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Biomedical subjects

Lars Bendtsen

Publications and source records attributed to Lars Bendtsen.

4 recordsLinked to original sources

Experimental muscle pain and tenderness following infusion of endogenous substances in humans.

Several human models of myofascial pain exist, but none are similar to clinical pain. The aim of the present study was to develop a clinically relevant model of prolonged human myofascial pain using infusion of the naturally occurring endogenous substances. Initially, bradykinin (Bk), serotonin (5-hydroxytryptamine (5-HT)), histamine (His), prostaglandin E(2) (PGE(2)), adenosine-tri-phosphate (ATP), and their combinations were infused into the trapezius muscle of 36 healthy subjects in a total of 67 sessions to identify substances, which could induce a moderate muscle pain. PGE(2), ATP, and a combination of Bk, 5-HT, His, and PGE(2) produced the intended moderate pain. These substances were further examined in a randomised, blinded, placebo-controlled dose-finding design in 15 healthy subjects in 68 sessions. PGE(2) (3, 6, and 12 nmol/ml) induced mild pain and tenderness not different from placebo. ATP (9000, 18,000, and 36,000 nmol/ml) induced pain of moderate to strong intensity (P=0.04) and the dose of 18,000 nmol/ml furthermore produced moderate local tenderness (P=0.04). Because of unacceptable side effects in subsequent examinations, further studies of ATP in humans were suspended. Infusion of the combination of Bk (92 nmol), 5-HT (156 nmol), His (140 nmol), and PGE(2) (1.95 nmol) produced a moderate pain intensity (P=0.04) and mild tenderness (P=0.04) without inducing unacceptable side effects. Intramuscular infusion of a combination of Bk, 5-HT, His, and PGE(2) induced a prolonged moderate pain and tenderness in healthy humans, and this model may be a valuable tool in future studies of the pathophysiological mechanisms of myofascial pain.

Adult↗

Sensitization: its role in primary headache.

The pathophysiology of the two most common primary headaches, migraine and tension-type headache, is complex and not yet fully understood. Recent animal and human studies examining these headaches indicate that the nociceptive input to the central nervous system (CNS) may be increased due to activation or sensitization of peripheral sensory afferents. The barrage of nociceptive impulses may result in sensitization of second- and third-order neurons in the CNS. In this way, sensitization may play a role in initiation and maintenance of migraine and tension-type headache. It is likely that the effects of established medication for both disorders may be partly due to a reduction in sensitization. Several interesting drugs that counteract sensitization are under development, and targeting this mode of action seems to be a promising way of improving the treatment for these prevalent disorders.

Animals↗

Muscle palpation with controlled finger pressure: new equipment for the study of tender myofascial tissues.

While manual palpation is the most important method for evaluation of tender myofascial tissues, it lacks reliability. Therefore, we have developed an instrument, called a 'palpometer', which allows the measurement of pressure exerted during palpation. The palpometer consists of a thin pressure-sensitive plastic device attached to the palpating finger, and of a scale recording the pressure applied to the device. Known forces were applied to the pressure sensitive device under various experimental conditions and the corresponding values were read on the palpometer scale. Then 14 observers, blinded to the palpometer scale, palpated the temporal muscle on the same subject twice, with an interval of 1 week. A highly significant correlation was found between palpometer recordings and forces applied to the pressure-sensitive device (P < 0.0001). Exerted force at a given palpometer value varied 3.1% within and 7.2% between 2 observers. During palpation of the temporal muscle pressure intensities within the 14 observers did not differ significantly from week to week (P = 0.68). Between the 14 observers pressure intensities varied considerably with a range of 73.5-196 arbitrary units. Thus, a reliable instrument for measuring pressure intensities during palpation of myofascial tissue has been developed. The large variation in palpation pressures between observers indicates that palpation of tender myofascial tissue may be considerably improved by use of the palpometer. This instrument will be indispensable in research studies employing palpation and in the training of physicians to diagnose myofascial pain disorders.

Adult↗