Evidence map›Paper›PMID 28915853›Full record

Trial reportBMC neurology2017

Low threshold unmyelinated mechanoafferents can modulate pain.

Kathrin Habig, Anne Schänzer, Wolfgang Schirner, Gothje Lautenschläger, Benjamin Dassinger, Håkan Olausson, Frank Birklein, Elke R Gizewski, Heidrun H Krämer

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC neurology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
40citing papers in PubMed, 1 pooled it
3.7field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

40 citing papers in PubMed, 1 synthesis or guideline pooled it, 74 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 3 countries.

Kathrin HabigDepartment of Neurology, Justus Liebig University, Klinikstr. 33, 35392, Giessen, Germany. kathrin.habig@neuro.med.uni-giessen.de.ORCID http://orcid.org/0000-0003-3450-3493
Anne SchänzerInstitute of Neuropathology, Justus Liebig University, Arndtstr. 16, 35392, Giessen, Germany.
Wolfgang SchirnerDepartment of Neurology, Justus Liebig University, Klinikstr. 33, 35392, Giessen, Germany.
Gothje LautenschlägerDepartment of Neurology, Justus Liebig University, Klinikstr. 33, 35392, Giessen, Germany.
Benjamin DassingerDepartment of Radiology, Justus Liebig University, Klinikstr.33, 35392, Giessen, Germany.
Håkan OlaussonCenter for Social and Affective Neuroscience, Linköping University, Linköpings Universitet, 58183, Linköping, Sweden.
Frank BirkleinDepartment of Neurology, University Medical Center, Johannes Gutenberg-University, Langenbeckstr. 1, 56101, Mainz, Germany.
Elke R GizewskiDepartment of Neuroradiology, Medical University Innsbruck, Innrain 52, 6020, Innsbruck, Austria.
Heidrun H KrämerDepartment of Neurology, Justus Liebig University, Klinikstr. 33, 35392, Giessen, Germany.
Justus-Liebig-Universität Gießen · DEInnsbruck Medical University · ATJohannes Gutenberg University Mainz · DELinköping University · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHuman, hairy skin contains a subgroup of C-fibers, the C-low threshold mechanoreceptive afferents ((C-LTMR) C-tactile or C-touch (CT) fibers) that are linked with the signaling of affective aspects of human touch. Recent studies suggest an involvement of these afferents in the modulation of pain in healthy volunteers. Small fiber neuropathy (SFN) is associated with a damage of C-fibers. Therefore, an impairment of C-LTMRs can be assumed. We aimed to elaborate a possible role of CT-afferents in pain modulation by investigating healthy volunteers and SFN-patients.

methodsExperiment I: 20 SFN-patients (12 women, median age 52.0 years) and 20 healthy controls (14 women, median age 43.0 years) participated in this prospective fMRI and psychophysical study. Heat-pain (HP), CT-targeted touch (slow brushing) and HP combined with CT-targeted touch were applied in randomized order to the left shank in a block design. The participants rated pain intensity on a visual analogue scale. Experiment II: We investigated a possible impact of pain intensity on CT induced pain modulation (10 healthy participants). The intensity of HP stimulation was chosen to induce pain intensity 50/100 (NRS). HP stimulation was applied with and without CT-targeted touch.

resultsExperiment I: CT-stimulation was sufficient to reduce heat pain in healthy participants (p = 0.016), but not in SFN-patients. HP induced pain intensity was significantly higher (32,2 vs 52,6) in SFN-patients. During HP, bold responses in pain associated areas were observed in both groups. Additional CT-stimulation elicited no significant difference of bold responses compared to HP. Experiment II: In healthy volunteers, we reproduced a significant reduction of HP intensity by CT-stimulation (p = 0.038).

conclusionsCT input seems to be sufficient to modulate pain, independent of intensity of the pain stimulus. As a prerequisite, the CT fibers have to be intact as in healthy volunteers. If CT fibers are impaired - as in SFN -, CT-targeted touch does not modulate pain intensity. The location of CT-induced pain modulation might be attributed to the level of the dorsal horn since the cortical activation pattern of heat pain with and without CT-targeted touch did not differ in healthy subjects and in SFN-patients.

Indexed as

AdultAgedCase-Control StudiesFemaleHot TemperatureHumansMaleMechanoreceptorsMiddle AgedNerve Fibers, UnmyelinatedPainPain MeasurementProspective StudiesSkinTouchYoung AdultCT afferentsfMRIPain inhibitionPain perceptionSmall fiber neuropathy (SFN)Spinal cord

Identifiers

PMID28915853
PMCPMC5603029
OpenAlexW2756168736

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.