Journal of Pain and Symptom Management
Volume 25, Issue 1 , Pages 64-73 , January 2003

Stability and Reliability of Detection Thresholds for Human A-Beta and A-Delta Sensory Afferents Determined by Cutaneous Electrical Stimulation

  • Christine N Sang, MD, MPH

      Affiliations

    • Corresponding Author InformationAddress reprint requests to: Christine N. Sang, MD, MPH, Department of Anesthesia, Clinics 3, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
    • Department of Anesthesia, Massachusetts General Hospital, Harvard Medical School,Boston, MA USA
  • ,
  • Mitchell B Max, MD

      Affiliations

    • Pain and Neurosensory Mechanisms Branch, National Institute of Dental Research, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
  • ,
  • Richard H Gracely, PhD

      Affiliations

    • Pain and Neurosensory Mechanisms Branch, National Institute of Dental Research, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA

,Accepted 25 February 2002.

  • Image Result

    Schematic of left arm marked by five equi-spaced sites. Sites 2 and 4 lie over the a) ulnar and b) median nerves, respectively.

    Schematic of left arm marked by five equi-spaced sites. Sites 2 and 4 lie over the a) ulnar and b) median nerves, respectively.

  • Image Result

    Experiment I. Effect of pulse duration on detection threshold and pain threshold. A: Sensory thresholds at three different pulse durations. The solid points represent the mean PT's; the hollow points

    Experiment I. Effect of pulse duration on detection threshold and pain threshold. A: Sensory thresholds at three different pulse durations. The solid points represent the mean PT's; the hollow points represent the mean DT's. Detection threshold error bars are too small to be visible. B: Ratios of pain to detection thresholds at three different pulse durations. Each data point represents the mean (± standard error) PT:DT ratio for the 10 subjects.

  • Image Result
    Experiment II. Time course of detection and pain thresholds for each site averaged over the 10 subjects. Each series of connected data points represents 6 successive determinations approximately 5 min

    Experiment II. Time course of detection and pain thresholds for each site averaged over the 10 subjects. Each series of connected data points represents 6 successive determinations approximately 5 minutes apart of DT and PT, without moving the electrode. Z1 through Z5 correspond to sites 1–5 in Figure 1.

  • Image Result
    Pain/Detection (PT:DT) ratios for all trials in Experiment II plotted against detection threshold. Data from each subject are shown by a unique symbol. Each subject received 6 DT and PT trials at each

    Pain/Detection (PT:DT) ratios for all trials in Experiment II plotted against detection threshold. Data from each subject are shown by a unique symbol. Each subject received 6 DT and PT trials at each of 5 locations for a total of 30 trials for each of the 10 subjects. The line indicates the maximum possible ratio with a stimulation limit of 10 mA. Data from 3 subjects with both detection thresholds greater than 8 and ratios near the limit are classified as outliers.

  • Image Result
    Experiment III. Effect of site on detection threshold and pain threshold. A: Sensory thresholds at the 5 sites (depicted in Figure 1). The hollow points represent mean DT's; the solid points represent

    Experiment III. Effect of site on detection threshold and pain threshold. A: Sensory thresholds at the 5 sites (depicted in Figure 1). The hollow points represent mean DT's; the solid points represent mean PT's. B: Ratios of pain to detection thresholds at the 5 sites. Each data point represents the mean PT:DT ratio for each individual subject.

  • Image Result
    Pain/Detection (PT:DT) ratios for all trials in Experiment III plotted against detection threshold. Data from each subject are shown by a unique symbol. Each subject received 6 DT and PT trials at eac

    Pain/Detection (PT:DT) ratios for all trials in Experiment III plotted against detection threshold. Data from each subject are shown by a unique symbol. Each subject received 6 DT and PT trials at each of 5 locations for a total of 30 trials for each of the 10 subjects. The line indicates the maximum possible ratio with a stimulation limit of 10 mA. Data from 3 subjects with both detection thresholds greater than 0.8 mA and ratios near the limit are classified as outliers.

PII: S0885-3924(02)00541-9

Journal of Pain and Symptom Management
Volume 25, Issue 1 , Pages 64-73 , January 2003