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Painful Stimulation and Transient Blocking of Nerve Transduction Due to Local Anesthesia Evoke Perceptual Distortions of the Face in Healthy Volunteers

  • Ina Skyt
    Correspondence
    Address reprint requests to Ina Skyt, BSc, Department of Psychology and Behavioural Sciences, Aarhus University, Bartholins Allé 9, 8000 Aarhus C, Denmark.
    Affiliations
    Department of Psychology and Behavioural Sciences, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark

    Section of Clinical Oral Physiology, Department of Dentistry, Aarhus University, Aarhus, Denmark
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  • Lilja Dagsdóttir
    Affiliations
    Section of Clinical Oral Physiology, Department of Dentistry, Aarhus University, Aarhus, Denmark

    Scandinavian Center for Orofacial Neurosciences, Stockholm, Sweden
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  • Lene Vase
    Affiliations
    Department of Psychology and Behavioural Sciences, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
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  • Lene Baad-Hansen
    Affiliations
    Section of Clinical Oral Physiology, Department of Dentistry, Aarhus University, Aarhus, Denmark

    Scandinavian Center for Orofacial Neurosciences, Stockholm, Sweden
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  • Eduardo Castrillon
    Affiliations
    Section of Clinical Oral Physiology, Department of Dentistry, Aarhus University, Aarhus, Denmark

    Scandinavian Center for Orofacial Neurosciences, Stockholm, Sweden
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  • Andreas Roepstorff
    Affiliations
    Interacting Minds Center, Center for Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
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  • Troels Staehelin Jensen
    Affiliations
    Danish Pain Research Center, Aarhus University Hospital, Aarhus, Denmark
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  • Peter Svensson
    Affiliations
    Section of Clinical Oral Physiology, Department of Dentistry, Aarhus University, Aarhus, Denmark

    Scandinavian Center for Orofacial Neurosciences, Stockholm, Sweden

    Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
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Published:January 29, 2015DOI:https://doi.org/10.1016/j.jpain.2015.01.006

      Highlights

      • This study examines whether injections of hypertonic saline can lead to perceptual distortions of the face in healthy volunteers.
      • Injections of isotonic saline into the infraorbital nerve region and the mental nerve region can lead to perceptual distortions.
      • Perceptual distortions of the face might also be influenced by the psychological variable of dissociation, as indicated by the statistically significant correlations between perceptual distortions and dissociation measured using a set of psychological questionnaires.

      Abstract

      Anecdotally, orofacial pain patients sometimes report that the painful face area feels “swollen.” Because there are no clinical signs of swelling, such illusions may represent perceptual distortions. In this study, we examine whether nociceptive stimulation can lead to perceptual distortion of the face in a way similar to that of local anesthesia. Sixteen healthy participants received injections of .4 mL hypertonic saline to induce short-term nociceptive stimulation, .4 mL mepivacaine (local anesthetic) to transiently block nerve transduction, and .4 mL isotonic saline as a control condition. Injections were administered in both the infraorbital and the mental nerve regions. Perceptual distortions were conceptualized as perceived changes in magnitude of the injected areas and the lips, and they were measured using 1) a verbal subjective rating scale and 2) a warping procedure. Prior to the study, participants filled in several psychological questionnaires. This study shows that both nociceptive stimulation (P < .05) and transient blocking of nerve transduction (P < .05) can lead to perceptual distortion of the face. A test-retest experiment including 9 new healthy subjects supported the results. Perceptual distortions were positively correlated with the psychological variable of dissociation in several conditions (P < .05). Perceptual distortions may therefore be influenced by somatosensory changes and psychological mechanisms.

      Perspective

      Knowledge of the factors that influence the perception of the face is important to understand the possible implications of perceptual distortions in orofacial pain disorders (and possibly other chronic pain states). Such information may ultimately open up new avenues of treatment for persistent orofacial pain.

      Key words

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