Document Detail


Perceptual wind-up in the human oesophagus is enhanced by central sensitisation.
MedLine Citation:
PMID:  16492716     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Oesophageal acid infusion induces enhanced pain hypersensitivity in non-acid exposed upper oesophagus (secondary hyperalgesia) in patients with non-cardiac chest pain, thus suggesting central sensitisation contributes to visceral pain hypersensitivity in functional gut disorders (FGD). Perceptual wind-up (increased pain perception to constant intensity sensory stimuli at frequencies>or=0.3 Hz) is used as a proxy for central sensitisation to investigate pain syndromes where pain hypersensitivity is important (for example, fibromyalgia). AIMS: Wind-up in central sensitisation induced human visceral pain hypersensitivity has not been explored. We hypothesised that if wind-up is a proxy for central sensitisation induced human visceral pain hypersensitivity, then oesophageal wind-up should be enhanced by secondary hyperalgesia. METHODS: In eight healthy volunteers (seven males; mean age 32 years), perception at pain threshold to a train of 20 electrical stimuli applied to the hand and upper oesophagus (UO) at either 0.1 Hz (control) or 2 Hz was determined before and one hour after a 30 minute lower oesophageal acid infusion. RESULTS: Wind-up occurred only with the 2 Hz train in the UO and hand (both p=0.01). Following acid infusion, pain threshold decreased (17 (4)%; p=0.01) in the UO, suggesting the presence of secondary hyperalgesia. Wind-up to the 2 Hz train increased in the UO (wind-up ratio 1.4 (0.1) to 1.6 (0.1); p=0.03) but not in the hand (wind-up ratio 1.3 (0.1) and 1.3 (0.1); p=0.3) CONCLUSION: Enhanced wind-up after secondary oesophageal hyperalgesia suggests that visceral pain hypersensitivity induced by central sensitisation results from increased central neuronal excitability. Wind-up may offer new opportunities to investigate the contribution of central neuronal changes to symptoms in FGD.
Authors:
S Sarkar; C J Woolf; A R Hobson; D G Thompson; Q Aziz
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2006-02-21
Journal Detail:
Title:  Gut     Volume:  55     ISSN:  0017-5749     ISO Abbreviation:  Gut     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-06-12     Completed Date:  2006-07-20     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  2985108R     Medline TA:  Gut     Country:  England    
Other Details:
Languages:  eng     Pagination:  920-5     Citation Subset:  AIM; IM    
Affiliation:
Department of GI Science, Clinical Sciences Building, Hope Hospital, Salford, University of Manchester, M6 8HD, UK. sanchoy@aol.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Electric Stimulation
Esophagus / physiology*
Hand
Humans
Hydrochloric Acid / pharmacology
Hydrogen-Ion Concentration
Learning / physiology*
Male
Middle Aged
Pain Measurement
Pain Threshold / physiology*
Perceptual Distortion
Chemical
Reg. No./Substance:
7647-01-0/Hydrochloric Acid
Comments/Corrections

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