Selective Laser Stimulator of C and A delta fibers

描述（由申请人提供）：本阶段I SBIR的目标是设计、开发、构建和测试可用于人类C和A-delta纤维（伤害感受器）差异激活的红外激光热刺激器的新原型。C和A-δ纤维伤害感受器介导不同来源的疼痛，因此负责将不同类型的疼痛信息传递到中枢神经系统。不同潜在病理的临床疼痛可以通过这两种疼痛纤维类型的激活来差异介导。因此，患者中C或A-δ纤维伤害感受器的差异激活的能力可以允许更特异性的诊断、药物处方中更好的预测能力以及更好地跟踪潜在疾病的临床进展的能力。目前，没有工具可用于在人体中进行C和A δ纤维的可再现的选择性激活，并且临床上使用的热刺激器依赖于电子控制的接触式加热器（Peltier热电偶）。然而，这些需要通过覆盖的皮肤层传导加热疼痛纤维。类似地，通常用于研究目的的激光刺激器（CO2和钍）将能量完全存款在皮肤表面上，而伤害感受器位于皮肤更深处。因此，对于珀耳帖热电偶和这些激光器，直接加热/激活伤害感受器是不可能的，但需要潜在危险的高表面温度。我们建议开发的激光刺激系统将使用红外相干光，由于其波长，允许直接刺激包含伤害感受器末端的底层组织。此外，我们的初步证据表明，通过改变激光刺激的参数，我们可以选择性地激活C或A-delta纤维，这可能是一种非常有用的临床工具。因此，该提案描述了开发和实验工作，其应允许开发允许选择性激活人类C或A-δ纤维的原型刺激器

DESCRIPTION (provided by applicant): The goal of this Phase I SBIR is to design, develop, build and test a new prototype of infra red laser thermal stimulator that can be used for differential activation of C and A-delta fibers (nociceptors) in humans. C and A-delta fiber nociceptors transduce and mediate pain of different sources, and are therefore responsible for carrying different types of pain information to the central nervous system. Clinical pain of different underlying pathologies can be differentially mediated by the activation of these two pain fiber types. Thus, the capacity of differential activation of C or A-delta fiber nociceptors in patients may allow for more specific diagnosis, better predictive power in pharmaceutical prescription, and better capacities to follow the clinical progress of the underlying disease. Currently, no tool is available to do the reproducible selective activation of C and A delta fibers in humans and clinically used thermal stimulators rely on electronically controlled contact heaters (Peltier thermodes). These, however, require conductive heating of pain fibers through overlying layers of skin. Similarly, laser stimulators commonly in use for research purposes (CO2 and Thullium) deposit energy entirely on the skin surface, whereas the nociceptors are located deeper in the skin. Thus, for both Peltier thermodes and these lasers, direct heating/activating of nociceptors is impossible, but requires potentially dangerous, high surface temperatures. The laser stimulation system that we propose to develop will use infrared coherent light that, due to its wavelength, allows for direct stimulation of underlying tissue that contains the nociceptor endings. Furthermore, our preliminary evidence suggests that, by altering the parameters of the laser stimulus, we can selectively activate either C or A-delta fibers, potentially allowing for a highly useful clinical tool. Thus, this proposal describes development and experimental work, which should allow for the development of a prototype stimulator that allows for selective activation of C or A-delta fibers in humans