High frequency electrical stimulation induces a long-lasting enhancement of event-related potentials but does not change the perception elicited by intra-epidermal electrical stimuli delivered to the area of secondary mechanical hyperalgesia

ABSTRACTHigh frequency electrical stimulation (HFS) of the skin induces increased pinprick sensitivity in the surrounding unconditioned skin (secondary hyperalgesia). Moreover, it has been shown that brief high intensity CO2 laser stimuli, activating both Aδ- and C-fiber nociceptors, are perceived as more intense when delivered in the area of secondary hyperalgesia. To investigate the contribution of A-fiber nociceptors to secondary hyperalgesia the present study assessed if the perception and brain responses elicited by low-intensity intra-epidermal electrical stimulation (IES), a method preferentially activating Aδ-fiber nociceptors, are increased in the area of secondary hyperalgesia. HFS was delivered to one of the two forearms of seventeen healthy volunteers. Mechanical pinprick stimulation and IES were delivered at both arms before HFS (T0), 20 minutes after HFS (T1) and 45 minutes after HFS (T2). In all participants, HFS induced an increase in pinprick perception at the HFS-treated arm, adjacent to the site of HFS. This increase was significant at both T1 and T2. HFS did not affect the percept elicited by IES, but did enhance the magnitude of the N2 wave of IES-evoked brain potentials, both at T1 and at T2. HFS induced a long-lasting enhancement of the N2 wave elicited by IES in the area of secondary hyperalgesia, indicating that HFS enhances the responsiveness of the central nervous system to nociceptive inputs conveyed by AMH-II nociceptors. However, we found no evidence that HFS affects the perception elicited by IES, which may suggest that AMH-II nociceptors do not contribute to HFS-induced secondary hyperalgesia.

Enhanced brain responses to C-fiber input in the area of secondary hyperalgesia induced by high-frequency electrical stimulation of the skin

High-frequency electrical stimulation (HFS) of the human skin induces an increase in both mechanical and heat pain sensitivity in the surrounding unconditioned skin. The aim of this study was to investigate the effect of HFS on the intensity of perception and brain responses elicited by the selective activation of C fibers. HFS was applied to the ventral forearm of 15 healthy volunteers. Temperature-controlled CO2 laser stimulation was used to activate selectively low-threshold C-fiber afferents without concomitantly activating Aδ-fiber afferents. These stimuli were detected with reaction times compatible with the conduction velocity of C fibers. The intensity of perception and event-related brain potentials (ERPs) elicited by thermal stimuli delivered to the surrounding unconditioned skin were recorded before (T0) and after HFS (T1: 20 min after HFS; T2: 45 min after HFS). The contralateral forearm served as a control. Mechanical hyperalgesia following HFS was confirmed by measuring the change in the intensity of perception elicited by mechanical punctate stimuli. HFS resulted in increased intensity of perception to mechanical punctate stimulation and selective C-fiber thermal stimulation at both time points. In contrast, the N2 wave of the ERP elicited by C-fiber stimulation (679 ± 88 ms; means ± SD) was enhanced at T1 but not at T2. The P2 wave (808 ± 105 ms) was unaffected by HFS. Our results suggest that HFS enhances the sensitivity to thermal C-fiber input in the area of secondary hyperalgesia. However, there was no significant enhancement of the magnitude of the C-fiber ERPs at T2, suggesting that quickly adapting C fibers do not contribute to this enhancement.

Multiple site optical recording of transmembrane voltage (MSORTV), single-unit recordings, and evoked field potentials from the olfactory bulb of skate (Raja erinacea)

1. Multiple site optical recording of transmembrane voltage (MSORTV), together with conventional extracellular electrophysiological techniques were utilized with in vivo and in vitro preparations of the olfactory bulb of the Atlantic skate Raja erinacea to analyze electrical activity simultaneously in layers deep to the glomerular layer. 2. In the living animals and the in vitro isolated olfactory bulb, orthodromic stimulation evoked a compound action potential in the olfactory nerve fibers, followed by a series of early field-potential waves (N1, P1, N2, P2, N3, and N4). During paired stimulation experiments, unusual patterns of facilitation and suppression were observed for the N2 wave. 3. After orthodromic stimulation, single units, presumably mitral/tufted cells, exhibited a period of early discharge, followed by a period of suppression of spontaneous activity and of their test response in a pair stimulation paradigm. Some neurons also exhibited a labile period of reexcitation that was accompanied by a late surface negative field potential; these responses were also present in olfactory bulb slices. 4. Extrinsic absorption changes obtained from 500-microns saggital slices of the olfactory bulb, stained with the pyrazooxonal dye RH-155, consisted mainly of two types of depolarizing responses, a fast and a slow component, followed under some conditions by a late hyperpolarization. All signals exhibited wavelength dependences typical of the action spectrum of RH-155 and were abolished in the presence of tetrodotoxin (TTX) or high K+ in the bath. 5. The fast component of the optical signal represents synchronous compound action potentials conducted by the olfactory nerve fibers or evoked in the mitral/tufted somata and axonal pathways. The slow depolarizing optical signal appeared, after orthodromic stimuli, mainly in the zone between the glomeruli and the mitral/tufted layer; barium (1–10 mM), which depolarizes glial cells, increased its size and duration, suggesting that this signal does not reflect a glial response to [K+]o. 6. Different condition/test (C/T) intervals produced partial or complete suppression of the test response, depending on the recording site and the stimulus intensity. Just threshold orthodromic stimuli evoked an intermediate period of facilitation of the slow signals. A similar period was also observed in the N2 wave of the field potential. 7. Calcium channel blockers such as cadmium ion, or a low Ca2+ medium, suppressed the slow optical component whether evoked by orthodromic, antidromic, or direct stimulation. gamma-Aminobutyric acid (GABA) and baclofen also reduced or blocked the slow component of the extrinsic absorption signal.(ABSTRACT TRUNCATED AT 400 WORDS)

Further Studies with a Noninvasive Method of Intracranial Pressure Estimation

A linear relationship between elevated intracranial pressure in patients with hydrocephalus and with cerebral edema and a latency shift of the N2 wave of the flash-evoked cortical potential is demonstrated. Although the relationship is good at pressures of 200 to 300 mm H2O, it is excellent at pressures above 300 mm H2O. This relationship establishes a reliable noninvasive method of estimating intracranial pressure.