Innocuous skin cooling modulates perception and neurophysiological correlates of brief CO 2 laser stimuli in humans

Abstract

The present study examined the influence of innocuous skin cooling on the perception and neurophysiological correlates of brief noxious CO 2 laser stimuli. In nine normal subjects, brief CO 2 laser pulses of four different intensities (duration 50 ms; diameter 5 mm; intensity range 5.8–10.6 mJ/mm 2) were delivered at random every 5–10 s on the dorsum of the hand. Innocuous skin cooling was performed by a thermode (20 °C; 3 × 3 cm) with a central hole for the laser test stimuli. Quality and intensity (VAS) of perceptions, reaction times and laser evoked potentials (LEPs) were examined. Signal detection theory analysis was performed to evaluate discrimination performance and decision criterion. During innocuous skin cooling, detection threshold increased from 4.8 ± 1.81 to 8.2 ± 1.05 mJ/mm 2 and pain threshold from 8.7 ± 1.53 to 13.5 ± 1.57 mJ/mm 2. proportion of detected stimuli decreased from 87% to 48% and pain reports from 42% to 10%. The well localized ‘pricking’ sensation mediated by Aδ-nociceptors almost vanished. The intensity of sensations (VAS scores) was considerably reduced. Sensory discriminative performance was significantly depressed but decision criterion remained unchanged. Reaction times were delayed. The late-LEPs, correlates of Aδ-nociceptor activations, were also significantly depressed while the ultra-late LEPs, correlates of C-nociceptors, were not affected. Taken together, these results strongly suggest that innocuous skin cooling interfered with the sensory processing of laser heat stimuli and more prominently with those related to Aδ-nociceptive input.