Callaghan Maureen, Sternbach Richard A, Nyquist Judith K, Timmermans Gretchen
Pain Unit, Veterans Administration Hospital, San Diego, Calif. 92161 U.S.A.
Pain. 1978 Aug;5(2):115-127. doi: 10.1016/0304-3959(78)90033-7.
Patients with chronic pain in one limb, who experienced pain reduction with transcutaneous neurostimulation, were examined for sensory perception in that limb before and during electrical analgesia. Contralateral limbs and normal subjects served as controls. Sensory stimuli were quantified, a range of stimuli were presented and data were analyzed according to sensory decision theory. Results showed that, compared to controls, painful limbs show considerable impairment in sensory sensitivity. With transcutaneous neurostimulation, however, sensitivity is improved towards normal, whereas electrical stimulation slightly impairs perception in normal limbs. These results suggest that electrical analgesia involves both peripheral small-fiber blockade and large-fiber stimulation; the latter is more noticeable in the normal limb, but the former effect is predominant when pain reduction occurs in a painful limb.
对一侧肢体患有慢性疼痛且经皮神经刺激后疼痛减轻的患者,在电镇痛前和电镇痛期间对该肢体的感觉知觉进行了检查。对侧肢体和正常受试者作为对照。对感觉刺激进行了量化,呈现了一系列刺激,并根据感觉决策理论对数据进行了分析。结果表明,与对照组相比,疼痛肢体的感觉敏感性有相当大的损害。然而,经皮神经刺激可使敏感性恢复到正常水平,而电刺激会轻微损害正常肢体的知觉。这些结果表明,电镇痛涉及外周小纤维阻滞和大纤维刺激;后者在正常肢体中更明显,但当疼痛肢体出现疼痛减轻时,前者的作用占主导地位。