How different experimental models of secondary hyperalgesia change the nociceptive flexion reflex

C. Leone; A. Di Lionardo; G. Di Pietro; G. Di Stefano; P. Falco; A.J. Blockeel; O. Caspani; L. Garcia-Larrea; A. Mouraux; K.G. Phillips; R.D. Treede; A. Truini

doi:10.1016/j.clinph.2021.08.018

How different experimental models of secondary hyperalgesia change the nociceptive flexion reflex

C. Leone, A. Di Lionardo, G. Di Pietro, G. Di Stefano, P. Falco, A.J. Blockeel, O. Caspani, L. Garcia-Larrea, A. Mouraux, K.G. Phillips, R.D. Treede, A. Truini

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Abstract

Objective: In this neurophysiological study in healthy humans, we assessed how central sensitization induced by either high-frequency stimulation (HFS) or topical capsaicin application modulates features of the RIII reflex response. The ability of these stimuli to engage the endogenous pain modulatory system was also tested.

Methods: In 26 healthy participants we elicited an RIII reflex using suprathreshold stimulation of the sural nerve. Subsequently HFS or capsaicin were applied to the foot and the RIII reflex repeated after15 minutes. Contact heating of the volar forearm served as the heterotopic test stimulus to probe activation of the endogenous pain modulatory system.

Results: HFS significantly reduced the pain threshold by 29% and the RIII reflex threshold by 20%. Capsaicin significantly reduced the pain threshold by 17% and the RIII reflex threshold by 18%. Both HFS and capsaicin left RIII reflex size unaffected. Numerical Rating Scale (NRS) pain scores elicited by the heterotopic noxious heat stimulus were unaffected by capsaicin and slightly increased by HFS.

Conclusions: HFS and capsaicin similarly modulated the pain threshold and RIII reflex threshold, without a concomitant inhibitory effect of the endogenous pain modulatory system. Significance: Our neurophysiological study supports the use of the RIII reflex in investigating central sensitization in humans.

Original language	English
Pages (from-to)	2989-2995
Number of pages	7
Journal	Clinical Neurophysiology
Volume	132
Issue number	12
Early online date	5 Oct 2021
DOIs	https://doi.org/10.1016/j.clinph.2021.08.018
Publication status	Published - Dec 2021

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© 2021 International Federation of Clinical Neurophysiology

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Leone, C., Lionardo, A. D., Pietro, G. D., Stefano, G. D., Falco, P., Blockeel, A. J., Caspani, O., Garcia-Larrea, L., Mouraux, A., Phillips, K. G., Treede, R. D., & Truini, A. (2021). How different experimental models of secondary hyperalgesia change the nociceptive flexion reflex. Clinical Neurophysiology, 132(12), 2989-2995. https://doi.org/10.1016/j.clinph.2021.08.018

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title = "How different experimental models of secondary hyperalgesia change the nociceptive flexion reflex",

abstract = "Objective: In this neurophysiological study in healthy humans, we assessed how central sensitization induced by either high-frequency stimulation (HFS) or topical capsaicin application modulates features of the RIII reflex response. The ability of these stimuli to engage the endogenous pain modulatory system was also tested.Methods: In 26 healthy participants we elicited an RIII reflex using suprathreshold stimulation of the sural nerve. Subsequently HFS or capsaicin were applied to the foot and the RIII reflex repeated after15 minutes. Contact heating of the volar forearm served as the heterotopic test stimulus to probe activation of the endogenous pain modulatory system.Results: HFS significantly reduced the pain threshold by 29% and the RIII reflex threshold by 20%. Capsaicin significantly reduced the pain threshold by 17% and the RIII reflex threshold by 18%. Both HFS and capsaicin left RIII reflex size unaffected. Numerical Rating Scale (NRS) pain scores elicited by the heterotopic noxious heat stimulus were unaffected by capsaicin and slightly increased by HFS.Conclusions: HFS and capsaicin similarly modulated the pain threshold and RIII reflex threshold, without a concomitant inhibitory effect of the endogenous pain modulatory system. Significance: Our neurophysiological study supports the use of the RIII reflex in investigating central sensitization in humans.",

author = "C. Leone and Lionardo, {A. Di} and Pietro, {G. Di} and Stefano, {G. Di} and P. Falco and A.J. Blockeel and O. Caspani and L. Garcia-Larrea and A. Mouraux and K.G. Phillips and R.D. Treede and A. Truini",

note = "Publisher Copyright: {\textcopyright} 2021 International Federation of Clinical Neurophysiology",

year = "2021",

month = dec,

doi = "10.1016/j.clinph.2021.08.018",

language = "English",

volume = "132",

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T1 - How different experimental models of secondary hyperalgesia change the nociceptive flexion reflex

AU - Leone, C.

AU - Lionardo, A. Di

AU - Pietro, G. Di

AU - Stefano, G. Di

AU - Falco, P.

AU - Blockeel, A.J.

AU - Caspani, O.

AU - Garcia-Larrea, L.

AU - Mouraux, A.

AU - Phillips, K.G.

AU - Treede, R.D.

AU - Truini, A.

PY - 2021/12

Y1 - 2021/12

N2 - Objective: In this neurophysiological study in healthy humans, we assessed how central sensitization induced by either high-frequency stimulation (HFS) or topical capsaicin application modulates features of the RIII reflex response. The ability of these stimuli to engage the endogenous pain modulatory system was also tested.Methods: In 26 healthy participants we elicited an RIII reflex using suprathreshold stimulation of the sural nerve. Subsequently HFS or capsaicin were applied to the foot and the RIII reflex repeated after15 minutes. Contact heating of the volar forearm served as the heterotopic test stimulus to probe activation of the endogenous pain modulatory system.Results: HFS significantly reduced the pain threshold by 29% and the RIII reflex threshold by 20%. Capsaicin significantly reduced the pain threshold by 17% and the RIII reflex threshold by 18%. Both HFS and capsaicin left RIII reflex size unaffected. Numerical Rating Scale (NRS) pain scores elicited by the heterotopic noxious heat stimulus were unaffected by capsaicin and slightly increased by HFS.Conclusions: HFS and capsaicin similarly modulated the pain threshold and RIII reflex threshold, without a concomitant inhibitory effect of the endogenous pain modulatory system. Significance: Our neurophysiological study supports the use of the RIII reflex in investigating central sensitization in humans.

AB - Objective: In this neurophysiological study in healthy humans, we assessed how central sensitization induced by either high-frequency stimulation (HFS) or topical capsaicin application modulates features of the RIII reflex response. The ability of these stimuli to engage the endogenous pain modulatory system was also tested.Methods: In 26 healthy participants we elicited an RIII reflex using suprathreshold stimulation of the sural nerve. Subsequently HFS or capsaicin were applied to the foot and the RIII reflex repeated after15 minutes. Contact heating of the volar forearm served as the heterotopic test stimulus to probe activation of the endogenous pain modulatory system.Results: HFS significantly reduced the pain threshold by 29% and the RIII reflex threshold by 20%. Capsaicin significantly reduced the pain threshold by 17% and the RIII reflex threshold by 18%. Both HFS and capsaicin left RIII reflex size unaffected. Numerical Rating Scale (NRS) pain scores elicited by the heterotopic noxious heat stimulus were unaffected by capsaicin and slightly increased by HFS.Conclusions: HFS and capsaicin similarly modulated the pain threshold and RIII reflex threshold, without a concomitant inhibitory effect of the endogenous pain modulatory system. Significance: Our neurophysiological study supports the use of the RIII reflex in investigating central sensitization in humans.

UR - https://doi.org/10.1016/j.clinph.2021.08.018

U2 - 10.1016/j.clinph.2021.08.018

DO - 10.1016/j.clinph.2021.08.018

M3 - Article (Academic Journal)

C2 - 34715423

SN - 1388-2457

VL - 132

SP - 2989

EP - 2995

JO - Clinical Neurophysiology

JF - Clinical Neurophysiology

IS - 12

ER -

How different experimental models of secondary hyperalgesia change the nociceptive flexion reflex

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