The Journal of Neurophysiology Vol. 78 No. 2 August 1997, pp. 992-1002
Copyright ©1997 The American Physiological Society

Characteristics of Temporal Summation of Second Pain Sensations Elicited by Brief Contact of Glabrous Skin by a Preheated Thermode

Charles J. Vierck Jr.¹, Richard L. Cannon¹, Gentry Fry¹, William Maixner², and Barry L. Whitsel³

¹ Department of Neuroscience, University of Florida College of Medicine, Gainesville, Florida 32610-0244; ² Dental Research Center, University of North Carolina School of Dentistry; and ³ Department of Physiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina 27599

Vierck, Charles J., Jr., Richard L. Cannon, Gentry Fry, William Maixner, and Barry L. Whitsel. Characteristics of temporal summation of second pain sensations elicited by brief contact of glabrous skin by a preheated thermode. J. Neurophysiol. 78: 992-1002, 1997. Temporal summation of sensory intensity was investigated in normal subjects using novel methods of thermal stimulation. A Peltier thermode was heated and then applied in a series of brief (700 ms) contacts to different sites on the glabrous skin of either hand. Repetitive contacts on the thenar or hypothenar eminence, at interstimulus intervals (ISIs) of 3 s, progressively increased the perceived intensity of a thermal sensation that followed each contact at an onset latency >2 s. Temporal summation of these delayed (late) sensations was proportional to thermode temperature over a range of 45-53°C, progressing from a nonpainful level (warmth) to painful sensations that could be rated as very strong after 10 contacts. Short-latency pain sensations rarely were evoked by such stimuli and never attained levels substantially above pain threshold for the sequences and temperatures presented. Temporal summation produced by brief contacts was greater in rate and amount than increases in sensory intensity resulting from repetitive ramping to the same temperature by a thermode in constant contact with the skin. Variation of the interval between contacts revealed a dependence of sensory intensity on interstimulus interval that is similar to physiological demonstrations of windup, where increasing frequencies of spike train activity are evoked from spinal neurons by repetitive activation of unmyelinated nociceptors. However, substantial summation at repetition rates of 0.33 Hz was observed for temperatures that produced only late sensations of warmth when presented at frequencies <0.16 Hz. Measurements of subepidermal skin temperature from anesthetized monkeys revealed different time courses for storage and dissipation of heat by the skin than for temporal summation and decay of sensory intensity for the human subjects. For example, negligible heat loss occurred during a 6-s interval between two trials of 10 contacts at 0.33 Hz, but ratings of sensory magnitude decreased from very strong levels of pain to sensations of warmth during the same interval. Evidence that temporal summation of sensory intensity during series of brief contacts relies on central integration, rather than a sensitization of peripheral receptors, was obtained using two approaches. In the first, a moderate degree of temporal summation was observed during alternating stimulation of adjacent but nonoverlapping skin sites at 0.33 Hz. Second, temporal summation was significantly attenuated by prior administration of dextromethorphan, a N-methyl-D-aspartate receptor antagonist.

This article has been cited by other articles:

				B. L. Whitsel, O. V. Favorov, Y. Li, M. Quibrera, and M. Tommerdahl Area 3a Neuron Response to Skin Nociceptor Afferent Drive Cereb Cortex, June 4, 2008; (2008) bhn086v1. [Abstract] [Full Text] [PDF]

				R. R. Edwards Individual differences in endogenous pain modulation as a risk factor for chronic pain Neurology, August 9, 2005; 65(3): 437 - 443. [Abstract] [Full Text] [PDF]

				L. Diatchenko, G. D. Slade, A. G. Nackley, K. Bhalang, A. Sigurdsson, I. Belfer, D. Goldman, K. Xu, S. A. Shabalina, D. Shagin, et al. Genetic basis for individual variations in pain perception and the development of a chronic pain condition Hum. Mol. Genet., January 1, 2005; 14(1): 135 - 143. [Abstract] [Full Text] [PDF]

				A. D. Craig Lamina I, but not Lamina V, Spinothalamic Neurons Exhibit Responses That Correspond With Burning Pain J Neurophysiol, October 1, 2004; 92(4): 2604 - 2609. [Abstract] [Full Text] [PDF]

				A. P. Mauderli, C. J. Vierck Jr., R. L. Cannon, A. Rodrigues, and C. Shen Relationships Between Skin Temperature and Temporal Summation of Heat and Cold Pain J Neurophysiol, July 1, 2003; 90(1): 100 - 109. [Abstract] [Full Text] [PDF]

				H. Foo and P. Mason Discharge of Raphe Magnus ON and OFF Cells Is Predictive of the Motor Facilitation Evoked by Repeated Laser Stimulation J. Neurosci., March 1, 2003; 23(5): 1933 - 1940. [Abstract] [Full Text] [PDF]

				A. D. Craig and D. Andrew Responses of Spinothalamic Lamina I Neurons to Repeated Brief Contact Heat Stimulation in the Cat J Neurophysiol, April 1, 2002; 87(4): 1902 - 1914. [Abstract] [Full Text] [PDF]

				A. D. Craig, K. Krout, and D. Andrew Quantitative Response Characteristics of Thermoreceptive and Nociceptive Lamina I Spinothalamic Neurons in the Cat J Neurophysiol, September 1, 2001; 86(3): 1459 - 1480. [Abstract] [Full Text] [PDF]

				A. Wadhwa, D. Clarke, C. S. Goodchild, and D. Young Large-Dose Oral Dextromethorphan as an Adjunct to Patient-Controlled Analgesia with Morphine after Knee Surgery Anesth. Analg., February 1, 2001; 92(2): 448 - 454. [Abstract] [Full Text] [PDF]

				M. Tommerdahl, K. A. Delemos, O. V. Favorov, C. B. Metz, C. J. Vierck Jr., and B. L. Whitsel Response of Anterior Parietal Cortex to Different Modes of Same-Site Skin Stimulation J Neurophysiol, December 1, 1998; 80(6): 3272 - 3283. [Abstract] [Full Text] [PDF]

				W. Danysz and C. G. Parsons Glycine and N-Methyl-D-Aspartate Receptors: Physiological Significance and Possible Therapeutic Applications Pharmacol. Rev., December 1, 1998; 50(4): 597 - 664. [Abstract] [Full Text] [PDF]