Long-term potentiation (LTP) and long-term depression (LTD) of synaptic strength are ubiquitous mechanisms of synaptic plasticity, but their functional relevance in humans remains obscure. Here we report that a long-term increase in perceived pain to electrical test stimuli was induced by high-frequency electrical stimulation (HFS) (5 ϫ 1 sec at 100 Hz) of peptidergic cutaneous afferents (27% above baseline, undiminished for Ͼ3 hr). In contrast, a long-term decrease in perceived pain (27% below baseline, undiminished for 1 hr) was induced by low-frequency stimulation (LFS) (17 min at 1 Hz). Pain testing with punctate mechanical probes (200 m diameter) in skin adjacent to the HFS-LFS conditioning skin site revealed a marked twofold to threefold increase in pain sensitivity (secondary hyperalgesia, undiminished for Ͼ3 hr) after HFS but also a moderate secondary hyperalgesia (30% above baseline) after strong LFS. Additionally, HFS but not LFS caused pain to light tactile stimuli in adjacent skin (allodynia). In summary, HFS and LFS stimulus protocols that induce LTP or LTD in spinal nociceptive pathways in animal experiments led to similar LTP-and LTD-like changes in human pain perception (long-term hyperalgesia or hypoalgesia) mediated by the conditioned pathway. Additionally, secondary hyperalgesia and allodynia in adjacent skin induced by the HFS protocol and, to a minor extent, also by the LFS protocol, suggested that these perceptual changes encompassed an LTP-like heterosynaptic facilitation of adjacent nociceptive pathways by a hitherto unknown mechanism.

We report multiple lines of evidence for a stochastic signal that is correlated among 67 pulsars from the 15 yr pulsar timing data set collected by the North American Nanohertz Observatory for Gravitational Waves. The correlations follow the Hellings–Downs pattern expected for a stochastic gravitational-wave background. The presence of such a gravitational-wave background with a power-law spectrum is favored over a model with only independent pulsar noises with a Bayes factor in excess of 1014, and this same model is favored over an uncorrelated common power-law spectrum model with Bayes factors of 200–1000, depending on spectral modeling choices. We have built a statistical background distribution for the latter Bayes factors using a method that removes interpulsar correlations from our data set, finding p = 10−3 (≈3σ) for the observed Bayes factors in the null no-correlation scenario. A frequentist test statistic built directly as a weighted sum of interpulsar correlations yields p = 5 × 10−5 to 1.9 × 10−4 (≈3.5σ–4σ). Assuming a fiducial f −2/3 characteristic strain spectrum, as appropriate for an ensemble of binary supermassive black hole inspirals, the strain amplitude is 2.4 − 0.6 + 0.7 × 10 − 15 (median + 90% credible interval) at a reference frequency of 1 yr−1. The inferred gravitational-wave background amplitude and spectrum are consistent with astrophysical expectations for a signal from a population of supermassive black hole binaries, although more exotic cosmological and astrophysical sources cannot be excluded. The observation of Hellings–Downs correlations points to the gravitational-wave origin of this signal.

We present ultra high speed optical coherence tomography (OCT) with multi-megahertz line rates and investigate the achievable image quality. The presented system is a swept source OCT setup using a Fourier domain mode locked (FDML) laser. Three different FDML-based swept laser sources with sweep rates of 1, 2.6 and 5.2MHz are compared. Imaging with 4 spots in parallel quadruples the effective speed, enabling depth scan rates as high as 20.8 million lines per second. Each setup provides at least 98dB sensitivity and approximately 10microm resolution in tissue. High quality 2D and 3D imaging of biological samples is demonstrated at full scan speed. A discussion about how to best specify OCT imaging speed is included. The connection between voxel rate, line rate, frame rate and hardware performance of the OCT setup such as sample rate, analog bandwidth, coherence length, acquisition dead-time and scanner duty cycle is provided. Finally, suitable averaging protocols to further increase image quality are discussed.

Quantitative sensory testing (QST) is an instrument to assess positive and negative sensory signs, helping to identify mechanisms underlying pathologic pain conditions. In this study, we evaluated the test-retest reliability (TR-R) and the interobserver reliability (IO-R) of QST in patients with sensory disturbances of different etiologies. In 4 centres, 60 patients (37 male and 23 female, 56.4±1.9years) with lesions or diseases of the somatosensory system were included. QST comprised 13 parameters including detection and pain thresholds for thermal and mechanical stimuli. QST was performed in the clinically most affected test area and a less or unaffected control area in a morning and an afternoon session on 2 consecutive days by examiner pairs (4 QSTs/patient). For both, TR-R and IO-R, there were high correlations (r=0.80-0.93) at the affected test area, except for wind-up ratio (TR-R: r=0.67; IO-R: r=0.56) and paradoxical heat sensations (TR-R: r=0.35; IO-R: r=0.44). Mean IO-R (r=0.83, 31% unexplained variance) was slightly lower than TR-R (r=0.86, 26% unexplained variance, P<.05); the difference in variance amounted to 5%. There were no differences between study centres. In a subgroup with an unaffected control area (n=43), reliabilities were significantly better in the test area (TR-R: r=0.86; IO-R: r=0.83) than in the control area (TR-R: r=0.79; IO-R: r=0.71, each P<.01), suggesting that disease-related systematic variance enhances reliability of QST. We conclude that standardized QST performed by trained examiners is a valuable diagnostic instrument with good test-retest and interobserver reliability within 2days. With standardized training, observer bias is much lower than random variance. Quantitative sensory testing performed by trained examiners is a valuable diagnostic instrument with good interobserver and test-retest reliability for use in patients with sensory disturbances of different etiologies to help identify mechanisms of neuropathic and non-neuropathic pain.

We describe a novel buffering technique for increasing the A-scan rate of swept source optical coherence tomography (SSOCT) systems employing low duty cycle swept source lasers. This technique differs from previously reported buffering techniques in that it employs a fast optical switch, capable of switching in 60 ns, instead of a fused fiber coupler at the end of the buffering stage, and is therefore appreciably more power efficient. The use of the switch also eliminates patient exposure to light that is not used for imaging that occurs at the end of the laser sweep, thereby increasing the system sensitivity. We also describe how careful management of polarization can remove undesirable artifacts due to polarization mode dispersion. In addition, we demonstrate how numerical compensation techniques can be used to modify the signal from a Mach-Zehnder interferometer (MZI) clock obtained from the original sweep to recalibrate the buffered sweep, thereby reducing the complexity of systems employing lasers with integrated MZI clocks. Combining these methods, we constructed an SSOCT system employing an Axsun technologies laser with a sweep rate of 100kHz and 6dB imaging range of 5.5mm. The sweep rate was doubled with sweep buffering to 200 kHz, and the imaging depth was extended to 9 mm using coherence revival. We demonstrated the feasibility of this system by acquiring images of the anterior segments and retinas of healthy human volunteers.