SYMPATHETIC NERVOUS-SYSTEM ACTIVITY DURING SKIN COOLING IN HUMANS - RELATIONSHIP TO STIMULUS-INTENSITY AND PAIN SENSATION
SYMPATHETIC NERVOUS-SYSTEM ACTIVITY DURING SKIN COOLING IN HUMANS - RELATIONSHIP TO STIMULUS-INTENSITY AND PAIN SENSATION
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DOI：
10.1113/jphysiol.1992.sp019268
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发表时间：
1992-08-01
影响因子：
5.5
通讯作者：
CALLISTER, R
中科院分区：
文献类型：
--
作者：
KREGEL, KC;SEALS, DR;CALLISTER, R
1.我们的目的是确定传出交感神经系统活动骨骼肌（MSNA）和动力学的刺激和疼痛感觉在局部皮肤冷却在人类之间的关系。记录10名健康受试者的小腿MSNA（腓神经微神经造影）、心率、动脉血压、手部皮肤和肌肉温度以及疼痛感。在将手浸入从无毒到极度有毒（28、21、14、7和0 ℃）的不同温度的水中期间和之后（3分钟）。浸泡产生了一个突然的，水的温度依赖性下降的手皮肤温度（最初30秒），然后由一个更渐进的下降。相比之下，手肌肉温度下降几乎是线性浸泡期间。在整个浸泡在28，21和14摄氏度的水温和在7摄氏度水平的初始阶段，感觉范围从不痛到有点痛;然而，7摄氏度浸泡的后一阶段和整个0摄氏度水平被认为是强烈的疼痛。在21-7摄氏度的水温下浸泡最初15-30秒期间，所有受试者的MSNA均较对照水平下降（平均47- 58%，P < 0.05），而平均动脉血压没有变化。MSNA然后返回到并保持在整个28-14摄氏度浸泡控制水平，虽然动脉压，主要是收缩压，略有上升。经过一段时间的延迟后，MSNA在7 ℃（90 s时P < 0.05）和0 ℃（60 s时P < 0.05）水平的浸泡期间以渐进的水温依赖性方式增加，达到约为对照的200和300%的峰值。MSNA的这些升高与动脉压的平行升高相关。在所有水温下，浸泡开始时心率均上升（P < 0-05），但在60-90 s后迅速下降至对照水平。在28-7 ℃水平下，心率增幅较小（约为5次/min），增幅相似，但在最冷水温下增幅为对照水平的两倍。这些观察结果表明，在人类中：（a）非伤害性皮肤冷却的初始快速阶段与MSNA的抑制有关;（B）持续的非伤害性皮肤冷却对MSNA没有明显的影响;（c）在持续的严重皮肤冷却期间MSNA的刺激与皮肤温度下降至小于或等于15 ℃和强烈疼痛的感觉有关;和（d）皮肤冷却引起轻微的、短暂的心动过速，该心动过速在极端有害水平下最大，但在宽的无害范围内与刺激强度无关。在非伤害性皮肤冷却的初始阶段，皮肤温度的变化率和幅度以及与肌肉交感神经抑制和心动过速相关的感觉与低阈值冷敏感皮肤传入的激活一致。相反。与MSNA刺激相关的皮肤温度和剧烈疼痛感觉的显著下降与高阈值冷痛（主要是C）纤维的放电特性一致。
1. Our aim was to determine the relationship between efferent sympathetic nervous system activity to skeletal muscle (MSNA) and both the dynamics of the stimulus and pain sensation during localized skin cooling in humans. MSNA in the lower leg (peroneal microneurography), heart rate, arterial blood pressure, hand skin and muscle temperatures and perceptions of pain were recorded in ten healthy subjects before. during and after immersion (3 min) of a hand in water of different temperatures ranging from non-noxious to extremely noxious (28, 21, 14, 7 and 0-degrees-C).2. Immersion produced an abrupt, water temperature-dependent fall in hand skin temperature (initial 30 s) followed by a more gradual decline. In contrast, the fall in hand muscle temperature was almost linear during immersion. Throughout immersions at the 28, 21, and 14-degrees-C water temperatures and during the initial phase of the 7-degrees-C level, sensations ranged from not painful to somewhat painful; however, the latter phase of the 7-degrees-C immersion and the entire 0-degrees-C level were perceived as intensely painful.3. During the initial 15-30 s of immersion at the 21-7-degrees-C water temperatures, MSNA decreased from control levels in all subjects (47-58 % on average, P < 0.05), whereas mean arterial blood pressure did not change. MSNA then returned to and remained at control levels throughout the 28-14-degrees-C immersions, although arterial pressure, primarily systolic, rose slightly.4. After some delay, MSNA increased during immersion at both the 7-degrees-C (P < 0.05 at 90 s) and 0-degrees-C (P < 0.05 at 60 s) levels in a progressive, water temperature-dependent manner, achieving peak values of approximately 200 and 300 % of control. respectively, by 2.0-2.5 min. These elevations in MSNA were associated with parallel increases in arterial pressure.5. Heart rate rose during the onset of immersion at all water temperatures (P < 0-05), but fell rapidly to control levels after 60-90 s The increases were small (approximately 5 beats/min) and similar at the 28-7-degrees-C levels, but were twice as great at the coldest water temperature.6. These observations indicate that in humans: (a) the initial, rapid phase of non-noxious skin cooling is associated with inhibition of MSNA; (b) sustained, non-noxious skin cooling has no obvious effect on MSNA; (c) the stimulation of MSNA during sustained, severe skin cooling is associated with declines in skin temperature to less-than-or-equal-to 15-degrees-C and sensations of intense pain; and (d) skin cooling evokes a mild, transient tachycardia which is greatest at an extremely noxious level, but is independent of stimulus intensity within a broad non-noxious range.7. The rates and magnitudes of changes in skin temperature and the sensations associated with muscle sympathoinhibition and tachycardia during the initial phase of non-noxious skin cooling are consistent with the activation of low-threshold, cold-sensitive cutaneous afferents. In contrast. the marked declines in skin temperature and sensations of intense pain associated with the stimulation of MSNA are consistent with the discharge properties of high-threshold, cold-pain (primarily C) fibres.