threshold ◽  
Pain Patients

AbstractObjectivesThe underlying mechanisms for individual differences in experimental pain are not fully understood, but genetic susceptibility is hypothesized to explain some of these differences. In the present study we focus on three genetic variants important for modulating experimental pain related to serotonin (SLC6A4 5-HTTLPR/rs25531 A>G), catecholamine (COMT rs4680 Val158Met) and opioid (OPRM1 rs1799971 A118G) signaling. We aimed to investigate associations between each of the selected genetic variants and individual differences in experimental pain.MethodsIn total 356 subjects (232 low back pain patients and 124 healthy volunteers) were genotyped and assessed with tests of heat pain threshold, pressure pain thresholds, heat pain tolerance, conditioned pain modulation (CPM), offset analgesia, temporal summation and secondary hyperalgesia. Low back pain patients and healthy volunteers did not differ in regards to experimental test results or allelic frequencies, and were therefore analyzed as one group. The associations were tested using analysis of variance and the Kruskal-Wallis test.ResultsNo significant associations were observed between the genetic variants (SLC6A4 5-HTTLPR/rs25531 A>G, COMT rs4680 Val158Met and OPRM1 rs1799971 A118G) and individual differences in experimental pain (heat pain threshold, pressure pain threshold, heat pain tolerance, CPM, offset analgesia, temporal summation and secondary hyperalgesia).ConclusionsThe selected pain-associated genetic variants were not associated with individual differences in experimental pain. Genetic variants well known for playing central roles in pain perception failed to explain individual differences in experimental pain in 356 subjects. The finding is an important contribution to the literature, which often consists of studies with lower sample size and one or few experimental pain assessments.

Intradermal recombinant human nerve growth factor induces pressure allodynia and lowered heat-pain threshold in humans

Neurology ◽  
1997 ◽  
Vol 48 (2) ◽  
pp. 501-505 ◽  
Author(s):  
P. J. Dyck ◽  
S. Peroutka ◽  
C. Rask ◽  
E. Burton ◽  
M. K. Baker ◽  
...  
Keyword(s):  
Nerve Growth Factor ◽  
Growth Factor ◽  
Pain Threshold ◽  
Heat Pain ◽  
Nerve Growth ◽  
Heat Pain Threshold ◽  
Human Nerve

scholarly journals Sodium Channel Nav1.7 Is Essential for Lowering Heat Pain Threshold after Burn Injury

2012 ◽  
Vol 32 (32) ◽  
pp. 10819-10832 ◽  
Author(s):  
S. D. Shields ◽  
X. Cheng ◽  
N. Uceyler ◽  
C. Sommer ◽  
S. D. Dib-Hajj ◽  
...  
Keyword(s):  
Sodium Channel ◽  
Pain Threshold ◽  
Burn Injury ◽  
Heat Pain ◽  
Heat Pain Threshold

scholarly journals High-Frequency Transcutaneous Peripheral Nerve Stimulation Induces a Higher Increase of Heat Pain Threshold in the Cutaneous Area of the Stimulated Nerve When Confronted to the Neighbouring Areas

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
M. Buonocore ◽  
N. Camuzzini ◽  
M. Cecini ◽  
E. Dalla Toffola
Keyword(s):  
Electrical Stimulation ◽  
Pain Relief ◽  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Radial Nerve ◽  
Pain Threshold ◽  
Heat Pain ◽  
Electrical Nerve Stimulation ◽  
Heat Pain Threshold ◽  
Painful Area

Background. TENS (transcutaneous electrical nerve stimulation) is probably the most diffused physical therapy used for antalgic purposes. Although it continues to be used by trial and error, correct targeting of paresthesias evoked by the electrical stimulation on the painful area is diffusely considered very important for pain relief.Aim. To investigate if TENS antalgic effect is higher in the cutaneous area of the stimulated nerve when confronted to neighbouring areas.Methods. 10 volunteers (4 males, 6 females) underwent three different sessions: in two, heat pain thresholds (HPTs) were measured on the dorsal hand skin before, during and after electrical stimulation (100 Hz, 0.1 msec) of superficial radial nerve; in the third session HPTs, were measured without any stimulation.Results. Radial nerve stimulation induced an increase of HPT significantly higher in its cutaneous territory when confronted to the neighbouring ulnar nerve territory, and antalgic effect persisted beyond the stimulation time.Conclusions. The location of TENS electrodes is crucial for obtaining the strongest pain relief, and peripheral nerve trunk stimulation is advised whenever possible. Moreover, the present study indicates that continuous stimulation could be unnecessary, suggesting a strategy for avoiding the well-known tolerance-like effect of prolonged TENS application.

Influence of skin temperature on heat pain threshold in humans

1996 ◽  
Vol 107 (3) ◽  
Author(s):  
Antti Pertovaara ◽  
Timo Kauppila ◽  
MinnaM. H�m�l�inen
Keyword(s):  
Skin Temperature ◽  
Pain Threshold ◽  
Heat Pain ◽  
Heat Pain Threshold

Shorter Articles and Notes an Optimum Interval in the Assessment of Pain Threshold

1967 ◽  
Vol 19 (1) ◽  
pp. 54-58 ◽  
Author(s):  
Dian R. Hasalam ◽  
E. A. C. Thomas
Keyword(s):  
Statistical Analysis ◽  
Theoretical Model ◽  
Pain Threshold ◽  
Heat Pain ◽  
Heat Pain Threshold ◽  
Optimum Interval

When the Limiting Method is used to measure heat-pain threshold, the observed threshod has been shown to depend on the size of the stimulus increment used (Haslam, 1965). An experiment is reported here which repeats a finding of the experiment referred to above that the variability of threshold is relatively large when the stimulus increment is small. A statistical analysis of the data shows that the previously untested hypothesis that pain threshold is uniform over the population (Hardy, Wolff and Goodell, 1952) is a reasonable one. The psychological implications of threshold variability are discussed in the light of a theoretical model, and a criterion for an optimum interval in the assessment of heat-pain threshold is discussed.

Visuo–tactile stimulation, but not type of movement, modulates pain during the vision of a moving virtual limb

2019 ◽  
Vol 9 (5) ◽  
pp. 449-460 ◽  
Author(s):  
Calum Gordon ◽  
Alba Barbullushi ◽  
Stefano Tombolini ◽  
Federica Margiotta ◽  
Alessia Ciacci ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Tactile Stimulation ◽  
Pain Threshold ◽  
Pain Modulation ◽  
Heat Pain ◽  
Immersive Virtual Reality ◽  
Pain Thresholds ◽  
Heat Pain Threshold ◽  
Different Types ◽  
Healthy Participants

Aim: Evidence has revealed a relationship between pain and the observation of limb movement, but it is unknown whether different types of movements have diverse modulating effects. In this immersive virtual reality study, we explored the effect of the vision of different virtual arm movements (arm vs wrist) on heat pain threshold of healthy participants. Patients & methods: 40 healthy participants underwent four conditions in virtual reality, while heat pain thresholds were measured. Visuo–tactile stimulation was used to attempt to modulate the feeling of virtual limb ownership while the participants kept their arms still. Results: Effects on pain threshold were present for type of stimulation but not type of movement. Conclusion: The type of observed movement does not appear to influence pain modulation, at least not during acute pain states.

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