Reliability of Temporal Summation and Diffuse Noxious Inhibitory Control

Cathcart, Stuart; Winefield, Anthony H.; Rolan, Paul; Lushington, Kurt

doi:10.1155/2009/523098

Cited by 137 publications

(151 citation statements)

References 25 publications

(52 reference statements)

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“…This variability is unlikely to be due to poor test reproducibility, as heterotopic stimulation has been validated as a reproducible method for induction of EPM in healthy volunteers. 35,62 Our data show that trait stress, anxiety and depression do not play a major role in EPM, although state psychological factors may contribute to the variability in EPM. 61 However, recent evidence in healthy controls indicates the predominant effect of anxiety or anxiety sensitivity on pain is relayed via cortical pathways and not via those assessed by heterotopic stimulation, which include major spinal and brainstem components.…”

Section: Discussionmentioning

confidence: 69%

Visceral pain perception in patients with irritable bowel syndrome and healthy volunteers is affected by the MRI scanner environment

Wong

Oudenhove

et al. 2016

UEG Journal

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Background: The MRI scanner environment induces marked psychological effects, but specific effects on pain perception and processing are unknown and relevant to all brain imaging studies. Objectives and methods: We performed visceral and somatic quantitative sensory and pain testing and studied endogenous pain modulation by heterotopic stimulation outside and inside the functional MRI scanner in 11 healthy controls and 13 patients with irritable bowel syndrome. Results: Rectal pain intensity (VAS 0-100) during identical distension pressures increased from 39 (95% confidence interval: 35-42) outside the scanner to 53 (43-63) inside the scanner in irritable bowel syndrome, and from 42 (31-52) to 49 (39-58), respectively, in controls (ANOVA for scanner effect: p ¼ 0.006, group effect: p ¼ 0.92). The difference in rectal pain outside versus inside correlated significantly with stress (r ¼ À0.76, p ¼ 0.006), anxiety (r ¼ À0.68, p ¼ 0.02) and depression scores (r ¼ À0.67, p ¼ 0.02) in controls, but not in irritable bowel syndrome patients, who a priori had significantly higher stress and anxiety scores. ANOVA analysis showed trends for effect of the scanner environment and subject group on endogenous pain modulation (p ¼ 0.09 and p ¼ 0.1, respectively), but not on somatic pain (p > 0.3). Conclusion: The scanner environment significantly increased visceral, but not somatic, pain perception in irritable bowel syndrome patients and healthy controls in a protocol specifically aimed at investigating visceral pain. Psychological factors, including anxiety and stress, are the likely underlying causes, whereas classic endogenous pain modulation pathways activated by heterotopic stimulation play a lesser role. These results are highly relevant to a wide range of imaging applications and need to be taken into account in future pain research. Further controlled studies are indicated to clarify these findings.

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Section: Discussionmentioning

confidence: 69%

Visceral pain perception in patients with irritable bowel syndrome and healthy volunteers is affected by the MRI scanner environment

Wong

Oudenhove

et al. 2016

UEG Journal

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“…Pressure pain thresholds (PPTs) were measured at the middle of the right trapezius belly (PPT shoulder) and at the dorsal surface of the right hand middle finger midway between the first and second distal joint (PPT finger) with an analogue Fisher algometer (Force Dial, Wagner Instruments, Greenwich CT, USA) (31,32). Participants' PPTs were determined by gradually increasing the pressure provided by the algometer (at a rate of 1 kg/s) until the point the sensation first became painful (participants were instructed to say "stop" at this point).…”

Section: Pressure Pain Thresholdsmentioning

confidence: 99%

“…After the first, fifth, and thenth pulse, the participant was asked to verbally rate his/her pain on a Visual Analogue Scale (VAS) ranging from 0 (= no pain) to 10 (= worst possible pain). The outcome measure for TS is the difference between the tenth and the first VAS score (31,32).…”

Section: Endogenous Pain Facilitation: Temporal Summationmentioning

confidence: 99%

Associations between cognitive performance and pain in chronic fatigue syndrome: comorbidity with fibromyalgia does matter

et al. 2015

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Background: In addition to the frequently reported pain complaints, performance-based cognitive capabilities in patients with chronic fatigue syndrome (CFS) with and without comorbid fibromyalgia (FM) are significantly worse than those of healthy controls. In various chronic pain populations, cognitive impairments are known to be related to pain severity. However, to the best of our knowledge, the association between cognitive performance and experimental pain measurements has never been examined in CFS patients.Objectives: This study aimed to examine the association between cognitive performance and self-reported as well as experimental pain measurements in CFS patients with and without FM.Study Design: Observational study.Setting: The present study took place at the Vrije Universiteit Brussel and the University of Antwerp.Methods: Forty-eight (18 CFS-only and 30 CFS+FM) patients and 30 healthy controls were studied. Participants first completed 3 performance-based cognitive tests designed to assess selective and sustained attention, cognitive inhibition, and working memory capacity. Seven days later, experimental pain measurements (pressure pain thresholds [PPT], temporal summation [TS], and conditioned pain modulation [CPM]) took place and participants were asked to fill out 3 questionnaires to assess self-reported pain, fatigue, and depressive symptoms.Results: In the CFS+FM group, the capacity of pain inhibition was significantly associated with cognitive inhibition. Self-reported pain was significantly associated with simple reaction time in CFS-only patients. The CFS+FM but not the CFS-only group showed a significantly lower PPT and enhanced TS compared with controls. Limitations:The cross-sectional nature of this study does not allow for inferences of causation. Conclusions:The results underline disease heterogeneity in CFS by indicating that a measure of endogenous pain inhibition might be a significant predictor of cognitive functioning in CFS patients with FM, while self-reported pain appears more appropriate to predict cognitive functioning in CFS patients without FM.

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“…CPM effect was described as the difference in TS (the difference in increase in pain intensity) prior to and during cuff inflation. The test-retest reliability of the experimental noxious protocol was described previously [34].…”

Section: Experimental Pain Measurement: Conditioned Pain Modulationmentioning

confidence: 99%

Endogenous pain inhibition is unrelated to autonomic responses in acute whiplash-associated disorders

Kooning

Daenen

Roussel³

et al. 2015

J Rehabil Res Dev

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Abstract-Patients with acute whiplash-associated disorder (WAD) demonstrate an inefficient endogenous pain inhibition and may experience a dysfunction in autonomic nervous system reactivity to pain. This study compared the autonomic response to painful stimuli between patients with acute and chronic WAD and healthy controls. In addition, the role of the autonomic nervous system for explaining inefficient endogenous pain inhibition was examined in acute WAD. Seventeen patients with acute WAD, 30 patients with chronic WAD, and 31 healthy controls participated in an experiment evaluating the autonomic nervous system at rest and during painful stimuli. Skin conductance and heart rate variability (HRV) parameters were monitored continuously during conditioned pain modulation. A significant autonomic response to pain was present for skin conductance and two HRV parameters in all experimental groups. There was an interaction effect in the skin conductance response to pain but not in HRV responses in any of the groups. In patients with acute WAD, no significant correlations were present between pain, pressure pain thresholds, pain inhibition, and any of the autonomic parameters. This study refutes autonomic dysfunction at rest and in response to pain in acute WAD. The dysfunctional conditioned pain modulation appears unrelated to autonomic responses to pain.

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Reliability of Temporal Summation and Diffuse Noxious Inhibitory Control

Abstract: The present results indicate acceptable within-session test-retest reliability of TS and DNIC. The results support the possibility of future experimental studies examining factors affecting TS and DNIC.

Cited by 137 publications

References 25 publications

Visceral pain perception in patients with irritable bowel syndrome and healthy volunteers is affected by the MRI scanner environment

Visceral pain perception in patients with irritable bowel syndrome and healthy volunteers is affected by the MRI scanner environment

Associations between cognitive performance and pain in chronic fatigue syndrome: comorbidity with fibromyalgia does matter

Endogenous pain inhibition is unrelated to autonomic responses in acute whiplash-associated disorders

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