Modulation by cold pressor test of single pulse and pulse train electrocutaneous stimulation

E.M. van der Heide, Jan R. Buitenweg, Michel Johannes Antonius Maria van Putten, Enrico Marani, Wim Rutten

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Purpose At present our knowledge of various processes involved in chronification of pain is limited. Novel observation techniques can increase our understanding of neurophysiological mechanisms in pain processing. Earlier, a comparison between single pulse (SP) and pulse train (PT) electrocutaneous stimulation was performed. We showed that both SP and PT influence subjective ratings and evoked potentials (EP) components differently. Using an additional modulating pain stimulus might give further insight in these differences. A commonly used modulating stimulus is the cold pressor test (CPT). CPT evokes a diffuse noxious inhibitory control (DNIC) effect. Pain patients show impairment of DNIC and abnormal endogenous modulation. In this study, we analysed the effect of the CPT on the processing of SP and PT stimuli in subjects using subjective pain ratings and EPs. Method Healthy subjects (10m/12f) were electrically stimulated at the left middle fingertip during two protocols. In a protocol the right hand was immersed in water of 0-1°C (CPT) or 32°C (control). Subjects had to withdraw and re-immerse their hand after subsequently 3 and 1 minute until the end of the protocol. Grand average EPs and numeric rating scale (NRS) scores were averaged from 105 stimuli of 5 stimulus amplitudes or number of pulses (NoP). Results The results showed a decrease of amplitude of EP components and decrease of subjective ratings by CPT, for both SP and PT. The relationship between NRS and stimulus amplitude or NoP was unchanged by CPT. For both SP and PT both N150 and P300 EP amplitudes decreased by CPT. Conclusion NRS scores and EP component amplitudes decreased by CPT. The different effects for SP and PT were not changed by CPT. Inhibition by CPT might be ascribed to activation of endogenous pain modulation by DNIC. These results are promising to further our knowledge of the nociceptive system.
Original languageUndefined
Title of host publication13th European Congress of Clinical Neurophysiology
Place of PublicationAmsterdam
Number of pages1
Publication statusPublished - 5 May 2008
Event13th European Congress of Clinical Neurophysiology, ECCN 2008 - Istanbul, Turkey
Duration: 4 May 20088 May 2008
Conference number: 13

Publication series

NameClinical Neurophysiology
NumberSupplement 1
ISSN (Print)1388-2457
ISSN (Electronic)1872-8952


Conference13th European Congress of Clinical Neurophysiology, ECCN 2008
Abbreviated titleECCN


  • EWI-13361
  • IR-62446
  • METIS-251150
  • BSS-Central mechanisms underlying chronic pain

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