Threshold and rate sensitivity of low‐threshold thermal nociception

Abstract

Previous studies have shown that sensations of burning, stinging or pricking can be evoked by warming or cooling the skin to innocuous temperatures [low-threshold thermal nociception (LTN)] below the thresholds of cold- and heat-sensitive nociceptors. LTN implies that some primary afferent fibers classically defined as warm and cold fibers relay stimulation to the nociceptive system. We addressed this question in humans by determining if different adaptation temperatures (ATs) and rates of temperature change would affect thermal sensation and LTN similarly. In Experiment 1 subjects rated the intensity of warmth, cold and nociceptive sensations produced by increasing steps in temperature (+/-0.5 degrees C increments) from ATs of 35, 33 and 31 degrees C for cooling, and 30, 32 and 34 degrees C for heating. Depending upon the AT, thresholds for nociceptive and thermal sensations estimated from the rating data differed by as little as -1.0 degrees C for cooling and +1.5 degrees C for heating. Thresholds of thermal and nociceptive sensations shifted by similar amounts across the three ATs during cooling, whereas during heating the nociceptive threshold was significantly affected only between ATs of 32 and 34 degrees C. In Experiment 2, increasing the rate of temperature change from 0.5 to 4.0 degrees C/s increased the intensity of thermal and nociceptive sensations significantly but the effect was greatest for nociceptive sensations during heating. The results of both experiments are consistent with the mediation of LTN by low-threshold thermoreceptors, although LTN caused by heating may depend on a subset of fibers that express less sensitive TRP channels than those that serve sensations of warmth at the mildest temperatures.