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      Stability of behavioral estimates of activity-dependent modulation of pain

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          Temporal sensory summation of pain (TSSP) is a proxy measure of windup in humans and results in increased ratings of pain caused by a repetitive, low-frequency noxious stimulus. Aftersensations (ASs) are pain sensations that remain after TSSP has been induced. We examined the within-session and across-session variability in TSSP and AS estimation in healthy participants and in participants with exercise-induced muscle pain in order to determine whether the presence of pain affected the stability of TSSP and ASs. TSSP was estimated by application of 10 repetitive, low-frequency (<0.33 Hz) thermal pulses and measured by the simple slope of pain ratings between the first and fifth pulses. ASs were measured by the presence of any remaining pain sensations up to 1 minute after TSSP was induced. TSSP estimation remained moderately stable in pain-free participants and in participants with pain within a single testing session but demonstrated low stability across sessions in pain-free participants. AS estimation was stable for all groups. Estimation of TSSP and ASs using these protocols appears to be a reliable single-session outcome measure in studies of interventions for acute muscle pain and in experimental studies with healthy participants. This article evaluates the reliability of a commonly used method of estimating TSSP and ASs in both healthy participants and in a clinically relevant model of acute pain. These protocols have the potential to be used as single-session outcome measures for interventional studies and in experimental studies.

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          Aftersensations in experimental and clinical hypersensitivity.

          This study examined aftersensations after repetitive pinprick stimulation in nerve injury patients with allodynia and in capsaicin sensitized skin in control subjects. Forty-one patients and 12 male control subjects were stimulated repetitively with a computer-driven von Frey hair in sensitized skin and in contralateral normal skin at 0.2 and 2.0Hz. Pain during and after stimulation was scored on an electronic visual analogue scale and sampled on a computer. Maximum evoked pain, time to pain onset, duration of pain and duration of aftersensations were calculated from stored data. Aftersensations were significantly more frequent in sensitized skin than in contralateral normal skin in both control subjects and patients. Pain was evoked more frequently and maximum evoked pain score was significantly higher in sensitized skin compared to contralateral normal skin in both groups. Furthermore, evoked pain score was frequency dependent with a significantly higher pain score at 2.0 than at 0.2Hz. There was a significant positive correlation between maximum evoked pain scores and duration of aftersensations both in patients and control subjects. No difference was observed in maximum pain score, time to pain onset and duration of aftersensations between the groups. Findings suggest that aftersensations and evoked pain are mediated by a common mechanism, which most likely is central. The clinical manifestation of aftersensations can be mimicked in an experimental pain model so aftersensations may be another useful parameter in assessment of central sensitization.

            Author and article information

            J Pain Res
            Journal of Pain Research
            Dove Medical Press
            24 May 2011
            : 4
            : 151-157
            [1 ] Department of Physical Therapy, University of Florida, Gainesville, FL, USA
            [2 ] Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL, USA
            [3 ] Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
            Author notes
            Correspondence: Meryl J Alappattu, Department of Physical Therapy, University of Florida, PO Box 100154, Gainesville, FL 32610-0154, USA, Tel +1 352 273 6123, Fax +1 352 273 6109, Email meryl@ 123456phhp.ufl.edu
            © 2011 Alappattu et al, publisher and licensee Dove Medical Press Ltd.

            This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

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