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  • Ref The Kyoto protocol of IASP...

    Originally posted by Luke Rickards
    Pain. 2008 Jul 31;137(3):473-7. Epub 2008 Jun 25.
    Related Articles, Links

    The Kyoto protocol of IASP Basic Pain Terminology.

    Loeser JD, Treede RD.

    Department of Neurological Surgery, University of Washington, Box 356470, Seattle, WA 98195, USA. jdloeser@u.washington.edu

    PMID: 18583048 [PubMed - in process]

    Here is the full text
    http://www.somasimple.com/forums/showthread.php?t=5879

    Yesssss.
    Last edited by bernard; 24-07-2008, 04:04 PM.
    "I did a small amount of web-based research, and what I found is disturbing"--Bob Morris

  • #2
    I thought you'd like that, Jon.
    Luke Rickards
    Osteopath

    Comment


    • #3
      Wonderful. Thanks Luke.
      Diane
      www.dermoneuromodulation.com
      SensibleSolutionsPhysiotherapy
      HumanAntiGravitySuit blog
      Neurotonics PT Teamblog
      Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
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      @dfjpt
      SomaSimple on Facebook
      @somasimple

      "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

      “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

      “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

      "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

      "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

      Comment


      • #4
        Thanks Luke. Very helpful.
        We don't see things as they are, we see things as WE are - Anais Nin

        I suppose it's easier to believe something than it is to understand it.
        Cmdr. Chris Hadfield on rise of poor / pseudo science

        Pain is a conscious correlate of the implicit perception of threat to body tissue - Lorimer Moseley

        We don't need a body to feel a body. Ronald Melzack

        Comment


        • #5
          Quick comments:
          1. I'm glad they're holding off on the concept of chronic pain being a disease for now. I would like to have listened to some of the spirited discussion.
          2. The section on nociception helped me and I thought it was interesting how they divided nociception into peripheral and central nociception.
          3. There might be a minor terminology problem (but I'm not sure) in the following sentence given that that they took some care to distinguish between nociceptors and nociceptive neurons earlier in the paper. "...perhipheral sensitization may be defined simply as increased responsiveness of nociceptors to stimulation of their receptive fields, increased responsiveness of central nociceptive neurons to stimulation of their receptive fields is not sufficiently precise to define central sensitization." Any thoughts?
          4. I still have some internal processing to do as it pertains to their section on allodynia/hyperalgesia.
          5. I'll be interested to see how the term "dysfunctional pain" develops. I'll keep my eye open for its use in peer-reviewed literature. The concept describes an important portion of the PT patient population.

          Great stuff Loeser, Treede, and IASP. :thumbs_up
          Last edited by Jon Newman; 23-07-2008, 12:16 AM.
          "I did a small amount of web-based research, and what I found is disturbing"--Bob Morris

          Comment


          • #6
            Thanks Luke!!!

            :thumbs_up:thumbs_up
            Cory Blickenstaff, PT, OCS

            Pain Science and Sensibility Podcast
            Leaps and Bounds Blog
            My youtube channel

            Comment


            • #7
              Jon's stupid question of the day: am I correct to conclude that there are no nociceptive neurons above the level of the spinal cord (i.e. in the brain)?
              "I did a small amount of web-based research, and what I found is disturbing"--Bob Morris

              Comment


              • #8
                My understanding is that the brain has no sensory neurons of any kind, for itself. It's all interneuron, projection neurons, descending neuron, etc. All processing. Not "feeling." The meninges have sensory innervation though, and the vessels probably do, but they are not "brain."
                Recall the stories about brain operations done with only local anesthetic.
                Diane
                www.dermoneuromodulation.com
                SensibleSolutionsPhysiotherapy
                HumanAntiGravitySuit blog
                Neurotonics PT Teamblog
                Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
                Canadian Physiotherapy Association Pain Science Division Facebook page
                @PainPhysiosCan
                WCPT PhysiotherapyPainNetwork on Facebook
                @WCPTPTPN
                Neuroscience and Pain Science for Manual PTs Facebook page

                @dfjpt
                SomaSimple on Facebook
                @somasimple

                "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

                “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

                “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

                "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

                "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

                Comment


                • #9
                  If there aren't actually central nociceptive neurons, in a structural sense, might it be an improvement to think of central neurons as being part of a functional system; a nociceptive circuit?
                  Eric Matheson, PT

                  Comment


                  • #10
                    Thanks Diane,

                    I'm trying to get my head around some of the new definitions and their implications. It's pendantic and something my whiny inner taxonomist is motivating me to pursue. According to the paper the new definition (or newly added definition) of "nociceptive neuron" is

                    A central or peripheral neuron that is capable of encoding noxious stimuli
                    Further,

                    Non-nociceptive neurons (e.g. LT: lowthreshold neurons in the spinal cord) may respond to noxious stimuli, because these stimuli are above their thresholds. But only nociceptive neurons (HT: highthreshold, WDR: wide-dynamic range) are capable of encoding the relevant properties of those stimuli (e.g. intensity in the painful range, location)
                    Therefore second order neurons (at least) can be "nociceptive neurons" (but they can't be nociceptors.)

                    I'll try to be more explicit regarding my taxonomic turmoil. The thalamus is typically involved in the the processing of noxious stimuli. Would that aspect of noxious stimuli processing be considered encoding or does the encoding process end at the brainstem (even if only for taxonomic purposes)?

                    I should add that regardless of whether the nerves that make up the thalamus can be considered to be nociceptive neurons, they do seem to participate in nociception (if they process noxious stimuli) as nociception is

                    The neural processes of encoding and processing noxious stimuli
                    which allows for not just encoding but processing in general.

                    Edit: On second thought it says encoding AND processing. So the thalamus would not participate in nociception unless part of its role can be considered to be encoding.
                    Last edited by Jon Newman; 24-07-2008, 05:30 AM.
                    "I did a small amount of web-based research, and what I found is disturbing"--Bob Morris

                    Comment


                    • #11
                      Thalamic pain however (if I'm understanding) is a spontaneous discharge of the neurons in the thalaums and that process would be termed sensitization rather than nociception because in such a case no noxious stimulus has been encoded at any point (which is a requirement of nociception.)



                      (I like parenthesis and probably use them too much)
                      "I did a small amount of web-based research, and what I found is disturbing"--Bob Morris

                      Comment


                      • #12
                        I see what you're saying now, I think..
                        So, if secondary and third order neurons are part of a nociceptive processing circuit, they are nociceptive neurons, but they can't be nociceptors, because they aren't "out there" with a nociceptor on the end of them. They are interneurons.

                        Right?
                        Diane
                        www.dermoneuromodulation.com
                        SensibleSolutionsPhysiotherapy
                        HumanAntiGravitySuit blog
                        Neurotonics PT Teamblog
                        Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
                        Canadian Physiotherapy Association Pain Science Division Facebook page
                        @PainPhysiosCan
                        WCPT PhysiotherapyPainNetwork on Facebook
                        @WCPTPTPN
                        Neuroscience and Pain Science for Manual PTs Facebook page

                        @dfjpt
                        SomaSimple on Facebook
                        @somasimple

                        "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

                        “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

                        “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

                        "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

                        "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

                        Comment


                        • #13
                          Maybe. Yes to the nociceptor part however. From the paper, the definition of nociceptor is

                          A sensory receptor that is capable of transducing and encoding noxious stimuli
                          Further,

                          Non-nociceptive receptors (e.g. tactile receptors, warm receptors) may respond to noxious stimuli (mechanical or thermal, respectively), when these stimuli are above their respective thresholds. But only nociceptors are capable of encoding the relevant properties of those stimuli (e.g. sharpness, heat intensity in the painful range). This is to clarify that a nociceptor is a peripheral nerve ending acting as a sensory receptor, where transduction into generator potentials and encoding into trains of action potentials take place
                          So transduction (not just transmission) is crucial to a nociceptor (a type of nociceptive neuron.) The distinguishing characteristic for nociceptive neurons in general is the ability to encode (whatever that means) noxious stimuli.
                          Last edited by Jon Newman; 25-08-2008, 01:42 AM.
                          "I did a small amount of web-based research, and what I found is disturbing"--Bob Morris

                          Comment


                          • #14
                            Ah yes, encoding. To encode, glia are required. Because synapses are required, and synapses are managed by proteins made by glia.
                            Diane
                            www.dermoneuromodulation.com
                            SensibleSolutionsPhysiotherapy
                            HumanAntiGravitySuit blog
                            Neurotonics PT Teamblog
                            Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
                            Canadian Physiotherapy Association Pain Science Division Facebook page
                            @PainPhysiosCan
                            WCPT PhysiotherapyPainNetwork on Facebook
                            @WCPTPTPN
                            Neuroscience and Pain Science for Manual PTs Facebook page

                            @dfjpt
                            SomaSimple on Facebook
                            @somasimple

                            "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

                            “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

                            “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

                            "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

                            "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

                            Comment


                            • #15
                              This is what Wikipedia says about encoding (nothing in Knol). I think it gives the general idea although I'm quite certain their examples, especially the on/off aspect, are quite simplistic. For instance, we all know that when we stub our toe we don't stop hurting as soon as we stop stubbing.
                              Last edited by Jon Newman; 24-07-2008, 01:16 PM.
                              "I did a small amount of web-based research, and what I found is disturbing"--Bob Morris

                              Comment

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