Showing papers on "Summation published in 2018"

Interactive effects of conditioned pain modulation and temporal summation of pain-the role of stimulus modality.

Abstract: Conditioned pain modulation (CPM) and temporal summation of pain (TSP) are 2 experimental paradigms capturing endogenous pain modulation, which have repeatedly demonstrated clinical relevance. Conditioned pain modulation describes the inhibition of the pain response to a test stimulus (Ts) when a second noxious stimulus, the conditioning stimulus (CS), is concurrently applied. Temporal summation of pain describes the enhanced pain response to a series of stimuli compared with single stimuli. Temporal summation of pain-limiting effects of CPM are likely but may depend on the stimulus modality of the Ts. This study aimed at investigating these differential effects of stimulus modality. Thirty-five healthy volunteers completed 2 experimental blocks (Ts modality: pressure vs heat) in balanced order. Both blocks consisted of 3 conditions: baseline (no CS), CPM1 (nonpainful CS: 42 degrees C water bath), and CPM2 (painful CS: 46 degrees C water bath). Single stimuli and series of stimuli were alternatingly applied to assess TSP by means of a Numerical Rating Scale. Both TSP and CPM were successfully induced with no difference between the 2 Ts modalities. We also detected a significant interaction between TSP and CPM, with higher pain reduction for a series of Ts compared with single Ts during the painful CS. Interestingly, this interaction was modality-dependent: TSP for heat Ts was completely abolished by CPM, whereas this was not the case for pressure Ts. Our findings suggest different forms of central sensitization induced by TSP using either heat or pressure stimuli, which differ in their susceptibility to CPM. Clinical implications and directions for future research are discussed.

Spatial summation in the human fovea: Do normal optical aberrations and fixational eye movements have an effect?

Abstract: Psychophysical inferences about the neural mechanisms supporting spatial vision can be undermined by uncertainties introduced by optical aberrations and fixational eye movements, particularly in fovea where the neuronal grain of the visual system is fine. We examined the effect of these preneural factors on photopic spatial summation in the human fovea using a custom adaptive optics scanning light ophthalmoscope that provided control over optical aberrations and retinal stimulus motion. Consistent with previous results, Ricco's area of complete summation encompassed multiple photoreceptors when measured with ordinary amounts of ocular aberrations and retinal stimulus motion. When both factors were minimized experimentally, summation areas were essentially unchanged, suggesting that foveal spatial summation is limited by postreceptoral neural pooling. We compared our behavioral data to predictions generated with a physiologically-inspired front-end model of the visual system, and were able to capture the shape of the summation curves obtained with and without pre-retinal factors using a single postreceptoral summing filter of fixed spatial extent. Given our data and modeling, neurons in the magnocellular visual pathway, such as parasol ganglion cells, provide a candidate neural correlate of Ricco's area in the central fovea.

Optimisation of perimetric stimuli for mapping changes in spatial summation in glaucoma.

Abstract: Despite being considered the current reference standard for perimetric testing in glaucoma, standard automated perimetry has several cardinal limitations, including an unacceptably high test-retest variability, which increases with increasing depth of defect, and a limited useable dynamic range, with test-retest variability spanning almost the entire instrument range in advanced glaucomatous damage. Prior studies have shown that spatial summation, the mechanism by which the visual system integrates light energy across the area of a stimulus, differs in disease, with an enlarged Ricco’s area (the limit of complete spatial summation) found in individuals with glaucoma. The aim of this work was to investigate whether a perimetric stimulus designed to exploit these changes in spatial summation would enable a greater signal/noise ratio (SNR) than that of the current standard stimulus, by directly measuring the displacement of the spatial summation function in glaucoma. Three stimulus forms were developed; one varying in area alone, one varying in both area and contrast simultaneously, and one varying in contrast alone, all operating within the local Ricco’s area. These novel stimuli were compared with the standard Goldmann III stimulus, in terms of disease signal, noise, and SNR. The experiments presented in this thesis indicate that a stimulus modulating in area alone may offer greater benefits for measuring glaucomatous changes in spatial summation in a clinical setting, in the form of a greater disease signal, more uniform response variability with depth of defect, and greater SNR, when compared with the standard Goldmann III stimulus. Additionally, there is some indication that this stimulus is more robust to the effects of intraocular straylight than the Goldmann III stimulus, although test-retest variability and robustness to optical defocus are largely similar. As this work represents the early investigations of this stimulus, further work is required to examine its translation into a clinical environment.

Unilateral Lateral Epicondylalgia Shows a Pro-nociceptive Pain Profile: A Case-control Observational Study.

Abstract: Lateral epicondylalgia (LE, tennis elbow) is characterised by both local tissue pathology and features indicative of secondary hyperalgesia. The aim of this study was to evaluate endogenous pain modulation characteristics in people with chronic LE, and to investigate the relationship between endogenous pain modulation and clinical characteristics. This case control observational study included 25 participants with LE of at least 6 weeks' duration and 15 age-matched (±5▒y) healthy control participants, who were each evaluated in a single session. Pain and disability were assessed using the Patient-Rated Tennis Elbow Evaluation and pain-free grip strength. Endogenous pain modulation was assessed using pressure pain threshold (PPT), cold pain threshold (CPT), conditioned pain modulation (CPM) and temporal summation. The LE group exhibited significantly lower PFG and PPT bilaterally compared to the control group. CPT was significantly reduced on the affected side compared to the matched control side. There was no significant difference between groups for CPM, however the LE group exhibited significantly increased facilitation as measured by temporal summation (between-group difference in change score of 9.6▒mm on a 0-100▒mm pain visual analogue scale, 95% confidence intervals 3.4 to 15.8▒mm). There was no significant correlation between pain modulation and clinical measures of pain and disability. LE is characterised by locally increased facilitation of pain, as measured by temporal summation, but this is not associated with severity of pain or disability.

Spatiotemporal Summation and Recognition Effects for a Dual-Emitter Light-Induced Neuromorphic Device

Abstract: We propose and fabricate a dual-emitter light-induced neuromorphic device composed of two light-induced devices with a common collector and base. Two InGaN multiple-quantum-well diodes (MQW-diodes) are used as the emitters to generate light, and one InGaN MQW-diode is used as the common collector to absorb the emitted light. When the presynaptic voltages are synchronously applied to the two emitters, the collector demonstrates an adding together of the excitatory postsynaptic voltage (EPSV). The width and period of the two input signals constitute the code to generate spatial summation and recognition effects at the same time. Experimental results confirm that temporal summation caused by the repetitive-pulse facilitation could significantly strengthen the spatial summation effect due to the adding together behavior when the repetitive stimulations are applied to the two emitters in rapid succession. Particularly, the resonant summation effect occurs at the cosummation region when the two repetitive-pulse signals have a resonant period, which offers a more sophisticated spatiotemporal EPSV summation function for the dual-emitter neuromorphic device.

Spatial summation in the human fovea: the effect of optical aberrations and fixational eye movements

Abstract: Psychophysical inferences about the neural mechanisms supporting spatial vision can be undermined by uncertainties introduced by optical aberrations and fixational eye movements, particularly in fovea where the neuronal grain of the visual system is fine. We examined the effect of these pre-neural factors on photopic spatial summation in the human fovea using a custom adaptive optics scanning light ophthalmoscope that provided control over optical aberrations and retinal stimulus motion. Consistent with previous results, Ricco9s area of complete summation encompassed multiple photoreceptors when measured with ordinary amounts of ocular aberrations and retinal stimulus motion. When both factors were minimized experimentally, summation areas were essentially unchanged, suggesting that foveal spatial summation is limited by post-receptoral neural pooling. We compared our behavioral data to predictions generated with a physiologically-inspired front-end model of the visual system, and were able to capture the shape of the summation curves obtained with and without pre-retinal factors using a single post-receptoral summing filter of fixed spatial extent. Given our data and modeling, neurons in the magnocellular visual pathway, such as parasol ganglion cells, provide a candidate neural correlate of Ricco9s area in the central fovea.

Measurements of Temporal Summation of Heat Pain: a Pilot Investigation in Healthy Humans

Abstract: Temporal summation of pain (TSP) is a promising tool for measuring the pain modulation processes in healthy subjects and patients with chronic pain. We tried to find optimal stimulation parameters in order to elicit a robust reproducible TSP phenomenon. Twenty healthy volunteers (15 women and 5 men) completed four sessions/conditions of pulsating heat pain stimulation, applied to the left forearm with a frequency of 0.33–0.4 sec–1 using a contact heat-evoked potential stimulator. The stimulation temperature (step +0.5°C or +1.0°C up to the pain threshold, pain tolerance), pulse duration (500, 800, or 1000 msec), and number of stimuli (60 or 90) were varied. The participants rated the pain intensity at the first and every 10th heat pulse, using a numeric rating scale (NRS) 0–100. The TSP was calculated as the difference between the lowest rating and the rating of the last stimulus and was compared between conditions. The optimal condition (19 out of 20 participants responded with TSP) showed temperature at pain tolerance, pulse duration of 800 msec, and 90 stimuli. In addition, this condition showed weaker side effects (painful discomfort) than those with less (60) but longer (1000 msec) stimuli presented 1.0 degree above the pain threshold. The protocol with a relatively high stimulus repetition and a moderate pulse duration seems to be the optimal protocol to reproduce TSP. Heat stimulation with longer pulse durations and higher stimulation temperatures was less feasible.

Suprathreshold contrast summation over area using drifting gratings.

Abstract: This study investigated contrast summation over area for moving targets applied to a fixed-size contrast pedestal-a technique originally developed by Meese and Summers (2007) to demonstrate strong spatial summation of contrast for static patterns at suprathreshold contrast levels. Target contrast increments (drifting gratings) were applied to either the entire 20% contrast pedestal (a full fixed-size drifting grating), or in the configuration of a checkerboard pattern in which the target increment was applied to every alternate check region. These checked stimuli are known as "Battenberg patterns" and the sizes of the checks were varied (within a fixed overall area), across conditions, to measure summation behavior. Results showed that sensitivity to an increment covering the full pedestal was significantly higher than that for the Battenberg patterns (areal summation). Two observers showed strong summation across all check sizes (0.71°-3.33°), and for two other observers the summation ratio dropped to levels consistent with probability summation once check size reached 2.00°. Therefore, areal summation with moving targets does operate at high contrast, and is subserved by relatively large receptive fields covering a square area extending up to at least 3.33° × 3.33° for some observers. Previous studies in which the spatial structure of the pedestal and target covaried were unable to demonstrate spatial summation, potentially due to increasing amounts of suppression from gain-control mechanisms which increases as pedestal size increases. This study shows that when this is controlled, by keeping the pedestal the same across all conditions, extensive summation can be demonstrated.