Spatial summation of thermal stimuli assessed by a standardized, randomized, single-blinded technique

Spatial summation of thermal stimuli assessed by a standardized, randomized, single-blinded... AbstractBackground and aimsQuantitative sensory testing of thermal perception (QTT) is a valuable method in clinical and experimental assessment of the function of small nerve fibres. Previous studies have indicated existence of spatial summation for warmth, cool and heat pain stimulation, but study designs and assessment methods have not always been mutually consistent. The aims of this study were, first, to examine spatial summation of QTT by differently sized contact thermodes, and, second, to evaluate if these differences are significant from a clinical and scientific perspective.MethodsSixteen healthy subjects were included. Warmth detection (WDT), cool detection (CDT) and heat pain (HPT) thresholds were assessed in random order, with the stimulation areas of the contact thermodes of 3.0, 6.3 and 12.5 cm2, blinded to the subjects. Assessments were made bilaterally at volar part of the distal arm and medial part of the lower leg. Data analyses were by a mixed model with random effect for subject and fixed-effects for the variables, site (arm/leg), thermode area (ln thermode area) and side (dominant/non-dominant), in addition to conventional pairwise non-parametric comparisons.ResultsData from 2 subjects were excluded. In the remaining 14 subjects only 4 subjects were able to identify the correct sequence of thermode sizes. The model demonstrated highly statistical significant relationships regarding main effects: thermode area (P < 0.0001) and stimulation site (P < 0.0001; except for CDT P = 0.011). The only significant interaction was between thermode area*site (P = 0.005) for CDT. The study demonstrated in 17 of 18 possible comparisons between thermode size and stimulation site, a significant spatial summation for WDT, CDT and HPT.ConclusionThis randomized, single-blind study of thermal thresholds demonstrated spatial summation and that considerable deviations may occur if values obtained with differing thermode sizes are used uncritically.ImplicationsData from the present study enable interpolation of thermal thresholds with differing thermode sizes, facilitating comparisons across studies. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Scandinavian Journal of Pain de Gruyter

Spatial summation of thermal stimuli assessed by a standardized, randomized, single-blinded technique

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Publisher
de Gruyter
Copyright
© 2014 Scandinavian Association for the Study of Pain
ISSN
1877-8860
eISSN
1877-8879
D.O.I.
10.1016/j.sjpain.2014.12.001
Publisher site
See Article on Publisher Site

Abstract

AbstractBackground and aimsQuantitative sensory testing of thermal perception (QTT) is a valuable method in clinical and experimental assessment of the function of small nerve fibres. Previous studies have indicated existence of spatial summation for warmth, cool and heat pain stimulation, but study designs and assessment methods have not always been mutually consistent. The aims of this study were, first, to examine spatial summation of QTT by differently sized contact thermodes, and, second, to evaluate if these differences are significant from a clinical and scientific perspective.MethodsSixteen healthy subjects were included. Warmth detection (WDT), cool detection (CDT) and heat pain (HPT) thresholds were assessed in random order, with the stimulation areas of the contact thermodes of 3.0, 6.3 and 12.5 cm2, blinded to the subjects. Assessments were made bilaterally at volar part of the distal arm and medial part of the lower leg. Data analyses were by a mixed model with random effect for subject and fixed-effects for the variables, site (arm/leg), thermode area (ln thermode area) and side (dominant/non-dominant), in addition to conventional pairwise non-parametric comparisons.ResultsData from 2 subjects were excluded. In the remaining 14 subjects only 4 subjects were able to identify the correct sequence of thermode sizes. The model demonstrated highly statistical significant relationships regarding main effects: thermode area (P < 0.0001) and stimulation site (P < 0.0001; except for CDT P = 0.011). The only significant interaction was between thermode area*site (P = 0.005) for CDT. The study demonstrated in 17 of 18 possible comparisons between thermode size and stimulation site, a significant spatial summation for WDT, CDT and HPT.ConclusionThis randomized, single-blind study of thermal thresholds demonstrated spatial summation and that considerable deviations may occur if values obtained with differing thermode sizes are used uncritically.ImplicationsData from the present study enable interpolation of thermal thresholds with differing thermode sizes, facilitating comparisons across studies.

Journal

Scandinavian Journal of Painde Gruyter

Published: Oct 1, 2015

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