The subjective sensation induced by various thermal pulse stimulation in healthy volunteers

Abstract

Abstract Aims Novel quantitative thermal stimulator devices (QTSDs) have been developed to deliver thermal pulse stimulation with regulated constant temperatures (0–45°C) with a Peltier element probe (16 cm2). The aim of this study was to investigate subjective sensation induced by the interaction between simultaneously applied painful cold and heat stimuli in various sites. Methods Twenty healthy subjects (12 men and 8 women, age range: 25–45 years) participated. The intensity of cold pain (CP) and heat pain (HP) stimuli were assessed by visual analogue scale (VAS) and adjusted to elicit approximately 70/100 mm. Alternately pulse stimulations (pulse duration of 40 s; 0.025 Hz) which consisted of CP, HP, or neutral temperature (32°C) were applied. Four conditions were tested and subjective sensations were assessed: (1) one QTSD was applied to non-dominant forearm and cold-heat pulse stimulation was applied. Two QTSDs were applied to (2) non-dominant ipsilateral forearm with 5 cm apart, (3) non-dominant and contralateral forearms, (4) non-dominant forearm and ipsilateral thigh, respectively. In conditions of (2)–(4), CP-neutral pulse stimulation (C-Neutral) and neutral-HP pulse stimulation (Neutral-H) were applied simultaneously with opposite phase, respectively. Results CP and HP were 3.9±1.0°C (mean±SD) and 43.6±0.9°C (mean±SD), respectively. The VAS values for CP and HP were 73.4±2.0 mm (mean±SD) and 76.4 ±4.8 mm (mean±SD), respectively. Some subjects could not discriminate cold or heat sensation and some felt cold as heat (paradoxical sensation). The number of subjects with such paradoxical sensation in (1), (2), (3), (4) were 9 (45%), 2 (10%), 0 (0%) and 3 (15%), respectively. Conclusions In healthy volunteers, simultaneous alternately cold-heat pulse stimulation on one site triggered paradoxical thermal sensation, which to a much less degree is triggered when C-Neutral and Neutral-H were applied to different dermatomes. This suggests that the mechanism is primarily triggered peripherally.