Abstract
BackgroundPain has a distinct sensory and affective (i.e., unpleasantness) component. BreEStim, during which electrical stimulation is delivered during voluntary breathing, has been shown to selectively reduce the affective component of post-amputation phantom pain. The objective was to examine whether BreEStim increases pain threshold such that subjects could have improved tolerance of sensation of painful stimuli.MethodsEleven pain-free healthy subjects (7 males, 4 females) participated in the study. All subjects received BreEStim (100 stimuli) and conventional electrical stimulation (EStim, 100 stimuli) to two acupuncture points (Neiguan and Weiguan) of the dominant hand in a random order. The two different treatments were provided at least three days apart. Painful, but tolerable electrical stimuli were delivered randomly during EStim, but were triggered by effortful inhalation during BreEStim. Measurements of tactile sensation threshold, electrical sensation and electrical pain thresholds, thermal (cold sensation, warm sensation, cold pain and heat pain) thresholds were recorded from the thenar eminence of both hands. These measurements were taken pre-intervention and 10−min post-intervention.ResultsThere was no difference in the pre-intervention baseline measurement of all thresholds between BreEStim and EStim. The electrical pain threshold significantly increased after BreEStim (27.5±6.7% for the dominant hand and 28.5±10.8% for the non-dominant hand, respectively). The electrical pain threshold significantly decreased after EStim (9.1±2.8% for the dominant hand and 10.2±4.6% for the non–dominant hand, respectively) (F[1, 10] = 30.992, p = .00024). There was no statistically significant change in other thresholds after BreEStim and EStim. The intensity of electrical stimuli was progressively increased, but no difference was found between BreEStim and EStim.ConclusionVoluntary breathing controlled electrical stimulation selectively increases electrical pain threshold, while conventional electrical stimulation selectively decreases electrical pain threshold. This may translate into improved pain control.
Highlights
Pain is a subjective feeling in nature
Based on our pioneering discovery that human voluntary breathing could have systemic effects [5,6,7,8,9], we proposed an innovative treatment – Breathing-controlled electrical stimulation (BreEStim) for neuropathic pain management [10,11]
The electrical pain threshold increased from 16.862.8 mA preBreEStim to 22.065.5 mA post-BreEStim
Summary
Pain has distinct sensory and affective (i.e., unpleasantness) dimensions and can induce an avoidance behavior [1]. Memory mechanisms play an important role in the persistence of the awareness of chronic neuropathic pain as well as in the reinforcement of the associated distress. The memory of the event could last for the rest of life. When associated with a negative emotional context, pain (e.g., phantom pain after amputation) could be perceived as aversive, and re-triggered by a stressful life event [2]. Pain has a distinct sensory and affective (i.e., unpleasantness) component. BreEStim, during which electrical stimulation is delivered during voluntary breathing, has been shown to selectively reduce the affective component of postamputation phantom pain. The objective was to examine whether BreEStim increases pain threshold such that subjects could have improved tolerance of sensation of painful stimuli
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