Across- and within-session variability of ratings of painful contact heat stimuli

Quiton, Raimi L.; Greenspan, Joel D.

doi:10.1016/j.pain.2007.08.034

Cited by 56 publications

(46 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Variation in pain within an individual can occur across stimulation sites and across time [50; 59]. Given that such within subject variation exists, placebo and nocebo responses cannot simply be defined as responses that are below or above those of control stimuli.…”

Section: Methodsmentioning

confidence: 99%

Brain mechanisms supporting violated expectations of pain

Zeidan¹,

Lobanov²,

Kraft

et al. 2015

Pain

View full text Add to dashboard Cite

The subjective experience of pain is influenced by interactions between prior experiences, future predictions and incoming afferent information. Expectations of high pain can exacerbate pain while expectations of low pain during a consistently noxious stimulus can produce significant reductions in pain. However, the brain mechanisms associated with processing mismatches between expected and experienced pain are poorly understood, but are important for imparting salience to a sensory event in order to override erroneous top-down expectancy-mediated information. The present investigation examined pain-related brain activation when expectations of pain were abruptly violated. After conditioning participants to cues predicting low or high pain, ten incorrectly cued stimuli were administered across 56 stimulus trials to determine if expectations would be less influential on pain when there is a high discordance between pre-stimulus cues and corresponding thermal stimulation. Incorrectly cued stimuli produced pain ratings and pain-related brain activation consistent with placebo analgesia, nocebo hyperalgesia, and violated expectations. Violated expectations of pain were associated with activation in distinct regions of the inferior parietal lobe, including the supramarginal and angular gyrus, and intraparietal sulcus, the superior parietal lobe, cerebellum and occipital lobe. Thus, violated expectations of pain engage mechanisms supporting salience-driven sensory discrimination, working memory, and associative learning processes. By overriding the influence of expectations on pain, these brain mechanisms are likely engaged in clinical situations where patients’ unrealistic expectations for pain relief diminish the efficacy of pain treatments. Accordingly, these findings underscore the importance of maintaining realistic expectations to augment the effectiveness of pain management.

show abstract

Section: Methodsmentioning

confidence: 99%

Brain mechanisms supporting violated expectations of pain

Zeidan¹,

Lobanov²,

Kraft

et al. 2015

Pain

View full text Add to dashboard Cite

show abstract

“…The first session consisted of a control session in which subjects underwent the same heat pain testing procedure used in the medication sessions but without exposure to a conditioning stimulus (i.e., water bath) or medication. The purpose of the additional pre-experimental session was to confirm that the testing temperature resulted in the intended pain range, orient the subject to the actual timing of the testing conditions, and reduce across day inhibition (Quiton & Greenspan, 2008). The session timeline is illustrated in Fig.…”

Section: Methodsmentioning

confidence: 99%

Reduction of conditioned pain modulation in humans by naltrexone: an exploratory study of the effects of pain catastrophizing

et al. 2012

View full text Add to dashboard Cite

The current study tested the hypothesis that conditioned pain modulation is mediated by the release of endogenous opioids with a placebo-controlled (sugar pill) study of naltrexone (50 mg) in 33 healthy volunteers over two counter-balanced sessions. Pain modulation consisted of rating of heat pain (palm) during concurrent cold water immersion (foot). Compared to baseline heat pain ratings, concurrent foot immersion lowered pain intensity ratings, which suggests an inhibitory effect, was reduced with naltrexone, suggesting at least partial dependence of inhibition on endogenous opioids. An exploratory analysis revealed that individual differences in catastrophizing moderated the effects of naltrexone; endogenous opioid blockade abolished modulation in subjects lower in catastrophizing while modulation was unaffected by naltrexone among high catastrophizers. The results suggest a role of endogenous opioids in endogenous analgesia, but hint that multiple systems might contribute to conditioned pain modulation, and that these systems might be differentially activated as a function of individual differences in responses to pain.

show abstract

“…The threshold depends on the rate of temperature rise and reaction time (53). Second, ratings of pain intensity are influenced by psychological factors such as expectations, anxiety, and pain coping strategies, which vary from individual to individual (19,38). Third, some late afferent signals of slow-conducting C-fibers reached the brain even after the increase (or decrease) in the thermode temperature had been stopped by the button press so that delayed pain may have influenced the ratings.…”

Section: Continuedmentioning

confidence: 99%

Thermoreception and nociception of the skin: a classic paper of Bessou and Perl and analyses of thermal sensitivity during a student laboratory exercise

Kuhtz-Buschbeck¹,

Andresen²,

Göbel³

et al. 2010

Advances in Physiology Education

View full text Add to dashboard Cite

About four decades ago, Perl and collaborators were the first ones who unambiguously identified specifically nociceptive neurons in the periphery. In their classic work, they recorded action potentials from single C-fibers of a cutaneous nerve in cats while applying carefully graded stimuli to the skin (Bessou P, Perl ER. Response of cutaneous sensory units with unmyelinated fibers to noxious stimuli. J Neurophysiol 32: 1025-1043, 1969). They discovered polymodal nociceptors, which responded to mechanical, thermal, and chemical stimuli in the noxious range, and differentiated them from low-threshold thermoreceptors. Their classic findings form the basis of the present method that undergraduate medical students experience during laboratory exercises of sensory physiology, namely, quantitative testing of the thermal detection and pain thresholds. This diagnostic method examines the function of thin afferent nerve fibers. We collected data from nearly 300 students that showed that 1) women are more sensitive to thermal detection and thermal pain at the thenar than men, 2) habituation shifts thermal pain thresholds during repetititve testing, 3) the cold pain threshold is rather variable and lower when tested after heat pain than in the reverse case (order effect), and 4) ratings of pain intensity on a visual analog scale are correlated with the threshold temperature for heat pain but not for cold pain. Median group results could be reproduced in a retest. Quantitative sensory testing of thermal thresholds is feasible and instructive in the setting of a laboratory exercise and is appreciated by the students as a relevant and interesting technique.

show abstract

Across- and within-session variability of ratings of painful contact heat stimuli

Cited by 56 publications

References 31 publications

Brain mechanisms supporting violated expectations of pain

Brain mechanisms supporting violated expectations of pain

Reduction of conditioned pain modulation in humans by naltrexone: an exploratory study of the effects of pain catastrophizing

Thermoreception and nociception of the skin: a classic paper of Bessou and Perl and analyses of thermal sensitivity during a student laboratory exercise

Contact Info

Product

Resources

About