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Eur J Pain. 2010 Apr;14(4):359-65. doi: 10.1016/j.ejpain.2009.06.001. Epub 2009 Jul 14.

Electrical low-frequency stimulation induces long-term depression of sensory and affective components of pain in healthy man.

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Interdisciplinary Center for Clinical Research, RWTH Aachen University, Pauwelsstrasse 30, D-52074 Aachen, Germany.


Electrical low-frequency stimulation (LFS) of nociceptive skin afferents reliably induces long-term depression (LTD) of pain. Recent experiments have assessed the effects of LTD on pain perception by using a simple one-dimensional rating scale. The psychophysical study investigated the impact of noxious LFS on the sensory and affective aspects of pain perception by multidimensional rating scales. In 20 healthy volunteers, nociceptive fibers of the left hand dorsum were electrically stimulated by a concentric electrode. Test stimulation series (15 stimuli each, 0.125Hz) were performed before (Pre) and after (Post) a conditioning LFS (1Hz, 20min) or no stimulation period (Control). Pain ratings concerning test stimulation and LFS were obtained by multidimensional assessment including Verbal rating scale of perceived stimulus intensity (VRS-I) and unpleasantness (VRS-U) and pain perception scale with sensory (SES-S) and affective items (SES-A). After the conditioning LFS, VRS-I, VRS-U, SES-S, and SES-A decreased as compared to Pre series and Control. During conditioning LFS, ratings decreased. Factor analysis of SES-S revealed sole reduction of superficial sharp pain perception after conditioning LFS in contrast to Control experiment. Perception of deep rhythmic pain decreased over time. Deep constant pain and superficial heat pain were not affected. Electrical test stimulation via concentric electrode evokes sensory as well as affective pain perception. Both components decrease during noxious, conditioning LFS and remain depressed for at least one hour. Reduction of sharp pain points to Adelta fiber mediated LTD. These results stress the analgesic potency of LTD and its possible impact on future therapy in chronic pain.

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