• Title/Summary/Keyword: Sensory thresholds

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Effect of 8% lidocaine spray on the sensory and pain thresholds of the skin of the face and hands evaluated by quantitative sensory testing

  • Okayasu, Ichiro;Komiyama, Osamu;Ayuse, Takao;De Laat, Antoon
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.6
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    • pp.361-365
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    • 2018
  • Background: Recently, we examined the effects of 2% lidocaine gel on the tactile sensory and pain thresholds of the face, tongue and hands of symptom-free individuals using quantitative sensory testing (QST); its effect was less on the skin of the face and hands than on the tongue. Consequently, instead of 2% lidocaine gel, we examined the effect of 8% lidocaine spray on the tactile sensory and pain thresholds of the skin of the face and hands of healthy volunteers. Methods: Using Semmes-Weinstein monofilaments, QST of the skin of the cheek and palm (thenar skin) was performed in 20 healthy volunteers. In each participant, two topical sprays were applied. On one side, 0.2 mL of 8% lidocaine pump spray was applied, and on the other side, 0.2 mL of saline pump spray was applied as control. In each participant, QST was performed before and 15 min after each application. Pain intensity was measured using a numeric rating scale (NRS). Results: Both the tactile detection threshold and filament-prick pain detection threshold of the cheek and thenar skin increased significantly after lidocaine application. A significant difference between the effect of lidocaine and saline applications was found on the filament-prick pain detection threshold only. NRS of the cheek skin and thenar skin decreased after application of lidocaine, and not after application of saline. Conclusion: The significant effect of applying an 8% lidocaine spray on the sensory and pain thresholds of the skin of the face and hands can be objectively scored using QST.

The Influence of Medium Frequency Currents According to Frequency on Sensory Threshold (중주파 전류의 주파수가 감각 역치에 미치는 영향)

  • Yu, Jin-Ho;Hwang, Tae-Yeon;Jeong, Jin-Gyu
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.7 no.1
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    • pp.23-27
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    • 2009
  • Purpose : The purpose of this study was to examine the effects of different medium frequency currents on afferent fibers. Methods : Thirty healthy volunteers who had no known history of neurological disorders were equally assigned to one of three groups; 2500Hz, 4000Hz, and control and each group was applied to the left wrist in palmer cutaneous branch of radial nerve by different medium frequency currents for 15 min. We measured the changes of thresholds for tactile, two-point discrimination, and thresholds for pain. Results : The results showed that the medium frequency currents stimulation increased thresholds for tactile, two-point discrimination, and thresholds for pain. However, there is no statistically significant difference between group 2500Hz and group 4000Hz. Conclusion : This may explain thresholds for tactile, two-point discrimination, and thresholds for pain plain medium frequency currents stimulation inhibits the excitability of afferent fibers, but the effect of the frequency difference within medium frequency currents is not demonstrated.

Orofacial Thermal Quantitative Sensory Testing (QST): A Study of Healthy Korean Women and Sex Difference

  • Ahn, Sung-Woo;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.40 no.3
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    • pp.96-101
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    • 2015
  • Purpose: Thermal sensory test as an essential part of quantitative sensory testing (QST) has been recognized as a useful tool in the evaluation of the trigeminal nerve function. Normative data in the orofacial region have been reported but the data on differences in the test site, sex and ethnicity are still insufficient. Thus, this study aimed to investigate the normal range of orofacial thermal QST data in the healthy Korean women, and assess sex difference of thermal perception in the orofacial regions. Methods: Thermal QST was conducted on 20 healthy women participants (mean age, 26.4 years; range, 21 to 34 years). The thermal thresholds (cold detection threshold, CDT; warm detection threshold, WDT; cold pain threshold, CPT; and heat pain threshold, HPT) were measured bilaterally at the 5 trigeminal sites (the forehead, cheek, mentum, lower lip and tongue tip). The normative thermal thresholds of women in the orofacial region were evaluated using one-way ANOVA and compared with the previously reported data from age- and site-matched 30 healthy men (mean age, 26.1 years; range, 23 to 32 years) using two-way ANOVA. One experienced operator performed the tests of both sexes and all tests were done in the same condition except the time variability. Results: Women showed significant site differences for the CDT (p<0.001), WDT (p<0.001), and HPT (p=0.047) in the orofacial region. The CDT (p<0.001) and the CPT (p=0.007) presented significant sex difference unlike the WDT and the HPT. Conclusions: The thermal sensory evaluation in the orofacial region should be considered in the context of site and sex and the normative data in this study could be useful for assessment of the sensory abnormalities in the clinical setting.

Associations Among Different Types of Quantitative Pain Measures in TMD Patients (측두하악장애환자에서 다양한 종류의 정량적 통각검사들의 연관성에 관한 연구)

  • Park, Ji-Woon;Kim, Yong-Woo;Chung, Jin-Woo
    • Journal of Oral Medicine and Pain
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    • v.32 no.4
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    • pp.413-419
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    • 2007
  • The aims of this study were to investigate the relationships among several types of thermal pain thresholds, and pressure pain thresholds. This study was designed to examine whether there were associations among different types of pain thresholds, and among different recording sites for each pain threshold measurement. Pain sensitivity thresholds including cold pain threshold (CPT), heat pain threshold (HPT), heat pain tolerance threshold (PTT), and pressure pain threshold (PPT) of 56 subjects with symptoms of temporomandibular disorders were measured on temporal muscle, masseter muscle, TMJ, and tibial areas. Thermal pain thresholds including CPT, HPT, and PTT did not show any gender differences. However, women showed significantly lower PPTs than men on all recording sites. Three thermal pain thresholds including CPT, HPT, and PTT showed weak to high correlations on all the recording sites (r= 0.324 to 0.754, p<0.05). PPTs did not show any significant correlations between each thermal pain threshold. The pain threshold of each recording site showed weak to high correlations in all pain threshold measures (r= 0.284 to 0.878, p<0.05). Our study demonstrated that thermal pain thresholds, and pain tolerance thresholds were significantly correlated, but did not show any correlation between thermal pain thresholds and pressure pain thresholds. There were relatively high correlations among the pain thresholds of different recording sites.

Effects of Bupivacaine Pretreatment at the Periphery on the Expression of Mechanical Hyperalgesia in a Rat Model of Peripheral Neuropathy (백서의 말초신경 통증 모델에서 신경결찰 전 말초에 주입된 Bupivacaine이 기계적 통각과민의 발현에 미치는 영향)

  • Chung, Yong-Bo;Leem, Joong-Woo;Chung, Eun-Jung;Lee, Jung-Chan;Choi, Yoon
    • The Korean Journal of Pain
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    • v.14 no.1
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    • pp.7-11
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    • 2001
  • Background: Although several mechanisms of causalgia, which results from a partial injury to the peripheral nerve trunk, have been proposed, whether or not antidromic impulses from the injured neurons contribute to the development of the mechanical hyperalgesia has not been studied. The purpose of this experiment is was to investigate the role of antidromic impulses to the peripheral sensory receptor site on the development of mechanical hyperalgesia in a rat model of peripheral neuropathy. Methods: Rats were prepared with tight ligation of by tightly ligating the left fifth and sixth lumbar spinal nerves. The effect of bupivacaine pretreatment on the development of mechanical hyperalgesia was evaluated by injecting 0.5% bupivacaine (0.3 ml) into the plantar surface of the left hind paw before the skin incision was made. For the control group, normal saline (0.3 ml) was injected instead of bupivacaine. To measure the mechanical hyperalgesia, paw withdrawal thresholds were measured using a series of von Frey hairs. Mechanical hyperalgesia was measured a the day before, and 1, 2, 3, 4, 7, and 14 days after the surgery. Results: The control group showed decreased withdrawal thresholds from the day after the surgery (the values were $14.0{\pm}0.5$, $8.9{\pm}1.3$, $8.4{\pm}1.6$, $6.9{\pm}1.2$, $8.8{\pm}1.5$, $10.5{\pm}1.3$, and $8.6{\pm}1.3$ g; at -1, 1, 2, 3, 4, 7, and 14 days after the surgery, respectively). However, withdrawal thresholds of the bupivacaine-pretreated group showed increased withdrawal thresholds for three days after the surgery ($14.5{\pm}0.3$, $12.6{\pm}1.4$, $12.7{\pm}1.1$, $10.5{\pm}1.3$ g; at 1, 1, 2, 3 days after the surgery). Conclusions: Our result suggests that antidromic impulses to the peripheral sensory receptors are at least partly responsible for the initial development of mechanical hyperalgesia in a rat model of peripheral neuropathy.

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Odor Thresholds and Breathing Changes of Human Volunteers as Consequences of Sulphur Dioxide Exposure Considering Individual Factors

  • Kleinbeck, Stefan;Schaper, Michael;Juran, Stephanie A.;Kiesswetter, Ernst;Blaszkewicz, Meinolf;Golka, Klaus;Zimmermann, Anna;Bruning, Thomas;Van Thriel, Christoph
    • Safety and Health at Work
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    • v.2 no.4
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    • pp.355-364
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    • 2011
  • Objectives: Though sulfur dioxide (SO2) is used widely at workplaces, itseffects on humans are not known. Thresholds are reportedwithout reference to gender or age and occupational exposure limits are basedon effects on lung functioning, although localized effects in the upper airways can be expected. This study's aim is to determine thresholds with respect to age and gender and suggests a new approach to risk assessment using breathing reflexes presumably triggered by trigeminal receptors in the upper airways. Methods: Odor thresholds were determined by the ascending method of limits in groups stratified by age and gender. Subjects rated intensities of different olfactory and trigeminal perceptions at different concentrations of $SO_2$. During the presentation of the concentrations, breathing movements were measured by respiratory inductive plethysmography. Results: Neither age nor gender effects were observed for odor threshold. Only ratings of nasal irritation were influenced bygender. A benchmark dose analysis on relative respiratory depth revealed a 10%-deviation from baseline at about 25.27 mg/$m^3$. Conclusion: The proposed new approach to risk assessment appearsto be sustainable. We discuss whether a 10%-deviation of breathingdepth is relevant.

A Pilot Study for Thermal Threshold Test of Trigeminal Nerve Injuries (삼차신경손상의 온도역치검사에 대한 예비연구)

  • Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.37 no.4
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    • pp.243-250
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    • 2012
  • Trigeminal nerve injuries due to invasive dental procedures such as implant surgery and extraction is one of the most serious issues in dentistry and may provoke medico-legal problems. Thus, for objective and reliable assessment of nerve injury, a need of QST (quantitative sensory testing) is emphasized and thermal threshold test is an essential part of QST, reported to have acceptable reliability in the orofacial region. This pilot study aimed to evaluate thermal thresholds for limited cases of trigeminal nerve injures. The study investigated 18 clinical cases with trigeminal nerve injuries who visited Department of Oral Medicine, Dankook Univeristy Dental Hospital during the period from May 2011 to Oct 2012. Thermal thresholds was measured by Thermal Sensory Analyzer, TSA-II (Medoc, Israel). Their CDT(cold detection threshold) was significantly decreased in the affected sides compared to the unaffected sides. Other parameters such as WDT(warm detection threshold), CPT(cold pain threshold) and HPT(heat pain threshold) did not show statistical difference between the affected and unaffected sides. Further researches are required to compare thermal thresholds relative to types of nerve deficits such as thermal hyper- or hypoesthesia and hyper- or hypoalgesia for larger sample.

Relationship between Plantar Tactile Sensory Thresholds and Balance for Life-Care Increase in Patients with Stroke (뇌졸중 환자의 라이프케어 증진을 위한 발바닥 감각역치와 균형의 상관관계)

  • An, Kwang-Bin;Jeon, Hye-Joo
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.8
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    • pp.237-244
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    • 2020
  • Sensory impairment is common following a stroke. Tactile afferent inputs from the plantar foot provide important information to the central nervous system to generate balance. The present study, which recruited 50 stroke patients, aims to determine the relationship between plantar tactile sensory threshold (PTST) and balance in patients with stroke. The PTST was evaluated at two sites (hallux and heel) using Semmes-Weinstein monofilaments. The balance abilities were measured by the degree of weight distribution in quiet standing (QS) and sitting-to-standing position (STS) using a MTD system and Berg balance scale (BBS). The hallux and heel sensory thresholds (ST) in the affected side were higher than the non-affected side (P < 0.05). The degree of weight distribution in the affected side was lower than the non-affected side. QS and STS showed P < 0.05, with BBS score of 36.00 ± 1.53. The hallux ST in the affected side correlated with BBS (r = -0.444, P < 0.05), QS (r = -0.332, P < 0.05), and STS (r = -0.390, P < 0.05), whereas the heel ST in the affected side correlated with BBS (r = -0.467, P < 0.05), QS (r = -0.532, P < 0.05), and STS (r = - 0.516, P < 0.05), suggesting that higher detected PTST might have an influence on the decreasing balance abilities. The study of sensory threshold in patients with stroke will help their rehabilitation and sensory evaluation.

Quantitative Sensory Test: Normal Range in Korean Adults and Application to Diabetic Polyneuropathy (정량적 감각 검사: 한국인에서의 연령별 정상 범위 및 당뇨병성 다발신경병증에서의 유용성 평가)

  • Kim, Su-Hyun;Kim, Sung-Min;Ahn, Suk-Won;Hong, Yoon-Ho;Park, Kyung-Seok;Sung, Jung-Joon;Lee, Kwang-Woo
    • Annals of Clinical Neurophysiology
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    • v.12 no.1
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    • pp.21-26
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    • 2010
  • Background: Although quantitative sensory test (QST) is being used with increasing frequency for measuring sensory thresholds in clinical practice and epidemiologic studies, there has been no age-matched normative data in Korean adults. The objective of this study is to evaluate the value of QST in diabetic polyneuropathy with normal range in Korean adults. Methods: The Computer Aided Sensory Examination IV 4,2 (WR Medical Electronics Co., Stillwater, Minnesota, U.S.A.), with 4,2,1 stepping algorithm was used to determine vibration and cold perception threshold in 70 normal controls and 19 patients with diabetic polyneuropathy aged from 21 to 79 years. The data were used to define age-matched upper and lower normal limits and normal range of side to side difference. We also evaluated the duration of diabetes, serum HbA1C level, and findings of nerve conduction study (NCS) and QST in patients with diabetic polyneuropathy. Results: In normal adults, sensory thresholds slightly increased with age, and a slight side-to-side difference was observed. The diagnostic sensitivity of QST was not higher than NCS in patients with diabetic polyneuropathy (36.8% vs. 42.1%, p=0.716), especially among elderly patients. Conclusions: QST might be used as a complementary test for NCS in the diagnosis of diabetic polyneuropathy. Although the QST is a simple method for the evaluation of peripheral nerve function, there are some limitations. Most of all, because the QST measuring is dependent on the subjective response of patients, the degree of concentration and cooperation of the patients can significantly affect the result. And thus, attention should be paid during the interpretation of QST results in patients with peripheral neuropathy.

Effect of Electrical Stimulation Level on Quantitative Sensory Test Induced Erythema by UV Radiation (전기자극수준이 자외선에 의한 홍반의 정량적 감각검사에 미치는 효과)

  • Kim, Su-Hyon;Kim, Hyun-Jin
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.10 no.2
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    • pp.1-6
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    • 2012
  • Purpose : This study is to investigate the modulatory effects to the ultraviolet induced erythema of pain processing system. Methods : Thirty six healthy volunteers were divided into none treatment group (n=6), indomethacine group (n=6), subsensory level electrical stimulation group (n=6), sensory level electrical stimulation group (n=6), motor level electrical stimulation group (n=6), noxious level electrical stimulation group (n=6). Subjects were induced erythema for three times minimal erythema dose (MED) at upper arm of dermatome C6 level. Each experimental group had mechanical pain threshold (MPT), electrical pain threshold (EPT), thermal pain threshold (TPT). Results : This study revealed that we observed that pain thresholds were significantly correlated with each other in pain processing system. The effect of electrical stimulation levels evaluates were shown to be significant differences pain control effect in electrical stimulation group (sensory, motor level electrical stimulation groups) more than indomethacine group, subsensory level and control group. Conclusion : In this study, it was found that the effect of ultraviolet induced erythema of pain control by modulatory electrical stimulation.