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Not as 'blurred' as expected? Acuity and spatial summation in the pain system.

Pain 2020 September 3
Spatial acuity measured by 2-point discrimination threshold (2PD) and spatial summation of pain (SSp) are useful paradigms to probe the pain system in humans. Whether the results of these paradigms are influenced by different stimulus modalities and intensities is unclear. The aim of this study was to test 2PD controlling the stimulus modality and the intensity and to investigate the effect of modality on SSp. Thirty-seven healthy volunteers were tested for 2PDs with two stimulus modalities (electrocutaneous, mechanical) and intensity (noxious, innocuous). For each condition, participants received stimuli to either one or two points on their lower back with different distances (2 to 14cm, steps of 2cm). It was found that 2PDs were significantly smaller for noxious stimuli for both modalities. In contrast, between-modality comparison reproduced previous reports of impaired acuity for noxious stimulation. Higher pain intensities were reported when a larger area was stimulated (SSp), independent of the modality. Furthermore, reported pain intensities were higher when the distance between two stimulated areas was increased from 2cm to 6cm (p<0.001), 8cm (p<0.01) and 14cm (p<0.01). 2PDs determined by mechanical and electrocutaneous stimuli were significantly correlated within both stimulus intensities, i.e. innocuous (r=0.34, p<0.05) and noxious (r=0.35, p<0.05). The current results show three novel findings: i) the precision of the pain system might be higher than in the innocuous (tactile) system when mechanical and electrocutaneous modalities are used, ii) the pattern of distance-based and area-based SSp is comparable irrespective of the modality applied (mechanical and electrocutaneous), iii) both modalities are moderately correlated.

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