• The Korean Journal of Pain
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• v.21 no.2
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• pp.126-130
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• 2008

Background: Females generally have a lower pain and temporal summation threshold than men. However, the results of studies designed to evaluate gender differences in the thresholds of heat pain and the temporal summation have been inconsistent. Newly developed device, CHEPS (Contact Heat Evoked Potential Stimulation) model of PATHWAY, have superiority on its fast rise and return time in temperature. Therefore we investigated gender differences in heat pain and temporal summation threshold. Methods: Forty healthy volunteers (20 males and 20 females) were enrolled in this study. A thermode was applied to the volar side of each volunteer's left forearm and heat pain and the temporal summation threshold was then measured. The heat pain threshold was estimated using the staircase method by starting from $36^{\circ}C$ and then increasing the temperature in $0.5^{\circ}C$ increments. The temporal summation threshold was estimated by applying five successive stimulation of the same temperature starting at $2^{\circ}C$ lower than the heat pain threshold and then increasing the temperature in $0.5^{\circ}C$ increments. Results: The mean heat pain thresholds was found to be $41.63{\pm}1.63^{\circ}C$ for males and $41.60{\pm}1.84^{\circ}C$ for females and the temporal summation thresholds were found to be $40.83{\pm}1.64^{\circ}C$ for males and $40.77{\pm}1.93^{\circ}C$ for females. The differences between males and females were not statistically significant. Conclusions: The result of this study suggested that there are no gender differences in heat pain and temporal summation threshold.

• 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.

• Physical Therapy Korea
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• v.3 no.2
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• pp.19-28
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• 1996

The purpose of this study was to asses and compare the effects of superficial heating on the pain threshold at limbs in healthy adult and adult hemiplegia. We used hot pack for superficial heat and applied to healthy adult(n=12) and adult hemiplegia(n=12) on lumbar region. Pain treshold was quantatively measured by an electrical stimulator and measured before hot pack application, immediatly and post 30 minutes after hot pack application on the distal parts of limbs(styloid process of radius, medial malleoulus of tibia). The results were as follows 1) A statically significant defference in pain treshold were not found at limbs of healthy adult and adult hemiplegia that have an affected side and a non-affected side before hot pack application, immediatly and post 30 minutes after hot pack apllication(p>0.05). 2) In comparance of pain threshold of upper and lower limbs in the all subjects, pain threshold was significantly increase at lower limbs(p<0.01). 3) In comparance of pain threshold of limbs between healthy adult and adult hemiplegia, pain threshold was showed a significant defferance at the upper and lower limbs of affected side before hot pack application(p<0.05, p<0.01).

• Journal of Oral Medicine and Pain
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• v.47 no.2
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• pp.87-94
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• 2022

Purpose: This study aimed to evaluate the differences between clinical and quantitative sensory testing (QST) results among persistent idiopathic dentoalveolar pain (PIDP), inflammatory dental pain, and control group subjects to identify discriminative clinical features for differential diagnosis. Methods: Thirty-three patients (5 PIDP-a without surgical procedures 10 PIDP-b with surgical procedures, 8 dental pain patients, and 10 controls) were evaluated for clinical features and QST results. Cold pain threshold, heat pain threshold, mechanical pain threshold (MPT), mechanical pain sensitivity, and pressure pain threshold (PPT) were performed. Psychological factors were assessed using Symptom Checklist-90-Revision (SCL-90-R) and a chart review was conducted to evaluate additional discriminative clinical features such as pain quality and treatment prognosis. Results: The dental pain group had lower PPT than the PIDP-b and the control group. The PIDP-a group showed higher MPT and PPT than the PIDP-b and dental pain group but the difference was not statistically significant. Differences in SCL-90-R SOM (Somatization), O-C (obsessive-compulsive), ANX (anxiety), and PSY (Psychoticism) values were statistically significant among groups. PIDP-a and PIDP-b groups showed remaining symptoms after treatment and the pain tended to spread widely, whereas, in toothache patients, symptoms disappeared after treatment. However, factors that confound the diagnosis, such as an increase in pain during chewing and a decrease in the pain threshold at the affected site, could also be identified. Conclusions: PIDP and dental pain groups have distinct clinical symptoms, but there are also factors that cause confusing in diagnosis. Therefore, various clinical examination results should be carefully reviewed and comprehensively evaluated in the differential diagnosis process.

• The Journal of Korean Physical Therapy
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• v.26 no.6
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• pp.442-448
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• 2014

Purpose: The objective of this study is to evaluate the effect of neuro-feedback training and transcutaneous electrical nerve stimulation (TENS) on stress, quantitative sensory threshold and pain in patients suffering from tension type headache. Methods: 22 participants who passed the preliminary evaluation were enrolled in the study and 11 participants were randomly assigned to each group. The control group (n=11) was subject to the TENS treatment of which was composed of a 20-minute session for 5 times a week during 4 weeks, and the experimental group (n=11) was subject to both neuro feedback training and TENS treatment for 10 minutes a day and 5 days a week during 4 weeks. The Perceived Stress Scale (PSS) was used to measure a level of stress and the quantitative sensory testing (QST) was used for the measurement of cold pain threshold (CPT) and heat pain threshold (HPT); A degree of pain was evaluated through the headache impact test-6 (HIT-6). Results: In comparision of all dependent variables between the control and subject groups, there were significant differences in stress, quantitative sensory threshold and pain after the treatment (p<0.05), and the experimental group showed significant differences in stress, CPT, HPT and pain (p<0.05) and the control group showed only a significant difference in HPT (p<0.05). Conclusion: Findings of this study demonstrate that the concomitant administration of the TENS treatment and neuro feedback training is effective on alleviation of stress, quantitative sensory threshold and pain in patients with tension type headache.

• 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.

• Journal of Acupuncture Research
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• v.29 no.4
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• pp.25-34
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• 2012

Objectives : This study was conducted to investigate the effects of fixed-intensity and varied-intensity electroacupuncture in pain and sensory threshold concerning parameters visual analogue scale(VAS), brief pain inventory(BPI) and quantitative sensory testing(QST), among chronic tension headache patients. Methods : Thirty patients with chronic tension headache were randomly assigned to three groups and received different kinds of electroacupuncture at $ST_{36}$ and $ST_{37}$. Group A received fixed-intensity electroacupuncture(fixed-EA), group B received varied-intensity electroacupuncture (varied-EA), and group C received only acupuncture treatment without electrical stimulation as a control group. The intervention was given three times per week, and continued in two weeks. All the experiments were conducted blindly. Results : Fixed-EA group showed a significant decrease of VAS and BPI compared to the baseline measurement, while both varied-EA and control group did not. Of the parameters of QST, subtraction of heat pain threshold(HPT) and cold pain threshold(CPT) slightly increased in all groups, but this was not significant. Conclusions : These results suggest that fixed-EA reduce pain and improve quality of life in patients with chronic tension headache and that acupuncture may regulate patient's pain sensitivity through changing sensory threshold.

• 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.

• The Korean Journal of Physiology and Pharmacology
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• v.20 no.1
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• pp.129-136
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• 2016

This study was performed to investigate whether an intra-articular injection of transient receptor potential vanilloid 1 (TRPV1) receptor agonist, resiniferatoxin (RTX) would alleviate behavioral signs of arthritic pain in a rat model of osteoarthritis (OA). We also sought to determine the effect of RTX treatment on calcitonin gene-related peptide (CGRP) expression in the spinal cord. Knee joint inflammation was induced by intra-articular injection of monosodium iodoacetate (MIA, $8mg/50{\mu}l$) and weight bearing percentage on right and left hindpaws during walking, paw withdrawal threshold to mechanical stimulation, and paw withdrawal latency to heat were measured to evaluate pain behavior. Intra-articular administration of RTX (0.03, 0.003 and 0.0003%) at 2 weeks after the induction of knee joint inflammation significantly improved reduction of weight bearing on the ipsilateral hindlimb and increased paw withdrawal sensitivity to mechanical and heat stimuli. The reduction of pain behavior persisted for 3~10 days according to each behavioral test. The MIA-induced increase in CGRP immunoreactivity in the spinal cord was decreased by RTX treatment in a dose-dependent manner. The present study demonstrated that a single intra-articular administration of RTX reduced pain behaviors for a relatively long time in an experimental model of OA and could normalize OA-associated changes in peptide expression in the spinal cord.

• The Korean Journal of Pain
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• v.35 no.4
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• pp.391-402
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• 2022

Background: The mechanism of peripheral axon transport in neuropathic pain is still unclear. Chemokine ligand 13 (CXCL13) and its receptor (C-X-C chemokine receptor type 5, CXCR5) as well as GABA transporter 1 (GAT-1) play an important role in the development of pain. The aim of this study was to explore the axonal transport of CXCL13/CXCR5 and GAT-1 with the aid of the analgesic effect of botulinum toxin type A (BTX-A) in rats. Methods: Chronic constriction injury (CCI) rat models were established. BTX-A was administered to rats through subcutaneous injection in the hind paw. The pain behaviors in CCI rats were measured by paw withdrawal threshold and paw withdrawal latencies. The levels of CXCL13/CXCR5 and GAT-1 were measured by western blots. Results: The subcutaneous injection of BTX-A relieved the mechanical allodynia and heat hyperalgesia induced by CCI surgery and reversed the overexpression of CXCL13/CXCR5 and GAT-1 in the spinal cord, dorsal root ganglia (DRG), sciatic nerve, and plantar skin in CCI rats. After 10 mmol/L colchicine blocked the axon transport of sciatic nerve, the inhibitory effect of BTX-A disappeared, and the levels of CXCL13/CXCR5 and GAT-1 in the spinal cord and DRG were reduced in CCI rats. Conclusions: BTX-A regulated the levels of CXCL13/CXCR5 and GAT-1 in the spine and DRG through axonal transport. Chemokines (such as CXCL13) may be transported from the injury site to the spine or DRG through axonal transport. Axon molecular transport may be a target to enhance pain management in neuropathic pain.