Evidence for central summation of C and A delta nociceptive activity in man

Pain. 1994 Nov;59(2):273-280. doi: 10.1016/0304-3959(94)90080-9.

Abstract

Using two different stimulators, we have induced activity in A delta and C afferents in order to investigate a possible summation of nociceptive activity from these two fiber types. We used nociceptive electrical stimulation to evoke activity in A delta fibers. High-intensity light from a xenon lamp, focused into a liquid light guide which was positioned on a spot painted black under the sole of the foot, resulted in a characteristic delayed burning sensation, indicating selective C-fiber activation. By varying the delay between radiant heat and electrical stimuli (0-3000 msec), sensations evoked by these stimuli were brought to coincide. When we elicited the electrical stimulation during on-going burning pain, corresponding to a delay of approximately 1 sec between the stimulations, we found a significantly higher nociceptive withdrawal reflex in tibialis anterior (P < 0.01) and a higher overall pain rating (P < 0.05). The existence of a summation mechanism at the spinal cord is the most likely explanation for our findings. Furthermore, the results demonstrate that the nociceptive reflex may be modulated by on-going C-fiber activity.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Electric Stimulation
  • Electromyography
  • Female
  • Humans
  • Male
  • Motor Neurons / physiology
  • Nerve Fibers / physiology*
  • Nerve Fibers, Myelinated / physiology*
  • Nociceptors / physiology*
  • Pain Measurement
  • Photic Stimulation
  • Reaction Time / physiology
  • Sural Nerve / physiology