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人类中弥散性伤害性抑制控制对伤害性热刺激的编码

Encoding of nociceptive thermal stimuli by diffuse noxious inhibitory controls in humans.

作者信息

Willer J C, De Broucker T, Le Bars D

机构信息

Laboratoire de Neurophysiologie, Faculté de Médecine Pitié-Salpêtrière, Paris, France.

出版信息

J Neurophysiol. 1989 Nov;62(5):1028-38. doi: 10.1152/jn.1989.62.5.1028.

Abstract
  1. It has previously been shown that, in normal humans, heterotopic painful thermal conditioning stimuli induce parallel increase in the thresholds of a spinal nociceptive flexion reflex (RIII reflex) and the concurrent sensation of pain elicited by electrical stimulation of the sural nerve. On the basis of analogous animal studies, we proposed that such phenomena could be related to diffuse noxious inhibitory controls (DNIC), which have been described in the rat. The present study, which was carried out on normal volunteer subjects, was particularly concerned with the extent and temporal characteristics of the depressive effects of DNIC triggered by painful thermal stimuli on RIII reflex activity. In addition, because it was possible that these depressive effects could have resulted from a direct postsynaptic inhibition of motoneurons, a second part of the study was aimed at determining whether or not the heterotopic noxious thermal stimuli also affected the excitability of alpha-motoneurons, as monitored by the monosynaptic Hoffmann reflex (H reflex) technique. 2. In the 11 subjects under study, application of moderate, nonnoxious temperatures (40-44 degree C) to the contralateral hand (via a thermoregulated and agitated waterbath) did not modify the RIII reflex nor the associated sensation of pain. By contrast noxious temperatures clearly depressed the RIII reflex and the concurrent sensation of pain, both during and after the conditioning procedure (CP), in a direct linear relationship to the temperature of the waterbath in the 45-47 degree C range; the maximal depressive effect was observed with the highest conditioning temperature. A significant relationship was also found between the extent of the RIII depression during the CP and that during a 10-min period of post-CP observation. 3. The depressive effects observed on both the RIII reflex and pain were not associated with clear change in autonomic functions. Respiration remained stable during the sessions, with no significant relationship between the temperatures of the waterbath and respiratory rate. Heart rate was slightly but significantly increased during the immersion of the hand in the 46 or 47 degree C waterbaths; this increase, however, ceased with the end of CP. 4. Application of thermal conditioning stimuli produced a slight but nonsignificant increase of the monosynaptic H reflex during the first minute of CP, no matter what was the temperature of the waterbath. However, there were no subsequent variations during the 6-min period of post-CP observation.(ABSTRACT TRUNCATED AT 400 WORDS)
摘要
  1. 先前的研究表明,在正常人体中,异位疼痛性热调节刺激会使脊髓伤害性屈曲反射(RIII反射)的阈值以及同时由腓肠神经电刺激引发的疼痛感觉平行升高。基于类似的动物研究,我们提出这种现象可能与在大鼠中已被描述的弥漫性伤害性抑制控制(DNIC)有关。本研究针对正常志愿者受试者开展,特别关注由疼痛性热刺激触发的DNIC对RIII反射活动的抑制作用的程度和时间特征。此外,由于这些抑制作用可能是由运动神经元的直接突触后抑制导致的,所以研究的第二部分旨在确定异位伤害性热刺激是否也会影响α运动神经元的兴奋性,这通过单突触霍夫曼反射(H反射)技术进行监测。2. 在11名受试对象中,对侧手部施加适度的、无害的温度(40 - 44摄氏度)(通过温度调节和搅拌的水浴)并未改变RIII反射以及相关的疼痛感觉。相比之下,在条件刺激过程(CP)期间及之后,有害温度明显抑制了RIII反射和同时出现的疼痛感觉,在45 - 47摄氏度范围内与水浴温度呈直接线性关系;在最高条件刺激温度下观察到最大抑制效果。在CP期间RIII反射的抑制程度与CP后10分钟观察期内的抑制程度之间也发现了显著关系。3. 在RIII反射和疼痛上观察到的抑制作用与自主神经功能的明显变化无关。在实验过程中呼吸保持稳定,水浴温度与呼吸频率之间无显著关系。在手部浸入46或47摄氏度水浴期间心率略有但显著增加;然而,这种增加在CP结束时停止。4. 无论水浴温度如何,热调节刺激在CP的第一分钟内会使单突触H反射略有但不显著地增加。然而,在CP后6分钟的观察期内没有后续变化。(摘要截断于400字)

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