Differential processing of laser stimuli by Aδ and C fibres in major depression

&NA; Clinical studies have revealed that up to 92% of major depressed patients report pain complaints such as back or abdominal pain. Furthermore, patients suffering from depression exhibit increased superficial pain thresholds and decreased ischemic (deep) pain thresholds during experimental pain testing in comparison to healthy controls. Here, we aimed to investigate a putative role of Aδ‐ and C‐fibre activation in altered pain perception in the disease. Laser‐evoked potentials (LEPs) of 27 unmedicated depressed patients and 27 matched controls were recorded. Aδ and C fibres were activated separately. Amplitudes and latencies of N2 and P2 peaks of Aδ‐ (Aδ‐LEP) and C‐fibre‐ (C‐LEP) related LEPs were evaluated. Depressed patients showed significantly decreased Aδ‐LEP amplitudes (N2 peak: P = 0.019; P2 peak: P = 0.024) and delayed C‐LEP latencies (P2 peak: P = 0.0495; N2 peak: P = 0.0556). In contrast, C‐LEP amplitudes and Aδ‐LEP latencies were unaffected. Our results might be suggestive of the differential impact of physiological changes on pain processing in depression. Thus, Aδ‐LEP might reflect the physiological correlate of the augmented superficial pain thresholds during depression. On the contrary, the C‐fibre component mediates the facets of pain processing, outlasting the stimulation period, and has been shown to be exaggerated in chronic pain states. Therefore, the functional over‐representation of the C‐fibre component found in our study might be a possible link between depression and associated pain complaints. Laser‐evoked potentials of depressed patients and controls were recorded. Results suggest a differential impact of physiological changes of the disease on pain processing.

[1]  J. Guelfi,et al.  Pain Complaints in Depressed Inpatients , 2000, Psychopathology.

[2]  H. Sauer,et al.  Influence of gender and hemispheric lateralization on heat pain perception in major depression. , 2003, Journal of psychiatric research.

[3]  W. Miltner,et al.  Brain electrical correlates of pain processing , 1998, Zeitschrift für Rheumatologie.

[4]  Double stimulation of tiny skin areas in human subjects increases the number of C- and Aδ-fiber responses , 2005, Neuroscience Letters.

[5]  W. Miltner,et al.  Scalp topography of ultralate (C-fibres) evoked potentials following thulium YAG laser stimuli to tiny skin surface areas in humans , 2001, Clinical Neurophysiology.

[6]  Wagner F. Gattaz,et al.  Pain perception threshold in major depression , 1993, Biological Psychiatry.

[7]  J. Hirsch,et al.  Comparison of contrast-response functions from multifocal visual-evoked potentials (mfVEPs) and functional MRI responses. , 2008, Journal of vision.

[8]  B. Lumb,et al.  Selective inhibition from the anterior hypothalamus of C- versus A-fibre mediated spinal nociception , 2008, PAIN.

[9]  Karl-Jürgen Bär,et al.  Increased Prefrontal Activation During Pain Perception in Major Depression , 2007, Biological Psychiatry.

[10]  Dc Washington.  Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. , 1994 .

[11]  Thomas Weiss,et al.  A bioadaptive approach for experimental pain research in humans using laser-evoked brain potentials , 1997, Neuroscience Letters.

[12]  K. Bär,et al.  Increased cold-pain thresholds in major depression. , 2010, The journal of pain : official journal of the American Pain Society.

[13]  B. Lumb.  Hypothalamic and midbrain circuitry that distinguishes between escapable and inescapable pain. , 2004, News in physiological sciences : an international journal of physiology produced jointly by the International Union of Physiological Sciences and the American Physiological Society.

[14]  Tom Eichele,et al.  Semi-automatic identification of independent components representing EEG artifact , 2009, Clinical Neurophysiology.

[15]  U. Baumgärtner,et al.  Clinical usefulness of laser-evoked potentials , 2003, Neurophysiologie Clinique/Clinical Neurophysiology.

[16]  R. Meyer,et al.  Secondary hyperalgesia to punctate mechanical stimuli. Central sensitization to A-fibre nociceptor input. , 1999, Brain : a journal of neurology.

[17]  R. Treede,et al.  Cerebral potentials evoked by painful, laser stimuli in patients with syringomyelia. , 1991, Brain : a journal of neurology.

[18]  U. Baumgärtner,et al.  Differential nociceptive deficits in patients with borderline personality disorder and self-injurious behavior: laser-evoked potentials, spatial discrimination of noxious stimuli, and pain ratings , 2004, Pain.

[19]  R. Kakigi,et al.  Conduction velocity of the spinothalamic tract following CO2 laser stimulation of C-fibers in humans , 2002, Pain.

[20]  F. Mauguière,et al.  Hyperalgesia with reduced laser evoked potentials in neuropathic pain , 1999, Pain.

[21]  S J Linton,et al.  A review of psychological risk factors in back and neck pain. , 2000, Spine.

[22]  A. Beck,et al.  An inventory for measuring depression. , 1961, Archives of general psychiatry.

[23]  A. Mouraux,et al.  Determinants of laser-evoked EEG responses: pain perception or stimulus saliency? , 2008, Journal of neurophysiology.

[24]  M. Heinricher,et al.  Descending control of nociception: Specificity, recruitment and plasticity , 2009, Brain Research Reviews.

[25]  B. Lumb,et al.  Spinal dorsal horn neuronal responses to myelinated versus unmyelinated heat nociceptors and their modulation by activation of the periaqueductal grey in the rat , 2006, The Journal of physiology.

[26]  Thomas Weiss,et al.  Brain activation upon selective stimulation of cutaneous C- and Aδ-fibers , 2008, NeuroImage.

[27]  Till R. Schneider,et al.  Using ICA for the Analysis of Multi-Channel EEG Data , 2010 .

[28]  Sutthiphong Srigrarom.  Dynamics of isolated columnar vortex in tube with sinusoidal cross-section , 2005, J. Vis..

[29]  A. Mouraux,et al.  Nociceptive laser-evoked brain potentials do not reflect nociceptive-specific neural activity. , 2009, Journal of neurophysiology.

[30]  B. Lumb,et al.  Midbrain control of spinal nociception discriminates between responses evoked by myelinated and unmyelinated heat nociceptors in the rat , 2006, Pain.

[31]  W. Miltner,et al.  Laser-evoked potentials to noxious stimulation during hypnotic analgesia and distraction of attention suggest different brain mechanisms of pain control. , 2001, Psychophysiology.

[32]  Gian Domenico Iannetti,et al.  A multisensory investigation of the functional significance of the “pain matrix” , 2011, NeuroImage.

[33]  M. Avoli,et al.  Laser‐evoked potentials as a tool for assessing the efficacy of antinociceptive drugs , 2010, European journal of pain.

[34]  L. Plaghki,et al.  The effects of A‐fiber pressure block on perception and neurophysiological correlates of brief non‐painful and painful CO2 laser stimuli in humans , 2003, European journal of pain.

[35]  S. Lautenbacher,et al.  Pain perception in depression: relationships to symptomatology and naloxone‐sensitive mechanisms. , 1994, Psychosomatic medicine.

[36]  J. Lorenz,et al.  Neurophysiological evaluation of pain. , 1998, Electroencephalography and clinical neurophysiology.

[37]  Karl-Jürgen Bär,et al.  Pain perception in major depression depends on pain modality , 2005, Pain.

[38]  T. Patterson,et al.  Prevalence, onset, and risk of psychiatric disorders in men with chronic low back pain: a controlled study , 1991, Pain.

[39]  Stefan Debener,et al.  Simultaneous EEG and fMRI: Recording, Analysis, and Application , 2010 .

[40]  Terrence J. Sejnowski,et al.  Enhanced detection of artifacts in EEG data using higher-order statistics and independent component analysis , 2007, NeuroImage.

[41]  L Leistritz,et al.  Connectivity Analysis of Somatosensory Evoked Potentials in Patients with Major Depression , 2010, Methods of Information in Medicine.

[42]  E. Walker,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .

[43]  T. Weiss,et al.  Pseudohypoalgesia on the Skin: A Novel View on the Paradox of Pain Perception in Depression , 2011, Journal of clinical psychopharmacology.

[44]  M. Hamilton.  A RATING SCALE FOR DEPRESSION , 1960, Journal of neurology, neurosurgery, and psychiatry.

[45]  L. Plaghki,et al.  Direct isolation of ultra-late (C-fibre) evoked brain potentials by CO2 laser stimulation of tiny cutaneous surface areas in man , 1996, Neuroscience Letters.

[46]  Arnaud Delorme,et al.  EEGLAB: an open source toolbox for analysis of single-trial EEG dynamics including independent component analysis , 2004, Journal of Neuroscience Methods.

[47]  W. Maixner,et al.  Reduced tolerance and cardiovascular response to ischemic pain in minor depression. , 1999, Journal of affective disorders.

[48]  W. Katon,et al.  Depression and pain comorbidity: a literature review. , 2003, Archives of internal medicine.

[49]  James N. Campbell,et al.  Peripheral mechanisms of cutaneous nociception , 2006 .

[50]  J. Marshall.  THE SKIN SENSES , 1969 .

[51]  B. Lumb.  Inescapable and Escapable Pain is Represented in Distinct Hypothalamic‐Midbrain Circuits: Specific Roles for aδ‐ and C‐Nociceptors , 2002, Experimental physiology.

[52]  T. Mayer,et al.  Psychiatric Illness and Chronic Low-Back Pain: The Mind and the Spine—Which Goes First? , 1993, Spine.

[53]  R. Treede,et al.  Laser-evoked cerebral potentials in the assessment of cutaneous pain sensitivity in normal subjects and patients. , 1991, Revue neurologique.

[54]  S. Debener,et al.  Source localization of auditory evoked potentials after cochlear implantation. , 2007, Psychophysiology.

[55]  Chris Dickens,et al.  Impact of Depression on Experimental Pain Perception: A Systematic Review of the Literature with Meta-Analysis , 2003, Psychosomatic medicine.

[56]  B. Lumb,et al.  Descending control of spinal nociception from the periaqueductal grey distinguishes between neurons with and without C-fibre inputs , 2008, Pain.

[57]  P. Roland.  Cortical representation of pain , 1992, Trends in Neurosciences.

[58]  Tobias Rachow,et al.  Sympathetic skin response following painful electrical stimulation is increased in major depression , 2010, PAIN®.

[59]  R. Melzack.  The McGill Pain Questionnaire: Major properties and scoring methods , 1975, PAIN.

[60]  T. Weiss,et al.  Selektive C-Faser-Stimulation durch Stimulation winziger Hautareale , 2006, Der Schmerz.

[61]  F. Cerveró,et al.  Somatic and visceral inputs to the thoracic spinal cord of the cat: marginal zone (lamina I) of the dorsal horn. , 1987, The Journal of physiology.

[62]  Rolf-Detlef Treede,et al.  Neurophysiological studies of pain pathways in peripheral and central nervous system disorders , 2003, Journal of Neurology.

[63]  Koji Inui,et al.  Cerebral responses following stimulation of unmyelinated C-fibers in humans: electro- and magneto-encephalographic study , 2003, Neuroscience Research.

[64]  H. Jasper,et al.  The ten-twenty electrode system of the International Federation. The International Federation of Clinical Neurophysiology. , 1999, Electroencephalography and clinical neurophysiology. Supplement.

[65]  L. Plaghki,et al.  Determination of nerve conduction velocity of C-fibres in humans from thermal thresholds to contact heat (thermode) and from evoked brain potentials to radiant heat (CO2 laser) , 1999, Neurophysiologie Clinique/Clinical Neurophysiology.

[66]  R. Kakigi,et al.  CO2 laser‐induced pain‐related somatosensory evoked potentials in peripheral neuropathies: Correlation between electrophysiological and histopathological findings , 1991, Muscle & nerve.

[67]  S. Lautenbacher,et al.  Relationship between clinical pain complaints and pain sensitivity in patients with depression and panic disorder. , 1999, Psychosomatic medicine.

[68]  G. D. Iannetti,et al.  Laser evoked potentials for assessing sensory neuropathy in human patients , 2004, Neuroscience Letters.