Biomedical subjects

Hong-You Ge

Publications and source records attributed to Hong-You Ge.

9 recordsLinked to original sources

PubMed2006

Referred pain from trapezius muscle trigger points shares similar characteristics with chronic tension type headache.

Referred pain and pain characteristics evoked from the upper trapezius muscle was investigated in 20 patients with chronic tension-type headache (CTTH) and 20 age- and gender-matched controls. A headache diary was kept for 4 weeks in order to confirm the diagnosis and record the pain history. Both upper trapezius muscles were examined for the presence of myofascial trigger points (TrPs) in a blinded fashion. The local and referred pain intensities, referred pain pattern, and pressure pain threshold (PPT) were recorded. The results show that referred pain was evoked in 85% and 50% on the dominant and non-dominant sides in CTTH patients, much higher than 55% and 25% in controls (P<0.01). Referred pain spread to the posterior-lateral aspect of the neck ipsi-lateral to the stimulated muscle in both patients and controls, with additional referral to the temple in most patients, but none in controls. Nearly half of the CTTH patients (45%) recognized the referred pain as their usual headache sensation, i.e. active TrPs. CTTH patients with active TrPs in the right upper trapezius muscle showed greater headache intensity and frequency, and longer headache duration than those with latent TrPs. CTTH patients with bilateral TrPs reported significantly decreased PPT than those with unilateral TrP (P<0.01). Our results showed that manual exploration of TrPs in the upper trapezius muscle elicited referred pain patterns in both CTTH patients and healthy subjects. In CTTH patients, the evoked referred pain and its sensory characteristics shared similar patterns as their habitual headache pain, consistent with active TrPs. Our results suggest that spatial summation of perceived pain and mechanical pain sensitivity exists in CTTH patients.

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PubMed2006

Sympathetic facilitation of hyperalgesia evoked from myofascial tender and trigger points in patients with unilateral shoulder pain.

OBJECTIVE: To provide evidence for the sympathetic-sensory interaction within a trigger point, which may contribute to local and referred pain and sympathetic symptoms in myofascial pain syndrome. METHODS: Pressure pain threshold (PPT) was measured from a trigger point in the painful side, from a tender point in the non-painful side in the infraspinatus muscles, and from a normal control point in the tibialis anterior muscle in 21 patients with unilateral shoulder pain. In addition, pressure threshold for eliciting referred pain (referred pain threshold, PTRP) was determined, then the intensity was measured of local and referred pain evoked by a pressure equal to 1.5 times PRPT, applied at the trigger point, in 11 patients. All measurements were taken during normal respiration and elevated intrathoracic pressure (EITP). RESULTS: PPT was significantly lower at the trigger than tender points during normal respiration (P=0.001). PPT decreased significantly at both the tender and trigger points during EITP compared with normal respiration (P<0.001). Significant decreases in referred pain threshold and increases in local and referred pain intensities were seen during EITP than normal respiration (all, P<0.01). CONCLUSIONS: These results provide evidence of sympathetic facilitation of mechanical sensitization and the local and referred muscle pain. SIGNIFICANCE: Sympathetic hyperactivity needs to be considered during the clinical evaluation and management of myofascial pain syndrome.

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PubMed2006

Spectral moments of mechanomyographic signals recorded with accelerometer and microphone during sustained fatiguing contractions.

The aim of this study was to analyse the trends of the first three power spectral moments of the mechanomyogram (MMG) signal recorded by a microphone (MMG(MIC)) and an accelerometer (MMG(ACC)) during sustained contractions. MMG signals were recorded from the biceps brachii muscle in 14 healthy male subjects during a 3 min isometric elbow flexion at 30% of the maximal voluntary contraction. MMG absolute and normalised root mean square (RMS), mean power frequency (MNF), power spectral variance (Mc2), and skewness (mu3) were computed. For both MMG(MIC) and MMG(ACC), absolute and normalised RMS and Mc2 increased while MNF and mu3 decreased with contraction time (P<0.001). The rates of change of RMS over time were significantly correlated (P<0.001) for MMG(MIC) and MMG(ACC) but not correlated for spectral moments. The coefficient of variation of RMS was higher for MMG(MIC) than for MMG(ACC), while the opposite was observed for mu3 (P<0.05). It was concluded that higher order spectral moments of the MMG signal change during sustained contraction, indicating a complex modification of the shape of the power spectrum and not just scaling of the bandwidth. This is most likely due to the additional motor unit recruitment with fatigue and to the non-linear summation of motor unit contributions to the signal. Moreover, the characteristics of MMG signals recorded with microphones and accelerometers have important differences, which should be taken into account when comparing results from different studies.

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PubMed2006

Hypoalgesia in the referred pain areas after bilateral injections of hypertonic saline into the trapezius muscles of men and women: a potential experimental model of gender-specific differences.

OBJECTIVE: The study was to assess the local pain intensity, referred pain patterns, and changes in the pressure pain thresholds of the local and referred pain areas following bilateral injections of hypertonic saline into trapezius muscles and to delineate gender differences in pain profile and the possible modulation of pressure pain thresholds. METHODS: Fifteen healthy men and women each participated. Pain intensity and areas were assessed after bilateral injections. The pressure pain thresholds in the trapezius and posterolateral neck muscles (referred pain areas) were measured before and 7.5 and 15 minutes postinjection. RESULTS: The time to maximal pain intensity was significantly shorter after the second injection than after the first injection. Patients exhibited a bilaterally symmetrical distribution of pain areas that included the neck to shoulder angle and the posterolateral neck. Bilateral injections significantly elevated pressure pain thresholds in the right and left posterolateral neck muscles 7.5 and 15 minutes postinjection. In men but not women, the pressure pain thresholds measured in the posterolateral neck muscles 7.5 and 15 minutes after the second injection were higher than those after the first injection and also higher than those after the second injection in women, men tolerated more pressure than women at all time points. DISCUSSION: These findings indicate that both excitatory and inhibitory mechanisms modulate pain response characteristics in bilateral neck-shoulder pain conditions and suggest that there may be a more potent inhibitory control mechanism in men than women. This experimental model may be potentially used to detect gender differences in descending inhibition.

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PubMed2005

Gender-specific differences in electromyographic changes and perceived pain induced by experimental muscle pain during sustained contractions of the upper trapezius muscle.

The aim of the study was to investigate gender-specific differences in the pain-induced alterations of muscle activity during sustained contractions of the upper trapezius muscle. Surface electromyographic (EMG) signals were recorded bilaterally from the upper trapezius muscles of healthy volunteers (10 men and 9 women). The subjects held the arms at 90 degrees abduction for 5 s (short contraction) and 3 min (sustained contraction). These contractions were performed before, during, and after injection of 0.5 ml of hypertonic saline (5.8%) bilaterally in the upper trapezius muscles. Injection of isotonic saline (0.9%) served as control. The root mean square (RMS) and mean power frequency (MPF) were computed from the EMG signals and normalized to the values obtained during maximal voluntary contractions. In the short contractions, injection of hypertonic saline, but not isotonic saline, induced a less pronounced decrease in RMS in women than men, and a significant decrease in MPF in men but not women. In the sustained contractions, RMS slope increased and MPF slope decreased (less negative) with muscle pain in men but not women. It was concluded that the pain-induced changes in motor control strategies during sustained contractions differ in men and women, which may partly explain gender differences in the incidence of musculoskeletal pain.

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PubMed2005

Gender differences in pain modulation evoked by repeated injections of glutamate into the human trapezius muscle.

Gender differences in pain habituation, temporal summation, and pressure hyperalgesia evoked by repeated injections of glutamate into the dominant trapezius muscle were investigated. The glutamate-evoked muscle pain intensity and pressure pain threshold (PPT) were assessed. The PPTs were measured bilaterally in the trapezius muscles (local pain area) and posterolateral neck muscles (referred pain area) after glutamate injection in healthy and age-matched males and females (each n=14). Two glutamate injections (0.4 ml, 2M each) were injected with an interval of 5 min. One injection of glutamate (0.4 ml, 2M) served as a control. Males, but not females, rated the second injection (maximal pain intensity) significantly less painful than the first injection. The area under the visual analogue scale pain curve of the second injection was significantly larger than the first injection in females. Repeated glutamate injections, but not one-glutamate injection, significantly decreased PPTs in the local pain area, with no significant gender differences. No PPTs changes were observed either in the contralateral trapezius muscle or bilaterally in the referred pain areas in either sex. These results suggest that a less efficient pain habituation and a greater susceptibility to the development of temporal summation of muscle pain in females, but not in males, might be one of the contributing factors to the higher incidence of neck shoulder pain in females. In addition, the reduction of PPTs in the local pain area evoked by intramuscular glutamate injection may represent an early process of peripheral pressure hyperalgesia, which is most likely gender independent.

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PubMed2004

Simultaneous modulation of the exteroceptive suppression periods in the trapezius and temporalis muscles by experimental muscle pain.

OBJECTIVE: To investigate whether the exteroceptive suppression (ES) periods in the trapezius and temporalis muscles could be simultaneously modulated by either experimental trapezius muscle pain or temporalis muscle pain. METHODS: Fourteen healthy volunteers participated in two sessions with randomised injections of either hypertonic or isotonic saline into the right trapezius muscle or right temporalis muscle. The pain intensity was continuously scored on a 10 cm electronic visual analogue scale. During muscle contraction, the early (ES1) and late (ES2) reflex in the temporalis and late (ES2) reflex in the trapezius elicited by electrical stimulation of the right infraorbital nerve were recorded pre-, during-, and post-injection. RESULTS: Hypertonic saline injection induced local muscle pain and referred pain with the maximal pain intensity of 6.3+/-0.5 cm in the right trapezius and 6.7+/-0.6 cm in the right temporalis muscles. Injection of either hypertonic or isotonic saline into the right trapezius muscle was associated with significantly shortened ES2 duration and offset time in the injected right trapezius muscle. Only injection of hypertonic saline into the right trapezius muscle could significantly reduce the ES2 offset time and decrease the degree of suppression of ES2 in the right temporalis and left trapezius muscles. Injection of either hypertonic or isotonic saline into the right trapezius muscle evoked no changes in ES2 parameters in the left temporalis muscle. Injection of hypertonic saline, but not isotonic saline, into the right temporalis muscle caused a significantly shorter ES2 offset time and shorter ES2 duration bilaterally in the temporalis and trapezius muscles. CONCLUSIONS: The findings of the present study provide evidence for a bi-directional effects reflecting convergence of muscle afferents from the trigeminal and upper cervical neural systems in humans, which may partly underlie the manifestations of pain referral between these two areas.

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PubMed2004

Sex differences in temporal characteristics of descending inhibitory control: an evaluation using repeated bilateral experimental induction of muscle pain.

Little is known about sex differences in the temporal pattern of descending inhibitory mechanisms, such as descending noxious inhibitory control (DNIC). Sex differences in temporal characteristics of DNIC were investigated by measuring pressure pain thresholds (PPTs) over time in the trapezius muscles (local pain areas) and the posterolateral neck muscles (referred pain areas) following repeated bilateral injection of hypertonic versus isotonic saline into both trapezius muscles. Ten females and 11 males received two consecutive bilateral injections, with 15 min interval, of either 5.8% hypertonic saline (0.5 ml in each side for each bilateral injection) or isotonic saline as a control in a randomized manner. Following hypertonic saline injection, the maximal pain intensities of the first and second bilateral injections were significantly higher in females than in males. The PPTs in the trapezius muscles were significantly lower in females than in males. Significantly higher PPTs (hypoalgesia) in men than in women were shown 15 min after the first bilateral injection, and 7.5 and 15 min after the second bilateral injection in the referred pain areas. Importantly, the second bilateral injection failed to further increase the PPTs for both sexes. These results showed that there were sex differences in temporal characteristics of descending inhibition with long-lasting hypoalgesia in men than in women. Repeated noxious muscular stimuli may inhibit further build-up of DNIC, which may reflect a mechanism of plasticity of the descending inhibitory systems following recurrent nociceptive barrage for both sexes.

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PubMed2003

Hypoalgesia to pressure pain in referred pain areas triggered by spatial summation of experimental muscle pain from unilateral or bilateral trapezius muscles.

Animal and human experimental studies have suggested the importance of spatial summation in the nociception processing and in the activation of descending inhibition. However, the relationship between the areas (size) of muscles stimulated and the recruitment of descending inhibition has not been addressed. Consequently, we tested whether bilateral versus unilateral injection of hypertonic saline into trapezius muscles caused hypoalgesia to pressure pain (pressure pain thresholds, PPTs) in the local pain areas (the trapezius muscles) and the referred pain areas (the posterolateral neck muscles). Two groups of volunteers participated. One group received a unilateral injection (one injection) and the other group bilateral injections (two injections). In the bilateral group, hypertonic saline was injected in one trapezius first, and 45 s later, while pain was still present from the first injection, a second injection was performed into the contralateral trapezius muscle. The saline-evoked time to maximal pain was significantly shorter after the second injection than after the first injection. More subjects developed referred pain after the bilateral compared with the unilateral injection. In the referred pain areas, the PPTs 7.5 and 15 min after the second injection were significantly increased compared with the first injection, while no changes in the PPT were observed in local and referred pain areas after unilateral injection. This suggests that the induction of descending inhibition was triggered by spatial summation during the later phase of experimentally induced muscle pain. The present experimental model might be used for further investigation of descending inhibition related to the spatial characteristics of nociceptive stimuli in humans.

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