Abstract
The purpose of this study was to assess the reliability of the RIII reflex threshold and Pain threshold in three repeated trials using electrocutaneous stimuli. Each trial was separated by a mean of 4.3 ± 2.9 days (between-trials) and included two repeated measurements (within-trial) of the RIII reflex threshold (RIII-T) and the Pain threshold (PT) separated by 20 min. The participants were 14 healthy males (mean age ± SD, 23.5 ± 5.3 years). There was a significant difference between the RIII-T and PT. The reliability of the RIII-T and PT shows a between-trials coefficient of variance (CVSEM) of 16.1 and 16.9%, respectively. The within-trial CVSEM for RIII-T and PT was 5.4 and 4.3%, respectively. There was a significant correlation between the RIII-T threshold and PT. The parallel association and correlation of the RIII-T with the PT suggests that the RIII-T is valid in experimental pain studies under standardised resting conditions.
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References
Andersen OK, Jensen LM, Brennum J, Arendt-Nielsen L (1995) Modulation of the human nociceptive reflex by cyclic movements. Eur J Appl Physiol Occup Physiol 70:311–321. doi:10.1007/BF00865028
Arendt-Nielsen L, Brennum J, Sindrup S, Bak P (1994) Electrophysiological and psychophysical quantification of temporal summation in the human nociceptive system. Eur J Appl Physiol 68:266–273. doi:10.1007/BF00376776
Baldissera F, Hultborn H, Illert M (eds) (1981) Integration in spinal neuronal systems. American Physiological Society, Bethesda
Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310
Boureau F, Luu M, Doubrere JF (1991) Study of experimental pain measures and nociceptive reflex in chronic pain patients and normal subjects. Pain 44:131–138. doi:10.1016/0304-3959(91)90126-I
Bromm B, Treede RD (1980) Withdrawal reflex, skin resistance reaction and pain ratings due to electrical stimuli in man. Pain 9:339–354. doi:10.1016/0304-3959(80)90048-2
Cohen J (1998) Statistical power analysis for the behavioral sciences. Lawrence Erlbaum Associates, Inc, Hillsdale
Collins WR Jr, Nulsen FE, Randt CT (1960) Relation of peripheral nerve fiber size and sensation in man. Arch Neurol 3:381–385
Defrin R, Peleg S, Weingarden H, Heruti R, Urca G (2007) Differential effect of supraspinal modulation on the nociceptive withdrawal reflex and pain sensation. Clin Neurophysiol 118:427–437. doi:10.1016/j.clinph.2006.10.015
Dowman R (1991) Spinal and supraspinal correlates of nociception in man. Pain 45:269–281. doi:10.1016/0304-3959(91)90051-X
Dowman R (1993) A noninvasive strategy for identifying and quantifying innocuous and nociceptive peripheral afferent activity evoked by nerve stimulation. Physiol Behav 53:1163–1169. doi:10.1016/0031-9384(93)90374-O
Edwards L, Ring C, McIntyre D, Carroll D, Clarke R, Webb O et al (2006) Increases in arousal are associated with reductions in the human nociceptive flexion reflex threshold and pain ratings: evidence for dissociation between nociception and pain. J Psychophysiol 20:259–266. doi:10.1027/0269-8803.20.4.259
Eklund K, Grimby L, Kugelburg E (1959) Nociceptive reflexes of the human foot. The plantar responses. Acta Physiol Scand 47:297–298
Ertekin C, Ertekin N, Karcioglu M (1975) Conduction velocity along human nociceptive reflex afferent nerve fibres. J Neurol Neurosurg Psychiatry 38:959–965
France CR, Suchowiecki S (1999) A comparison of diffuse noxious inhibitory controls in men and women. Pain 81:77–84. doi:10.1016/S0304-3959(98)00272-3
France CR, al’absi M, Ring C, France JL, Brose J, Spaeth D, Harju A, Nordehn G, Wittmers LE (2005) Assessment of opiate modulation of pain and nociceptive responding in young adults with a parental history of hypertension. Biol Psychol 70:168–174. doi:10.1016/j.biopsycho.2005.01.012
Gracely RH (1999) Studies of pain in human subjects. In: Wall PD, Melzack R (eds) Textbook of Pain. Churchill Livingstone, Edinburgh, pp 385–407
Gronroos M, Pertovaara A (1993) Capsaicin-induced central facilitation of a nociceptive flexion reflex in humans. Neurosci Lett 159:215–218. doi:10.1016/0304-3940(93)90837-B
Guieu R, Blin O, Pouget J, Serratrice G (1992) Nociceptive threshold and physical activity. Can J Neurol Sci 19:69–71
Hugon M (1973) Exteroceptive reflexes to stimulation of the sural nerve in normal man. In: Desmedt JE (ed). Basel, Karger, pp 713–729
Lund I, Lundeberg T, Kowaiski J, Sandberg L, Norrbrink Budh C, Svensson E (2005) Evaluation of variations in sensory and Pain threshold assessments by electrocutaneous stimulation. Physiother Theory Pract 21(2):81–92. doi:10.1080/09593980590922307
Mylius V, Kunz M, Schepelmann K, Lautenbacher S (2005) Sex differences in nociceptive withdrawal reflex and pain perception. Somatosens Mot Res 22:207–211. doi:10.1080/08990220500262414
Nord S, Durkovic R (1988) Evocation of “early” and “late” components of a cutaneous reflex by non-painful stimuli in man. Soc Neurosci Abstr 14:1303
Portney LG, Watkins MP (1993) Foundations of clinical research. Appleton & Lange, Norwalk
Price DD (2000) Psychological and neural mechanisms of the affective dimension of pain. Science 288:1769–1772. doi:10.1126/science.288.5472.1769
Rhudy JL, France CR (2007) Defining the nociceptive flexion reflex (NFR) threshold in human participants: a comparison of different scoring criteria. Pain 128(3):244–253
Rhudy JL, Williams AE, McCabe KM, Nguyên MAT, Rambo P (2005) Affective modulation of nociception at spinal and supraspinal levels. Psychophysiology 42:579–587
Rosier EM, Iadarola MJ, Coghill RC (2002) Reproducibility of pain measurement and pain perception. Pain 98:205–216. doi:10.1016/S0304-3959(02)00048-9
Sandrini G, Alfonsi E, Bono G, Facchinetti F, Montalbetti L, Nappi G (1986) Circadian variations of human flexion reflex. Pain 25:403–410. doi:10.1016/0304-3959(86)90245-9
Sandrini G, Serrao M, Rossi P, Romaniello A, Cruccu G, Willer JC (2005) The lower limb flexion reflex in humans. Prog Neurobiol 77:353–395. doi:10.1016/j.pneurobio.2005.11.003
Sang CN, Max MB, Gracely RH (2003) Stability and reliability of detection thresholds for human A-Beta and A-Delta sensory afferents determined by cutaneous electrical stimulation. J Pain Symptom Manage 25:64. doi:10.1016/S0885-3924(02)00541-9
Schomburg ED (1990) Spinal sensorimotor systems and their supraspinal control. Neurosci Res 7:265–340. doi:10.1016/0168-0102(90)90008-3
Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86:420–428. doi:10.1037/0033-2909.86.2.420
Skljarevski V, Ramadan NM (2002) The nociceptive flexion reflex in humans-review article. Pain 96:3–8. doi:10.1016/S0304-3959(02)00018-0
Terkelsen AJ, Andersen OK, Hansen PO, Jensen TS (2001) Effects of heterotopic- and segmental counter-stimulation on the nociceptive withdrawal reflex in humans. Acta Physiol Scand 172:211–217. doi:10.1046/j.1365-201x.2001.00856.x
Wiesenfeld-Hallin Z, Hallin RG, Persson A (1984) Do large diameter cutaneous afferents have a role in the transmission of nociceptive messages? Brain Res 311:375–379. doi:10.1016/0006-8993(84)90104-5
Willer JC (1977) Comparative study of perceived pain and nociceptive flexion reflex in man. Pain 3:69–80. doi:10.1016/0304-3959(77)90036-7
Willer JC (1980) Anticipation of pain-produced stress: electrophysiological study in man. Physiol Behav 25:49–51. doi:10.1016/0031-9384(80)90181-X
Willer JC, Albe-Fessard D (1983) Further studies on the role of afferent input from relatively large diameter fibers in transmission of nociceptive messages in humans. Brain Res 278:318–321. doi:10.1016/0006-8993(83)90263-9
Willer JC, Roby A, Le Bars D (1984) Psychophysical and electrophysiological approaches to the pain-relieving effects of heterotopic nociceptive stimuli. Brain 107(Pt 4):1095–1112. doi:10.1093/brain/107.4.1095
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Micalos, P.S., Drinkwater, E.J., Cannon, J. et al. Reliability of the nociceptive flexor reflex (RIII) threshold and association with Pain threshold. Eur J Appl Physiol 105, 55–62 (2009). https://doi.org/10.1007/s00421-008-0872-x
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DOI: https://doi.org/10.1007/s00421-008-0872-x