Relation of Peripheral Nerve Fiber Size and Sensation in Man

Collins, William F.; Nulsen, Frank E.; Randt, Clark T.

doi:10.1001/archneur.1960.00450040031003

Cited by 255 publications

(71 citation statements)

References 7 publications

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“…Clinically, windup has been reported in fibromyalgia patients compared to normal controls, suggesting that central sensitization contributes to processes uncerlying hyperalgesia and persistant pain states ( One type of extracellular recordings is the compound action potential (CAP) recording from nerves and fiber tracts, which records the various peaks related to the conduction velocity of various axon population in the peripheral nerve (Clark, Hughes, & Gasser, 1935;Gasser, 1941). Recording of CAPs in humans is crucial to determine the impulse conduction in the slowest fibers, which is correlated to the sensation of pain (Collins, Nulsen, & Randt, 1960;Heinbecker, Bishop, & O'Leary, 1933). Field potential in the CNS tracts is also a valuable approach in determining the rostrocaudal distribution of nociceptive primary afferent axons and their terminal arborizations (TRAUB & Mendell, 1988;TRAUB, Sedivec, & Mendell, 1986).…”

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confidence: 99%

The biopsychosocial approach to chronic pain: Scientific advances and future directions.

Gatchel¹,

Peng²,

Peters³

et al. 2007

Psychological Bulletin

2,601

1,903

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The prevalence and cost of chronic pain is a major physical and mental health care problem in the United States today. As a result, there has been a recent explosion of research on chronic pain, with significant advances in better understanding its etiology, assessment and treatment. The purpose of the present article is to provide a review of the most noteworthy developments in the field. The biopsychosocial model is now widely accepted as the most heuristic approach to chronic pain. With this model in mind, a review of the basic neuroscience processes of pain (the bio part of biopsychosocial), as well as the psychosocial factors is presented. This spans research on how psychological and social factors can interact with brain processes to influence health and illness, to the development of new technologies, such as brain imaging, that provide new insights into brain-pain mechanisms.KEY WORDS: biopsychosocial; chronic pain; neuroscience of pain; pain and cognition; pain and emotion Biopsychosocial Approach to Chronic Pain 3The Biopsychosocial Approach to Chronic Pain: Scientific Advances and Future Directions During the past decade, there has been an explosion of research on chronic pain, with significant advances in understanding its etiology, assessment and treatment (Gatchel, 2004; Turk & Monarch, 2002). This research has important health care implications Epidemiological research has shown that chronic pain (loosely defined as prolonged and persistant pain of at least 3-months duration) and chronic recurrent pain (recurrent episodes of pain interspersed with pain free periods extending over months or years) affects 10% -20% of adults in the general population (Blyth et al., 2001; Gureje, Von Korff, Simon & Gater, 1998; Vehaak, Kerssens, Dekker, Sorbi & Bensing, 1998). For example, in a large-scale epidemiological study, Von Korff, Crane, Lane et al. (2005) estimated a 19% prevalence for chronic spinal pain (neck and back) in the U.S. in the previous year, and a 29% lifetime rate. The American Academy of Pain Management (2003) asserted that approximately 57% of all adult Americans reported experiencing recurrent or chronic pain in the past year. About 62% of those individuals reporting being in pain for more than 1 year, and 40% noted that they were constantly in pain. Indeed, as Gatchel (2004) has summarized that pain is a pervasive medical problem: it affects over 50 million Americans and costs more than $70 billion annually in health care costs and lost productivity; it accounts for more than 80% of all physician visits. Moreover, chronic pain is often associated with major comorbid psychiatric disorders and emotional suffering.As the above factors attest, the prevalence and cost of chronic pain is a major physical and mental health care problem in the United States. Moreover, individuals 50 years of age and older are twice as likely to have been diagnosed with chronic pain (Gatchel, 2004;. Currently, there are approximately 35 million Americans aged 65 years or older, accounting for 12.4% of t...

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confidence: 99%

The biopsychosocial approach to chronic pain: Scientific advances and future directions.

Gatchel¹,

Peng²,

Peters³

et al. 2007

Psychological Bulletin

2,601

1,903

View full text Add to dashboard Cite

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“…The hiatus between such receptive units and sensation is partially narrowed by studies on conscious human beings. Work of this type has consistently documented a correlation between the recruitment of slowly-conducting myelinated fibres to cutaneous nerve volleys and the first reports of pain (Heinbecker, Bishop & O'Leary, 1933;Collins, Nulsen & Randt, 1960;Hugon, 1967). Consequently, mechanisms responsible for pain are set in motion by the activity of fine myelinated afferent fibres.…”

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confidence: 98%

Myelinated afferent fibres innervating the primate skin and their response to noxious stimuli

Perl¹

1968

The Journal of Physiology

317

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SUMMARY1. The functional characteristics of cutaneous receptors in the squirrel monkey were determined by recording discharges of single myelinated afferent fibres in peripheral nerves with micro-electrodes or from fine filaments prepared by dissection. One hundred and sixty-nine fibres of the posterior femoral cutaneous nerve and 209 of the superficial radial nerve with conduction velocities between 4 and 88 m/sec were classified according to the nature of the most effective stimulus, discharge characteristics, adaptation rate and organization of the receptive field.2. Twenty per cent of the fibres innervating either hairy or glabrous skin required strong mechanical stimuli for activation; thresholds ranged from moderate to overtly damaging pressures. This class showed little or no sensitivity to thermal changes including noxious heat. Their receptive fields consisted of numerous, mechanically-excitable points or spots. All such fibres gave higher impulse frequencies to noxious than to innocuous mechanical stimuli and a large fraction were considered to be nociceptors because they responded only to noxious deformation. The conduction velocities of nociceptors were distributed between 5 and 28 m/sec.3. All but a few of the other fibres encountered responded vigorously to innocuous stimuli and were readily identified as corresponding to one of the receptor types known to exist in either the primate or the cat. These sensitive receptors were systematically tested by intense cutaneous stimuli; their response to injurious stimuli always could be mimicked by innocuous ones.4. Therefore, in the primate a particular class of slowly-conducting myelinated fibres is partially responsible for signalling mechanicallyinduced cutaneous damage. The probable relation between such afferent fibres and certain kinds of cutaneous pain is explored.

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“…However, the concept of 'specific' sensory fibres involves consideration of not only the response of a receptor to a specific stimulus, but also the perceptual experience aroused by excitation of the receptor (Hensel, 1952). Monitoring of perception can only be carried out in man, and difficulties in recording volleys in slow fibres in intact man have limited the number of studies in which perception has been correlated with evoked neural activity (Collins et al, 1960;Hensel and Boman, 1960).…”

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confidence: 99%

Fibre function and perception during cutaneous nerve block.

MacKenzie¹,

Burke²,

Skuse³

et al. 1975

Journal of Neurology, Neurosurgery & Psychiatry

244

132

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SYNOPSISIn awake human subjects, neural responses in radial nerves to electrical stimulation were recorded with intrafascicular tungsten microelectrodes. Changes in the activity of individual fibre groups during blocking procedures were recorded and correlated with simultaneous alterations in the perception of standardized stimuli. Light touch sensibility in hairy skin appeared to depend on the integrity of A-beta-gamma fibres, cold and pinprick on A-delta fibres, and warmth and dull pain on C fibres.

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Relation of Peripheral Nerve Fiber Size and Sensation in Man

Cited by 255 publications

References 7 publications

The biopsychosocial approach to chronic pain: Scientific advances and future directions.

The biopsychosocial approach to chronic pain: Scientific advances and future directions.

Myelinated afferent fibres innervating the primate skin and their response to noxious stimuli

Fibre function and perception during cutaneous nerve block.

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