title: Involvement of α2-adrenoceptors in inhibitory and facilitatory pain modulation processes.
abstract: BACKGROUND
  In healthy humans, high-frequency electrical stimulation (HFS) of the forearm not only produces hyperalgesia at the site of stimulation but also reduces sensitivity to pressure-pain on the ipsilateral side of the forehead. In addition, HFS augments the ipsilateral trigeminal nociceptive blink reflex and intensifies the ipsilateral component of conditioned pain modulation. The aim of this study was to determine whether α2-adrenoceptors mediate these ipsilateral nociceptive influences.
  
  
  METHODS
  The α2-adrenoceptor antagonist yohimbine was administered to 22 participants in a double-blind, placebo-controlled crossover study. In each session, thermal and mechanical sensitivity in the forearms and forehead was assessed before and after HFS. In addition, the combined effect of HFS and yohimbine on the nociceptive blink reflex and on conditioned pain modulation was explored. In this paradigm, the conditioning stimulus was cold pain in the ipsilateral or contralateral temple, and the test stimulus was electrically evoked pain in the forearm.
  
  
  RESULTS
  Blood pressure and electrodermal activity increased for several hours after yohimbine administration, consistent with blockade of central α2-adrenoceptors. Yohimbine not only augmented the nociceptive blink reflex ipsilateral to HFS but also intensified the inhibitory influence of ipsilateral temple cooling on electrically evoked pain at the HFS-treated site in the forearm. Yohimbine had no consistent effect on primary or secondary hyperalgesia in the forearm or on pressure-pain in the ipsilateral forehead.
  
  
  CONCLUSIONS
  These findings imply involvement of α2-adrenoceptors both in ipsilateral antinociceptive and pronociceptive pain modulation processes. However, a mechanism not involving α2-adrenoceptors appears to mediate analgesia in the ipsilateral forehead after HFS.
authors.affiliation: Centre for Research on Chronic Pain and Inflammatory Diseases, Murdoch University, Perth, WA, Australia.
authors.forename: L
authors.initials: L
authors.lastname: Vo
authors.affiliation: Centre for Research on Chronic Pain and Inflammatory Diseases, Murdoch University, Perth, WA, Australia.
authors.forename: P D
authors.initials: PD
authors.lastname: Drummond
mesh_terms: D000293:Adolescent; D058669:Adrenergic alpha-2 Receptor Antagonists / Q000494:pharmacology; D000328:Adult; D001767:Blinking / Q000187:drug effects; D003080:Cold Temperature; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004558:Electric Stimulation; D005260:Female; D007839:Functional Laterality / Q000187:drug effects; D006358:Hot Temperature; D006801:Humans; D008297:Male; D008875:Middle Aged; D059225:Nociception / Q000187:drug effects; D010146:Pain / Q000503:physiopathology*; D010812:Physical Stimulation; D018341:Receptors, Adrenergic, alpha-2 / Q000187:drug effects*; D015016:Yohimbine / Q000494:pharmacology; D055815:Young Adult
chemical_list: D058669:Adrenergic alpha-2 Receptor Antagonists; D018341:Receptors, Adrenergic, alpha-2; D015016:Yohimbine