Rossi Paolo, Pierelli Francesco, Parisi Leoluca, Perrotta Armando, Bartolo Michelangelo, Amabile Giuseppe, Serrao Mariano
Dipartimento di Neurologia Clinica e Otorinolaringoiatria, Istituto di Clinica delle Malattie Nervose e Mentali, II Clinica Neurologica, Università di Roma 'La Sapienza', Viale dell'Università 30, 00185, Rome, Italy.
Clin Neurophysiol. 2003 Jan;114(1):1-6. doi: 10.1016/s1388-2457(02)00321-8.
To evaluate the effect of heterotopic painful stimulation (HPS) on the cutaneous silent period (CSP) and the withdrawal flexor reflex (WFR) in the upper limbs, in an attempt to better identify the nociceptive component of the CSP and its functional relationship with the flexor reflex.
The CSP at different stimulus intensities, the WFR and the H/M ratio were studied in 12 healthy adults. Neurophysiological measurements were recorded in the following 4 conditions: (1) control session; (2) non-painful session (dipping hand in water at 25 degrees C); (3) painful (cold pressor test, CPT); and (4) after-effect (3-8 min after taking hand out of water at 5-6 degrees C).
During the CPT, the duration of the high-threshold CSP was approximately 23% shorter than the baseline value, the high-threshold CSP latency was approximately 10% longer than the baseline value, and the mean RIII reflex area was approximately 40% smaller than the baseline reflex area (all P<0.05). A significant correlation was found between the percentage decrease in the CSP duration and the WFR area (r=0.61, P<0.05).
Our findings indicate that the HPS specifically inhibits both the high-threshold CSP and the WFR, thereby providing further evidence that these cutaneous reflexes are functionally and anatomically related, and that they represent different aspects of a complex nocifensive response.
评估异位疼痛刺激（HPS）对上肢皮肤静息期（CSP）和屈肌反射（WFR）的影响，以更好地识别CSP的伤害性成分及其与屈肌反射的功能关系。
对12名健康成年人进行不同刺激强度下的CSP、WFR和H/M比值的研究。在以下4种条件下记录神经生理学测量结果：（1）对照阶段；（2）非疼痛阶段（将手浸入25摄氏度的水中）；（3）疼痛阶段（冷加压试验，CPT）；（4）后效应阶段（将手从5-6摄氏度的水中取出3-8分钟后）。
在CPT期间，高阈值CSP的持续时间比基线值缩短约23%，高阈值CSP潜伏期比基线值延长约10%，平均RIII反射面积比基线反射面积小约40%（均P<0.05）。CSP持续时间的减少百分比与WFR面积之间存在显著相关性（r=0.61，P<0.05）。
我们的研究结果表明，HPS特异性地抑制高阈值CSP和WFR，从而进一步证明这些皮肤反射在功能和解剖学上相关，并且它们代表复杂伤害防御反应的不同方面。
