Impact de la cécité sur le système nociceptif

La vision joue un rôle très important dans la prévention du danger. La douleur a aussi pour fonction de prévenir les lésions corporelles. Nous avons donc testé l’hypothèse qu’une hypersensibilité à la douleur découlerait de la cécité en guise de compensation sensorielle. En effet, une littérature exhaustive indique qu’une plasticité intermodale s’opère chez les non-voyants, ce qui module à la hausse la sensibilité de leurs sens résiduels. De plus, plusieurs études montrent que la douleur peut être modulée par la vision et par une privation visuelle temporaire. Dans une première étude, nous avons mesuré les seuils de détection thermique et les seuils de douleur chez des aveugles de naissance et des voyants à l’aide d’une thermode qui permet de chauffer ou de refroidir la peau. Les participants ont aussi eu à quantifier la douleur perçue en réponse à des stimuli laser CO2 et à répondre à des questionnaires mesurant leur attitude face à des situations douloureuses de la vie quotidienne. Les résultats obtenus montrent que les aveugles congénitaux ont des seuils de douleur plus bas et des rapports de douleur plus élevés que leurs congénères voyants. De plus, les résultats psychométriques indiquent que les non-voyants sont plus attentifs à la douleur. Dans une deuxième étude, nous avons mesuré l’impact de l'expérience visuelle sur la perception de la douleur en répliquant la première étude dans un échantillon d’aveugles tardifs. Les résultats montrent que ces derniers sont en tous points similaires aux voyants quant à leur sensibilité à la douleur. Dans une troisième étude, nous avons testé les capacités de discrimination de température des aveugles congénitaux, car la détection de changements rapides de température est cruciale pour éviter les brûlures. Il s’est avéré que les aveugles de naissance ont une discrimination de température plus fine et qu’ils sont plus sensibles à la sommation spatiale de la chaleur. Dans une quatrième étude, nous avons examiné la contribution des fibres A∂ et C au traitement nociceptif des non-voyants, car ces récepteurs signalent la première et la deuxième douleur, respectivement. Nous avons observé que les aveugles congénitaux détectent plus facilement et répondent plus rapidement aux sensations générées par l’activation des fibres C. Dans une cinquième et dernière étude, nous avons sondé les changements potentiels qu’entrainerait la perte de vision dans la modulation descendante des intrants nociceptifs en mesurant les effets de l’appréhension d’un stimulus nocif sur la perception de la douleur. Les résultats montrent que, contrairement aux voyants, les aveugles congénitaux voient leur douleur exacerbée par l’incertitude face au danger, suggérant ainsi que la modulation centrale de la douleur est facilitée chez ces derniers. En gros, ces travaux indiquent que l’absence d’expérience visuelle, plutôt que la cécité, entraine une hausse de la sensibilité nociceptive, ce qui apporte une autre dimension au modèle d’intégration multi-sensorielle de la vision et de la douleur.Vision is important for avoiding encounters with objects in the environment that may imperil physical integrity. Since pain also plays a major role in preventing bodily injury, we tested whether, in the absence of vision, pain hypersensitivity would arise from an adaptive shift to other sensory channels. Indeed, a wealth of literature indicates that blindness leads to sensory compensation and crossmodal plasticity. Furthermore, studies have shown that pain perception can be modulated by vision and by temporary visual deprivation. In a first study, we measured innocuous and noxious thermal thresholds using a Peltier-based thermotester in congenitally blind and normal sighted participants. We also assessed their suprathreshold pain ratings using a CO2 laser device and evaluated their attitude towards daily pain encounters using questionnaires on attention and anxiety. Results show that congenitally participants have lower pain thresholds and higher suprathreshold pain ratings. The psychometric data further indicates that they are more attentive to pain compared to their sighted peers. In a second study, we investigated whether visual experience has an impact on pain perception by replicating the first study in late blind participants. Results indicate that individuals who lost sight later in life are similar to the sighted in every aspect of pain perception that we measured. In a third study, we tested whether blind individuals have supranormal skills in detecting small and quick increases in temperature, as these thermal cues of the environment might help identifying and avoiding potentially harmful objects. Results show that congenitally blind participants outperform their sighted peers and that they are more susceptible to spatial summation of heat. In a fourth study, we examined the contribution of A∂ and C-fibres to blind individuals’ nociceptive processing, as these fibres are thought to signal the first and second pain, respectively. Our findings indicate that congenital blindness leads to an enhanced detection to C-fibre mediated sensations and to faster reaction times to these nociceptive inputs. In a fifth and final study, we probed the potential changes in the descending modulation of nociceptive inputs following visual deprivation by measuring the effects of psychological factors like anticipation and anxiety on blind individuals’ pain perception. Results show that congenitally blind participants are more sensitive to pain in response to uncertainty about threat, suggesting that they are more susceptible to top-down modulation of pain. Overall, this work indicates that visual deprivation from birth, but not later in life, causes a leftward shift in the stimulus–response function to nociceptive stimuli and lends new support to a model of sensory integration of vision and pain processing

Hypersensitivity to pain in congenital blindness

Vision is important for avoiding encounters with objects in the environment that may imperil physical integrity. We tested whether, in the absence of vision, a lower pain threshold would arise from an adaptive shift to other sensory channels. We therefore measured heat and cold pain thresholds and responses to suprathreshold heat stimuli in 2 groups of congenitally blind and matched normal‐sighted participants. We also assessed detection thresholds for innocuous warmth and cold, and participants’ attitude toward painful encounters in daily life. Our results show that, compared to sighted subjects, congenitally blind subjects have lower heat pain thresholds, rate suprathreshold heat pain stimuli as more painful, and have increased sensitivity for cold pain stimuli. Thresholds for nonpainful thermal stimulation did not differ between groups. The results of the pain questionnaires further indicated that blind subjects are more attentive to signals of external threats. These findings indicate that the absence of vision from birth induces a hypersensitivity to painful stimuli, lending new support to a model of sensory integration of vision and pain processing

Comportement et Calcul du Champ Électromagnétique Engendré à Proximité de Lignes d’Énergie Transportant des Signaux HF

International audienc

Aδ and not C fibers mediate thermal hyperalgesia to short laser stimuli after burn injury in man.

It remains unclear which nerve fibers are responsible for mediating hyperalgesia after skin injury. Here, we examined the role of Aδ and C fibers in inflammatory hyperalgesia after a first-degree burn injury. A CO2 laser delivered ultrafast short constant-temperature heat pulses to the upper part of the lower leg to stimulate selectively the relatively fast-conducting thinly myelinated Aδ and the slowly conducting unmyelinated C fibers. Participants were asked to respond as fast as possible whenever they detected a thermal stimulus. Thresholds and reaction times to selective Aδ and C fiber activations were measured in the conditioned and the surrounding intact skin, at pre-injury, and 1 hour and 24 hours after injury. First-degree burn injury caused a significant decrease in Aδ fiber detection thresholds and a significant increase in the proportion of Aδ-fiber-mediated responses in the inflamed area 24 hours, but not 1 hour, after burn injury. No changes in heat perception were observed in the intact skin surrounding the injury. No group differences in C-fiber-mediated sensations were observed. Our findings indicate that quickly adapting Aδ fibers but not quickly adapting C fibers are sensitized when activated by short and ultrafast heat stimuli after skin burn injury. Our results further show that this change occurs between 1 hour and 24 hours after injury and that it does not extend to the skin surrounding the injury

Dose-Related Reduction in Hippocampal Neuronal Populations in Fetal Alcohol Exposed Vervet Monkeys

Fetal alcohol spectrum disorder (FASD) is a chronic debilitating condition resulting in behavioral and intellectual impairments and is considered the most prevalent form of preventable mental retardation in the industrialized world. We previously reported that 2-year-old offspring of vervet monkey (Chlorocebus sabeus) dams drinking, on average, 2.3 ± 0.49 g ethanol per Kg maternal body weight 4 days per week during the last third of pregnancy had significantly lower numbers of CA1 (−51.6%), CA2 (−51.2%) and CA3 (−42.8%) hippocampal neurons, as compared to age-matched sucrose controls. Fetal alcohol-exposed (FAE) offspring also showed significantly lower volumes for these structures at 2 years of age. In the present study, we examined these same parameters in 12 FAE offspring with a similar average but a larger range of ethanol exposures (1.01–2.98 g/Kg/day; total ethanol exposure 24–158 g/Kg). Design-based stereology was performed on cresyl violet-stained and doublecortin (DCX)-immunostained sections of the hippocampus. We report here significant neuronal deficits in the hippocampus with a significant negative correlation between daily dose and neuronal population in CA1 (r2 = 0.486), CA2 (r2 = 0.492), and CA3 (r2 = 0.469). There were also significant correlations between DCX population in the dentate gyrus and daily dose (r2 = 0.560). Both correlations were consistent with linear dose-response models. This study illustrates that neuroanatomical sequelae of fetal ethanol exposure are dose-responsive and suggests that there may be a threshold for this effect

Thermal thresholds in normally sighted (NS), late blind (LB) and congenitally blind (CB) subjects.

<p>A: LB have heat pain (HP) and cold pain (CP) thresholds similar to NS. In contrast, HP and CP thresholds were significantly lower in CB compared to LB and NS. There were no group differences for innocuous warmth detection (WD) and cool detection (CD) thresholds. B: LB rate supra-threshold nociceptive stimuli similarly to NS. In contrast, CB rated supra-threshold stimuli as more painful compared to both LB and NS. Error bars represent the standard error of the mean. *p<0.05, **p<0.01, ***p<.001.</p

Study samples used for each of the measurements.

<p>Study samples used for each of the measurements.</p

The neural signature of the decision value of future pain

SignificanceWe often willingly experience pain to reach a goal. However, potential pain can also prevent reckless action. How do we consider future pain when deciding on the best course of action? To date, the precise neural mechanisms underlying the valuation of future pain remain unknown. Using functional MRI, we derive a whole-brain signature of the value of future pain capable of predicting participants&apos; choices to accept pain in exchange for a reward. We show that this signature is characterized by a distributed pattern of activity with clear contributions from structures encoding reward and salience, notably the ventral and dorsal striatum. These findings highlight how the brain assigns value to future pain when choosing the best course of action.11Nsciescopu