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Journal of Neuroscience, Vol 15, 333-341, Copyright © 1995 by Society for Neuroscience
Novel classes of responsive and unresponsive C nociceptors in human skin
R Schmidt, M Schmelz, C Forster, M Ringkamp, E Torebjork and H Handwerker
Department of Clinical Neurophysiology, University Hospital, Uppsala, Sweden.
One hundred ninety-four cutaneous C-fibers were recorded from the human
peroneal nerve; 118 units were found by mechanical stimuli and 76 units
were detected by electrical stimulation through a surface electrode. Needle
electrodes were then inserted for electrical intradermal stimulation in the
innervation territory of the units. Afferent and efferent sympathetic
C-fibers were identified by slowing of conduction velocity after activation
either by physical or chemical skin stimuli, or by arousal maneuvers
eliciting sympathetic reflexes. In addition to mechano-heat-responsive C
units (CMH) also found in previous studies, we here report on novel classes
of C nociceptors in human skin, namely, units responding only to mechanical
stimuli (CM), units responding only to heating (CH), and units that were
insensitive to mechanical and heating stimuli and also to sympathetic
provocation tests (CMiHi). With the electrical search technique we found
45% CMH, 13% CM, 6% CH, 24% CMiHi, and 12% sympathetic units. Excitation by
topically applied mustard oil occurred in 58% of CMH units, and in
one-third of CM and CMiHi units, respectively. Some CM, CH, and CMiHi units
were sensitized to heating and/or to mechanical stimuli after topical
application of mustard oil or capsaicin. These units then acquired
responsiveness to a stimulus modality to which they previously were
insensitive. Such recruitment of previously silent nociceptors implies
spatial summation to the nociceptive barrage at central levels, and may
contribute both to primary hyperalgesia to heat and pressure after chemical
irritation, and to secondary hyperalgesia as a consequence of central
sensitization.
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