Relationships between the intensity and duration of Peltier heat stimulation and pain magnitude.
Relationships between the intensity and duration of Peltier heat stimulation and pain magnitude.
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DOI：
10.1007/s00221-012-3375-2
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发表时间：
2013-03
影响因子：
2
通讯作者：
Riley, Joseph L., III
中科院分区：
文献类型：
--
作者：
Vierck, Charles J.;Mauderli, Andre P.;Riley, Joseph L., III
使用Peltier热电极的斜坡和保持热刺激是用于人类疼痛敏感性的定量感觉测试的标准程序。由于有髓鞘和无髓鞘的伤害性传入优先响应于变化和稳定的温度，分别，斜坡和保持热刺激可以评估输入的处理从A-δ伤害性感受器早期和C伤害性感受器在长期的热刺激后期。为了评价在长时间Peltier刺激期间从动态变化到稳定温度的进展，获得了探针-皮肤界面处的温度记录。首先，记录接触并保持刺激期间的温度（电磁线圈供电，将预热的热电极输送到皮肤）提供了从刺激开始时的散热评估，未受到斜坡污染。散热效果持续长达8秒。并且部分地解释了作为1-16秒持续时间的组合函数的疼痛强度的显著增加。和刺激强度从43°C至59° C。在较长时间的刺激过程中的记录显示，珀耳帖刺激产生了长达75秒的温度反馈振荡，受试者对疼痛的连续评级跟踪了这种振荡。在120秒内。试验中，在振荡消退后45秒内观察到疼痛的敏感性。相反，在130.5秒期间未观察到致敏。交替升高和降低温度的刺激，保持目标eVAS评分为35。因此，当不被Peltier刺激的反馈控制所固有的振荡破坏时，长持续时间刺激可以用于评估可能是C伤害感受的敏化。
Ramp-and-hold heat stimulation with a Peltier thermode is a standard procedure for quantitative sensory testing of human pain sensitivity. Because myelinated and unmyelinated nociceptive afferents respond preferentially to changing and steady temperatures, respectively, ramp-and-hold heat stimulation could assess processing of input from A-delta nociceptors early and C nociceptors late during prolonged thermal stimulation. In order to evaluate the progression from dynamic change to a steady temperature during prolonged Peltier stimulation, recordings of temperatures at the probe-skin interface were obtained. First, recordings of temperature during contact-and-hold stimulation (solenoid powered delivery of a preheated thermode to the skin) provided an evaluation of heat dissipation from the beginning of stimulation, uncontaminated by ramping. The heat sink effect lasted up to 8 sec. and accounted in part for substantial increases in pain intensity as a combined function of durations from 1–16 sec. and stimulus intensities from 43°C to 59°. Recordings during longer periods of stimulation showed that Peltier stimulation generated feedback oscillations in temperature for up to 75 sec that were tracked by subjects’ continuous ratings of pain. During 120 sec. trials, sensitization of pain was observed over 45 seconds after the oscillations subsided. In contrast, sensitization was not observed during 130.5 sec. of stimulation with alternately increasing and decreasing temperatures that maintained a target eVAS rating of 35. Thus, long duration stimulation can be utilized to evaluate sensitization, presumably of C nociception, when not disrupted by oscillations inherent to feedback control of Peltier stimulation.
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