Inhibitory effects do not depend on the subjective experience of pain during heterotopic noxious conditioning stimulation (HNCS): a contribution to the psychophysics of pain inhibition.

Heterotopic noxious conditioning stimulation (HNCS) has been thought to give access to the diffuse noxious inhibitory controls (DNIC) in man, which can be activated in wide-dynamic-range neurons by noxious stimulation from remote areas of the body and form the neurophysiological basis of the phenomenon 'pain inhibits pain'. The latter phenomenon suggests that the subjective experience of pain is a prerequisite for an inhibitory action. The necessity of using painful stimuli as conditioning and as test stimuli to produce inhibitory effects was investigated in the present study, using a HNCS paradigm.

Enhanced long-latency somatosensory potentials in major depressive disorder.

Bodily misperceptions are a frequent symptom in major depressive disorder. A reduced ability to deflect attention from somatosensory stimuli may contribute to the generation of unpleasant bodily sensations and co-occur with altered habituation of the brain electric reactions to somatosensory stimuli. The aim of the present study was to explore whether attention-related components of somatosensory evoked potentials (SSEP) and the habituation of these components are altered in major depression.

[A rare cause of carpal tunnel syndrome: leprosy. Latency period of decades is possible].

In a 63-year-old German woman with no apparent exposure to leprosy, clinical and histological evidence of tuberculoid leprosy was found. A noteworthy feature of this case is either the very long incubation time of 45 years, or the mode of infection involving an only short encounter in an endemic region. In the event of unclear lesions--on white skin not, typically, hypopigmented, but reddish--accompanied by disordered sensation, we in Europe must also give consideration to the possibility of a sporadic case of leprosy.

Orienting response and frontal midline theta activity: a somatosensory spectral perturbation study.

Objective: Brain electric activity in the theta frequency band has been associated with the encoding of new, and the retrieving of previously stored, information. We studied the time course of stimulus-to-stimulus changes of theta activity under repetitive somatosensory stimulation.

Materials And Methods: Twelve healthy subjects participated in the study.

Topography and morphology of heart action-related EEG potentials.

Joint ECG and EEG measurements were performed in 22 healthy subjects under standardized laboratory conditions. Averaged EEG potentials were computed using the R-peaks in the ECG as reference events. Spatio-temporal potential patterns of heart action-related EEG activity were obtained from 26 scalp channels.

Autonomic reactivity and hormonal secretion in lactate-induced panic attacks.

To compare autonomic and neuroendocrine responses during lactate-induced panic attacks, heart rate variability and cortisol and atrial natriuretic hormone (ANH) levels were measured in patients with panic attacks and in healthy control subjects. In a randomized double-blind design, all subjects received either 10 ml/kg body weight of 0.5 M racemic sodium lactate or normal saline from 1100 to 1120.

Cardiac field effects on the EEG.

The electrical field of the heart propagates throughout the entire body and causes changes in the surface potentials on the scalp that are superimposed on brain electric signals. When heart cycle-related EEG averaging is performed, e.g.

[The pathophysiology of anxiety disorders].

Often anxiety is based upon real or imagined threats and followed by insufficient coping strategies. Some anxiety states are exclusively caused by organic brain diseases, especially by primary tumours of the mesiotemporal lobe. The type of anxiety-disorders depends on the underlying psychodynamic and neurobiological mechanisms.

Assessing daily problems with diabetes: a subject-oriented approach to compliance.

The reliability, construct validity, and discriminant validity of a new self-report questionnaire, the Questionnaire on Stress in Diabetic Patients, were assessed in a sample of 617 patients with insulin-dependent diabetes mellitus and non-insulin-dependent diabetes mellitus. The 90-item inventory is designed to assess psychosocial stress associated with problems in daily living with diabetes. One of the intended uses is to identify psychosocial factors hampering patient compliance with the necessary treatment regimen.

Coping with fear of long-term complications in diabetes mellitus: a model clinical program.

Preliminary results are reported on the efficacy of a behaviorally oriented group therapy (n = 17) intended to improve coping with fear of long-term complications in patients with diabetes mellitus. Treatment consisted of exposure in imagination, relaxation training and analysis of dysfunctional health beliefs. Pre-, posttreatment and 3-month follow-up measure showed significant improvements regarding fear, acceptance of chronic disease and work.

Tonic pain evoked by pulsating heat: temporal summation mechanisms and perceptual qualities.

The properties of a newly developed tonic heat pain model (THPM), which makes use of pulsating contact heat, were investigated in 18 young men. The most important feature of this model is that repetitive heat pulses with an intensity of 1 degree C above the individual pain threshold are employed. This approach was used to tailor the tonic pain stimulation to the individual pain sensitivity.

Pain sensitivity in recovered anorexics, restrained and unrestrained eaters.

The heat pain threshold and local skin temperature were assessed in 23 former anorexic in-patients with an 'intermediate' (N = 9) or 'good' outcome (N = 14) and in 21 restrained and 20 unrestrained eaters. All subjects were female. The group means of the pain thresholds did not differ significantly from each other, suggesting that the homogeneous increase in pain thresholds we had previously observed in acutely ill eating disorder patients is state dependent.

Theoretical and empirical considerations on the relation between 'body image', body scheme and somatosensation.

The authors first discuss possible interactions between the hitherto neglected neurophysiological and neuropsychological factors and the traditionally accepted cognitive and affective factors in 'body image' formation. They then report on a study of the relation between body size perception (video distortion technique, image marking procedure, kinaesthetic size estimation apparatus) and somatosensation (thermal, pain and vibration thresholds) in young women. Included in the study were questionnaires on eating behaviour and motivation, body attitude or body satisfaction, and depressive mood and thoughts.

The role of body size in somatosensory testing.

To try to replicate our earlier findings of body size influences in somatosensory testing we measured thresholds of heat pain, warmth, cold and vibration in 66 young, normal-weight women. Our assumption was that true body measure effects have to be demonstrable even in a sample limited with regard to age and sex and without extreme body size variation (which may be linked to pathology). In the present sample, body size (a linear combination of height and weight) did not have a very strong relation with any of the somatosensory thresholds (slightly stronger for the warmth and cold thresholds than for the heat pain and vibration thresholds).

Body size perception and body satisfaction in restrained and unrestrained eaters.

In 21 restrained and 20 unrestrained eaters body size perception was measured using the video distortion technique (VDT), the image marking procedure (IMP) and the kinesthetic size estimating apparatus (KSEA). Body satisfaction was assessed by questionnaires (Body Shape Questionnaire, Dieting scale of the Eating Attitudes Test). Restrained eaters showed no systematic over- or underestimation of the body size but less perceptual accuracy (in VDT and KSEA).

[Compliance problems in type I diabetic patients].

Using a newly developed interview concept, 49 type I diabetics were questions about "obstacles to compliance". The patients were asked to identify, in nine different areas of life, any common concrete obstacles to compliance with self-treatment in terms of dietary measures, injections and self monitoring. Emotional barriers and the structuring of everyday activities proved to be of particular importance for compliance with dietary measures, and aspects of the doctor-patient relationship for insulin injection.

Disturbances of C-fibre-mediated sensibility in lumbosacral disc disease.

In nine patients with chronic lumbosacral disc disease and radicular symptoms clearly restricted to one leg, C-fibre-mediated sensibility was measured by determination of the thresholds for heat pain and warmth on the foot, ipsi- and contralaterally to the nerve root compression. The thresholds were compared with the values for 19 healthy subjects. In the patients the warmth threshold was increased in the ipsilateral dermatome and normal in the contralateral dermatome.

[Cardiovascular factors of cardiac phobia--a field study].

The interaction between psychological and physiological factors was studied with a field approach in 28 patients with cardiac phobia and 20 healthy controls. A 24-hour ambulatory ECG was recorded, and the subjects were instructed to report their activities and any cardiac perception during this period. Additionally, psychological tests assessing well-being (Bf-S), bodily complaints (B-L), and state and trait anxiety (Stai-S and Stai-T) were administered.

Dieting and pain sensitivity: a validation of clinical findings.

To validate findings of a reduced pain sensitivity in anorexia and bulimia nervosa, the effects of dieting on somatosensation (especially pain sensitivity) were investigated in healthy young women. One group of subjects (n = 11) received a calorically reduced balanced diet for 21 days, while the other group (n = 14) continued to eat normally. The fasting state induced in the dieting subjects was comparable to that of eating disorder patients, since the dieters showed a reduction of the body mass index, a decrease in triiodothyronine and an increase in beta-hydroxybutyric acid plasma levels.

Sex differences in pain and thermal sensitivity: the role of body size.

Sex differences in heat-pain and thermal sensitivity were investigated in 32 women (20 to 60 years of age) and 32 men (17 to 63 years of age) who had no somatosensory impairments. Pain thresholds were measured with stimuli of two different durations (phasic and tonic). Warmth and cold thresholds were assessed as indices of thermal sensitivity.

Pain sensitivity in anorexia nervosa and bulimia nervosa.

Pain threshold was measured with short heat stimuli using a contact thermode in 19 patients with anorexia nervosa, 20 patients with bulimia nervosa, and 21 control subjects. Both patient groups had significantly elevated pain thresholds compared with the control subjects. In the total sample, no substantial covariation could be demonstrated among pain threshold and clinical, physiological, metabolic, or psychological data.