<p>Multisensory Sensitivity is Related to Deep-Tissue but Not Cutaneous Pain Sensitivity in Healthy Individuals</p>

Abstract

Purpose: Some individuals with chronic pain find daily life sensations (eg, noise, light, or touch) aversive. This amplification of multisensory sensations has been associated with centrally mediated plasticity; for example, greater multisensory sensitivity (MSS) occurs in patients with fibromyalgia than rheumatoid arthritis. However, whether MSS preferentially relates to pain measures which reflect central influences (eg, dynamic quantitative sensory testing (QST) or referred pain), or whether the MSS-pain relationship requires priming from chronic pain, is unknown. Thus, this cross-sectional study investigated the relationships between MSS assessed in a pain-free state and evoked pain sensitivity. Methods: Experimental intramuscular infusion pain and multiple static and dynamic QST were assessed in 465 healthy, pain-free adults: pain thresholds using pressure (PPTs) and heat (HPTs), temporal summation of pain (TSP) using pressure, heat or punctate stimuli, and conditioned pain modulation (CPM) using pressure or heat test stimuli. MSS was assessed using 7 items from Barsky's Somatosensory Amplification Scale. Differences in pain and QST between sex-specific MSS quartiles were assessed, adjusting for multiple comparisons. All participants completed at least one intramuscular infusion condition, but not all were asked to complete each QST (n=166-465). Results: Both static and dynamic QST differed between highest and lowest MSS quartiles using pressure stimuli: lower PPTs (adjusted-p<0.01); increased pressure TSP (adjusted-p=0.02); lower pressure CPM (adjusted-p=0.01). However, none of the heat or punctate QST measures (HPTs, TSP, or CPM) differed between MSS quartiles (adjusted-p>0.05). Odds of experiencing TSP or referred pain was not greater, whereas CPM was 8-fold less likely, in those with highest MSS. Conclusion: Normal variation in non-noxious MSS is related to both static and dynamic pain sensitivity, without sensitization associated with chronic pain, but is dependent on the QST stimulus. Thus, common influences on MSS and pain sensitivity may involve central mechanisms but are likely more complex than previously recognized.

Assessing Multisensory Sensitivity Across Scales: Using the Resulting Core Factors to Create the Multisensory Amplification Scale

“…17,56 While MSS and QST likely both provide insights regarding CNS processing, they may not be fully interchangeable. First, MSS has been associated with mechanical but not heat QST assessments, in otherwise pain-free individuals in one study, 51 but in another study involving knee OA patients, no relationship between MSS and QST was observed. 32 However, this area has not been well explored, leaving the relationships between MSS and QST poorly understood.…”

“…For example, some propose that MSS refers to an exaggerated behavioral response (e.g., covering ears in noisy environments), 3 whereas others describe it as discomfort from multiple sensory systems, 32 with personality-like trait properties. 2 Analogously, there is a wide range of terminology used in the literature to describe this phenomenon, including: MSS or multisensory hypersensitivity; 51,53 sensory-processing sensitivity; 2 sensory over-responsiveness; 4 sensory defensiveness; 54 sensory amplification; 7 generalized sensory sensitivity; 44 and others. This high degree of terminology variance likely reflects the varied fields converging on this construct from different perspectives.…”

Temporal Summation in Fibromyalgia Patients: Comparing Phasic and Tonic Paradigms

“…This might be problematic in particular for the tonic stimulus, when the dynamics of tissue perfusion and heat dissipation could have played a role in the absence of tonic summation observed in most of our subjects. Another limitation is the fact that both our protocols for summation involved response to heat, therefore, our findings could be different if other stimuli, i.e., pressure, were used (78). Finally, due to the exploratory nature of our analyses, no corrections for multiple comparisons were made.…”

A comparison of pain, fatigue, and function between post–COVID-19 condition, fibromyalgia, and chronic fatigue syndrome: a survey study

“…However, this group with post-COVID-19 reported essentially normal multisensory sensitivity. 128 Heightened sensory sensitivity is suggestive of poor regulation of somatosensory input by the central nervous system, 57,87,96 which may also require longer timeframes to induce such neural adaptations. 55 Thus, it may be that the shorter duration of post-COVID-19 relative to FMS is contributing to this difference, or it may simply be unique to FMS as elevated multisensory sensitivity was not observed in those with CFS.…”