Conditioned Pain Modulation Induced by Non-noxious Thermal Conditioning Stimulus

Transcription

1 34 J Meikai Dent Med 461, 34 39, 2017 conditioned pain modulation Conditioned pain modulationcpmconditioning stimulus : CS CS CPM CPM CS pressure pain threshold : PPT3 CS CS 12 PPT CPM CPM P CPM conditioned pain modulationcpm Conditioned Pain Modulation Induced by Non-noxious Thermal Conditioning Stimulus Yuka OONO, Hidenori KUBO, Katsuhiro MATSUMOTO, Keiko TAKASHIMA, Toshikatsu IMAMURA, Shigenori UCHIDA, Saori TAKAGI and Hikaru KOHASE Division of Dental Anesthesiology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry Abstract : Conditioned pain modulationcpmis a phenomenon that the pain is modified by the conditioning stimulus CS. CPM is one of the endogenous pain modulatory mechanism. To date, CPM has been evaluated with noxious CS. It is not clear whether CPM is induced by non noxious CS. The aim of this study was to investigate whether non noxious thermal conditioning stimuli induce CPM in healthy humans. As CS, non noxious cold stimulus, non noxious warm stimulus, and non noxious cold and warm simultaneous stimulus were applied to the forearm. At the opposite forearm, pressure pain thresholdspptwere measured at five time points ; before CSbaseline, during three kinds of CS and 12 minutes after CS. CPM effects were evaluated as the ratio of PPT during CS or 12 minutes after CS to baseline. CPM was induced by CS of non noxious warm stimulus 22.5and non noxious cold and warm simultaneous stimulus47.9p0.01. Five of the 14 subjects35.7complained burning pain with non noxious cold and warm simultaneous stimulus. This study revealed that non noxious warm stimulus and non noxious cold and warm simultaneous stimulus induced CPM. Key words : conditioned pain modulationcpmnon noxious thermal conditioning stimulus

2 CPM 35 diffuse noxious inhibitory controls : DNIC 1 2, 3 conditioning stimulus : CS 4 DNIC DNIC 1 DNIC conditioned pain modulation CPM CPM 11 CPM 12, CPM CPM VAS VAS VAS 3 CPM 3 PI-20 TM, 85 mm65 mm, 20 g TM, 96 mm70 mm R TM 7.5 cm Fig 1 1 A TM visual analogue scalevas0-100 mm VAS Fig 1 An example of CPM evaluation with non-noxious cold and warm simultaneous conditioning stimulus. The site of non-noxious cold stimulusaand non-noxious warm stimulusbwas assigned randomly. PPT was measured at the dominant forearm, the opposite side to the application of CS. CS : conditioning stimulus, PPT : pressure pain threshold, A : non-noxious cold stimulus, B : non-noxious warm stimulus.

3 Fig 2 Study design An example of study sequence. The order of application of three kinds of CSnon-noxious cold stimulus, non-noxious warm stimulus and non-noxious cod and warm simultaneous stimuluswas randomized. PPT : pressure pain threshold, CS : conditioning stimulus, VAS : visual analogue scale 4 CPM test stimulus : TS pressure pain threshold : PPTPPT Fig 1PPT 1 cm 2 3 N/s30 kpa/s 15 AIKOH PPT N 1 3 PPT PPT CPM PPTbaseline PPT CPM one-way ANOVA posthoc testtukey-testp Table 1 Table 1 5 Fig 2 25 PPT baseline3 12 after CS 5 baseline PPT VAS VAS VAS VAS 2 Table meanSE meanSE meanSE Table 1 Characteristics of subjects age heightcm weightkg genderm/f n14, medianinterquartile range /6

4 CPM 37 Table 2 Measurement of skin temperature and VAS before experiment cold stimulus warm stimulus cold and warm stimulus cold stimulus warm stimulus skin temperaturedegree Celcius VASforcoldorwarmmm VAS for painmm n14, meanstandard error of mean, VAS ; visual analogue scale Table 3 CPM effect during CS cold warm cold and warm after CS CPM CPM CPM effect n14, meanstandard error of mean, CPM ; conditioned pain modulation, CS ; conditioning stimulus meanSE meanse VAS mmmean SE VAS mmmean SE VAS mm meanse VAS mmmeanse VAS mmmeanse VAS mmmeanse 1 CPM Testani 16 CPM CPM CPM CPM meanse Aδ DNIC/CPM 1, 4, 7 3 CPM meanSE meanSE CPM P0.01 CPM P meanse CPM 3 10 CPM meanSE Table 3 1 CPM 2 2 CPM CPM DNIC CPM 14 Pud PPT CPM cold pressor task PPT CPM CPM

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