Secondary hyperalgesia to mechanical but not heat stimuli following a capsaicin injection in hairy skin

&NA; A psychophysical investigation was carried out to examine whether heat hyperalgesia exists within the secondary mechanical hyperalgesia zone surrounding a capsaicin injection site on hairy skin. A non‐contact laser stimulator was used to deliver temperature controlled stimuli to sites within and outside the zone of mechanical hyperalgesia. Heat testing was carried out before and after the intradermal injection of 50 &mgr;g of capsaicin into the volar forearm. The zones of mechanical hyperalgesia to punctate and stroking stimuli and the region of flare were also mapped after the capsaicin injection. Heat pain thresholds inside the secondary mechanical hyperalgesic zone were not significantly different from thresholds outside the secondary mechanical hyperalgesia zone. In addition, pain ratings to an ascending series of heat stimuli delivered inside the zone of secondary hyperalgesia were not significantly different from pain ratings outside the zone of secondary hyperalgesia. Thus, there was no evidence for heat hyperalgesia within the zone of secondary hyperalgesia to punctate mechanical stimuli. Though the areas of punctate and stroking hyperalgesia were correlated, no correlation existed between the magnitude of capsaicin evoked pain and the areas mechanical hyperalgesia to punctate and stroking stimuli or the area of flare. This suggests that independent mechanisms may mediate evoked pain, central sensitization that leads to mechanical hyperalgesia, and axon reflexive flare.

[1]  Robert H. LaMotte,et al.  Dose-dependent pain and mechanical hyperalgesia in humans after intradermal injection of capsaicin , 1989, Pain.

[2]  P. Wall Neurophysiological mechanisms of referred pain and hyperalgesia , 1993 .

[3]  H. Torebjörk,et al.  Central changes in processing of mechanoreceptive input in capsaicin‐induced secondary hyperalgesia in humans. , 1992, The Journal of physiology.

[4]  A. Basbaum,et al.  Receptor endocytosis and dendrite reshaping in spinal neurons after somatosensory stimulation. , 1995, Science.

[5]  R. Treede,et al.  Dissociated secondary hyperalgesia in a subject with a large-fibre sensory neuropathy , 1993, Pain.

[6]  Richard A. Meyer,et al.  A Laser Stimulator for the Study of Cutaneous Thermal and Pain Sensations , 1976, IEEE Transactions on Biomedical Engineering.

[7]  James N. Campbell,et al.  EVIDENCE FOR DIFFERENT MECHANISMS OF PRIMARY AND SECONDARY HYPERALGESIA FOLLOWING HEAT INJURY TO THE GLABROUS SKIN , 1984 .

[8]  H. Wolff,et al.  STUDIES ON PAIN: THE RELATION BETWEEN CUTANEOUS VASODILATATION, PAIN THRESHOLD AND SPONTANEOUS ITCHING AND PAIN , 1957, The American journal of the medical sciences.

[9]  Martin Koltzenburg,et al.  Dynamic and static components of mechanical hyperalgesia in human hairy skin , 1992, Pain.

[10]  T. Bliss,et al.  NMDA receptors - their role in long-term potentiation , 1987, Trends in Neurosciences.

[11]  P R Burgess,et al.  Myelinated afferent fibres responding specifically to noxious stimulation of the skin , 1967, The Journal of physiology.

[12]  E. Perl,et al.  Myelinated afferent fibres innervating the primate skin and their response to noxious stimuli , 1968, The Journal of physiology.

[13]  B. Lynn,et al.  The sensitization of high threshold mechanoreceptors with myelinated axons by repeated heating. , 1977, The Journal of physiology.

[14]  R. LaMotte,et al.  Neurogenic hyperalgesia: central neural correlates in responses of spinothalamic tract neurons. , 1991, Journal of neurophysiology.

[15]  Robert H. LaMotte,et al.  Sensitization of cat dorsal horn neurons to innocuous mechanical stimulation after intradermal injection of capsaicin , 1989, Brain Research.

[16]  H. Kehlet,et al.  Time course of primary and secondary hyperalgesia after heat injury to the skin. , 1993, British journal of anaesthesia.

[17]  James N. Campbell,et al.  Cutaneous injection of the capsaicin analogue, NE-21610, produces analgesia to heat but not to mechanical stimuli in man , 1992, Pain.

[18]  G. Bennett,et al.  Neuropathic pain sensations are differentially sensitive to dextrorphan , 1994, Neuroreport.

[19]  R. LaMotte,et al.  Peripheral neural mechanisms of cutaneous hyperalgesia following mild injury by heat , 1982, The Journal of neuroscience : the official journal of the Society for Neuroscience.

[20]  W. Jänig,et al.  Small diameter myelinated afferents produce vasodilatation but not plasma extravasation in rat skin. , 1989, The Journal of physiology.

[21]  R. Meyer,et al.  Evidence for two different heat transduction mechanisms in nociceptive primary afferents innervating monkey skin. , 1995, The Journal of physiology.

[22]  M. Koltzenburg,et al.  Dynamic and static components of mechanical hyperalgesia in human hairy skin , 1992, Pain.

[23]  J. Szolcsányi,et al.  A pharmacological approach to elucidation of the role of different nerve fibres and receptor endings in mediation of pain. , 1977, Journal de physiologie.

[24]  R. Gilbert,et al.  Development of secondary hyperalgesia following non-painful thermal stimulation of the skin: a psychophysical study in man , 1993, Pain.

[25]  R. Meyer,et al.  A psychophysical study of secondary hyperalgesia: evidence for increased pain to input from nociceptors , 1994, Pain.

[26]  S. Lisney,et al.  The Axon Reflex: An Outdated Idea or a Valid Hypothesis? , 1989 .

[27]  R. LaMotte Psychophysical and neurophysiological studies of chemically induced cutaneous pain and itch. The case of the missing nociceptor. , 1988, Progress in brain research.

[28]  H. Wolff,et al.  Experimental evidence on the nature of cutaneous hyperalgesia. , 1950, The Journal of clinical investigation.

[29]  L. Arendt-Nielsen,et al.  The effect of pre- versus postinjury infiltration with lidocaine on thermal and mechanical hyperalgesia after heat injury to the skin , 1993, Pain.

[30]  J. Ochoa,et al.  Mechanical hyperalgesias in neuropathic pain patients: Dynamic and static subtypes , 1993, Annals of neurology.

[31]  R. LaMotte,et al.  Neurogenic hyperalgesia: psychophysical studies of underlying mechanisms. , 1991, Journal of neurophysiology.

[32]  R. LaMotte,et al.  Neurogenic hyperalgesia: the search for the primary cutaneous afferent fibers that contribute to capsaicin-induced pain and hyperalgesia. , 1991, Journal of neurophysiology.