Discriminative and affective touch in human experimental tactile allodynia

Recently, several studies have suggested a role for unmyelinated (C-tactile, CT) low-threshold mechanoreceptive afferents in the allodynic condition. In this psychophysical study we explored the integrity of both Aβ and CT afferent processing following application of the heat capsaicin model of tactile allodynia on the left forearm in healthy subjects (n=40). We measured tactile direction discrimination (TDD) to target the integrity of Aβ processing (n=20). The TDD accuracy was significantly lower in the allodynic compared to a control zone. In addition, we measured the perceived pleasantness and pain of brush stroking at CT targeted (slow) and CT sub-optimal (fast) stroking velocities to investigate the integrity of CT processing (n=20). When comparing touch pleasantness in the allodynic and control zone, there was a significantly larger difference in ratings for CT targeted compared to CT suboptimal stimulation. The results suggest a disturbance in both Aβ-mediated discriminative and CT-mediated affective touch processing in human experimental tactile allodynia. Our findings support the canonical view that tactile allodynia is signaled by Aβ afferents but that CTs seem to contribute by the loss of a pain inhibiting role.