Assessing the Influence of Nonischemic A-Fiber Conduction Blockade on Offset Analgesia: an experimental study

Luisa Luebke; Clara Gieseke Lopes; Yasmin Myka; Annika Lumma; Wacław M Adamczyk; Gabriela F Carvalho; Gwendolyne G M Scholten-Peeters; Kerstin Luedtke; Tibor M Szikszay

doi:10.1016/j.jpain.2024.104611

Assessing the Influence of Nonischemic A-Fiber Conduction Blockade on Offset Analgesia: an experimental study

Luisa Luebke, Clara Gieseke Lopes, Yasmin Myka, Annika Lumma, Wacław M Adamczyk, Gabriela F Carvalho, Gwendolyne G M Scholten-Peeters, Kerstin Luedtke, Tibor M Szikszay

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

Offset analgesia (OA) is believed to reflect the efficiency of the endogenous pain modulatory system. However, the underlying mechanisms are still being debated. Previous research suggested both, central and peripheral mechanisms, with the latter involving the influence of specific A-delta-fibers. Therefore, this study aimed to investigate the influence of a non-ischaemic A-fiber conduction blockade on the OA response in healthy participants. A total of 52 participants were recruited for an A-fiber conduction blockade via compression of the superficial radial nerve. To monitor fiber-specific peripheral nerve conduction capacity, quantitative sensory testing was performed continuously. Before, during and after the A-fiber block, an individualized OA-paradigm was applied to the dorsum of both hands (blocked and control side were randomized). Pain intensity of each heat stimulus was evaluated by an electronic visual analogue scale. A successful A-fiber conduction blockade was achieved in thirty participants. Offset analgesia has been verified within time (before, during, after blockade), and condition (blocked and control side) (p < 0.01, d > 0.5). Repeated measurements ANOVA showed no significant interaction effects between OA within condition and time (p = 0.24, η² p = 0.05). Hence, no significant effect of A-fiber blockade was detected on OA during noxious heat stimulation. The results suggest that peripheral A-fiber afferents may play a minor role in OA compared to alternative central mechanisms or other fibers. However, further studies are needed to substantiate a central rather than peripheral influence on OA. PERSPECTIVE: This article presents the observation of offset analgesia before, during and after a successful A-fiber conduction blockade in healthy volunteers. A better understanding of the mechanisms of offset analgesia and endogenous pain modulation in general may help to explain the underlying aspects of pain disorders.

Original language	English
Article number	104611
Pages (from-to)	1-12
Number of pages	12
Journal	The Journal of Pain
Volume	25
Issue number	10
Early online date	20 Jun 2024
DOIs	https://doi.org/10.1016/j.jpain.2024.104611
Publication status	Published - Oct 2024

Bibliographical note

Funding

The authors declare no conflict of interest. Support for this research was provided by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) \u2014 493000854. WMA is supported by the Polish National Science Center (2020/37/B/HS6/04196).

Funders	Funder number
Deutsche Forschungsgemeinschaft
German Research Foundation	493000854
Polish National Science Center	2020/37/B/HS6/04196

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@article{9b020b55146c43028716b18001c0ff91,

title = "Assessing the Influence of Nonischemic A-Fiber Conduction Blockade on Offset Analgesia: an experimental study",

abstract = "Offset analgesia (OA) is believed to reflect the efficiency of the endogenous pain modulatory system. However, the underlying mechanisms are still being debated. Previous research suggested both, central and peripheral mechanisms, with the latter involving the influence of specific A-delta-fibers. Therefore, this study aimed to investigate the influence of a non-ischaemic A-fiber conduction blockade on the OA response in healthy participants. A total of 52 participants were recruited for an A-fiber conduction blockade via compression of the superficial radial nerve. To monitor fiber-specific peripheral nerve conduction capacity, quantitative sensory testing was performed continuously. Before, during and after the A-fiber block, an individualized OA-paradigm was applied to the dorsum of both hands (blocked and control side were randomized). Pain intensity of each heat stimulus was evaluated by an electronic visual analogue scale. A successful A-fiber conduction blockade was achieved in thirty participants. Offset analgesia has been verified within time (before, during, after blockade), and condition (blocked and control side) (p < 0.01, d > 0.5). Repeated measurements ANOVA showed no significant interaction effects between OA within condition and time (p = 0.24, η² p = 0.05). Hence, no significant effect of A-fiber blockade was detected on OA during noxious heat stimulation. The results suggest that peripheral A-fiber afferents may play a minor role in OA compared to alternative central mechanisms or other fibers. However, further studies are needed to substantiate a central rather than peripheral influence on OA. PERSPECTIVE: This article presents the observation of offset analgesia before, during and after a successful A-fiber conduction blockade in healthy volunteers. A better understanding of the mechanisms of offset analgesia and endogenous pain modulation in general may help to explain the underlying aspects of pain disorders. ",

author = "Luisa Luebke and Lopes, {Clara Gieseke} and Yasmin Myka and Annika Lumma and Adamczyk, {Wac{\l}aw M} and Carvalho, {Gabriela F} and Scholten-Peeters, {Gwendolyne G M} and Kerstin Luedtke and Szikszay, {Tibor M}",

note = "Copyright {\textcopyright} 2024. Published by Elsevier Inc.",

year = "2024",

month = oct,

doi = "10.1016/j.jpain.2024.104611",

language = "English",

volume = "25",

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T1 - Assessing the Influence of Nonischemic A-Fiber Conduction Blockade on Offset Analgesia

T2 - an experimental study

AU - Luebke, Luisa

AU - Lopes, Clara Gieseke

AU - Myka, Yasmin

AU - Lumma, Annika

AU - Adamczyk, Wacław M

AU - Carvalho, Gabriela F

AU - Scholten-Peeters, Gwendolyne G M

AU - Luedtke, Kerstin

AU - Szikszay, Tibor M

PY - 2024/10

Y1 - 2024/10

N2 - Offset analgesia (OA) is believed to reflect the efficiency of the endogenous pain modulatory system. However, the underlying mechanisms are still being debated. Previous research suggested both, central and peripheral mechanisms, with the latter involving the influence of specific A-delta-fibers. Therefore, this study aimed to investigate the influence of a non-ischaemic A-fiber conduction blockade on the OA response in healthy participants. A total of 52 participants were recruited for an A-fiber conduction blockade via compression of the superficial radial nerve. To monitor fiber-specific peripheral nerve conduction capacity, quantitative sensory testing was performed continuously. Before, during and after the A-fiber block, an individualized OA-paradigm was applied to the dorsum of both hands (blocked and control side were randomized). Pain intensity of each heat stimulus was evaluated by an electronic visual analogue scale. A successful A-fiber conduction blockade was achieved in thirty participants. Offset analgesia has been verified within time (before, during, after blockade), and condition (blocked and control side) (p < 0.01, d > 0.5). Repeated measurements ANOVA showed no significant interaction effects between OA within condition and time (p = 0.24, η² p = 0.05). Hence, no significant effect of A-fiber blockade was detected on OA during noxious heat stimulation. The results suggest that peripheral A-fiber afferents may play a minor role in OA compared to alternative central mechanisms or other fibers. However, further studies are needed to substantiate a central rather than peripheral influence on OA. PERSPECTIVE: This article presents the observation of offset analgesia before, during and after a successful A-fiber conduction blockade in healthy volunteers. A better understanding of the mechanisms of offset analgesia and endogenous pain modulation in general may help to explain the underlying aspects of pain disorders.

AB - Offset analgesia (OA) is believed to reflect the efficiency of the endogenous pain modulatory system. However, the underlying mechanisms are still being debated. Previous research suggested both, central and peripheral mechanisms, with the latter involving the influence of specific A-delta-fibers. Therefore, this study aimed to investigate the influence of a non-ischaemic A-fiber conduction blockade on the OA response in healthy participants. A total of 52 participants were recruited for an A-fiber conduction blockade via compression of the superficial radial nerve. To monitor fiber-specific peripheral nerve conduction capacity, quantitative sensory testing was performed continuously. Before, during and after the A-fiber block, an individualized OA-paradigm was applied to the dorsum of both hands (blocked and control side were randomized). Pain intensity of each heat stimulus was evaluated by an electronic visual analogue scale. A successful A-fiber conduction blockade was achieved in thirty participants. Offset analgesia has been verified within time (before, during, after blockade), and condition (blocked and control side) (p < 0.01, d > 0.5). Repeated measurements ANOVA showed no significant interaction effects between OA within condition and time (p = 0.24, η² p = 0.05). Hence, no significant effect of A-fiber blockade was detected on OA during noxious heat stimulation. The results suggest that peripheral A-fiber afferents may play a minor role in OA compared to alternative central mechanisms or other fibers. However, further studies are needed to substantiate a central rather than peripheral influence on OA. PERSPECTIVE: This article presents the observation of offset analgesia before, during and after a successful A-fiber conduction blockade in healthy volunteers. A better understanding of the mechanisms of offset analgesia and endogenous pain modulation in general may help to explain the underlying aspects of pain disorders.

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DO - 10.1016/j.jpain.2024.104611

M3 - Article

C2 - 38908497

SN - 1526-5900

VL - 25

SP - 1

EP - 12

JO - The Journal of Pain

JF - The Journal of Pain

IS - 10

M1 - 104611

ER -

Assessing the Influence of Nonischemic A-Fiber Conduction Blockade on Offset Analgesia: an experimental study

Abstract

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