Asymmetry and time-course of cutaneous sympathetic reflex responses following sustained excitation of chemosensitive nociceptors in humans

Magerl, Walter; Koltzenburg, M; Schmitz, Jörg; Handwerker, Hermann O.

doi:10.1016/0165-1838(95)00077-1

Cited by 31 publications

(17 citation statements)

References 35 publications

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“…Although Magerl et al (1996) attributed the asymmetry of this response to a segmental somatosympathetic reflex, the present findings suggest the involvement of a lateralized supraspinal reflex.…”

Section: Discussionmentioning

confidence: 48%

“…Importantly, Magerl et al (1996) reported that sympathetic vasoconstrictor reflexes to sustained nociceptive stimulation of the forearm were greater in the ipsilateral than contralateral hand. Although Magerl et al (1996) attributed the asymmetry of this response to a segmental somatosympathetic reflex, the present findings suggest the involvement of a lateralized supraspinal reflex.…”

Section: Discussionmentioning

confidence: 99%

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Immersion of the hand in ice water releases adrenergic vasoconstrictor tone in the ipsilateral temple

Drummond

2006

Autonomic Neuroscience

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Immersion of the hand in painfully-cold water induces cutaneous vasodilatation in the temples, more so ipsilaterally than contralaterally. To investigate the mechanism of this response, guanethidine or saline was administered by transcutaneous iontophoresis to a recording site in the temple of ten participants before they immersed one of their hands in ice water. Guanethidine displaces noradrenaline from sympathetic nerve terminals and inhibits sympathetic noradrenergic neurotransmission. Therefore, it was hypothesized that guanethidine pretreatment would block vasodilatation mediated by release of sympathetic vasoconstrictor tone in cutaneous vessels in the temple. During hand immersion, increases in the amplitude of the pulse waveform detected by laser Doppler flowmetry were greater in the ipsilateral than contralateral temple (86% versus 34% above baseline, p<0.05), and pretreatment with guanethidine prevented this asymmetric response (ipsilateral response 21% above baseline and contralateral response 32%, difference not significant). Guanethidine also inhibited ipsilateral increases in cutaneous blood flow during hand immersion in responsive participants. These findings suggest that limb pain inhibited ipsilateral adrenergic vasoconstrictor outflow in the temple. Thus, the findings challenge the concept of the sympathetic nervous system as a "mass action" system that discharges in unison to meet environmental demands. Instead, they suggest that the sympathetic nervous system is highly differentiated, with separate control of discrete reflex pathways on each side of the body.

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Section: Discussionmentioning

confidence: 48%

Section: Discussionmentioning

confidence: 99%

Immersion of the hand in ice water releases adrenergic vasoconstrictor tone in the ipsilateral temple

Drummond

2006

Autonomic Neuroscience

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“…Magerl et al [5] noted that slight increases in pinching pressure were mirrored by slight increases in vasoconstriction in the thumb, even though subjects were usually unaware of the pressure change. Magerl et al [6] further reported that topical application of mustard oil to the forearm, which elicits burning pain, and histamine, which induces itching, lowered the temperature of the hands. Since the decrease was greater ipsilaterally than contralaterally, Magerl et al suggested that cutaneous nociceptive neurons form the afferent limb of a spinal sympathetic vasoconstrictor reflex.…”

Section: Supraspinal Influences On Spinal Sympathetic Reflexesmentioning

confidence: 96%

Supraspinal influences on spinal sympathetic reflexes

Drummond

2003

Clinical Autonomic Research

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“…In healthy humans, measurements of skin temperature and skin blood flow during noxious stimulation suggest the existence of regional sympathetic vasoconstrictor reflexes [15][16][17], similar to the nociceptor-driven segmental sympathetic reflexes demonstrated in electrophysiologic studies in the cat [18,19]. However, simultaneous recordings of sympathetic nerve traffic from skin-innervating nerve fascicles in both legs in human subjects have shown no differences in sympathetic outflow to a limb subjected to various experimental painful stimuli, compared with the contralateral nonpainful limb [20].…”

Section: Does Pain Elicit a Regional Change In Sympathetic Nerve Actimentioning

confidence: 99%

What lies above and beyond the concept of “sympathetically maintained pain”?

Elam

2001

Clinical Autonomic Research

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Asymmetry and time-course of cutaneous sympathetic reflex responses following sustained excitation of chemosensitive nociceptors in humans

Cited by 31 publications

References 35 publications

Immersion of the hand in ice water releases adrenergic vasoconstrictor tone in the ipsilateral temple

Immersion of the hand in ice water releases adrenergic vasoconstrictor tone in the ipsilateral temple

Supraspinal influences on spinal sympathetic reflexes

What lies above and beyond the concept of “sympathetically maintained pain”?

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