Affective modulation of nociception at spinal and supraspinal levels

Rhudy, Jamie L.; Williams, Amy E.; McCabe, K.; ̃n, Mary Anh Thù V. Nguyê; Rambo, Philip L.

doi:10.1111/j.1469-8986.2005.00313.x

Cited by 168 publications

(201 citation statements)

References 68 publications

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“…Second, participants, armed with the knowledge that they could terminate the experimental session at any time, were in control, further lessening the role of psychological factors. [78][79][80][81][82][83] Third, pain ratings to the supraorbital stimuli were comparable for the cervical and arm interventions, and remained unchanged across the trials. This dissociation between pain perception and R2 activity supports the possibility that the reductions in referred head pain, cervical tenderness, and inhibition of R2 were due to a specific "cervical," neurophysiological effect, rather than psychological influences.…”

Section: Discussionmentioning

confidence: 91%

Cervical Referral of Head Pain in Migraineurs: Effects on the Nociceptive Blink Reflex

Watson

Drummond

2014

Headache

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Objective.-To investigate cervical, interictal reproduction of usual head pain and its effect on the nociceptive blink reflex in migraineurs.Background.-Anatomical and neurophysiological studies in animals and humans have confirmed functional convergence of trigeminal and cervical afferent pathways. Migraineurs often present with occipital and neck symptoms, and cervical pain is referred to the head in most cases, suggesting that cervical afferent information may contribute to headache. Furthermore, the effectiveness of greater occipital nerve blockade in migraine and demonstrable modulation of trigeminal transmission following greater occipital nerve blockade suggest an important role for cervical afferents in migraine. However, to what extent cervical afferents contribute actively to migraine is still unknown.Methods.-The passive accessory intervertebral movements of the atlanto-occipital and C2-3 spinal segments of 15 participants (14 females, 1 male; age 24-44 years, mean age 33.3 years) with migraine were examined interictally. During 1 session, either the atlanto-occipital or C2-3 segment was examined, resulting in referred usual head pain, while in another session, pressure was applied over the common extensor origin (lateral epicondyle of the humerus) of the ipsilateral arm. Each intervention was repeated 4 times. The nociceptive blink reflex to a supraorbital electrical stimulus was elicited ipsilaterally during both sessions before and during each intervention. The main outcome variables were the number of recorded blinks, area under the curve and latencies of the R2 components of the nociceptive blink reflex. Participants also rated the intensity of referred head pain and the supraorbital stimulus on a scale of 0-10, where 0 = "no pain" and 10 = "intolerable pain," and rated the intensity of applied pressure where 0 = "pressure but no pain" and 10 = "intolerable pain."Results.-Participants reported a significant reduction in local tenderness ratings across the 4 trials for the cervical intervention but not for the arm (P = .005). The cervical intervention evoked head pain in all participants. As the cervical intervention was sustained, head pain decreased significantly from the beginning to the end of each trial (P = .000) and from the beginning of the first trial to the end of the last (P = .000). Pain evoked by the supraorbital stimulus was consistent from baseline to across the 4 trials (P = .635) and was similar for the cervical and arm interventions (P = .072). The number of blinks decreased significantly across the experiment (P = .000) and was comparable in the cervical and arm interventions (P = .624). While the R2 area under the curve decreased irrespective of intervention (P = .000), this reduction was significantly greater for the cervical intervention than when pressure was applied to the arm (P = .037). Analysis of the R2 latencies revealed a notable increase across the experiment (P = .037). However, this increase was significantly greater following the cervical than arm intervention (P ...

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Section: Discussionmentioning

confidence: 91%

Cervical Referral of Head Pain in Migraineurs: Effects on the Nociceptive Blink Reflex

Watson

Drummond

2014

Headache

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“…The findings of this study could be an indication that thrust manipulation in the upper thoracic spine is less effective in reducing pain in the more chronic patient group versus the more acute patient group. Pain is the result of the activity of the dorsal horn inter-neurons, 14,[102][103][104] which will determine the accumulative affect of the efferent input. This interneuron activity is not yet fully understood; 105 however, there are many neuro-chemicals, such as endorphins, Substance P, serotonin, and GABA, which could affect the activity of these interneurons.…”

Section: Discussionmentioning

confidence: 99%

“…47,90,106 The descending pathways from the cranial structures can result in an inhibiting or facilitating effect on the segmental interneurons. 57,102,[107][108][109][110][111][112][113][114] It has been shown that spinal manipulative techniques affect inter-neural activity at the spinal segments influencing the descending central pathways, 115,116 and also have an effect at the cortical level. 117 In a state of central sensitization, or chronic pain, it appears that there is a change in processing of nociceptive information in time.…”

Section: Discussionmentioning

confidence: 99%

Immediate effects of a thoracic spine thrust manipulation on the autonomic nervous system: a randomized clinical trial

Sillevis¹,

Cleland²,

Hellman³

et al. 2010

Journal of Manual & Manipulative Therapy

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Thoracic spine manipulation has been shown to be effective for the management of neck pain. The purpose of this study was to investigate the immediate effect of a T3-T4 spinal thrust manipulation on autonomic nervous system activity in subjects with chronic cervical pain. An additional aim was to determine if the manipulation resulted in an immediate pain relief in patients with chronic neck pain when compared to a placebo intervention. One hundred subjects with chronic neck pain were randomly assigned to receive either a thoracic thrust manipulation or a placebo intervention. The Friedman's test was used to evaluate the change in pupil diameter within both groups. The Wilcoxen signed-ranks test was used to explore pupil changes over time and to make paired comparisons of the pupil change between the groups. The MannWhitney U test was used to compare the change in pain perception for the chronic cervical pain group subjects receiving either the thrust manipulation or the placebo intervention. The results demonstrated that manipulation did not result in a change in sympathetic activity. Additionally, there was no significant difference in the subject's pain perception (P50.961) when comparing the effects of the thrust manipulation to the placebo intervention within this group of subjects with chronic neck pain. The clinical impression of this study is that manipulation of the thoracic spine may not be effective in immediately reducing pain in patients with chronic neck pain.

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“…The finding of lower NFR thresholds during Tetris ® computer game play compared to rest has been reported in a preliminary study in young healthy normotensives adults (Edwards et al, 2003b). In addition, other secondary tasks have been shown to facilitate NFR responses, including tasks which ask participants to search for differences between two pictures (Bathien and Morin, 1972), look at unpleasant pictures (Rhudy et al, 2005), or solve mental arithmetic problems (e.g., Edwards et al, 2006;McIntyre et al, 2006;Petersen et al, 2001). In contrast, early studies reported that secondary tasks, selected to be distracting and/or arousing, attenuated the NFR (Bathien, 1971;Bathien and Hugelin, 1969;Bathien andMorin, 1972,Willer et al, 1979).…”

Section: Discussionmentioning

confidence: 99%

Nociceptive flexion reflex thresholds and pain during rest and computer game play in patients with hypertension and individuals at risk for hypertension

Edwards

Ring

Al’Absi

et al. 2007

Biological Psychology

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Supraspinal pain modulation may explain hypertensive hypoalgesia. We compared nociceptive flexion reflex (NFR) thresholds and pain during rest and computer game play in hypertensives and normotensives (Experiment 1) and normotensives with and without hypertensive parents (Experiment 2). The game was selected to modulate activity in pain pathways. NFR thresholds did not differ between groups during rest or game play. Pain ratings never differed between hypertensives and normotensives, whereas individuals with hypertensive parents reported less pain during the first two NFR assessments, compared to those without. NFR thresholds and pain were reduced by game play compared to rest. The failure of game play to differentially modulate NFR thresholds or associated pain reports between groups argues against enhanced supraspinal modulation of nociception and pain in hypertensives and those at increased risk for hypertension.

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Affective modulation of nociception at spinal and supraspinal levels

Cited by 168 publications

References 68 publications

Cervical Referral of Head Pain in Migraineurs: Effects on the Nociceptive Blink Reflex

Cervical Referral of Head Pain in Migraineurs: Effects on the Nociceptive Blink Reflex

Immediate effects of a thoracic spine thrust manipulation on the autonomic nervous system: a randomized clinical trial

Nociceptive flexion reflex thresholds and pain during rest and computer game play in patients with hypertension and individuals at risk for hypertension

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