Abstract

Pain is an unpleasant sensory experience, associated with existing or potential tissue damage. It has also strong cognitive and emotional components. Stimuli that causes pain goes through process of nociception, which includes transduction, transmission, modulation and perception of said stimuli. Depending on the type of stimuli, we can classify human experimental pain models into mechanical, electrical, thermal and chemical. Information about pain mechanisms can be obtained from the following: 1) in vitro studies, 2) animal experiments, 3) human experimental pain studies and 4) clinical studies. Chosing the appropriate method for pain evaluation is a key step in the design of pain studies. Combining it with different electro-physiological and imaging methods, it can provide better objectivity and quantification of pain mechanisms. Focus in experimental pain studies is slowly shifting from static parameters of pain, such as pain threshold and maximum tolerance, to dynamic parameters, which can give us valuable insight in function of endogenous analgesic systems. This can be done using conditioned pain modulation. Using experimental pain on healthy voulenteers is key step in switching from animal models to clinical studies, foremost for validization of data from animals, making them important in translational research. Results from experimental pain studies can help us in understanding nociceptive mechanisms of acute and chronic pain, alongside development of new therapeutic modalities.

Highlights

  • Focus in experimental pain studies is slowly shifting from static parameters of pain, such as pain threshold and maximum tolerance, to dynamic parameters, which can give us valuable insight in function of endogenous analgesic systems

  • Results from experimental pain studies can help us in understanding nociceptive mechanisms of acute and chronic pain, alongside development of new therapeutic modalities

  • Yarnitsky D, Crispel Y, Eisenberg E, Granovsky Y, Ben-Nun A, Sprecher E, et al Prediction of chronic post-operative pain: Pre-operative difuzna nociceptivna inhibitorna kontrola (DNIC) testing identifies patients at risk

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Summary

Termalna stimulacija

Hladnoća: korišćenje hladnoće kao eksperimentalnog modela bola može se sprovesti pomoću primene leda, ohlađenih gel kesa ili uranjanjem ekstremiteta u hladnu vodu [29]. Ograničenje ove metode je u velikoj varijabilnosti u pragu i maksimalnoj toleranciji bola ispitanika, kao i u nedostatku standardizacije u dužini stimulacije i merljivosti odgovora [8]. Kontaktna toplota: primenjuje se pomoću kontaktne termode na kojoj se može regulisati temperatura. Nedostaci ove metode leže u tome što zavisno od veličine kontaktne površine termode sa kožom i njenog pritiska na kožu mogu postojati razlike u transferu temperature, što otežava komparaciju između različitih studija [10]. Korišćenje kratkih pulseva visokog intenziteta može da izazove selektivnu aktivaciju i bol koje prenosi samo Aδ vlaknima, dok niski intenzitet stimulacije može da dovede do bola koji se prenosi samo C-vlaknima, što omogućava ispitivanja mehanizama dve različite vrste bola istim modalitetom [37]. Zabeleženo je i da različite vrste lasera mogu da izazovu različite senzacije bola zavisno od dubine penetracije u tkiva [38]

Hemijska stimulacija
Uslovna modulacija bola
Full Text
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