scholarly journals Regionally Diffuse Muscle Pain-Hypersensitivity in Humans During Acute Muscle Pain

2019 ◽  
Author(s):  
J. S. Dunn ◽  
S. S. Nagi ◽  
D. A. Mahns
Keyword(s):  
Muscle Pain ◽  
Muscle Afferents ◽  
Diffuse Type ◽  
Pain Hypersensitivity ◽  
Spinal Mechanism ◽  
Flexor Carpi Ulnaris ◽  
Background Pain ◽  
Abductor Digiti Minimi ◽  
Chronic Pain Conditions ◽  
Stimulation Of

AbstractBackgroundWe have previously shown that an intramuscular infusion of 5% hypertonic saline (HS) produces a painful response to normally innocuous stimuli applied to overlying and adjacent skin regions. In the current study, we explored whether a similar interaction could be observed between adjacent, contralateral and remote muscles. Indeed, widespread muscle pain-hypersensitivity is a hallmark of chronic pain conditions such as fibromyalgia.Methods5% HS was infused into the flexor carpi ulnaris (FCU) muscle to develop a stable baseline pain (n=30). In separate experiments, each of the three test locations (n=10 per site), the adjacent abductor digiti minimi (ADM), contralateral FCU and contralateral tibialis anterior (TA) (part 1-3, respectively), 50μL of 0.9% normal saline (NS) was infused (in triplicate) prior to, during and following HS-induced muscle pain.ResultsUnder control conditions (no background pain), the infusion of NS was imperceptible by all subjects. In the presence of HS-induced background pain (FCU), in part 1 the NS co-infusion into ADM increased overall pain by 17%. This was replicated in the contralateral FCU (part 2) with a 12% pain increase, and in the TA (part 3) with a 15% pain increase in response to the NS co-infusions. Notably, over 80% of subjects perceived the NS-induced increase in pain at the HS-infusion location (FCU) rather than the NS-infusion location (adjacent, contralateral and remote).ConclusionsIntramuscular infusion of HS results in pain-hypersensitivity to sub-perceptual stimulation of muscle afferents in a somatotopically unrestricted manner, indicating the involvement of a central (likely supra-spinal) mechanism.SignificanceThis work provides evidence for a regionally diffuse type of pain hypersensitivity, manifesting as a painful response to normally sub-perceptual stimulation in the context of acute experimentally induced muscle pain. This phenomenon may provide parallels to clinically relevant painful conditions and neuropathies.

scholarly journals Modulation of Muscle Pain Is Not Somatotopically Restricted: An Experimental Model Using Concurrent Hypertonic-Normal Saline Infusions in Humans

2020 ◽  
Vol 1 ◽  
Author(s):  
James S. Dunn ◽  
David A. Mahns ◽  
Saad S. Nagi
Keyword(s):  
Normal Saline ◽  
Muscle Pain ◽  
Muscle Afferents ◽  
Spinal Mechanism ◽  
Flexor Carpi Ulnaris ◽  
Background Pain ◽  
Abductor Digiti Minimi ◽  
Forearm Muscle ◽  
Forearm Flexor ◽  
Stimulation Of

We have previously shown that during muscle pain induced by infusion of hypertonic saline (HS), concurrent application of vibration and gentle brushing to overlying and adjacent skin regions increases the overall pain. In the current study, we focused on muscle-muscle interactions and tested whether HS-induced muscle pain can be modulated by innocuous/sub-perceptual stimulation of adjacent, contralateral, and remote muscles. Psychophysical observations were made in 23 healthy participants. HS (5%) was infused into a forearm muscle (flexor carpi ulnaris) to produce a stable baseline pain. In separate experiments, in each of the three test locations (n = 10 per site)—ipsilateral hand (abductor digiti minimi), contralateral forearm (flexor carpi ulnaris), and contralateral leg (tibialis anterior)—50 μl of 0.9% normal saline (NS) was infused (in triplicate) before, during, and upon cessation of HS-induced muscle pain in the forearm. In the absence of background pain, the infusion of NS was imperceptible to all participants. In the presence of HS-induced pain in the forearm, the concurrent infusion of NS into the ipsilateral hand, contralateral forearm, and contralateral leg increased the overall pain by 16, 12, and 15%, respectively. These effects were significant, reproducible, and time-locked to NS infusions. Further, the NS-evoked increase in pain was almost always ascribed to the forearm where HS was infused with no discernible percept attributed to the sites of NS infusion. Based on these observations, we conclude that intramuscular infusion of HS results in muscle hyperalgesia to sub-perceptual stimulation of muscle afferents in a somatotopically unrestricted manner, indicating the involvement of a central (likely supra-spinal) mechanism.

Declining inhibition elicited in cat lumbar motoneurons by repetitive stimulation of group II muscle afferents

1993 ◽  
Vol 70 (5) ◽  
pp. 1805-1810 ◽  
Author(s):  
J. Lafleur ◽  
D. Zytnicki ◽  
G. Horcholle-Bossavit ◽  
L. Jami
Keyword(s):  
Muscle Afferents ◽  
Repetitive Stimulation ◽  
Excitatory Postsynaptic Potential ◽  
Constant Input ◽  
Rapid Reduction ◽  
Group I ◽  
Constant Strength ◽  
Group I Afferents ◽  
Group Ii ◽  
Stimulation Of

1. The aim of the present experiments was to verify whether group II inputs from gastrocnemius medialis (GM) muscle could elicit declining inhibitions similar to those observed during GM contractions in a variety of lumbar motoneurons of the cat spinal cord. Motoneurons were recorded intracellularly in chloralose- or pentobarbitone-anesthetized preparations during electrical stimulation of GM nerve with repetitive trains. 2. With strengths in the group I range, repetitive stimulation evoked the usual Ia excitation in homonymous motoneurons and excitatory postsynaptic potential (EPSP) amplitudes remained constant throughout the stimulation sequence. In synergic plantaris motoneurons lacking an excitatory connection with Ia afferents from GM, the same stimulation, kept at a constant strength throughout the stimulation sequence, elicited rapidly decreasing inhibitory potentials reminiscent of those evoked by GM contractions. 3. In motoneurons of pretibial flexors, quadriceps, and posterior biceps-semitendinosus, the stimulation strength required to observe declining inhibitions resembling those produced by GM contractions was 4-8 times group I threshold, engaging group II in addition to group I fibers. 4. These results show that input from GM group II plus group I afferents can elicit inhibitory effects in a variety of motoneurons. Such observations support the hypothesis that messages from spindle secondary endings and/or nonspecific muscle receptors activated during contraction might contribute to the widespread inhibition caused by GM contractions. 5. Inasmuch as constant input in group II and group I afferents evoked declining inhibitory potentials, the origin of the decline must be central, which suggests that the rapid reduction of contraction-induced inhibitions also depended on a central mechanism.

Central command, but not muscle reflex, stimulates cutaneous sympathetic efferents of cats

1998 ◽  
Vol 274 (5) ◽  
pp. H1552-H1559 ◽  
Author(s):  
Janeen M. Hill ◽  
Marc P. Kaufman
Keyword(s):  
Electrical Stimulation ◽  
Blocking Agent ◽  
Muscle Afferents ◽  
Group Iii ◽  
Hairy Skin ◽  
Sympathetic Efferents ◽  
Muscle Reflex ◽  
Decerebrate Cats ◽  
Sympathetic Discharge ◽  
Stimulation Of

We determined the effects of stimulation of the mesencephalic locomotor region (MLR) and the muscle reflex, each evoked separately, on the discharge of cutaneous sympathetic fibers innervating the hairy skin of decerebrate cats. Electrical stimulation of the MLR was performed while the cats were paralyzed with vecuronium bromide. The muscle reflex was evoked while the cats were not paralyzed by electrical stimulation of the tibial nerve at current intensities that did not activate directly group III and IV muscle afferents. MLR stimulation increased, on average, the discharge of the 23 cutaneous sympathetic fibers tested ( P < 0.05). The muscle reflex, in contrast, had no overall effect on the discharge of 21 sympathetic fibers tested ( P > 0.05). Both maneuvers markedly increased mean arterial pressure and heart rate ( P < 0.05). Prevention of the baroreceptor reflex with the α-adrenergic blocking agent phentolamine did not reveal a stimulatory effect of the muscle reflex on cutaneous sympathetic discharge. We conclude that the MLR is a more important mechanism than is the muscle reflex in controlling sympathetic discharge to hairy skin during dynamic exercise.

Synaptic organization of defined motor-unit types in cat tibialis anterior

1980 ◽  
Vol 43 (6) ◽  
pp. 1631-1644 ◽  
Author(s):  
R. P. Dum ◽  
T. T. Kennedy
Keyword(s):  
Motor Unit ◽  
Tibialis Anterior ◽  
Muscle Afferents ◽  
Medial Gastrocnemius ◽  
Synaptic Organization ◽  
Ia Afferents ◽  
Group I ◽  
Ia Epsp ◽  
Group I Afferents ◽  
Stimulation Of

1. Synaptic potentials were recorded intracellularly in tibialis anterior (TA) motoneurons following stimulation of a descending brain stem pathway, the medial longitudinal fasciculus (MLF), and three segmental inputs, the homonymous and heteronymous group Ia afferents, the group I afferents from the antagonist, and the cutaneous and muscle afferents. Intracellular stimulation of the motoneurons was used to classify them, based on the properties of the innervated muscle units, into types FF, F(int), FR, and S (6, 16). 2. The sum of the monosynaptic EPSP amplitudes resulting from stimulation of homonymous and heteronymous group Ia afferents (summed group Ia EPSP) was inversely related to motoneuron size, as assessed by motoneuron input resistance, and was inversely related to motor-unit tetanic tension. Type-FF, -FR, and -S motoneurons showed significant differences in the mean amplitude of their summed group Ia EPSPs. 3. The amplitudes of disynaptic IPSPs resulting from stimulation of group I afferents in the antagonist muscle also showed an inverse relationship to motoneuron size. The observed relationships between motoneuron size and the monosynaptic group Ia EPSP amplitude or the disynaptic group I IPSP amplitude are compatible with the “size principle” of motor-unit recruitment (26). 4. The amplitudes of the monosynaptic EPSPs evoked in TA motoneurons by stimulation of the MLF were distributed rather randomly among all types of TA motoneurons. A slight tendency of larger monosynaptic EPSPs to occur in motoneurons with larger tetanic tensions was observed. 5. The polysynaptic effects from cutaneous and muscle afferents in sural and gastrocnemius-soleus nerves were frequently excitatory on type-FF motoneurons, but were primarily inhibitory on type-FR and -S motoneurons. Clearly, the polysynaptic cutaneous and muscle inputs and the monosynaptic MLF input onto TA motoneurons show a different pattern of synaptic organization than the group I inputs. 6. In general, the synaptic organization of the TA motor nucleus is similar to that of its extensor antagonist, medial gastrocnemius (MG) (2--5, 7, 8), when analogous neural circuits are compared. This parallel organization suggests a commonality of motor-control systems for both flexor and extensor muscles.

Reversibility of Ia EPSP investigated with intracellularly iontophoresed QX-222

1982 ◽  
Vol 48 (2) ◽  
pp. 419-430 ◽  
Author(s):  
J. A. Flatman ◽  
I. Engberg ◽  
J. D. Lambert
Keyword(s):  
Action Potential ◽  
Muscle Afferents ◽  
Field Potentials ◽  
Potential Generation ◽  
Action Potential Firing ◽  
Hindlimb Muscle ◽  
Potential Firing ◽  
Ia Epsp ◽  
High Conductance ◽  
Stimulation Of

1. Cat lumbosacral motoneurons were impaled by two individually advanced microelectrodes: one to record membrane potential (EM), the second to pass depolarizing currents. 2. During the passage of depolarizing current ramps the repetitive action-potential firing and the later high conductance (GM) state obscured and distorted Ia excitatory postsynaptic potentials (EPSPs) evoked by electrical stimulation of hindlimb muscle afferents. 3. Intracellular iontophoresis of QX-222 (a trimethyl analogue of lignocaine) or methylxylocholine, prevented action-potential generation and reduced the GM increase during current depolarization so that positive levels of EM could be reached. 4. Following QX-222 treatment it was possible to demonstrate a reversal of the Ia EPSP including its first part, at EM values between -13 and +32 mV. Reversal was seen in 13 of the 22 motoneurons tested. 5. Reversal was easiest to obtain in motoneurons of the deep peroneal group. More positive levels of EM were needed to show a reversal in neurons of the gastrocnemius-so-leus group. (The 10-90% rise times of the EPSPs were rather similar for both groups.) 6. In a few motoneurons the initial part of the Ia EPSP reversed at a more negative EM than a later part. This was best seen after subtraction of the extracellular field potentials from the records.

Long-Latency Afferent Inhibition During Selective Finger Movement

2005 ◽  
Vol 94 (2) ◽  
pp. 1115-1119 ◽  
Author(s):  
Bernhard Voller ◽  
Alan St Clair Gibson ◽  
Mikhail Lomarev ◽  
Sulada Kanchana ◽  
James Dambrosia ◽  
...  
Keyword(s):  
Index Finger ◽  
Motor Evoked Potentials ◽  
Finger Movement ◽  
Afferent Inhibition ◽  
Long Latency ◽  
Neuronal Mechanisms ◽  
Co Activation ◽  
Abductor Digiti Minimi ◽  
Muscles Of The Hand ◽  
Stimulation Of

Stimulation of a peripheral nerve of a hand at rest modulates excitability in the motor cortex and, in particular, leads to inhibition when applied at an interval of ∼200 ms (long-latency afferent inhibition; LAI). Surround inhibition (SI) is the process that inhibits neighboring muscles not involved in a particular task. The neuronal mechanisms of SI are not known, and it is possible that LAI might contribute to it. Using transcranial magnetic stimulation (TMS) with and without movement of the index finger, the motor-evoked potentials (MEPs) were measured of two functionally distinct target muscles of the hand (abductor digiti minimi muscle = ADM, 1st dorsal interosseus muscle = FDI). Electrical stimulation was applied 180 ms before TMS to either the fifth finger or the index finger. Both homotopic and heterotopic finger stimulation resulted in LAI without movement. With index finger movement, motor output further decreased with homo- and heterotopic stimulation in the ADM. In the moving FDI, however, there was no change with either homo- or heterotopic stimulation. Additionally, in the unstimulated movement trials, LAI increased with the amount of unintentional co-activation that occurred despite attempts to maintain the ADM at rest. However, with finger stimulation added, there were almost no increased MEPs despite co-activation. These findings suggest that LAI increases during movement and can enhance SI.

Fatigue-related firing of distal muscle nociceptors reduces voluntary activation of proximal muscles of the same limb

2014 ◽  
Vol 116 (4) ◽  
pp. 385-394 ◽  
Author(s):  
David S. Kennedy ◽  
Chris J. McNeil ◽  
Simon C. Gandevia ◽  
Janet L. Taylor
Keyword(s):  
Magnetic Stimulation ◽  
Elbow Flexion ◽  
Muscle Afferents ◽  
Voluntary Contraction ◽  
Voluntary Activation ◽  
Elbow Flexors ◽  
Group Iii ◽  
Distal Muscle ◽  
Fatiguing Exercise ◽  
Stimulation Of

With fatiguing exercise, firing of group III/IV muscle afferents reduces voluntary activation and force of the exercised muscles. These afferents can also act across agonist/antagonist pairs, reducing voluntary activation and force in nonfatigued muscles. We hypothesized that maintained firing of group III/IV muscle afferents after a fatiguing adductor pollicis (AP) contraction would decrease voluntary activation and force of AP and ipsilateral elbow flexors. In two experiments ( n = 10) we examined voluntary activation of AP and elbow flexors by measuring changes in superimposed twitches evoked by ulnar nerve stimulation and transcranial magnetic stimulation of the motor cortex, respectively. Inflation of a sphygmomanometer cuff after a 2-min AP maximal voluntary contraction (MVC) blocked circulation of the hand for 2 min and maintained firing of group III/IV muscle afferents. After a 2-min AP MVC, maximal AP voluntary activation was lower with than without ischemia (56.2 ± 17.7% vs. 76.3 ± 14.6%; mean ± SD; P < 0.05) as was force (40.3 ± 12.8% vs. 57.1 ± 13.8% peak MVC; P < 0.05). Likewise, after a 2-min AP MVC, elbow flexion voluntary activation was lower with than without ischemia (88.3 ± 7.5% vs. 93.6 ± 3.9%; P < 0.05) as was torque (80.2 ± 4.6% vs. 86.6 ± 1.0% peak MVC; P < 0.05). Pain during ischemia was reported as Moderate to Very Strong. Postfatigue firing of group III/IV muscle afferents from the hand decreased voluntary drive and force of AP. Moreover, this effect decreased voluntary drive and torque of proximal unfatigued muscles, the elbow flexors. Fatigue-sensitive group III/IV muscle nociceptors act to limit voluntary drive not only to fatigued muscles but also to unfatigued muscles within the same limb.

Sign in / Sign up

Export Citation Format

Share Document