Lateral inhibition during nociceptive processing

Spatial summation of pain is the increase of perceived intensity that occurs as the stimulated area increases. Spatial summation of pain is sub-additive in that increasing the stimulus area produces a disproportionately small increase in the perceived intensity of pain. A possible explanation for sub-additive summation may be that convergent excitatory information is modulated by lateral inhibition. To test the hypothesis that lateral inhibition may limit spatial summation of pain, we delivered different patterns of noxious thermal stimuli to the abdomens of 15 subjects using a computer-controlled CO2-laser. Lines (5mm wide) of variable lengths (4cm, 8cm) were compared to two-point stimuli delivered at the same position/separation as the length of lines. When compared to one-point control stimuli, two-point stimulus patterns produced statistically significant spatial summation of pain, while no such summation was detected during line stimulus patterns. Direct comparison of pain intensity evoked by two-point pattern stimuli with line pattern stimuli revealed that two-point patterns were perceived as significantly more painful, despite the fact that the two-point pattern stimulated far smaller areas of skin. Thus, the stimulation of the skin region between the endpoints of the lines appears to produce inhibition. These findings indicate that lateral inhibition limits spatial summation of pain and is an intrinsic component of nociceptive information processing. Disruption of such lateral inhibition may contribute substantially to the radiation of some types of chronic pain.