The Effect Of Pulse Shape and Frequency Of Electrical Conditioning Stimulation On The Induction Of Secondary Hyperalgesia

Stouffs, Alexandre;Lebrun, Louisien;Mouraux, André;van den Broeke, Emanuel
(2019) EFIC - 11th CONGRESS OF THE EUROPEAN PAIN FEDERATION EFIC — Location: Valencia, Spain (4.September.2019)

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Background and aims: Animal studies showed that high frequency stimulation (HFS) of peripheral C-fibers induces long-term potentiation (LTP) within spinal nociceptive circuits. In humans, HFS (five 100 Hz trains of electrical pulses for 1 sec repeated every 10 seconds) applied to the skin using an electrode designed to activate nociceptive afferents induces secondary mechanical hyperalgesia, considered as a manifestation of central sensitization. Our aim was to test the frequency-dependence of HFS-induced secondary hyperalgesia, and whether part of the effects of HFS could be due to charge accumulation in the stimulated skin. Methods: In a first experiment (N=15), we compared within subjects the secondary hyperalgesia induced by 100-Hz HFS using monophasic vs. charge-compensated biphasic pulses. In a second experiment (N=3x15) we compared between subjects the secondary hyperalgesia induced by 100, 20 and 5 Hz charge-compensated stimulation, keeping constant the number of pulses and the inter-train interval. Secondary hyperalgesia was quantified as the change in intensity of perception elicited by 128 mN pinprick stimuli and the size of the area of increased pinprick sensitivity. Results: No significant difference was observed in the secondary hyperalgesia induced by monophasic vs. biphasic pulses. The increase in pinprick sensitivity was dependent on stimulation frequency, and maximal for 20 vs. 5 and 100 Hz stimulation. Conclusions: Charge accumulation does not influence secondary hyperalgesia induced by HFS. 20 Hz stimulation induces a stronger secondary hyperalgesia than both 5 and 100 Hz stimulation. Future studies are needed to understand whether this frequency-dependence is due to peripheral vs. central factors.
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Stouffs, A., Lebrun, L., Mouraux, A., & van den Broeke, E. (2019). The Effect Of Pulse Shape and Frequency Of Electrical Conditioning Stimulation On The Induction Of Secondary Hyperalgesia. EFIC - 11th CONGRESS OF THE EUROPEAN PAIN FEDERATION EFIC, Valencia, Spain. https://hdl.handle.net/2078.5/117768