Quick discrimination of A(delta) and C fiber mediated pain based on three verbal descriptors.

<h4>Background</h4>A(δ) and C fibers are the major pain-conducting nerve fibers, activate only partly the same brain areas, and are differently involved in pain syndromes. Whether a stimulus excites predominantly A(δ) or C fibers is a commonly asked question in basic pain research but a...

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Autores principales: Florian Beissner, Amadeus Brandau, Christian Henke, Lisa Felden, Ulf Baumgärtner, Rolf-Detlef Treede, Bruno G Oertel, Jörn Lötsch
Formato: article
Lenguaje:EN
Publicado: Public Library of Science (PLoS) 2010
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Acceso en línea:https://doaj.org/article/4815551418b34ba998c3aa967ed35f9f
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Sumario:<h4>Background</h4>A(δ) and C fibers are the major pain-conducting nerve fibers, activate only partly the same brain areas, and are differently involved in pain syndromes. Whether a stimulus excites predominantly A(δ) or C fibers is a commonly asked question in basic pain research but a quick test was lacking so far.<h4>Methodology/principal findings</h4>Of 77 verbal descriptors of pain sensations, "pricking", "dull" and "pressing" distinguished best (95% cases correctly) between A(δ) fiber mediated (punctate pressure produced by means of von Frey hairs) and C fiber mediated (blunt pressure) pain, applied to healthy volunteers in experiment 1. The sensation was assigned to A(δ) fibers when "pricking" but neither "dull" nor "pressing" were chosen, and to C fibers when the sum of the selections of "dull" or "pressing" was greater than that of the selection of "pricking". In experiment 2, with an independent cohort, the three-descriptor questionnaire achieved sensitivity and specificity above 0.95 for distinguishing fiber preferential non-mechanical induced pain (laser heat, exciting A(δ) fibers, and 5-Hz electric stimulation, exciting C fibers).<h4>Conclusion</h4>A three-item verbal rating test using the words "pricking", "dull", and "pressing" may provide sufficient information to characterize a pain sensation evoked by a physical stimulus as transmitted via A(δ) or via C fibers. It meets the criteria of a screening test by being easy to administer, taking little time, being comfortable in handling, and inexpensive while providing high specificity for relevant information.