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Cited by 286

The DOI matches its Crossref record; 67 of the 67 references it cites were found in a registry or an index.

Topical menthol--a human model for cold pain by activation and sensitization of C nociceptors

Wasner, G.·2004·Brain

Abstract

Although cold hyperalgesia is a frequent symptom in patients with neuropathic pain, it is poorly understood. We investigated the mechanisms of cold pain by studying the effect of menthol on pain, temperature perception, touch sensation and skin perfusion. In 10 subjects, 40% l-menthol, and ethanol, serving as control, were topically applied to the forearm in a double-blinded two-way crossover study. Menthol induced significant pain and cold sensations, punctate and cold hyperalgesia and an increase in cutaneous perfusion. Other mechano-sensory and thermal tests were unchanged (touch, cold and warm detection thresholds, heat pain threshold; no dynamic and static hyperalgesia, no wind-up). To investigate the underlying mechanisms, the effects of menthol versus ethanol on the dorsum of the hand were tested during A fibre conduction blockade of the superficial radial nerve in another 10 subjects. The block itself led to hypoaesthesia for mechanical stimuli and anaesthesia for cold perception, but induced an increase in cold-mediated pain. This was due to lack of inhibition of C nociceptors normally exerted by concomitant activation of A fibres. Under these conditions, menthol-induced cold sensation and punctate hyperalgesia were abolished. However, menthol induced spontaneous pain with a trend to higher values than without block. Furthermore, the hyperalgesia to cold stimuli, that was already present during A fibre block, was further increased significantly by menthol. We suggested that menthol acts to sensitize cold-sensitive peripheral vasoactive C nociceptors and activates cold-specific A delta fibres. Punctate hyperalgesia is due to central sensitization based on the ongoing activity in the sensitized cold-sensitive peripheral C nociceptors. In conclusion, topical menthol is a human model for cold pain by exposing for the first time the mechanism of sensitized peripheral cold C nociceptors that may also be involved in neuropathic pain.

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Metadata

Authors
Wasner, G.
Venue
Brain
Published
2004-02-26
Volume
127
Issue
5
Pages
1159-1171
ISSN
  • 0006-8950 (ISSN-L)
  • 1460-2156
OpenAlex
W2137215180
Cited by
286
References
67
FWCI
11.21
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: Topical menthol--a human model for cold pain by activation and sensitization of C nociceptors. https://app.cochat.ai/papers/10.1093/brain/awh134
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Wasner, G. (2004). Topical menthol--a human model for cold pain by activation and sensitization of C nociceptors. Brain. https://doi.org/10.1093/brain/awh134

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Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.