Neuroscience and biobehavioral reviews
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CT (C tactile) afferents are a distinct type of unmyelinated, low-threshold mechanoreceptive units existing in the hairy but not glabrous skin of humans and other mammals. Evidence from patients lacking myelinated tactile afferents indicates that signaling in these fibers activate the insular cortex. ⋯ CT fiber activation may also have a role in pain inhibition. This review outlines the growing evidence for unique properties and pathways of CT afferents.
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Decades of pain research have succeeded in elucidating complex mechanisms of acute activation and chronic sensitization of nociceptors leading to pain. In contrast, itch conditions have received less attention and even basic mechanisms for the induction of itch are still unclear. In this review we describe itch-specific pathways, but also evidence for a modified pattern theory of pruritus offering independent mechanisms for the itch induction. ⋯ However, concerning mechanisms of sensitization to itch or pain, surprisingly similar patterns have been observed lately in both inflamed tissue and in the spinal cord. These similarities open up two highly interesting perspectives: the role of well established analgesic therapeutic concepts can be validated in chronic itch conditions and on the other hand investigations of sensitization in easily accessible pruritic skin may help to validate concepts of nociception in humans. These perspectives illustrate that itch and pain research no longer follows separate paths, but can be advantageously interconnected.
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Neurosci Biobehav Rev · Feb 2010
ReviewKeeping pain in mind: a motivational account of attention to pain.
Attention is a key concept in many theories of pain perception. A clinically popular idea is that pain is more intense in persons who are hypervigilant for or bias their attention to pain information. So far, evidence for such bias in pain patients as compared to healthy persons is inconclusive. ⋯ Attentional processing of pain information will be particularly enhanced when the focal goal is related to pain management (e.g., attempting to gain control). Future research should systematically investigate the role of motivation and goal pursuit in the attentional processing of pain-related information. This motivational perspective offers a powerful framework to explain inter- and intra-individual differences in the deployment of attention to pain-related information.