The significance of A-δ and C fibres for the perception of synthetic heat

Synthetic heat is a perception of strong, but not painful, heat arising when skin is stimulated by an alternating pattern of adjacent cold and warmth. This study examines the contribution of different classes of nerve fibres to this perception. In 40 subjects changes in synthetic heat and thermal perceptions were studied during a 30-min ischaemic nerve block in one reaction time, and one threshold determination task. Synthetic heat stimuli were described as hot or warm, but not as painful, and were preceded by a transient cold. Reaction times for synthetic heat stimuli did not differ from those for cold stimuli. Thresholds for synthetic heat and thermal stimuli were similar. During A fibre nerve block the perception of synthetic heat lost the cold component whereas the frequency of hot and warm descriptors did not change. The perception of cold stimuli changed, such that pure cold was replaced by dysaesthetic descriptors. Reaction times and thresholds for thermal and synthetic heat stimuli increased equally during the nerve block. It is concluded that the perception of synthetic heat most likely arises from the fusion of signals dependent on unmyelinated low threshold cold and warm receptors. It is not dependent on A-delta cold fibres, and a contribution of nociceptors is quite unlikely. The possibility of a psychological contribution at the perceptual level is discussed. (C) 2002 European Federation of Chapters of the International Association for the Study of Pain. Published by Elsevier Science Ltd. All rights reserved.