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

Edwards, Louisa; Ring, Christopher; Al’Absi, Mustafa; McIntyre, David; Martin, Una

doi:10.1016/j.biopsycho.2007.06.005

Cited by 25 publications

(21 citation statements)

References 87 publications

(121 reference statements)

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“…Furthermore, numerous observations in normotensive individuals at risk of hypertension indicate that, in many cases, hypoalgesia precedes the occurrence of hypertension. Offspring of hypertensives exhibited attenuated nociceptive and pain responding , inter alia , in studies based on cold pressor testing (al'Absi et al, ; Stewart & France, ), ischemia induction (Stewart & France, ), mechanical pressure application (D'Antono et al, ; Ditto, Séguin Boulerice, Pihl, & Tremblay, ), heat application (Bragdon, Light, Girdler, & Maixner (), electrocutaneous stimulation (Ditto, France, & France, ; Page & France, ) and sural nerve stimulation (al'Absi et al, ; Edwards et al, ). Considering this, hypoalgesia may be associated with a genetic predisposition to hypertension rather than being a consequence of elevated BP (France, ).…”

Section: Discussionmentioning

confidence: 99%

Blood pressure and the perception of illusive pain

et al. 2016

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Numerous studies have documented an inverse relationship between blood pressure and sensitivity to experimental nociceptive stimulation. The present study aimed to investigate possible associations between blood pressure and the occurrence and intensity of paradoxical pain induced by the thermal grill paradigm. Thirty-one healthy subjects were stimulated three times for 1 min with the nonnoxious temperatures of 15°C and 41°C set at the interlaced cold and warm bars of a water bath-driven thermal grill. Blood pressure and heart rate were recorded concomitantly. On account of previous observations of an association between the sensitivity of the cardiac baroreflex and pain perception, this parameter was additionally obtained. Numerical rating scales were used to quantify subjective pain intensity and pain unpleasantness; subjects were classified as responders and nonresponders to thermal grill stimulation based on pain intensity ratings. Responders exhibited lower systolic and diastolic blood pressure than nonresponders, and inverse linear associations arose between blood pressure and pain intensity and unpleasantness. Baroreflex sensitivity was unrelated to pain ratings. The findings confirmed the hypothesis of a blood pressure dependence of paradoxical pain and support the notion that the cardiovascular and pain regulatory systems interact not only in the processing of pain elicited by noxious input, but also in nonnoxiously generated illusive pain. While this finding is not consistent with the assumption of an involvement of the baroreflex system in mediating the observed interaction, psychological traits and neurochemical factors are alternatively considered.

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Section: Discussionmentioning

confidence: 99%

Blood pressure and the perception of illusive pain

et al. 2016

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“…In three practice trials, their sural nerve was stimulated (2, 4, 6 mA) and participants provided a pain rating. Nociceptive flexion reflex thresholds were then measured (data reported elsewhere; Edwards et al, 2007). Following a 5 min rest, pain threshold and tolerance were determined.…”

Section: Methodsmentioning

confidence: 99%

Effects of naltrexone on electrocutaneous pain in patients with hypertension compared to normotensive individuals

Ring

Al’Absi

Edwards

et al. 2008

Biological Psychology

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An opioid mechanism may help explain hypertensive hypoalgesia. A double-blind placebocontrolled design compared the effects of opioid blockade (naltrexone) and placebo on electrocutaneous pain threshold, pain tolerance, and retrospective McGill Pain Questionnaire ratings in 35 unmedicated patients with essential hypertension and 28 normotensive individuals. The hypertensives experienced less pain than normotensives during the assessment of their pain tolerance; however, this manifestation of hypertensive hypoalgesia was not moderated by naltrexone. These findings fail to support the hypothesis that essential hypertension is characterised by relative opioid insensitivity.

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“…While this sounds counterintuitive, there is some evidence to support this possibility. Specifically, several studies examining the effect of distraction (eg, mental arithmetic) on NFR magnitudes 33 and NFR threshold 13,14,36 have noted enhanced NFR during distraction (but see, Refs. [2][3][4]64).…”

Section: Threat-evoked Amplification Of Pain and Nociceptive Flexion mentioning

confidence: 99%

Does pain catastrophizing contribute to threat-evoked amplification of pain and spinal nociception?

Terry

Thompson²,

Rhudy³

2016

Pain

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Unpredictable threat amplifies pain and spinal nociception (as measured by the nociceptive flexion reflex, NFR), but it is unknown whether pain catastrophizing mediates this threat-related amplification. To examine this, the present study experimentally reduced catastrophizing and examined the effect on threat-evoked pain/NFR facilitation. Healthy pain-free participants (N 5 113) were randomly assigned to a brief 30-minute intervention designed to reduce catastrophic thoughts or a control intervention that involved education about pain neurobiology. Before the interventions, participants underwent a block of 8 pseudorandomly ordered periods of safe (no abdominal shock) and threat (abdominal shock possible) during which pain and NFR were evoked by electric stimulations to the ankle. After the safe/threat periods, participants rated pain intensity, pain unpleasantness, and situation-specific pain catastrophizing. The same test block was delivered after the intervention to examine changes in catastrophizing and threat-evoked pain/NFR facilitation. As expected, pain catastrophizing was reduced by the catastrophizing reduction intervention, relative to the control group. Furthermore, pain intensity, unpleasantness, and NFR magnitudes were higher during threat periods than safe. However, this threat-related pain/NFR amplification was not attenuated by the catastrophizing reduction intervention at the group level, although the intervention generally led to lower pain ratings (but not reduced NFR), regardless of the context. Nonetheless, bootstrapped mediation analyses found that reductions in catastrophizing mediated reductions in threat-related amplification of pain, but not NFR. This suggests that catastrophizing is partly responsible for threat-evoked pain amplification and provides further evidence that catastrophizing does not amplify pain at the spinal level.

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

Cited by 25 publications

References 87 publications

Blood pressure and the perception of illusive pain

Blood pressure and the perception of illusive pain

Effects of naltrexone on electrocutaneous pain in patients with hypertension compared to normotensive individuals

Does pain catastrophizing contribute to threat-evoked amplification of pain and spinal nociception?

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