Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2025
Fiber recruitment in intra-epidermal electrical stimulation: Assessing the likelihood of Aδ- and Aβ-fiber activation.
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Júlio Sara U, Vaterlaus Jana, Lütolf Robin, Kofler Markus, Hubli Michèle, Schubert Martin
Аннотация
OBJECTIVE: To compare intra-epidermal (IES) and transcutaneous (TES) electrical stimulation with regard to nociceptive Aδ-fiber activation and Aβ-fiber co-activation. Cutaneous silent periods (CSPs) were assessed as a proxy for Aδ-fiber activation, and cortical vertex potentials (VPs) in the absence of somatosensory evoked cortical potentials (SSEPs) were assessed to exclude Aβ-fiber activation.
METHODS: IES and TES were applied at increasing intensities (multiples of electrical detection threshold, EDT). In Experiment 1, psychophysical assessments, i.e., pain intensity and quality, and CSPs were compared for IES and TES at the index finger in 29 participants (10 m, 26.6 ± 3.5 years). In Experiment 2, SSEPs and VPs were compared for IES and TES over the superficial radial nerve in 28 participants (11 m, 26.6 ± 3.4 years).
RESULTS: IES, irrespective of stimulation intensity, was mainly perceived as noxious and significantly more painful than TES (p < 0.001). Significant EMG suppression (p = 0.002) indicated robust CSPs following IES, suggesting efficient Aδ-fiber activation compared to TES at 4x EDT. Moreover, SSEPs were absent in response to IES at 4x EDT, suggesting low Aβ-fiber co-activation, while VPs were consistently detected.
CONCLUSIONS: IES at 4x EDT produces efficient Aδ-fiber activation with minimal Aβ-fiber co-activation, accompanied by consistently detected VPs.
SIGNIFICANCE: IES at 4x EDT is suggested for efficient electrical nociceptive testing.
METHODS: IES and TES were applied at increasing intensities (multiples of electrical detection threshold, EDT). In Experiment 1, psychophysical assessments, i.e., pain intensity and quality, and CSPs were compared for IES and TES at the index finger in 29 participants (10 m, 26.6 ± 3.5 years). In Experiment 2, SSEPs and VPs were compared for IES and TES over the superficial radial nerve in 28 participants (11 m, 26.6 ± 3.4 years).
RESULTS: IES, irrespective of stimulation intensity, was mainly perceived as noxious and significantly more painful than TES (p < 0.001). Significant EMG suppression (p = 0.002) indicated robust CSPs following IES, suggesting efficient Aδ-fiber activation compared to TES at 4x EDT. Moreover, SSEPs were absent in response to IES at 4x EDT, suggesting low Aβ-fiber co-activation, while VPs were consistently detected.
CONCLUSIONS: IES at 4x EDT produces efficient Aδ-fiber activation with minimal Aβ-fiber co-activation, accompanied by consistently detected VPs.
SIGNIFICANCE: IES at 4x EDT is suggested for efficient electrical nociceptive testing.