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Dagfinn Matre

Publications and source records attributed to Dagfinn Matre.

6 recordsLinked to original sources

Placebo effects in laser-evoked pain potentials.

Placebo treatment may affect multiple components of pain, including inhibition of nociceptive input, automatic or deliberative appraisal of pain, or cognitive judgments involved in pain reporting. If placebo analgesia is due in part to an attenuation of early nociceptive processing, then pain-evoked event-related potentials (ERPs) should be reduced with placebo. In this study, we tested for placebo effects in P2 laser-evoked potentials at midline scalp electrodes. We found that placebo treatment produced significant decreases in P2 amplitude, and that P2 placebo responses were large enough to reflect a meaningful difference in nociceptive processing. However, we also found evidence that the very robust placebo-induced decreases in reported pain are not solely explained by early reductions in P2. N2 amplitude was affected by neither placebo nor reduction of laser intensity. These results suggest that placebo treatment affects early nociceptive processing, but that another component of placebo effects in reported pain occurs later, either in evaluation of pain or cognitive judgments about pain reports.

Adult↗

Placebo-induced changes in spinal cord pain processing.

Pain is an essential sensory modality, signaling injury or threat of injury. Pain perception depends on both biological and psychological factors. However, it is not known whether psychological factors modify spinal mechanisms or if its effect is limited to cortical processing. Here, we use a placebo analgesic model to show that psychological factors affect human spinal nociceptive processes. Mechanical hyperalgesia (hypersensitivity) after an injury is attributable to sensitized sensory neurons in the spinal cord. After a 5 min, 46 degrees C heating of the skin, subjects developed areas of mechanical hyperalgesia. This area was smaller in a placebo condition compared with a baseline condition. This result suggests that placebo analgesia affects the spinal cord as well as supra-spinal pain mechanisms in humans and provides strong supporting evidence that placebo analgesia is not simply altered reporting behavior. Central sensitization is thought to mediate the exaggerated pain after innocuous sensory stimulation in several clinical pain conditions that follow trauma and nervous-system injury. These new data indicate that expectation about pain and analgesia is an important component of the cognitive control of central sensitization.

Adult↗

Thermoreceptive innervation of human glabrous and hairy skin: a contact heat evoked potential analysis.

The human palm has a lower heat detection threshold and a higher heat pain threshold than hairy skin. Neurophysiological studies of monkeys suggest that glabrous skin has fewer low threshold heat nociceptors (AMH type 2) than hairy skin. Accordingly, we used a temperature-controlled contact heat evoked potential (CHEP) stimulator to excite selectively heat receptors with C fibers or Adelta-innervated AMH type 2 receptors in humans. On the dorsal hand, 51 degrees C stimulation produced painful pinprick sensations and 41 degrees C stimuli evoked warmth. On the glabrous thenar, 41 degrees C stimulation produced mild warmth and 51 degrees C evoked strong but painless heat sensations. We used CHEP responses to estimate the conduction velocities (CV) of peripheral fibers mediating these sensations. On hairy skin, 41 degrees C stimuli evoked an ultra-late potential (mean, SD; N wave latency: 455 (118) ms) mediated by C fibers (CV by regression analysis: 1.28 m/s, N=15) whereas 51 degrees C stimuli evoked a late potential (N latency: 267 (33) ms) mediated by Adelta afferents (CV by within-subject analysis: 12.9 m/s, N=6). In contrast, thenar responses to 41 and 51 degrees C were mediated by C fibers (average N wave latencies 485 (100) and 433 (73) ms, respectively; CVs 0.95-1.35 m/s by regression analysis, N=15; average CV=1.7 (0.41) m/s calculated from distal glabrous and proximal hairy skin stimulation, N=6). The exploratory range of the human and monkey palm is enhanced by the abundance of low threshold, C-innervated heat receptors and the paucity of low threshold AMH type 2 heat nociceptors.

Adolescent↗

Effects of localization and intensity of experimental muscle pain on ankle joint proprioception.

Accurate proprioceptive input is a prerequisite for balance control and coordination of movement. The present study investigated whether experimental muscle pain induced in healthy human subjects disturbed movement sense (detection of movement) or position sense (recognition of a reference position). Muscle pain was produced by infusion of 6% hypertonic saline simultaneously in m. tibialis anterior (TA) and m. soleus (experiment 1), by infusion of 6% hypertonic saline in TA (experiment 2) and by infusion of 9% hypertonic saline in TA (experiment 3). Control measurements were done with infusions of 0.9% isotonic saline. All infusions of 6% and 9% saline produced pain intensities significantly higher than the corresponding control infusions. Only infusion of 6% saline in two muscles (visual analogue scale=4-5) produced an elevation in movement detection thresholds which was significantly higher, compared with before infusion. No other significant changes in movement and position sense were found during the painful or control infusions. Pain of relatively high intensity in two antagonist muscles is necessary to disturb the movement detection threshold. The ability to recognize a reference position is not disturbed by experimentally induced muscle pain. Whether the disturbed movement sense is caused by sensitivity changes in muscle spindle afferents or altered processing of proprioceptive input cannot be answered. The present findings indicate that human ankle proprioception is rather robust to muscle pain.

Adult↗

Interaction between cutaneous and muscle afferent activity in polysynaptic reflex pathways: a human experimental study.

Interactions between the input from cutaneous and nociceptive muscle afferents in polysynaptic reflex pathways were investigated in man. Interaction was tested by evoking reflexes before, during, and after a period of muscle pain induced by intramuscular injection of hypertonic saline. Muscle pain was induced either in the ankle flexor (tibialis anterior, TA) or in the extensor (soleus, SOL) muscles by injection of 1 ml hypertonic saline. Electrical skin stimulation (1.1 x initial reflex threshold) at the dorsum of the foot over the tarsal joint was used to elicit cutaneo-muscular polysynaptic reflexes in the knee flexor semitendinosus (ST). The injected hypertonic saline evoked a robust muscle pain (the subjects made a continuous score of the muscle pain on a 0-10 cm VAS scale, and the mean VAS area was 1229+/-251 cm x s and lasting 390+/-30 s). In five of 12 subjects, the infusion of hypertonic saline into TA evoked referred pain to the dorsal aspect of the ankle. A significant inhibition (17+/-8.2%, P<0.05) of the ST-reflex by pain in SOL was observed. Pain in TA facilitated (92+/-36%, P<0.05) the short-latency part (50-70 ms post stimulation) of the reflex. The muscle pain did not modulate the perceived sensory intensity of the electrical stimuli. The findings indicate an interaction of input from thin muscle afferents and cutaneous group A-fibre afferents in polysynaptic segmental reflex pathways, which seems to depend on the location of the muscle pain.

Adult↗