Pain
-
Somatosensory evoked potentials (EPs) to stimuli ranging from barely perceptible to painful were recorded in 153 normal adults. Reliability of amplitude and amplitude/intensity slopes were demonstrated in 29 individuals tested twice, two or more weeks apart. In randomized, double-blind placebo controlled trials, both aspirin and morphine significantly diminished N120 component at high stimulus intensities. Age, sex and pharmacological effects paralleled those found with psychophysical techniques in part I of this study.
-
Comparative Study
Sensitivity of the McGill Pain Questionnaire to intensity and quality of laboratory pain.
Subjects completed a modified McGill Pain Questionnaire (MPQ) to describe one of two laboratory stressors (cold pressor or electrical tooth pulp stimulation) at one of two subjective intensities (pain threshold or pain tolerance). Differences in MPQ-derived scores were associated with both type of stressor and intensity level, as were patterns of frequently chosen word groups and specific words. These data support the validity of interpretations drawn from MPQ differences in clinical practice and research. In addition, the fact that the MPQ can be used in both clinical and laboratory settings suggests one way in which relevant dimensions of similarity and difference among "types" of pain may be clarified in later research.
-
Chronic pain patients reported pain intensity on each of 3 pain intensity scales, the visual analog, numerical and adjectival scales, and then ranked the scales in order of perceived best communication of pain intensity. All patients were able to complete an adjectival scale but 11% were unable to complete a visual analog scale and 2% failed at a numeric scale. The intensity of the pain ratings on the 3 scales were significantly correlated and there were no reliable differences in reported intensity as a function of preference. ⋯ Patients completing all 3 scales indicated a significant preference for the adjectival scale but the basis for this preference did not appear related to sex, etiology of pain, affective variables nor selected psychological variables. These data indicate that pain scale preference does not influence pain intensity report. Nevertheless, there are some clinical situations in which a numeric scale is likely to yield a better measure of pain intensity.
-
(1) The effects of stimulation of the nucleus raphe magnus (NRM) and the periaqueductal gray (PAG) were tested on the digastric (jaw-opening) reflex and on the activity of functionally identified single neurons recorded in trigeminal (V) subnucleus oralis in the brain stem. Reflex and neuronal responses evoked by tooth pulp stimulation could be readily suppressed for 250--1000 msec by PAG and NRM conditioning stimuli. ⋯ This suggests that some of the modulatory influences involve endogenous opiate-related mechanisms. (4) Many of the oralis neurons were identified as trigeminothalamic relay neurons on the basis of their antidromic response to ventrobasal thalamic stimulation; PAG and NRM conditioning produced not only a suppression of their orthodromic responses to oral-facial stimuli but also caused a decrease in the antidromic excitability of the relay neurons. This decrease may be indicative of raphe-induced postsynaptic inhibition of oralis neurons, and/or presynaptic facilitation of their thalamic endings.