HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (45) Citing Articles via Google Scholar Google Scholar Articles by Klede, M. Articles by Schmelz, M. Search for Related Content PubMed PubMed Citation Articles by Klede, M. Articles by Schmelz, M.

Central Origin of Secondary Mechanical Hyperalgesia

¹Department of Physiology and Experimental Pathophysiology, University of Erlangen/Nürnberg, 91054 Erlangen, Germany; and ²Department of Anesthesiology and Intensive Care Medicine, Faculty of Clinical Medicine Mannheim, University of Heidelberg, 68167 Mannheim, Germany

Submitted 18 December 2002; accepted in final form 29 January 2003

The contribution for the development of secondary mechanical hyperalgesia by peripheral mechanisms has not been fully elucidated. We have reevaluated the effects of local anesthetics on electrically evoked flare reaction and mechanical hyperalgesia in human skin. We applied 2% lidocaine via intradermal microdialysis fibers at a length of 10 cm for 110 min to the volar forearm to establish a narrow and stable "anesthetic strip." After 60 min of lidocaine perfusion, transdermal electrical stimulation (1 Hz, 50 mA) was applied at a distance of 1 cm from the microdialysis fibers for 30 min. The areas of allodynia and punctate hyperalgesia were marked at the end of the stimulation period. The flare reaction was assessed by laser Doppler scanner and infrared thermography. Total protein content of the dialysate collected at the stimulating electrode was measured photometrically. We found no increase in protein content during electrical stimulation. Flare area (12.4 ± 2.3 vs. 3.5 ± 1.2 cm²) and intensity (426 ± 24 vs. 257 ± 21 PU) were significantly reduced beyond the lidocaine strip. The mean temperature increase in the area beyond the lidocaine strip was significantly reduced (1.1 ± 0.1 vs. 0.2 ± 0.1°C) and did not differ from control areas. In contrast, allodynia (7.4 ± 0.7 and 8.6 ± 0.9 cm) and punctate hyperalgesia (7.6 ± 0.7 and 8.6 ± 0.9 cm) developed symmetrically on both sides of the anesthetic strip. Allodynia subsided 4 min after the end of the electrical stimulation. We conclude that the development of allodynia and punctate hyperalgesia in human skin is centrally mediated, whereas the axon reflex vasodilation is of peripheral origin.

This article has been cited by other articles:

				F. Seifert, G. Kiefer, R. DeCol, M. Schmelz, and C. Maihofner Differential endogenous pain modulation in complex-regional pain syndrome Brain, March 1, 2009; 132(3): 788 - 800. [Abstract] [Full Text] [PDF]

				M. C. Lee, L. Zambreanu, D. K. Menon, and I. Tracey Identifying Brain Activity Specifically Related to the Maintenance and Perceptual Consequence of Central Sensitization in Humans J. Neurosci., November 5, 2008; 28(45): 11642 - 11649. [Abstract] [Full Text] [PDF]

				B. A. Chizh, M. Gohring, A. Troster, G. K. Quartey, M. Schmelz, and W. Koppert Effects of oral pregabalin and aprepitant on pain and central sensitization in the electrical hyperalgesia model in human volunteers Br. J. Anaesth., February 1, 2007; 98(2): 246 - 254. [Abstract] [Full Text] [PDF]

				C. Maihofner, H. O. Handwerker, and F. Birklein Functional imaging of allodynia in complex regional pain syndrome Neurology, March 14, 2006; 66(5): 711 - 717. [Abstract] [Full Text] [PDF]

				C. Maihofner, H. O. Handwerker, B. Neundorfer, and F. Birklein Mechanical hyperalgesia in complex regional pain syndrome: A role for TNF-{alpha}? Neurology, July 26, 2005; 65(2): 311 - 313. [Abstract] [Full Text] [PDF]

				M. Schreckenberger, T. Siessmeier, A. Viertmann, C. Landvogt, H. -G. Buchholz, R. Rolke, R. -D. Treede, P. Bartenstein, and F. Birklein The unpleasantness of tonic pain is encoded by the insular cortex Neurology, April 12, 2005; 64(7): 1175 - 1183. [Abstract] [Full Text] [PDF]

				B. A. Chizh, M. Dusch, M. Puthawala, M. Schmelz, L. M. Cookson, R. Martina, J. Brown, and W. Koppert The Effect of Intravenous Infusion of Adenosine on Electrically Evoked Hyperalgesia in a Healthy Volunteer Model of Central Sensitization Anesth. Analg., September 1, 2004; 99(3): 816 - 822. [Abstract] [Full Text] [PDF]

				C. Maihofner, H. O. Handwerker, B. Neundorfer, and F. Birklein Cortical reorganization during recovery from complex regional pain syndrome Neurology, August 24, 2004; 63(4): 693 - 701. [Abstract] [Full Text] [PDF]