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Quantitative and qualitative analysis of touch, cold and warmth in health, neuropathic pain and fibromyalgia
Stockholm University, Faculty of Social Sciences, Department of Psychology.
2001 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The general aim of the present thesis is to examine tactile and thermal perceptual (dys)function by quantitative and qualitative tests of patients with neuropathic pain or fibromyalgia, and to compare results with those of healthy persons. A specific aim is to provide individual data for diagnostic purposes, specific to touch, cold, and warmth (profiles). The first question addressed is whether patients with ongoing pain are able to perform reliably in a scaling experiment. A second question addressed is on the nature of the relation between patient’s ongoing pain, and tactile and thermal (dys)function.

In Study I-IV patients’ spontaneous ongoing pain is scaled, and in psychophysical experiments perception thresholds determined, perceived intensity scaled, and perceived quality assessed. Inter-individual comparability in perceived intensity is achieved by calibrating individual scales of perceived intensity according to the Master Scaling procedure. In Study I, the applicability of the method of Master Scaling is extensively discussed and it is found to be particularly well suited for perceived intensity of touch, cold, and warmth, because of the common frame of reference represented by perceived intensity at thenar for the modality tested.

Study II examines tactile and thermal perception in patients with peripheral or central neuropathic pain, and shows: (a) patients are able to adequately scale perceived intensity; (b) paradoxical heat perception is reported for cold stimulation by five of seven patients with central post-stroke pain (CPSP), but by none of the patients with peripheral lesions; (c) peripheral nerve lesions are modality specific, with tactile and thermal functions independently affected, or, preserved; and (d) ongoing pain and perceived intensity of touch, cold, and warmth are uncorrelated, independent phenomena.

Study III examines the effects of age and gender on thermal perception in healthy persons, and shows that elderly and young women’s and men’s thermal perception varies in relation to body area. Thus, it provides useful reference data for future psychophysical tests. Study IV examines tactile and thermal perception in patients with fibromyalgia syndrome (FMS), and their age-matched controls, and shows: (a) paradoxical heat perception for cold stimulation in all FMS patients but in none of the controls, and (b) normal perceptions of touch and warmth in all patients and controls. Study V examines the effect of an ischemic nerve block on the experimentally induced perceptual phenomenon of "synthetic heat" in healthy persons. "Synthetic heat" has been hypothesized to be a model for CPSP patients’ cold-evoked burning pain, however, the results show: (a) A-delta cold specific fibers are not responsible for "synthetic heat" perception, and (b) "synthetic heat" is not described as "painful", only as "hot", results that question the involvement of nociceptors. In summary, the methods applied provide very specific individual profiles of perception of touch, cold, and warmth in health and pain disease. Perception of pradoxical heat for cold stimulation is found in CPSP patients in Study I, and in FMS patients in Study IV, and it is, therefore, suggested as a marker for centrally induced pain mechanisms. 

Place, publisher, year, edition, pages
Stockholm: Department of Psychology, Stockholm University , 2001. , 98 p.
Keyword [en]
Ongoing pain, tactile and thermal (dys)function, perceived intensity, Master Scaling, perceived quality
Keyword [sv]
Känsel, Smärta, fysiologisk psykologi, Fibromyalgi
National Category
Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:su:diva-143014ISBN: 91-7265-263-2 (print)OAI: oai:DiVA.org:su-143014DiVA: diva2:1094178
Public defence
2001-06-06, 10:00 (English)
Opponent
Note

Diss. (sammanfattning) Stockholm : Univ., 2001

Härtill 5 uppsatser

Available from: 2017-05-09 Created: 2017-05-09 Last updated: 2017-07-10Bibliographically approved

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