Neuro-physiologically, spatial summation occurs when subliminal inputs arising from multiple afferents induce action potentials in neurons. When applied to human pain physiology, this notion supports the observation that non-painful stimuli can induce pain when applied to larger body areas. Accordingly, painful stimuli that are applied to small areas become more painful when the stimulation area is enlarged. The likely pathophysiologic mechanism underlying spatial summation of pain is the convergence of low-intensity input from multiple afferents to common nociceptive pathways, ultimately eliciting a pain sensation after innocuous stimulation or amplifying pain after painful stimulation.Spatial summation of pain has been extensively studied in human research using different experimental models. Most investigations have confirmed the aforementioned phenomenon of increasing pain sensation with increasing stimulation area [1,2,3]. Interestingly, while spatial summation is particularly strong with stimuli applied within the same dermatome , it occurs also when stimuli are applied to different and even contralateral dermatomes . This suggests that spatial integration of nociceptive stimuli occurs not only at spinal cord level, but also at supraspinal centres.The clinical significance of spatial summation is obvious. Nociceptive input from wide areas or multiple sources are more likely to lead to uncontrolled pain with all related consequences,
Scandinavian Journal of Pain – de Gruyter
Published: Oct 1, 2017
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