Pain and Touch. Academic Press. Edited by Lawrence Kruger. Department of Neurobiology University of California, Los Angeles Los Angeles, California

Transcription

1 Pain and Touch Edited by Lawrence Kruger Department of Neurobiology University of California, Los Angeles Los Angeles, California San Diego New York Sydney Academic Press London Boston Tokyo Toronto

2 Contributors Foreword Preface History of Research on Touch Joseph C. Stevens and Barry G. Green I. Introduction 1 II. E. H. Weber ( ) 2 III. M. von Frey ( ) 4 IV. Research on Warmth and Cold 5 A. Punctiform Mapping of Warmth and Cold 5 B. Adaptation 7 C. Quantity and Quality 8 D. After V. Three Theories of Somesthcsis 10 A. Classical Theory 10 B. Head's Theory of Dual Sensibilities 11 C. Nafe's Pattern Theory of Feeling 12 VI. Research on Touch 13 A. Spatial Acuity 13 B. Vibration 14 C. Adaptation I 6 D. Active Touch 16

3 vi VII. Contemporary Directions 17 References 19 The Psychophysics of Tactile Perception and Its Peripheral Physiological Basis Joel D. Greenspan and Stanley J. Bolanowski I. Introduction 25 II. Skin Anatomy and the Physics of Cutaneous Stimulation 27 III. Mechanoreceptor Activation and Transduction 31 IV. Mcchanorcceptors Innervating the Glabrous Skin of the Hand 33 V. Psychophysical Channels and Vibrotactile Threshold in Glabrous Skin 37 VI. Mechanorcceptors in Hairy Skin 42 VII. Intensive Dimensions of Tactile Sensation 44 A. Perceived Intensity of Vibratory Stimulation 45 B. Perceived Intensity of Nonvibratory Forms of Stimulation and Correlated Mechanoreceptive Afferent Response Properties 48 C. Spatial Aspects of Stimulation That Influence Perceived Intensity 53 VIII. Temporal Dimensions of Tactile Perception 54 A. Difference Thresholds for Frequency Discrimination 54 B. Perceived Velocity of Tactile Stimuli 55 C. Adaptation to Sustained Stimuli 56 IX. Spatial Dimensions of Tactile Perception 57 A. Spatial Acuity with Surface-Normal Stimulation 58 Β. Shape Discrimination with Surface-Normal Stimulation 67 C. Suprathreshold Perception of Spatially Distinct Stimuli 68 D. Temporal Aspects of Stimulation Influencing Spatial Perception 69 E. Spatial Perception of Tangentially Moving Stimuli 70 X. Complex Perceptual Qualities and Associated Mechanoreceptor Properties 77 A. Roughness Perception 77 B. Complex Form (Character) Perception 84 XI. Concluding Remarks 86 References 86

4 vii 3 Somatosensory Cortex and Tactile Perceptions Harold Burton and Robert Sinclair I. Introduction 105 II. Somatosensory Cortical Areas 105 A. Anatomical Basis for Inclusion 105 B. Physiological Basis for Inclusion 110 III. Some Considerations of Receptive Fields 119 A. Changing Dimensions across Cortical Areas 119 IV. Attributes Represented in Cortical Activity Patterns 125 A. Neural Metrics for Temporal Patterns of Skin Stimulation 125 B. Evidence for Material (Micromorphic) Components of Objects 141 V. Cognitive Aspects of Touch 149 A. Tactile Memory 149 B. Attention 151 VI. Concluding Comments 160 References Nociception and Pain: Evolution of Concepts and Observations Edward R. Perl and Lawrence Kruger I. The Bell-Magendie Law 180 II. Sensory Dissociation 181 III. Early Cutaneous Psychophysics and the Structure of Afferent Terminals 182 IV. Afferent Fiber Diameter and Sensory Function 183 V. Early Reports of Signals from Primary Afferent Fibers 184 VI. The Question of Two Pains 185 VII. The Era of "Single-Unit" Analyses 186 VIII. Head's Protopathic Concept 188 IX. Spinal Gates and a Theory 189 X. Documentation of Specific Nociceptors 191 XI. Human Afferent Fiber Studies 193 XII. Peripheral Neuropathy and Pain 195 XIII. Spinal Nocireceptive Neurons 1% XIV. The Brain and Pain 198 XV. Pain Control and Treatment 201 References 202

5 viii Afferent Mechanisms of Pain Bruce Lynn and Edward R. Perl I. Introduction II. Fiber Size, Nerve Block, and Pain III. Single-Unit Studies A. Criteria for Classification of Nociceptors Β. Cutaneous Nociceptors C. Skeletal Muscle and Joints D. Cornea Ε. Teeth F. Visceral Sensory Units IV. Quantitive Comparisons of AfFerent Firing and Pain Sensations V. Nociceptor Sensitization Α. Inflammation and Nociceptors Β. Development of Sensitivity to Sympathetic Agents Following Nerve Injury VI. Summary References Measurement of Pain Sensation Richard H. Gracely and Bruce D. Naliboff I. Pain as a Univariate Variable 244 A. The Pain Threshold 244 B. Suprathreshold Scaling 254 II. Pain as Dual Variables of Intensity and Unpleasantness 285 A. Precedents from Other Sensory Modalities 285 B. Univalent versus Bivalent Hedonic 287 C. Validity of Hedonic Scales 288 D. Validity of Scales of Pain Unpleasantness 290 E. Interpretations of Changes in Pain Sensory Intensity and Unpleasantness 294 III. Multidimensional Pain Assessment 296 A. Criterion for Utility of Multidemensional Scaling of Pain 297 B. Methodology in Multidimensional Pain Psychophysics 298 C. Summary and Recommendations Regarding Multidimensional Scaling 305 IV. Conclusion 308 References 308

6 ix 7 Pathological Pain C. Richard Chapman and Mark Stillman I. Introduction 315 II. Biological Functions and Features of Normal Pain 317 A. Protective Functions 317 B. Pain and Disease 317 III. Some Perceptual Puzzles in Pathological Pain 318 A. Pain Referral 318 B. Postamputation Phantoms and Pain 319 IV. Basic Mechanisms of Nonpathological Pain 322 A. Transduction and Transmission 322 B. Brain Mechanisms 325 V. Mechanisms of Pathological Pain: Nociception 330 Α. Changes in Traumatized Tissue 330 B. Sympathetically Mediated Pain 332 C. Alterations in Central Pathways of Transmission 333 VI. Mechanisms of Pathological Pain: Neural Dysfunction 334 A. Peripheral Neuropathie Pain 334 B. Central Pain 335 C. Neuropathie Pain of Mixed Origin 336 VII. Summary and Conclusions 337 References Control of Pathological Pain Russell K. Portenoy I. Introduction 343 II. Definition and Classification of Pain 344 A. Nociception and Pain 344 B. Suffering 346 C. Definition of Chronic Pain 347 D. Categories of Patients with Pain 348 III. Principles of Pain Assessment 350 A. Temporal Features 351 B. Topographic Features 352 C. Etiologie Features 353 D. Syndromic Features 354 E. Pathophysiologie Features 354 IV. Management of Chronic Pain 357 A. Pharmacological Approaches 358 B. Anesthetic Approaches 375 C. Neurostimulatory Approaches 375 D. Physiatrie Approaches 376

7 χ Ε. Neurosurgical Approaches 376 F. Psychological Approaches 377 V. Conclusion 377 References 378 Index 387