[en] [en] OBJECTIVE: To compare nociceptive event-related brain potentials elicited by a high-speed contact-thermode vs an infrared CO2 laser stimulator.
METHODS: Contact heat-evoked potentials (CHEPs) and CO2 laser-evoked potentials (LEPs) were recorded in healthy volunteers using a high-speed contact-thermode (>200 °C/s) and a temperature-controlled CO2 laser. In separate experiments, stimuli were matched in terms of target surface temperature (55 °C) and intensity of perception. A finite-element model of skin heat transfer was used to explain observed differences.
RESULTS: For 55 °C stimuli, CHEPs were reduced in amplitude and delayed in latency as compared to LEPs. For perceptually matched stimuli (CHEPs: 62 °C; LEPs: 55 °C), amplitudes were similar, but CHEPs latencies remained delayed. These differences could be explained by skin thermal inertia producing differences in the heating profile of contact vs radiant heat at the dermo-epidermal junction.
CONCLUSIONS: Provided that steep heating ramps are used, and that target temperature is matched at the dermo-epidermal junction, contact and radiant laser heat stimulation elicit responses of similar magnitude. CHEPs are delayed compared to LEPs.
SIGNIFICANCE: CHEPs could be used as an alternative to LEPs for the diagnosis of neuropathic pain. Dedicated normative values must be used to account for differences in skin thermal transfer.
Disciplines :
Neurology
Author, co-author :
Lejeune, Nicolas ; Université de Liège - ULiège > GIGA > GIGA Consciousness - Coma Science Group
Petrossova, Eva; Institute of NeuroScience, UCLouvain, 53, Avenue E. Mounier, 1200 Brussels, Belgium
Frahm, Ken Steffen; Integrative Neuroscience, Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
Mouraux, André; Institute of NeuroScience, UCLouvain, 53, Avenue E. Mounier, 1200 Brussels, Belgium
Language :
English
Title :
High-speed heating of the skin using a contact thermode elicits brain responses comparable to CO2 laser-evoked potentials.
NL is a post-doctoral researcher of the F.R.S.-Fonds National pour la Recherche Scientifique (FNRS), Belgium. KSF is supported by the Danish National Research Foundation (DNRF121). We thank André Dufour from University of Strasbourg for conception of the thermal cutaneous stimulator and technical support.NL is a post-doctoral researcher of the F.R.S.-Fonds National pour la Recherche Scientifique (FNRS), Belgium. KSF is supported by the Danish National Research Foundation (DNRF121). We thank André Dufour from University of Strasbourg for conception of the thermal cutaneous stimulator and technical support.
Atherton, D.D., Facer, P., Roberts, K.M., Misra, V.P., Chizh, B.A., Bountra, C., et al. Use of the novel Contact Heat Evoked Potential Stimulator (CHEPS) for the assessment of small fibre neuropathy: Correlations with skin flare responses and intra-epidermal nerve fibre counts. BMC Neurol, 7, 2007, 21, 10.1186/1471-2377-7-21.
Baumgärtner, U., Cruccu, G., Iannetti, G.D., Treede, R.-D., Laser guns and hot plates. Pain 116:1–2 (2005), 1–3, 10.1016/j.pain.2005.04.021.
Churyukanov, M., Plaghki, L., Legrain, V., Mouraux, A., Thermal Detection Thresholds of Aδ- and C-Fibre Afferents Activated by Brief CO2 Laser Pulses Applied onto the Human Hairy Skin. PLoS One 7:4 (2012), 1–10, 10.1371/journal.pone.0035817.
Cruccu, G., Aminoff, M.J., Curio, G., Guerit, J.M., Kakigi, R., Mauguiere, F., et al. Recommendations for the clinical use of somatosensory-evoked potentials. Clin Neurophysiol 119:8 (2008), 1705–1719, 10.1016/j.clinph.2008.03.016.
De Keyser, R., van den Broeke, E.N., Courtin, A., Dufour, A., Mouraux, A., Event-related brain potentials elicited by high-speed cooling of the skin: A robust and non-painful method to assess the spinothalamic system in humans. Clin Neurophysiol 129:5 (2018), 1011–1019, 10.1016/j.clinph.2018.02.123.
De Schoenmacker, I., Berry, C., Blouin, J.-S., Rosner, J., Hubli, M., Jutzeler, C.R., et al. An intensity matched comparison of laser- and contact heat evoked potentials. Sci Rep, 11(1), 2021, 6861, 10.1038/s41598-021-85819-w.
Frahm, K.S., Andersen, O.K., Arendt-Nielsen, L., Mørch, C.D., Spatial temperature distribution in human hairy and glabrous skin after infrared CO2 laser radiation. Biomed Eng Online, 9(1), 2010, 69, 10.1186/1475-925X-9-69.
Frahm, K.S., Gervasio, S., Arguissain, F., Mouraux, A., New insights into cutaneous laser stimulation – dependency on skin and laser type. Neuroscience 448 (2020), 71–84, 10.1016/j.neuroscience.2020.09.021.
Greffrath, W., Baumgärtner, U., Treede, R.-D., Peripheral and central components of habituation of heat pain perception and evoked potentials in humans. Pain 132:3 (2007), 301–311, 10.1016/j.pain.2007.04.026.
Inui, K., Tran, T.D., Hoshiyama, M., Kakigi, R., Preferential stimulation of Aδ fibers by intra-epidermal needle electrode in humans. Pain 96:3 (2002), 247–252, 10.1016/S0304-3959(01)00453-5.
Leone, C., Dufour, A., Di Stefano, G., Fasolino, A., Di Lionardo, A., La Cesa, S., et al. Cooling the skin for assessing small-fibre function. Pain 160:9 (2019), 1967–1975, 10.1097/j.pain.0000000000001584.
Marchandise, E., Mouraux, A., Plaghki, L., Henrotte, F., Finite element analysis of thermal laser skin stimulation for a finer characterization of the nociceptive system. J Neurosci Methods 223 (2014), 1–10, 10.1016/j.jneumeth.2013.11.010.
Mouraux, A., Iannetti, G.D., Across-trial averaging of event-related EEG responses and beyond. Magn Reson Imaging 26:7 (2008), 1041–1054, 10.1016/j.mri.2008.01.011.
Mouraux, A., Iannetti, G.D., The search for pain biomarkers in the human brain. Brain 141:12 (2018), 3290–3307, 10.1093/brain/awy281.
Mouraux, A., Iannetti, G.D., Plaghki, L., Low intensity intra-epidermal electrical stimulation can activate Aδ-nociceptors selectively. Pain 150:1 (2010), 199–207, 10.1016/j.pain.2010.04.026.
Mulders, D., de Bodt, C., Lejeune, N., Courtin, A., Liberati, G., Verleysen, M., et al. Dynamics of the perception and EEG signals triggered by tonic warm and cool stimulation. PLoS One, 15(4), 2020, 10.1371/journal.pone.0231698.
Nahra, H., Plaghki, L., The effects of A-fiber pressure block on perception and neurophysiological correlates of brief non-painful and painful CO2 laser stimuli in humans. Eur J Pain 7:2 (2003), 189–199, 10.1016/S1090-3801(02)00099-X.
Plaghki, L., Mouraux, A., How do we selectively activate skin nociceptors with a high power infrared laser? Physiology and biophysics of laser stimulation. Neurophysiol Clin 33:6 (2003), 269–277.
Takahashi, S., Ishida, A., Kubo, A., Kawasaki, H., Ochiai, S., Nakayama, M., et al. Homeostatic pruning and activity of epidermal nerves are dysregulated in barrier-impaired skin during chronic itch development. Sci Rep, 9(1), 2019, 8625, 10.1038/s41598-019-44866-0.
Treede, R.D., Meyer, R.A., Raja, S.N., Campbell, J.N., Evidence for two different heat transduction mechanisms in nociceptive primary afferents innervating monkey skin. J Physiol 483:Pt 3 (1995), 747–758.