Biomedical subjects

T Graven-Nielsen

Publications and source records attributed to T Graven-Nielsen.

At least 37 records · Page 2Linked to original sources

PubMed2001

Motor potentials evoked by transcranial magnetic stimulation during isometric and dynamic masseter muscle contraction in humans.

The facilitation of muscle motor potentials evoked by transcranial magnetic stimulation (TMS) has been demonstrated convincingly during both isometric and dynamic activity in the limbs but not in the jaw muscles. An experimental design involving TMS, surface electromyography and controlled muscle-activity was employed to investigate the motor response of the human masseter during voluntary isometric and dynamic voluntary conditions. During the isometric condition, an increase in muscle facilitation resulted in a progressive increase in motor-evoked potential (MEP) amplitude that was consistently greater on the side contralateral to that subjected to TMS (P < 0.05). No difference in MEP amplitude or laterality of response was revealed for the two dynamic conditions. The sample size may have been too small to reveal any differences. The modulation of MEPs during isometric activity was probably due to cortical and brainstem mechanisms. Putative variation in masseter MEPs during dynamic conditions cannot be discounted.

Adult↗

PubMed2001

Inhibition of motor system excitability at cortical and spinal level by tonic muscle pain.

OBJECTIVE: To assess whether the motor system excitability can be modified by experimental tonic pain induced either in muscles or in subcutis. METHODS: Transcranial magnetic stimulation of the left primary motor cortex was used to record motor evoked potentials (MEPs) from the right abductor digiti minimi (ADM) muscle. Recordings were made before, during and after experimental pain induced by (1) injection of hypertonic (5%) saline into the right ADM, the right first dorsal interosseum (FDI) and the left ADM muscles, and (2) injection of hypertonic saline in the subcutaneous region of the right ADM. Both MEPs and H-reflex were recorded also from the right flexor carpi radialis (FCR) before, during and after muscle pain. RESULTS: MEPs recorded from the ADM muscle were significantly reduced in amplitude during pain induced in the right ADM and right FDI muscles, but not during pain in the left ADM muscle or during subcutaneous pain. This inhibitory effect was observed during the peak-pain and persisted also after the disappearance of the pain sensation. In the FCR muscle, the MEP inhibition was observed during the peak-pain, while a significant reduction of the H-reflex's amplitude was observed starting 1 min after the peak-pain. CONCLUSIONS: Tonic muscle pain can inhibit the motor system. The motor cortex inhibition observed at an early phase is followed by a reduction of the excitability of both cortical and spinal motoneurones.

Adult↗

PubMed2001

Non-painful and painful surface and intramuscular electrical stimulation at the thenar and hypothenar sites: differential cerebral dynamics of early to late latency SEPs.

Little is known about somatosensory evoked potentials (SEPs) from muscle stimulation compared to that from skin stimulation. The current study examined this issue in the full SEP spectrum (0-440 ms). The aims of the study were to (1) establish the dynamics of early to late latency SEPs from intramuscular stimulation in contrast to surface stimulation, (2) compare the effect of non-painful and painful stimuli on SEP latencies and amplitudes of the two methods, and (3) investigate to which extent these results can be shared between the median nerve innervated thenar site and ulnar nerve innervated hypothenar site. Stimuli were delivered (2 Hz) at a non-painful and a painful intensity above or within the thenar and hypothenar muscles of the hand. Maximas of the SEPs were extracted by a combination of global field power and visual inspection of the topographies. Amplitudes and latencies of the maximas were analysed by a two-way ANOVA with repeated measures. In the early phase (0-50 ms) the topographic patterns showed different dynamics between surface and intramuscular stimulation and in the late phase (100- 440 ms) prolonged latencies were found for intramuscular stimulation. Apart from this, similar topographic patterns and time sequences were obtained. Significant higher SEP amplitudes for most of the isolated components (C4'/P25, Fz/N35, C4'/P45, Fc2/N65, P4/P90, T4/N137, F3/P150, Cz/P240-P270) were found with surface stimulation compared to intramuscular stimulation. In contrast to surface stimulation, intramuscular stimulation at a stimulation frequency of 2 Hz did not result in a differentiation in amplitude for any of the isolated components. These results indicate differences in the early and late processing of sensory input from skin and muscle.

Adult↗

PubMed2001

Post-exercise muscle soreness after eccentric exercise: psychophysical effects and implications on mean arterial pressure.

The aim of the study was to examine the time course of changes in pressure pain threshold (PPT), visual analogue scale (VAS) pain and tenderness scores, McGill Pain Questionnaire (MPQ) descriptors, pain areas, skin temperature and mean arterial pressure (MAP) following intensive eccentric exercise. In 11 healthy male subjects, eccentric exercise of the first dorsal interosseous muscle (FDI) of the right hand with 114% maximum voluntary contraction weight (MVC) was used to induce post-exercise muscle soreness (PEMS) in the right hand, while the left hand served as a control. At 24 h to 48 h all the pain profiles indicated the presence of PEMS in the right hand when compared to before exercise (P<0.05). MPQ and pain area assessments also indicated PEMS immediately after the exercise, while the pain assessment by PPT and tenderness VAS showed insignificant pain immediately after the exercise. Skin temperature measured in the first web space of the hand did not change at any time. MAP was significantly reduced at 48 h. It is concluded that eccentric exercise of a small hand muscle is followed by PEMS and a reduced MAP after 48 h that may suggest a role of central mechanisms in the PEMS, thereby giving further insight into clinical aspects of muscle pain.

Adult↗

PubMed2001

Computer-controlled pneumatic pressure algometry--a new technique for quantitative sensory testing.

Hand-held pressure algometry usually assesses pressure-pain detection thresholds and provides little information on pressure-pain stimulus-response function. In this article, a cuff pressure algometry for advanced pressure-pain function evaluation is proposed. The experimental set-up consisted of a pneumatic tourniquet cuff, a computer-controlled air compressor and an electronic visual analogue scale (VAS) for constant pain intensity rating. Twelve healthy volunteers were included in the study. In the first part, hand-held algometry and cuff algometry were performed over the gastrocnemius muscle with constant compression rate. In the second part, the cuff algometry was performed with different compression rates to evaluate the influence of the compression rate on pain thresholds and other psychophysical data. Pressure-pain detection threshold (PDT), pain tolerance threshold (PTT), pain intensity, PDT-PTT time and other psychophysical variables were evaluated.Pressure-pain detection thresholds recorded over the gastrocnemius muscle with a hand-held and with a cuff algometer, were 482 +/- 19 kPa and 26 +/- 1.6 kPa, respectively. Pressure and pain intensities were correlated during cuff algometry. During increasing cuff compression, the subjective pain tolerance limit on VAS was 5.6 +/- 0.95 cm. There was a direct correlation between the number of compressions, the compression rate and pain thresholds. The cuff algometry technique is appropriate for pressure-pain stimulus-response studies. Cuff algometry allowed quantification of psychophysical response to the change of stimulus configuration.

Adult↗

PubMed2001

The peripheral apparatus of muscle pain: evidence from animal and human studies.

The peripheral apparatus of muscle pain consists of nociceptors that can be excited by endogenous substances and mechanical stimuli. Histologically, the nociceptors are free nerve endings supplied by group III (thin myelinated) and group IV (nonmyelinated) afferents with conduction velocities less than 30 m/s. At the molecular level, nociceptors have receptors for algesic substances, such as bradykinin, serotonin, and prostagladin E2. The purinergic receptors and tetrodotoxin-resistant sodium channels might be new important targets for the treatment of muscle pain. Algesic substances (capsaicin, bradykinin, serotonin, potassium chloride, and hypertonic saline) and other stimuli (ischemia, strong mechanical stimuli, and electrical stimuli) have been shown to induce nociception from muscle in animals and muscle pain in humans. Muscle nociceptors can be sensitized to chemical and mechanical stimuli. Contrary to a former belief, the sensitization is not an unspecific process; rather, it is caused by endogenous algesic substances binding to highly specific receptor molecules in the membrane of the nociceptive ending. For example, animal studies showed that serotonin sensitizes muscle nociceptors to chemical and mechanical stimuli. Later, human studies showed that serotonin combined with bradykinin induces muscle hyperalgesia to pressure. The sensitization process by endogenous substances that are likely to be released during trauma or inflammatory injury is probably the best established peripheral mechanism for muscle tenderness and hyperalgesia.

Animals↗

PubMed2001

Craniofacial muscle pain: review of mechanisms and clinical manifestations.

Epidemiologic surveys of temporomandibular disorders (TMD) have demonstrated that a considerable proportion of the population--up to 5% or 6%--will experience persistent pain severe enough to seek treatment. Unfortunately, the current diagnostic classification of craniofacial muscle pain is based on descriptions of signs and symptoms rather than on knowledge of pain mechanisms. Furthermore, the pathophysiology and etiology of craniofacial muscle pain are not known in sufficient detail to allow causal treatment. Many hypotheses have been proposed to explain cause-effect relationships; however, it is still uncertain what may be the cause of muscle pain and what is the effect of muscle pain. This article reviews the literature in which craniofacial muscle pain has been induced by experimental techniques in animals and human volunteers and in which the effects on somatosensory and motor function have been assessed under standardized conditions. This information is compared to the clinical correlates, which can be derived from the numerous cross-sectional studies in patients with craniofacial muscle pain. The experimental literature clearly indicates that muscle pain has significant effects on both somatosensory and craniofacial motor function. Typical somatosensory manifestations of experimental muscle pain are referred pain and increased sensitivity of homotopic areas. The craniofacial motor function is inhibited mainly during experimental muscle pain, but phase-dependent excitation is also found during mastication to reduce the amplitude and velocity of jaw movements. The underlying neurobiologic mechanisms probably involve varying combinations of sensitization of peripheral afferents, hyperexcitability of central neurons, and imbalance in descending pain modulatory systems. Reflex circuits in the brain stem seem important for the adjustment of sensorimotor function in the presence of craniofacial pain. Changes in somatosensory and motor function may therefore be viewed as consequences of pain and not factors leading to pain. Implications for the diagnosis and management of persistent muscle pain are discussed from this perspective.

Afferent Pathways↗

PubMed2000

Duration and distribution of experimental muscle hyperalgesia in humans following combined infusions of serotonin and bradykinin.

The present study examined distribution and duration of muscle hyperalgesia to pressure stimuli after intramuscular bolus-infusions of serotonin (5-HT, 20 nmol) and bradykinin (BKN, 10 nmol) in 10 volunteers. Infusions were given into the tibialis anterior (TA) muscle over 20 s with an inter-infusions interval of 3 min. Infusions of isotonic saline (NaCl, 0.9%) were given as control. Pain intensity was continuously scored on a visual analogue scale (VAS), and subjects drew the distribution of the pain areas on an anatomical map. Pressure pain thresholds (PPTs) were assessed with an electronic algometer at the injection site (10 cm below the patella), 2, 5, and 10 cm distal from the injection site, and at the ankle. Control assessments of PPTs were done at the contralateral TA and ankle. Skin sensibility was assessed with a Von Frey hair at the same sites. All measurements were done before and 5, 20, 40, and 60 min after infusions. The VAS-peak after BKN was significantly higher (P<0.05) compared with 5-HT and the second infusion of NaCl. The duration of the increase in VAS after 5-HT+BKN was significantly longer (P<0.05) compared with the infusions of NaCl. The local pain area after infusion of BKN was significantly larger (P<0.05) compared with 5-HT and control infusions. Cutaneous sensibility to tactile stimuli was not affected by any of the combinations. PPTs at the injection site and 2 cm (5, 20, and 40 min) were significantly decreased (P<0.05) after 5-HT+BKN compared with baseline and isotonic saline. In addition, PPTs were significantly decreased (P<0.05) after 5-HT+BKN at 5 cm (5 and 20 min) and 10 cm (5 min). Serotonin may enhance the effect of bradykinin in producing experimental muscle pain and muscle hyperalgesia to mechanical stimuli. The combination of serotonin and bradykinin can produce muscle hyperalgesia, lasted for up to 40 min and located within the muscle. No widespread hyperalgesia to the ankle and other leg (tested at 10 cm below the patella and ankle) was observed suggesting a predominant peripheral origin of the experimentally induced hyperalgesic stage.

Adult↗

PubMed2000

Quantitative analysis of reflex inhibition in single motor units in human masseter muscle: effects of stimulus intensity.

Inhibitory reflex responses to electrical stimulation of the mental nerve were studied in recordings from single motor units (SMU) in the human masseter muscle. A new analytical technique for spike train data was used. Electrical stimuli were delivered to the mental nerve when the SMU fired with two consecutive inter-spike intervals (ISIs) within the range of 90 ms to 110 ms. Stimuli were delivered with increasing stimulus delays after the preceding SMU action potential (AP). Sham, non-painful, and painful stimulus intensities were applied. The post-stimulus firing probability of the SMU was progressively decreased among the three conditions. Analysis of the relation between stimulus delays and ISI for the first post-stimulus APs revealed a linear relation which was shifted upward, and the slope was increased with increasing stimulus intensity. This may be explained by a differential effect of the increasing stimulus intensity on the duration and amplitude of the inhibitory post-synaptic potential. The methods used in the present study provide a useful means of quantifying the effects of motoneuron excitability in detail.

Adult↗

PubMed2000

Inhibition of motor unit firing during experimental muscle pain in humans.

Electromyographic activity was recorded in the masseter muscle to investigate whether the firing characteristics of single motor units (SMUs) were affected by muscle pain. Capsaicin was injected into the masseter to induce pain. The interspike interval (ISI) and recruitment threshold of SMUs were measured while subjects performed isometric contractions at 5, 7.5, 10, 15, and 20% of maximum voluntary contraction. All subjects were able to maintain a stable isometric force during pain, but the mean ISI was significantly increased without changing the recruitment threshold. In all the experimental conditions, the firing frequency increased with increasing force, and SMUs recruited at low force fired at higher rates for all force levels. These results suggest that acute stimulation of nociceptive muscle afferents inhibits SMU activity without changing recruitment order in the homonymous muscle.

Action Potentials↗

PubMed2000

Modulation of stretch-evoked reflexes in single motor units in human masseter muscle by experimental pain.

The interaction between muscle pain and motor function of the jaw has been examined in recent years, but the nature of the modulation of the short-latency stretch reflex by pain is not fully understood. In this study, the reflex responses to stretch were measured in single low-threshold motor units that were kept discharging at a constant frequency, before, during and after the induction of experimental pain in one masseter muscle by controlled infusion of hypertonic saline. The probability of evoking a reflex response in individual motor units in the painful muscle at near-monosynaptic latency was reduced by a mean of about 20%. However, the overall reflex response in the surface electromyogram of both the ipsi- and contralateral masseter muscles was greater during pain. This was apparently a secondary response to the pain-induced increase in pre-stimulus activity in the motoneurone pools of both muscles, because increased motoneurone excitability may facilitate stretch reflexes. It is concluded that the most likely explanation for the reduced reflex response of low-threshold masseter motor units during experimental pain is a tonic reduction in the fusimotor drive to the masseter spindles.

Adult↗

PubMed2000

The influence of experimental muscle pain on motor unit activity during low-level contraction.

In the present study we compared motor unit (MU) activity in a painful extensor carpi ulnaris (ECU) muscle to that of a pain-free control. According to the pain adaptation model the activity of the painful ECU muscle may be inhibited and its antagonist activity increased during wrist extension performed as a pre-defined low-force ramp. The pre-defined low force may then be maintained by increased activity in the pain-free synergist muscles such as the extensor carpi radialis (ECR) muscle. Nine females (31-47 years old) participated in the study. Maximal voluntary contraction (MVC) of the wrist extensors was performed. A catheter was inserted into the ECU muscle to allow the injection of hypertonic saline to evoke muscle pain, and a concentric needle was inserted for the recording of MU activity. Surface electromyograms were recorded from a synergist and an antagonist (ECR and flexor carpi radialis) to the painful ECU muscle. A force ramp of isometric wrist extensions up to 10% MVC, with a force increase of 1% MVC x s(-1), were performed followed by 60 s of sustained contraction at 10% MVC. The number of MUs recruited was almost identical for baseline and with pain, and no effect of experimental muscle pain was found on the properties of the MUs (amplitude, area) or their firing characteristics (mean firing rate, firing variability) during low-force ramp contraction. During the sustained 10% MVC, no effect of pain was found for concentric or surface EMG of the forearm muscles. At low force levels no pain-induced modulations were found in MU activity, when the mechanical condition was similar to that of a control situation.

Adult↗

PubMed2000

Experimental muscle pain modulates muscle activity and work performance differently during high and low precision use of a computer mouse.

The aim was to investigate the influence of experimental muscle pain on performance and upper extremity muscle activity during occupational work requiring different levels of precision. Experimental muscle pain was induced by infusing hypertonic saline (0.3 ml, 5% NaCl) into the extensor carpi ulnaris (ECU) muscle. The same amount of isotonic saline was infused on a separate day to act as a control. Tasks requiring use of a computer mouse with high and low levels of precision were performed during the two sessions. Electromyographic (EMG) activity was measured from the ECU, the flexor carpi radialis (FCR) and the trapezius muscles. A group of 13 men participated in the study. Performance measured as work cycle time, cursor movements on the screen, and velocity of cursor movement were unaffected by muscle pain. The ECU muscle pain did not modulate EMG profiles of either the trapezius or FCR muscles either during high or during low precision work. During the low precision work the painful ECU muscle showed lower EMG activity in specific phases of the work cycle (highest activity phases) compared to the control session (P<0.05), whereas during the high precision work, experimental pain had no effect on the activity of the ECU muscle. In conclusion experimental muscle pain seems to modulate motor control differently depending on the precision level of the task. This may be of importance for our understanding of why some tasks lead to chronic musculoskeletal disorders.

Adult↗

PubMed1999

The effect of differential and complete nerve block on experimental muscle pain in humans.

We have attempted to examine the nerve fiber population mediating experimentally induced muscle pain in humans. Two established methods induced muscle pain: continuous, intramuscular, electrical stimulation and intramuscular infusion of hypertonic saline. A progressive nerve block was achieved by a combination of compression nerve block and intravenous regional anesthesia. Regular tests of muscle pain intensity were performed during the blocking period of 60 min. At the same time, the blocking of thick and thin afferents was monitored by assessment of proprioception and cutaneous touch, pin-prick, pressure pain, and heat-detection thresholds. Electrically induced muscle pain was inhibited (P < 0.0001) in parallel with proprioception, touch, and pin-prick, which were mediated by thick and thin myelinated nerve fibers. Saline-induced muscle pain was inhibited (P < 0.002) synchronously with heat detection and pressure pain, which are mediated by unmyelinated nerve fibers. Based on the present psychophysical experiments, it is suggested that: (1) myelinated afferents mediated mainly electrically induced muscle pain, and (2) unmyelinated afferents mediated mainly saline-induced muscle pain.

Adult↗

PubMed1999

Effect of clenching levels on heteronymous H-reflex in human temporalis muscle.

Selective stimulation of the masseteric nerve has been shown to elicit a heteronymous H-reflex in the ipsilateral temporalis muscle during voluntary clenching. However, the relation between the electromyographic (EMG) activity of the temporalis muscle and the amplitude of the H-reflex has not been previously described. In the present study, the hypothesis was tested that there would be a positive relationship between the level of EMG activity and the amplitude of the H-reflex. The direct motor response (M-response) in the masseter muscle and the heteronymous H-reflex in the anterior temporalis muscle were successfully elicited by electrical stimulation of the masseteric nerve in 12 of 13 subjects. A new automatic system was used to control the on-line EMG activity and to trigger the stimulus. In a random order, two series of 20 stimuli were delivered at each of four clenching levels (0, 25, 50, and 75% of maximal voluntary contraction). The analysis showed that both the masseteric M-response and the temporalis H-reflex were reproducible within and between series. The amplitude of the temporalis H-reflex increased significantly at higher clenching levels (ANOVA: P=0.003). Clenching at 50% and 75% of the maximal voluntary contraction caused significantly larger amplitudes of the H-reflex than clenching at 25% of the maximal voluntary contraction; at rest, no H-reflex could be recorded. There was a significant correlation between the background EMG activity in the ipsilateral temporalis muscle and the amplitude of the H-reflex (Pearson: r=0.313, P=0.008). These data indicate that the heteronymous H-reflex can be reliably elicited by means of an automatic system for stimulus delivery and that the amplitude of the H-reflex is dependent on the preceding activity of the motoneuron pool.

Adult↗

PubMed1999

The effect of compression and regional anaesthetic block on referred pain intensity in humans.

The mechanisms underlying local and referred muscle pain are poorly understood. The aim of this experiment was to determine to which degree referred pain is dependent on peripheral or central mechanisms. This was studied by blocking sensory input from the referred pain area. Intramuscular electrical stimulation in the right anterior tibial muscle induced local muscle pain and referred pain in 12 subjects. Nerve blocks were applied on the lower limb between the local and the referred pain area for 60 min. Three different studies were performed: (1) no nerve block (2) compression block, and (3) compression block combined with intravenous regional anaesthesia. The referred pain intensity was assessed every 5 min. To monitor the blockade of myelinated and unmyelinated nerve fibres, touch, pinprick, position sense and heat and heat-pain detection thresholds were assessed on the dorsal side of the foot every 5 min. A significant reduction in referred pain intensity (40.5%) compared with the control experiment was found after 40 min with the compression ischemia nerve block until release of the tourniquet. In the combined nerve block experiment, a significant reduction of referred pain intensity (38.5%) was seen after 20 min and until the release of the tourniquet. There was no significant difference in the referred pain intensity between the two types of blocks. The present findings suggest that both peripheral and central mechanisms play a role in referred pain and that the myelinated fibres mediate the peripheral component.

Adult↗

PubMed1999

Generalised muscular hyperalgesia in chronic whiplash syndrome.

The whiplash syndrome has immense socio-economic impact. Despite extensive studies over the past years, the mechanisms involved in maintaining the pain in chronic whiplash patients are poorly understood. The aim of the present experimental study was to examine the muscular sensibility in areas within and outside the region involved in the whiplash trauma. Eleven chronic whiplash patients and 11 sex and age matched control subjects were included in the study. Before the experiment, the whiplash patients had pain in the neck and shoulder region with radiating pain to the arm. Five patients reported pain that was more widespread. The somatosensory sensibility in the areas over the infraspinatus, brachioradial, and anterior tibial muscles was assessed by pressure stimulation, pin-prick stimulation, and cotton swap stimulation. Infusion of hypertonic saline (5.85%, 0.5 ml) into the infraspinatus and anterior tibial muscles was performed to assess the muscular sensibility and referred pain pattern. The saline-induced muscle pain intensity was assessed on a continuous visual analogue scale (VAS). The distribution of pain was drawn on an anatomical map. The pressure pain thresholds were significantly lower in patients (P<0. 01) compared with controls: infraspinatus (mean 152.2 vs. 172.7 kPa), brachioradial (mean 70.0 vs. 363.8 kPa), and anterior tibial muscle (mean 172.7 vs. 497.8 kPa). The skin sensibility to pin-prick stimulation and cotton swap stimulation was not different between patients and controls. Infusion of hypertonic saline caused significantly higher VAS scores with longer duration in patients compared to control subjects (P<0.01). The area under the VAS-time curve was significantly (P<0.01) increased in patients compared to control subjects after injection into the infraspinatus muscle (mean 4138.1 vs. 780.0 cm s) and anterior tibial muscle (mean 4370.8 vs. 978.7 cm s). The saline infusion caused local pain defined as pain located around the injection site and referred pain areas not included in the local pain area. The area of local and referred pain were significantly larger in patients compared to control subjects (P<0.01). In the control group, the referred pain areas to infusion of hypertonic saline into the anterior tibial muscle were found at the dorsal aspect of the ankle. In contrast, the areas of referred pain were quite widespread in the patient group with both distal and proximal referred pain areas. In the present study, muscular hyperalgesia and large referred pain areas were found in patients with chronic whiplash syndrome compared to control subjects both within and outside the traumatised area. The findings suggest a generalised central hyperexcitability in patients suffering from chronic whiplash syndrome. This indicates that the pain might be considered as a neurogenic type of pain, and new pharmacological treatments should be investigated accordingly.

Adult↗

PubMed1999

Experimental human muscle pain induced by intramuscular injections of bradykinin, serotonin, and substance P.

After intramuscular (m. tibialis anterior) injection of three different algogenic substances, the pain intensity was continuously scored on a visual analogue scale (VAS) in eight volunteers. The subject drew the distribution of the local and referred pain areas on a map. Four times within the first hour after injection, the pressure pain-thresholds (PPTs) and supra pressure-pain thresholds were assessed at the injection point, 2 cm distal from the injection site, at the arm, and at the contralateral leg. Measurements were done before and after injection of 0.5 ml of the algogenic substance [bradykinin (BKN), serotonin (5-HT), substance P (SP)], and isotonic saline as control. Cutaneous sensitivity to mechanical stimuli was assessed with a Von Frey hair at the same location as PPT determinations.The pain intensity (VAS-peak) after BKN (2, 4, and 10 nmol) and 5-HT (2, 4, and 20 nmol) was significantly higher (p< 0.05) than after SP (0.2, 0.4, and 0.8 nmol) and isotonic saline. The VAS-peak after infusions of hypertonic saline was significantly higher (p< 0.05) compared with VAS-peaks after all other substances. A significantly larger (p< 0.05) local pain area was found after BKN compared with isotonic saline. After injections of hypertonic saline, the offsets of evoked pain were significantly longer (p< 0.05) and the local and referred pain areas were significantly larger (p< 0.05) compared with all other substances. There was no dose-response relation between the pain intensity and the different doses of BKN, 5-HT, and SP. PPTs and skin sensitivity were not affected by any of the injections.We conclude that under the present experimental conditions, BKN and 5-HT can produce low levels of muscle pain after intramuscular injection. In the used concentrations, however, BKN, 5-HT, and SP did not generate cutaneous or muscular hyperalgesia. Copyright 1999 European Federation of Chapters of the International Association for the Study of Pain.

Journal Article↗