Effects of the N-Methyl-D-Aspartate Receptor on Temporal Summation of Second Pain (Wind-up) in Irritable Bowel Syndrome

Qiqi Zhou, Donald D. Price, Christopher S. Callam, Michael A. Woodruff, G. Nicholas Verne

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Irritable bowel syndrome (IBS) is a common gastrointestinal disorder in which the pathophysiological mechanisms of the pain and hypersensitivity are not well understood. IBS patients frequently complain of pain in body regions somatotopically distinct from the gut, suggesting that central hyperalgesic mechanisms may be involved. In the current study, during the wind-up testing session, a series of 6 heat pulses were presented with an interstimulus interval (ISI) of 3 seconds. Following the 1st, 3rd, and 6th thermal stimuli, subjects were asked to rate the late thermal sensation or second pain. IBS patients who demonstrated temporal summation of pain (TSSP) then received dextromethorphan and placebo in a randomized, double-blind, fashion to block wind-up. The results showed: 1) a subset of IBS patients, but not controls, showed TSSP in response to a series of noxious heat pulses; and 2) TSSP was blocked by administration of dextromethorphan, an NMDA receptor antagonist. In summary, these findings further elucidate mechanisms of somatic hypersensitivity in a subset of IBS patients. Our results also support an etiologic basis for abnormal NMDA receptor mechanisms in some IBS patients. Future studies are needed to determine if NMDA receptor antagonists may be used to treat IBS patients. Perspective: This study evaluates temporal summation of second pain in a subset of IBS patients that is blocked by Dextromethorphan, an NMDA receptor antagonist. Theses results could lead to the use of an NMDA receptor antagonist in the treatment of pain in a subset of IBS patients.

Original languageEnglish (US)
Pages (from-to)297-303
Number of pages7
JournalJournal of Pain
Volume12
Issue number2
DOIs
StatePublished - Feb 2011

Fingerprint

Irritable Bowel Syndrome
N-Methyl-D-Aspartate Receptors
Pain
Dextromethorphan
Hot Temperature
Hypersensitivity
Body Regions
Placebos

Keywords

  • central sensitization
  • Irritable bowel syndrome
  • nociceptive stimuli
  • repetitive afferent barrage
  • temporal summation of second pain
  • visceral and thermal hypersensitivity
  • wind-up

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Neurology
  • Clinical Neurology

Cite this

Effects of the N-Methyl-D-Aspartate Receptor on Temporal Summation of Second Pain (Wind-up) in Irritable Bowel Syndrome. / Zhou, Qiqi; Price, Donald D.; Callam, Christopher S.; Woodruff, Michael A.; Verne, G. Nicholas.

In: Journal of Pain, Vol. 12, No. 2, 02.2011, p. 297-303.

Research output: Contribution to journalArticle

Zhou, Qiqi ; Price, Donald D. ; Callam, Christopher S. ; Woodruff, Michael A. ; Verne, G. Nicholas. / Effects of the N-Methyl-D-Aspartate Receptor on Temporal Summation of Second Pain (Wind-up) in Irritable Bowel Syndrome. In: Journal of Pain. 2011 ; Vol. 12, No. 2. pp. 297-303.
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