Heterotopic painful stimulation decreases the late component of somatosensory evoked potentials induced by electrical tooth stimulation

The purpose of this study was to determine the relationship between the late component of somatosensory evoked potentials (SEP) induced by electrical tooth stimulation and subjective pain estimation when heterotopically painful stimulation was delivered to humans. The noxious electrical conditioning stimuli were applied to the left median nerve in noxious session I and the right median nerve in noxious session II for 10 min. The amplitude of the late component and visual analogue scale (VAS) value were both decreased significantly by conditioning stimuli in both sessions. The maximum decreases in SEP amplitude and VAS value induced by conditioning stimuli were respectively 40.2 and 37.2% in noxious session I and 49.3 and 42.3% in noxious session II. After-effect was observed 5 min after removal of the conditioning stimuli. The rates of decrease were thus nearly the same and independent of the site of conditioning stimulation in noxious sessions I and II. The SEP amplitude was significantly correlated with VAS values. The present study revealed that SEP amplitude and subjective pain intensity estimated by VAS following electrical tooth stimulation can be decreased by noxious stimuli to hand. This finding that heterotopic painful stimulation attenuates experimentally-induced tooth pain suggests a triggering of diffuse noxious inhibitory control (DNIC) with after-effect in trigeminal region.