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Assayag N, Bar-Shalita T, Rand D. The Functional-Cognitive and Sensory Treatment (F-CaST) to improve rehabilitation outcomes of individuals with substance use disorder: a study protocol for a mixed-method randomized controlled trial. Addict Sci Clin Pract 2024; 19:28. [PMID: 38594737 PMCID: PMC11003090 DOI: 10.1186/s13722-024-00449-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 03/07/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Substance use disorder (SUD) is associated with executive function (EF) deficits and sensory modulation dysfunction (SMD). Yet, these deficits are not addressed therapeutically. This study aims to examine the effectiveness of the Functional-Cognitive and Sensory Treatment (F-CaST) compared to standard care to improve everyday performance and behavior and length of stay at the therapeutic community (TC) in individuals with SUD. In addition, to assess the improvement in EF, sensory modulation, participation, self-efficacy, life satisfaction, and use of strategies within and between groups. Satisfaction with F-CaST will also be assessed. METHODS Forty-eight participants from a community of men in a TC, aged 18-45 years will be randomly allocated to (i) F-CaST-(experimental group) providing sensory and EF strategies for improving daily function; (ii) standard care (control group) as provided in the TC. Assessments will be conducted by assessors blind to group allocation at 4 time points: T1- pre-intervention; T2- post-intervention; T3- 1-month follow-up; and T4- 3-month follow-up. Primary outcome measures will be everyday performance, assessed by the Canadian Occupational Performance Measure (COPM), behavior and length of stay in the TC; secondary outcome measures will assess EF, SMD. Semi-structured in-depth qualitative interviews will be conducted at T1, T2 and T4. DISCUSSION We hypothesize that F-CaST will lead to improved everyday performance and longer length of stay in the TC, compared to the control group. If F-CaST will prove to be effective, cognitive and sensory strategies may be incorporated as an adjunctive intervention in SUD rehabilitation. TRIAL REGISTRATION ClinicalTrials.gov NCT05647863 Registered on 13 December 2022, https://classic. CLINICALTRIALS gov/ct2/show/NCT05647863 .
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Affiliation(s)
- Naama Assayag
- Department of Occupational Therapy, School of Health Professions, Faculty of Medical and Health Sciences, Tel Aviv University, 6997801, Tel Aviv, Israel
| | - Tami Bar-Shalita
- Department of Occupational Therapy, School of Health Professions, Faculty of Medical and Health Sciences, Tel Aviv University, 6997801, Tel Aviv, Israel.
| | - Debbie Rand
- Department of Occupational Therapy, School of Health Professions, Faculty of Medical and Health Sciences, Tel Aviv University, 6997801, Tel Aviv, Israel
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Freund-Azaria A, Bart O, Regev R, Bar-Shalita T. Breastfeeding-related Pain, Sensory Over-responsiveness, and Exclusive Breastfeeding at 6 Months: A Prospective Cohort Study. Womens Health Issues 2024; 34:80-89. [PMID: 37940508 DOI: 10.1016/j.whi.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 09/18/2023] [Accepted: 09/27/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Exclusive breastfeeding (EBF) is recommended for the first 6 months of life, yet EBF rates at 6 months (T3) in most developed countries are low. Painful and nonpainful sensory stimuli processing is linked, and while pain has been suggested to restrict breastfeeding, its coupling with sensory over-responsiveness (SOR) in relation to breastfeeding has not yet been reported. OBJECTIVE We aimed to explore whether breastfeeding-related pain, SOR, and general pain sensitivity predict nonexclusive breastfeeding (NEBF) at T3. STUDY DESIGN In this prospective study, participants were recruited at 2 days postpartum (enrollment). For the assessment of breastfeeding-related pain, participants completed the visual analogue scale and the Short-Form McGill Pain Questionnaire at enrollment, and at 6 weeks after birth. At T3, they completed the Pain Sensitivity Questionnaire and the Sensory Responsiveness Questionnaire-Intensity Scale and then provided information about their breastfeeding status. Participants were divided into two groups accordingly: EBF and NEBF. RESULTS A total of 164 participants were reached at T3: EBF (n = 105) and NEBF (n = 59). The incidence of SOR was significantly higher among NEBF compared with EBF participants (25.4% vs. 11.4%; p = .020). Between enrollment and 6 weeks after birth, 72.3% of the EBF participants had reported a ≥30% pain reduction, compared with 44.8% of the NEBF participants (p = .001). Logistic regression modeling revealed that both breastfeeding-related pain reduction and SOR predicted NEBF at T3 (p < .001), indicating a 3.2 times (p = .001) and 2.5 times (p = .041) odds ratio for NEBF, respectively. CONCLUSIONS SOR and sustained breastfeeding-related pain predict NEBF at T3 and may emerge as substantial breastfeeding barriers.
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Affiliation(s)
- Adi Freund-Azaria
- Faculty of Medicine, Occupational Therapy Department, School of Health Professions, Tel-Aviv University, Ramat Aviv, Tel Aviv, Israel; Department of Neonatology, Meir Medical Center, Kfar-Saba, Israel
| | - Orit Bart
- Faculty of Medicine, Occupational Therapy Department, School of Health Professions, Tel-Aviv University, Ramat Aviv, Tel Aviv, Israel
| | - Rivka Regev
- Clalit Health Organization and Neonatal Follow-up Clinic, Meir Medical Center, Kfar-Saba, Israel
| | - Tami Bar-Shalita
- Faculty of Medicine, Occupational Therapy Department, School of Health Professions, Tel-Aviv University, Ramat Aviv, Tel Aviv, Israel.
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Adams GR, Gandhi W, Harrison R, van Reekum CM, Wood-Anderson D, Gilron I, Salomons TV. Do "central sensitization" questionnaires reflect measures of nociceptive sensitization or psychological constructs? A systematic review and meta-analyses. Pain 2023; 164:1222-1239. [PMID: 36729810 DOI: 10.1097/j.pain.0000000000002830] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 10/21/2022] [Indexed: 02/03/2023]
Abstract
ABSTRACT Central sensitization (CS) is defined as an increased nociceptive responsiveness due to sensitization of neurons in the central nervous system, usually the result of prolonged nociceptive input or a disease state associated with noxious inputs (eg, polyarthritis). The concept of CS has recently been adopted in clinical assessments of chronic pain, but its diagnosis in humans may now include a wide range of hypervigilant responses. The purpose of this review is to ascertain whether self-report questionnaires linked with CS are associated with enhanced nociceptive responses or whether they measure sensitivity in a broader sense (ie, emotional responses). According to our published, PROSPERO-registered review protocol (CRD42021208731), a predefined search of studies that involve the Central Sensitization Inventory (CSI) or Pain Sensitivity Questionnaire (PSQ), correlated with either nociceptive sensory tests or emotional hypervigilance was conducted on MEDLINE, PsycINFO, and Web of Science. Correlations between the CSI or PSQ with our primary outcomes were extracted and meta-analysed. A review of 66 studies totalling 13,284 participants found that the CSI (but not the PSQ) strongly correlated with psychological constructs: depression, anxiety, stress, pain catastrophising, sleep, and kinesiophobia. The CSI and PSQ showed weak or no correlations with experimental measures of nociceptive sensitivity: pain thresholds, temporal summation, or conditioned pain modulation. The PSQ did, however, correlate strongly with phasic heat and tonic cold pain tests. The studies reviewed did not provide sufficient evidence that self-report measures reflect a canonical understanding of CS. The CSI more closely reflects psychological hypervigilance than increased responsiveness of nociceptive neurons.
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Affiliation(s)
- Greig R Adams
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Wiebke Gandhi
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Richard Harrison
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Carien M van Reekum
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | | | - Ian Gilron
- Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON, Canada
| | - Tim V Salomons
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
- Department of Psychology, Queen's University, Kingston, ON, Canada
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Wang D, Frey-Law LA. Multisensory sensitivity differentiates between multiple chronic pain conditions and pain-free individuals. Pain 2023; 164:e91-e102. [PMID: 35588150 PMCID: PMC11075969 DOI: 10.1097/j.pain.0000000000002696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 05/16/2022] [Indexed: 02/06/2023]
Abstract
ABSTRACT Multisensory sensitivity (MSS) to nonpainful stimuli has been identified as a risk factor for the presence of coexisting chronic pain conditions. However, it remains unclear whether MSS can differentiate pain phenotypes involving different levels of central sensitivity. Both pain-free and those with chronic pain, particularly fibromyalgia (FM), migraine, or low back pain (LBP) were recruited, with pain comorbidities assessed. MSS was highest in FM, followed by migraine, then LBP, and lowest in pain-free individuals (adjusted between condition Cohen d = 0.32-1.2, P ≤ 0.0007). However, when secondly grouping patients by the total number of pain comorbidities reported, those with a single pain condition (but not FM) did not have significantly elevated MSS vs pain-free individuals (adj d= 0.17, P = 0.18). Elevated MSS scores produced increased odds of having 2 or more pain comorbidities; OR [95% CI] =2.0 [1.15, 3.42], without, and 5.6 [2.74, 11.28], with FM ( P ≤ 0.0001). Furthermore, those with low MSS levels were 55% to 87% less likely to have ≥ 2 pain comorbidities with or without FM (OR 0.45 [0.22, 0.88]-0.13 [0.05, 0.39]; P ≤ 0.0001). Our findings support that MSS can differentiate between pain phenotypes with different degrees of expected central mechanism involvement and also serve as a risk and resilience marker for total coexisting chronic pain conditions. This supports the use of MSS as a marker of heightened central nervous system processing and thus may serve as a clinically feasible assessment to better profile pain phenotypes with the goal of improving personalized treatment.
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Affiliation(s)
- Dan Wang
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
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Efraim Kaufman A, Weissman-Fogel I, Rosenthal MZ, Kaplan Neeman R, Bar-Shalita T. Opening a window into the riddle of misophonia, sensory over-responsiveness, and pain. Front Neurosci 2022; 16:907585. [PMID: 35992931 PMCID: PMC9381840 DOI: 10.3389/fnins.2022.907585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Misophonia and sensory over-responsiveness (SOR) share physiological and psychological symptoms. While individuals with SOR demonstrate pain perception alterations, these were not explored in misophonia. Methods This exploratory study comprised thirty healthy adults with (n = 15; based on the Misophonia Questionnaire) and without misophonia. The Sensory Responsiveness Questionnaire (SRQ) was used for evaluating sensory responsiveness. In addition, psychophysical tests were applied for quantification of: (i) stimulus-response function of painful stimuli, (ii) the individual perceived pain intensity, (iii) pain modulation efficiency, (iv) auditory intensity discrimination capability, and (v) painful and unpleasantness responses to six ecological daily sounds using the Battery of Aversiveness to Sounds (BAS). Results Individuals with misophonia reported higher scores in the SRQ-Aversive (p = 0.022) and SRQ-Hedonic (p = 0.029) scales as well as in auditory (p = 0.042) and smell (p = 0.006) sub-scales, indicating higher sensory responsiveness. Yet they were not identified with the SOR type of sensory modulation dysfunction. Groups did not differ in the pain psychophysical tests, and in auditory discrimination test scores (p > 0.05). However, in the misophonia group the BAS evoked higher pain intensity (p = 0.046) and unpleasantness (p <0.001) ratings in the apple biting sound, and higher unpleasantness rating in the scraping a dish sound (p = 0.007), compared to the comparison group. Conclusion Findings indicate increased sensory responsiveness in individuals with misophonia, yet not defined as SOR. Thus, this suggests that misophonia and SOR are two distinct conditions, differing in their behavioral responses to painful and non-painful stimuli.
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Affiliation(s)
- Adi Efraim Kaufman
- Department of Occupational Therapy, School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Irit Weissman-Fogel
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - M. Zachary Rosenthal
- Department of Psychiatry and Behavioral Sciences, Center for Misophonia and Emotion Regulation, Duke University Medical Center, Durham, NC, United States
| | - Ricky Kaplan Neeman
- Department of Communication Disorders, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tami Bar-Shalita
- Department of Occupational Therapy, School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Hamed R, Mizrachi L, Granovsky Y, Issachar G, Yuval-Greenberg S, Bar-Shalita T. Neurofeedback Therapy for Sensory Over-Responsiveness-A Feasibility Study. SENSORS 2022; 22:s22051845. [PMID: 35270991 PMCID: PMC8914621 DOI: 10.3390/s22051845] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 12/22/2022]
Abstract
Background: Difficulty in modulating multisensory input, specifically the sensory over-responsive (SOR) type, is linked to pain hypersensitivity and anxiety, impacting daily function and quality of life in children and adults. Reduced cortical activity recorded under resting state has been reported, suggestive of neuromodulation as a potential therapeutic modality. This feasibility study aimed to explore neurofeedback intervention in SOR. Methods: Healthy women with SOR (n = 10) underwent an experimental feasibility study comprising four measurement time points (T1—baseline; T2—preintervention; T3—postintervention; T4—follow-up). Outcome measures included resting-state EEG recording, in addition to behavioral assessments of life satisfaction, attaining functional goals, pain sensitivity, and anxiety. Intervention targeted the upregulation of alpha oscillatory power over ten sessions. Results: No changes were detected in all measures between T1 and T2. Exploring the changes in brain activity between T2 and T4 revealed power enhancement in delta, theta, beta, and gamma oscillatory bands, detected in the frontal region (p = 0.03−<0.001; Cohen’s d = 0.637−1.126) but not in alpha oscillations. Furthermore, a large effect was found in enhancing life satisfaction and goal attainment (Cohen’s d = 1.18; 1.04, respectively), and reduced pain sensitivity and anxiety trait (Cohen’s d = 0.70). Conclusion: This is the first study demonstrating the feasibility of neurofeedback intervention in SOR.
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Affiliation(s)
- Ruba Hamed
- Department of Occupational Therapy, Faculty of Medicine, School of Health Professions, Tel Aviv University, Tel Aviv 6997801, Israel; (R.H.); (L.M.)
| | - Limor Mizrachi
- Department of Occupational Therapy, Faculty of Medicine, School of Health Professions, Tel Aviv University, Tel Aviv 6997801, Israel; (R.H.); (L.M.)
| | - Yelena Granovsky
- Laboratory of Clinical Neurophysiology, Department of Neurology, Faculty of Medicine, Rambam Health Care Campus, Technion, Haifa 3109601, Israel;
| | - Gil Issachar
- Biomedical Engineering Department, Faculty of Engineering, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Shlomit Yuval-Greenberg
- School of Psychological Sciences, Tel Aviv University, Tel Aviv 6997801, Israel;
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Tami Bar-Shalita
- Department of Occupational Therapy, Faculty of Medicine, School of Health Professions, Tel Aviv University, Tel Aviv 6997801, Israel; (R.H.); (L.M.)
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
- Correspondence: ; Tel.: +972-525437631
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Assayag N, Berger I, Parush S, Mell H, Bar-Shalita T. Attention-Deficit/Hyperactivity Disorder Symptoms, Sensation-Seeking, and Sensory Modulation Dysfunction in Substance Use Disorder: A Cross Sectional Two-Group Comparative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052541. [PMID: 35270233 PMCID: PMC8909105 DOI: 10.3390/ijerph19052541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 02/12/2022] [Accepted: 02/14/2022] [Indexed: 12/23/2022]
Abstract
Background: Attention-deficit/hyperactivity disorder (ADHD) and sensation-seeking, a trait characterized by risk-related behaviors, have been recognized as risk factors in substance use disorder (SUD). Though ADHD co-occurs with sensory modulation dysfunction (SMD), SMD has scarcely been explored in SUD. Thus, this study aimed to characterize ADHD symptomology, sensation-seeking, and SMD, as well as to explore their contribution to SUD likelihood. Methods: A cross sectional two-group comparative study including therapeutic community residents with SUD (n = 58; study group) and healthy individuals (n = 62; comparison group) applying the MOXO continuous performance test (MOXO-CPT) evaluating ADHD-related symptoms. In addition, participants completed the ADHD Self-Report Scale—Version 1.1 for ADHD screening; the Brief Sensation Seeking Scale quantifying risk-taking behaviors; and the Sensory Responsiveness Questionnaire-Intensity Scale for identifying SMD. Results: The study group demonstrated higher SMD incidence (53.57% vs. 14.52%) and lower performance in three MOXO-CPT indexes: Attention, Impulsivity, and Hyperactivity, but not in Timing, compared to the comparison group. Sensory over-responsiveness had the strongest relationship with SUD, indicating 27-times increased odds for SUD (95% CI = 5.965, 121.216; p ≤ 0.0001). A probability risk index is proposed. Conclusion: We found SMD with the strongest relation to SUD exceeding that of ADHD, thus contributing a new perspective for developing future therapeutic modalities. Our findings highlight the need to address SMD above and beyond ADHD symptomology throughout the SUD rehabilitation.
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Affiliation(s)
- Naama Assayag
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel; (N.A.); (S.P.)
| | - Itai Berger
- Pediatric Neurology, Pediatric Division, Assuta Ashdod University Hospital, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva 8443944, Israel;
- School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem 9190501, Israel
| | - Shula Parush
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel; (N.A.); (S.P.)
| | - Haim Mell
- Department of Criminology, Max Stern Yezreel Valley College, Yezreel Valley 1930600, Israel;
| | - Tami Bar-Shalita
- Department of Occupational Therapy, School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Correspondence:
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Granot M, Srulovici E, Granovsky Y, Yarnitsky D, Kuperman P. Dispositional and situational personal features and acute post-collision head and neck pain: Double mediation of pain catastrophizing and pain sensitivity. PLoS One 2022; 17:e0262076. [PMID: 35007302 PMCID: PMC8746745 DOI: 10.1371/journal.pone.0262076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 12/17/2021] [Indexed: 11/23/2022] Open
Abstract
Pain variability can be partially attributed to psycho-cognitive features involved in its processing. However, accumulating research suggests that simple linear correlation between situational and dispositional factors may not be sufficiently explanatory, with some positing a role for mediating influences. In addition, acute pain processing studies generally focus on a post-operative model with less attention provided to post-traumatic injury. As such, this study aimed to investigate a more comprehensive pain processing model that included direct and indirect associations between acute pain intensity in the head and neck, pain catastrophizing (using pain catastrophizing scale (PCS)), and pain sensitivity (using the pain sensitivity questionnaire (PSQ)), among 239 patients with post-motor vehicle collision pain. The effect of personality traits (using Ten Items Personality Inventory (TIPI)) and emotional status (using Hospital Anxiety and Depression Scale (HADS) and Perceived Stress Scale (PSS)) on that model was examined as well. To this end, three Structural Equation Modeling (SEM) analyses were conducted. Overall, the data had good fit to all the models, with only PSQ found to have a direct correlation with acute pain intensity. The SEM analyses conversely revealed several mediations. Specifically, that: first, PSQ fully mediated the relationship between PCS and pain intensity; second, PCS and PSQ together fully mediated the relationship between conscientiousness (personality trait) and pain intensity; and finally, emotional status had direct and indirect links with PSQ and pain intensity. In conclusion, these models suggest that during the acute post-collision phase, pain sensitivity intermediates between emotional states and personality traits, partially via elevated pain catastrophizing thoughts.
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Affiliation(s)
- Michal Granot
- Department of Nursing, University of Haifa, Haifa, Israel
| | | | - Yelena Granovsky
- Faculty of Medicine, Technion- Israel Institute of Technology, Haifa, Israel
| | - David Yarnitsky
- Faculty of Medicine, Technion- Israel Institute of Technology, Haifa, Israel
- Department of Neurology, Rambam Health Care Campus, Haifa, Israel
| | - Pora Kuperman
- Department of Neurology, Rambam Health Care Campus, Haifa, Israel
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Can Sensory- and Attachment-Informed Approaches Modify the Perception of Pain? An Experimental Study. Pain Res Manag 2021; 2021:5527261. [PMID: 34804266 PMCID: PMC8601840 DOI: 10.1155/2021/5527261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 10/13/2021] [Indexed: 01/11/2023]
Abstract
Accumulating evidence linking pain with both attachment and sensory processing variables introduces the possibility that attachment- and sensory-informed strategies may modify pain experiences. The aim of this study was to investigate this proposition using an experimentally induced pain procedure. Pain perceptions of individuals using either a sensory-informed (weighted modality) or an attachment-informed (secure base priming) coping strategy were compared with those of individuals using no designated coping strategy. An independent measures experimental study design was used with a convenience sample of 272 pain-free adults. Experimental participants (n = 156) were randomly allocated to either an attachment (n = 75) or a sensory (n = 81) intervention group. Data from these participants were compared to those of 116 participants involved in an earlier cold pressor study in which no coping strategy was used. All participants completed the same sensory, attachment, and distress questionnaires and participated in the same cold pressor pain test. ANCOVAs revealed that participants in the sensory- and attachment-informed intervention groups reported significantly higher pain thresholds than the control group. Participants allocated to the sensory group also reported higher pain intensity scores than the control group. There were no significant differences in pain tolerance between the three groups after controlling for covariates. While further research is required, findings encourage further consideration of sensory- and attachment-informed strategies for people anticipating a painful experience.
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Sensory processing and detection thresholds of burn-injured patients: A comparison to normative data. Burns 2021; 48:1590-1598. [PMID: 34953592 DOI: 10.1016/j.burns.2021.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 10/06/2021] [Accepted: 10/11/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Emerging evidence suggests that individual levels of sensory sensitivity may impact treatment outcomes for people recovering from burn injuries. For example, individuals with higher levels of sensory sensitivity were less adherent with compression garment wear, often used for scar management. The purpose of this study was to characterise sensory patterns for a sample of burn-injured patients as a cohort, using normative data as the reference. As different patterns of sensory processing can have implications clinically, understanding this at the cohort level may provide valuable insight for therapy. METHOD This was a secondary analysis of data collected during a cross-sectional study. Adults (N = 117) attending the Professor Stuart Pegg Adult Burns Unit outpatient clinic completed the Adolescent/Adult Sensory Profile and the following quantitative sensory tests: two-point discrimination; mechanical detection threshold; and pressure pain threshold. RESULTS Compared to matched normative data, burn-injured patients reported higher levels of sensory sensitive and avoiding patterns, and experienced lower detection thresholds for touch and pain. CONCLUSIONS Higher reports of sensory sensitivity and sensory avoiding, and lower thresholds for touch and pain, have been correlated with tactile defensiveness. Tactile defensiveness has been associated with social withdrawal and isolation, all of which could contribute to decreased engagement in therapy. The ways in which these sensory characteristics impact on burn-related treatments, such as compression garment adherence, warrant further investigation.
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Agmon M, Bar-Shalita T, Kizony R. High Sensory Responsiveness in Older Adults is Associated with Walking Outside but Not Inside: Proof of Concept Study. Clin Interv Aging 2021; 16:1651-1657. [PMID: 34548788 PMCID: PMC8449548 DOI: 10.2147/cia.s322728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 08/12/2021] [Indexed: 11/30/2022] Open
Abstract
Background and Purpose Reduced mobility and a higher risk of falls among older adults are related to aging-associated sensory alteration. Sensory responsiveness (SR) has been found to be strongly correlated with postural control in studies on young adults in stimulating environments; however, SR has not been studied in the context of mobility among older adults, despite its potential to enhance fall risks. The aim of the current study is to characterize the associations between SR and gait under single and dual-task (ST, DT) conditions inside and outside the laboratory. Methods Twenty-six community-dwelling older adults (age 70.3 ± 4.6 years, 65.4% women) participated in this cross-sectional study. Gait variables were measured using the APDM system under single and dual task conditions, in a quiet corridor inside and in an ecological (outside) environment. SR was evaluated using the SR questionnaire and cognition was assessed with the Trail-Making Test and the Montreal Cognitive Assessment. Results SR was negatively associated with gait speed during ST (rs = −0.491, p < 0.05) and DT (rs = −0.528, p < 0.01) outside and with ST gait speed inside (rs = −0.528, p < 0.01). SR was positively associated with gait variability under DT (rs = 0.41, p < 0.05) and with DT cost (rs = 0.44, p < 0.05) only outside. Conclusion SR may play an important role in understanding mobility deterioration throughout the aging process, especially outside, illuminating the importance of SR evaluation among older adults during mobility assessment. Therefore, accounting for SR in gait research may contribute to a better understanding of mobility decline throughout the aging process.
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Affiliation(s)
- Maayan Agmon
- The Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Tami Bar-Shalita
- Department of Occupational Therapy, The Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Rachel Kizony
- Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences University of Haifa, Haifa, Israel.,Department of Occupational Therapy, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
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Costa-López B, Ferrer-Cascales R, Ruiz-Robledillo N, Albaladejo-Blázquez N, Baryła-Matejczuk M. Relationship between Sensory Processing and Quality of Life: A Systematic Review. J Clin Med 2021; 10:jcm10173961. [PMID: 34501408 PMCID: PMC8432132 DOI: 10.3390/jcm10173961] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/22/2021] [Accepted: 08/30/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Sensory processing has been described as the ability to register, modulate, and organize sensory information to respond to environmental demands. Different theoretical approaches have studied the differential characteristics of sensory processing, such as Dunn’s model. From this framework, high sensitivity in sensory processing has been described as responses to stimuli from environment quite often due to a rapid activation of the central nervous system. It should be noted that the association between high sensitivity in sensory processing and health outcomes obtained in different studies are not homogeneous, so it is necessary to develop a review of this research in order to clarify the relationship between sensory processing and quality of life. Methods: We conducted a systematic review of the relevant studies using the PubMed, ScienceDirect, Scopus, and ProQuest databases to assess how sensory processing patterns are related to quality of life. Results: Fourteen studies concerning sensory processing and quality of life were included in the review. Some studies indicate negative, moderate, and significant correlations between these variables in which high sensitivity is related to a poor quality of life in the population studied. Conclusions: High sensitivity in sensory processing could have a negative impact on quality of life, thereby facilitating a fluctuation in well-being, daily functioning, and health.
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Affiliation(s)
- Borja Costa-López
- Department of Health Psychology, University of Alicante, 03690 Alicante, Spain; (B.C.-L.); (N.A.-B.)
| | - Rosario Ferrer-Cascales
- Department of Health Psychology, University of Alicante, 03690 Alicante, Spain; (B.C.-L.); (N.A.-B.)
- Correspondence: (R.F.-C.); (N.R.-R.); Tel.: +34-96-590-9420 (R.F.-C.); +34-96590-1151 (N.R.-R.)
| | - Nicolás Ruiz-Robledillo
- Department of Health Psychology, University of Alicante, 03690 Alicante, Spain; (B.C.-L.); (N.A.-B.)
- Correspondence: (R.F.-C.); (N.R.-R.); Tel.: +34-96-590-9420 (R.F.-C.); +34-96590-1151 (N.R.-R.)
| | | | - Monika Baryła-Matejczuk
- Institute of Psychology and Human Sciences, University of Economics and Innovation, 20-209 Lublin, Poland;
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13
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Grouper H, Eisenberg E, Pud D. More Insight on the Role of Personality Traits and Sensitivity to Experimental Pain. J Pain Res 2021; 14:1837-1844. [PMID: 34168491 PMCID: PMC8216734 DOI: 10.2147/jpr.s309729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 05/14/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose The present study aimed to assess the influence of personality traits on the variability of sensitivity to pain in two distinct groups of healthy subjects with low versus high sensitivity to pain (LSP vs HSP, respectively). Methods Healthy subjects (n=156) were allocated to two groups according to their tolerability to cold stimulation (cold pressor test, CPT, 1°C). Group LSP (n=76) reached the cut-off time of 180±0 sec, and a size matched group of HSP (n=80) tolerated the CPT for an average of 10.5±3.4 sec only. Subjects from both groups completed the self-reported pain sensitivity questionnaire (PSQ), the Pain Catastrophizing Scale (PCS), and the Neuroticism Extraversion Openness - Five Factor Inventory (NEO-FFI). Results In comparison to the LSP group, HSP individuals had higher scores of PSQ (p<0.001), catastrophizing (p=0.001), and extraversion (p=0.01). By adjusting for age and gender, mediation analyses revealed that catastrophizing mediated the relationship between neuroticism and pain sensitivity, both in the allocation of subjects to a certain group of sensitivity to pain (LSP or HSP, B=0.02 95% CI: 0.006–0.040) and in the PSQ score (B=0.01 95% CI: 0.001–0.023). Conclusion These results, which were demonstrated by two different prisms (CPT and PSQ), point to the potential of the five-factor inventory and pain catastrophizing scale as tools for identifying specific personality traits associated with a high sensitivity to pain.
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Affiliation(s)
- Hadas Grouper
- Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Elon Eisenberg
- The Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.,Institute of Pain Medicine, Rambam Health Care Campus, Haifa, Israel
| | - Dorit Pud
- Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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14
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Machingura T, Lloyd C, Murphy K, Goulder S, Shum D, Green AH. Views about sensory modulation from people with schizophrenia and treating staff: A multisite qualitative study. Br J Occup Ther 2021. [DOI: 10.1177/0308022620988470] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Introduction Current non-pharmacological treatment options for people with schizophrenia are limited. There is, however, emerging evidence that sensory modulation can be beneficial for this population. This study aimed to gain insight into sensory modulation from the user’s and the treating staff’s perspectives. Method A qualitative content analysis design was used. Transcripts from occupational therapists ( n=11) and patients with schizophrenia ( n=13) derived from in-depth semi-structured interviews were analysed for themes using content analysis. Results Five themes emerged from this study: Service user education on the sensory approach is the key; A variety of tools should be tried; Sensory modulation provides a valued treatment option; There are challenges of managing perceived risk at an organisational level; and There is a shortage of accessible and effective training. Conclusion People with schizophrenia and treating staff had congruent perceptions regarding the use of sensory modulation as a treatment option. The findings suggest that sensory modulation can be a valued addition to treatment options for people with schizophrenia. We suggest further research on sensory modulation intervention effectiveness using quantitative methods so these results can be further explored.
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Affiliation(s)
- Tawanda Machingura
- Bond University, Gold Coast, Queensland, Australia
- Griffith University, School of Applied Psychology, Gold Coast Campus, Queensland, Australia
| | - Chris Lloyd
- Griffith University, School of Applied Psychology, Gold Coast Campus, Queensland, Australia
| | - Karen Murphy
- Griffith University, School of Applied Psychology, Gold Coast Campus, Queensland, Australia
| | | | - David Shum
- Griffith University, School of Applied Psychology, Gold Coast Campus, Queensland, Australia
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - and Heather Green
- Griffith University, School of Applied Psychology, Gold Coast Campus, Queensland, Australia
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15
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Crofton E, Meredith P, Gray P, Strong J. Compression garment wear and sensory variables after burn: a single-site study. Burns 2020; 46:1903-1913. [DOI: 10.1016/j.burns.2020.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 05/13/2020] [Accepted: 06/06/2020] [Indexed: 11/28/2022]
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16
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Bar-Shalita T, Ben-Ziv N, Granovsky Y, Weissman-Fogel I. An Exploratory Study Testing Autonomic Reactivity to Pain in Women with Sensory Over-Responsiveness. Brain Sci 2020; 10:E819. [PMID: 33167362 PMCID: PMC7694392 DOI: 10.3390/brainsci10110819] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/30/2020] [Accepted: 11/03/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Difficulty modulating sensory input related to multi-sensory integration dysfunction, specifically the sensory over-responsive (SOR) type, is associated with psychological distress and hyperalgesia in children and adults. Scares reports suggest atypical autonomic nervous system (ANS) reactivity to innocuous sensory stimuli in children with SOR. Thus, the ANS may contribute to sensory stimuli responses and psychological distress. This exploratory study aimed to characterize the ANS reactivity to single and dual pain stimulation, and in relation to psychological distress in adults with SOR. METHODS Healthy women with SOR (n = 9) vs. without SOR (n = 9) underwent two runs of single pain stimulation and a third run comprised of dual pain stimulation. Pain was self-rated, while heart rate variability was measured and analyzed in the time and frequency domains. In addition, questionnaires assessing anxiety and somatization were utilized. RESULTS While controls demonstrated a vagal tone withdrawal (root mean square of successive differences in R-R-intervals; (RMSSD)) p = 0.029 from base-line to the third run, this was absent in the SOR group. However, no group differences were found in pain ratings. Furthermore, groups differed in the correlations between R-R mean and the level of both anxiety (p = 0.006) and somatization (p < 0.001); while in the SOR group, higher levels of anxiety and somatization correlated with shorter R-R intervals, the opposite was found in the control group. CONCLUSIONS This is the first study to demonstrate in women with SOR atypical vagal tone reactivity to challenging pain load. Vagal tone reactivity is related to both pain ratings and psychological distress.
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Affiliation(s)
- Tami Bar-Shalita
- Department of Occupational Therapy, School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (T.B.-S.); (N.B.-Z.)
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Nurit Ben-Ziv
- Department of Occupational Therapy, School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (T.B.-S.); (N.B.-Z.)
| | - Yelena Granovsky
- Department of Neurology, Rambam Health Care Campus and the Laboratory of Clinical Neurophysiology, Faculty of Medicine, Technion, Haifa 3525433, Israel;
| | - Irit Weissman-Fogel
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa 3498838, Israel
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17
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Assayag N, Bonneh Y, Parush S, Mell H, Kaplan Neeman R, Bar-Shalita T. Perceived Sensitivity to Pain and Responsiveness to Non-noxious Sensation in Substance Use Disorder. PAIN MEDICINE 2020; 21:1902-1912. [PMID: 31782772 DOI: 10.1093/pm/pnz292] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This comparative cross-sectional study aimed to characterize individuals with substance use disorder (SUD) in self-perception of pain sensitivity, experimental auditory aversiveness, and non-noxious sensory responsiveness, as well as examine the associations with SUD. METHODS Therapeutic community (TC) individuals with SUD (N = 63, male 88.9%) and healthy controls (N = 60, male 86.7%) completed the Pain Sensitivity Questionnaire (PSQ) and the Sensory Responsiveness Questionnaire-Intensity Scale (SRQ-IS), followed by a psychophysical auditory battery, the Battery of Averseness to Sounds (BAS)-Revised. RESULTS The SUD group scored higher on the PSQ (P < 0.0001), BAS-R aversiveness (P < 0.0001), BAS-R-unpleasantness (P < 0.0001), and on the aftersensation of auditory aversiveness (P < 0.0001) and unpleasantness (P < 0.000). Fifty-four percent of the SUD group vs 11.7% of the control group were identified as having sensory modulation dysfunction (SMD; P < 0.0001). Logistic regression modeling revealed that the SRQ-IS-Aversive score had a stronger relationship, indicating a 12.6-times odds ratio for SUD (P = 0.0002). Finally, a risk score calculated from a linear combination of the logistic regression model parameters is presented based on the PSQ and SRQ. CONCLUSIONS This is the first study to explore sensory and aversive domains using experimental and self-reporting in situ, revealing pain perception alteration that co-occurs with high prevalence of SMD, specifically of the over-responsive type. Findings may be significant in clinical practice for treating pain, and for expanding therapeutic modalities as part of broader rehabilitation in TC and beyond, to better meet personalized therapy.
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Affiliation(s)
- Naama Assayag
- Faculty of Medicine, School of Occupational Therapy, Hadassah and Hebrew University, Jerusalem, Israel
| | - Yoram Bonneh
- School of Optometry and Vision Science, Mina & Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel
| | - Shula Parush
- Faculty of Medicine, School of Occupational Therapy, Hadassah and Hebrew University, Jerusalem, Israel
| | - Haim Mell
- Yezreel Valley College, Afula, Israel
| | - Ricky Kaplan Neeman
- Department of Communication Disorders, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tami Bar-Shalita
- Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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18
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Kuperman P, Granovsky Y, Bahouth H, Fadel S, Ben Lulu H, Bosak N, Buxbaum C, Sprecher E, Crystal S, Granot M. Explaining very early acute mild traumatic brain injury after motor vehicle collision pain variability: additive value of pain sensitivity questionnaire. Pain Rep 2020; 5:e821. [PMID: 32903910 PMCID: PMC7447377 DOI: 10.1097/pr9.0000000000000821] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 04/03/2020] [Accepted: 04/04/2020] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES Chronic pain is a common postcollision consequence. Wherein, a clearer understanding of acute pain can help stem the acute-to-chronic pain transition. However, the variability of acute pain is only partially explained by psychophysical pain characteristics as measured by quantitative sensory testing. The Pain Sensitivity Questionnaire (PSQ) may reflect inherent psychocognitive representations of patient's sensitivity and thus may reveal less-explored pain dimensions. In the vein of the biopsychosocial approach, this study aimed to explore whether PSQ holds additive value in explaining head and neck pain reports in very early acute-stage mild traumatic brain injury (mTBI) after collision, above the use of psychophysical assessment. METHODS Study cohort (n = 130) consisted of mTBI patients (age range 19-66, 57 F) after accident with area-of-injury pain of at least 20 on the day of testing (mean pain 58.4 ± 21.6, range 20-100 Numerical Pain Scale) who underwent clinical, psychophysical, and pain-related psychological assessment within 72-hour after injury. RESULTS Pain Sensitivity Questionnaire scores were significantly correlated with acute clinical, psychophysical, and pain-related psychological measures. Regression model (R 2 = 0.241, P < 0.001) showed that, together, age, sex, high PSQ, enhanced temporal summation, and less-efficient conditioned pain modulation explained head and neck pain variance. This model demonstrated that the strongest contribution to degree of postinjury pain was independently explained by PSQ (ß = 0.32) and then pressure pain threshold-conditioned pain modulation (ß = -0.25). CONCLUSION Appraisal of cognitive daily-pain representations, by way of memory and imagination, provides an additional important dispositional facet to explain the variability in the acute mTBI postcollision clinical pain experience, above assessing nociceptive responsiveness to experimentally induced pain.
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Affiliation(s)
- Pora Kuperman
- Faculty of Medicine, Technion—Israel Institute of Technology, Haifa, Israel
| | - Yelena Granovsky
- Faculty of Medicine, Technion—Israel Institute of Technology, Haifa, Israel
| | - Hany Bahouth
- Trauma and Emergency Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Shiri Fadel
- Faculty of Medicine, Technion—Israel Institute of Technology, Haifa, Israel
| | - Hen Ben Lulu
- Trauma and Emergency Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Noam Bosak
- Department of Neurology, Rambam Health Care Campus, Haifa, Israel
| | - Chen Buxbaum
- Department of Neurology, Rambam Health Care Campus, Haifa, Israel
| | - Elliot Sprecher
- Department of Neurology, Rambam Health Care Campus, Haifa, Israel
| | - Shoshana Crystal
- Faculty of Medicine, Technion—Israel Institute of Technology, Haifa, Israel
| | - Michal Granot
- Faculty of Welfare and Health Sciences, University of Haifa, Haifa, Israel
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19
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Sinclair C, Meredith P, Strong J. Pediatric Persistent Pain: Associations Among Sensory Modulation, Attachment, Functional Disability, and Quality of Life. Am J Occup Ther 2020; 74:7402205040p1-7402205040p11. [PMID: 32204782 DOI: 10.5014/ajot.2020.033308] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Although attachment is associated with sensory modulation among children and adolescents and insecure attachment is associated with pain severity among adolescents, relationships among sensory modulation, attachment, and function have not previously been demonstrated in a clinical sample of children and adolescents with complex persistent pain. OBJECTIVE To investigate relationships among sensory modulation, attachment, function, and quality of life (QOL) in a pediatric population with persistent pain. DESIGN Cross-sectional quantitative design. From October 2015 to July 2017, all children, adolescents, and parents attending a clinic for assessment completed questionnaires and were provided information and consent forms. Those who consented completed sensory modulation and attachment questionnaires. SETTING Tertiary pain management clinic. PARTICIPANTS Children (ages 8-12 yr) and adolescents (ages 13-18 yr) with persistent pain (pain of >3 mo duration or a specific pain disorder) and the capacity to answer questionnaires independently. MEASURES Standardized sensory modulation, attachment, pain intensity, functional disability, and QOL questionnaires. Hypotheses were generated before data collection. RESULTS Of 152 children and adolescents, 114 children (30 girls, 9 boys) and adolescents (68 girls, 7 boys) met study criteria and consented to participate. Hierarchical multiple regression analyses revealed that sensory sensitivity predicted disability for children and adolescents, and attachment anxiety mediated the relationship between low registration and poorer school-related QOL. CONCLUSION AND RELEVANCE Behaviors related to insecure attachment patterns provide a mediating pathway from sensory modulation to functional disability; addressing such behaviors clinically may facilitate engagement in daily activities for children and adolescents with persistent pain. WHAT THIS ARTICLE ADDS Results support the need to consider the interactions between sensory modulation and attachment when addressing functional abilities with occupational therapy treatment.
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Affiliation(s)
- Cate Sinclair
- Cate Sinclair, B. App Sci. O.T., M. Art Therapy, PhD, is Director, Allied Services, Pain Specialists Australia, Richmond, Victoria, Australia, and Honorary Member, Murdoch Children's Research Institute, Parkville, Victoria, Australia;
| | - Pamela Meredith
- Pamela Meredith, PhD, is Head of Occupational Therapy, School of Health, Medical and Applied Sciences, University of Central Queensland, Rockhampton, Queensland, Australia
| | - Jenny Strong
- Jenny Strong, PhD, is Emeritus Professor, School of Health and Rehabilitation, University of Queensland, Brisbane, Queensland, Australia
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20
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Bar-Shalita T, Cermak SA. Multi-sensory Responsiveness and Personality Traits Predict Daily Pain Sensitivity. Front Integr Neurosci 2020; 13:77. [PMID: 31998087 PMCID: PMC6966329 DOI: 10.3389/fnint.2019.00077] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 12/19/2019] [Indexed: 11/23/2022] Open
Abstract
Background: A continuous effort has been devoted to identifying factors that contribute to individual differences in pain perception. Amongst the personality traits, Neuroticism is assumed to be the most significant moderator of experimental and clinical pain. Multi-sensory responsiveness to daily sensations has been shown to be associated with pain perception. Yet, neither the relationship between personality traits and multi-sensory responsiveness nor the impact of both these factors to pain perception have been examined. Thus, this study aims to explore the contribution of both multi-sensory responsiveness and personality traits to pain perception in a daily context. Methods: A community-based sample of 204 adults completed the Sensory Responsiveness Questionnaire-Intensity Scale (SRQ-IS); the Big Five Inventory (BFI); and the Pain Sensitivity Questionnaire (PSQ). Results: The partial eta-square demonstrated that the SRQ-IS Aversive sub-scale score had the strongest relationship with the PSQ-Total score, accounting for 9% of the variation. The regression coefficient relating PSQ-Total score with SRQ-IS Aversive, and BFI sub-scales of Extraversion, Neuroticism and Openness-to-Experience scores was found to be r = 0.39 (p < 0.0001), accounting for 16% of the variance, and yielding a large effect size. Discussion: To the best of our knowledge this is the first study to report on the interplay between aversive responsiveness to daily sensations and personality traits of Neuroticism, Openness-to-Experience, and Extraversion as contributing factors to daily pain sensitivity, amongst which aversive responsiveness was found as the major contributing factor. This study may broaden the understanding of the pain experience variability, both in practice and in experimental research.
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Affiliation(s)
- Tami Bar-Shalita
- Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sharon A Cermak
- Chan Division of Occupational Science and Occupational Therapy at the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, United States.,Department of Pediatrics, USC Keck School of Medicine, Los Angeles, CA, United States
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21
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Labuschagne E, van Niekerk M. Sensory processing of women diagnosed with genito-pelvic pain/penetration disorder: a research proposal. BMC Res Notes 2019; 12:577. [PMID: 31519220 PMCID: PMC6743158 DOI: 10.1186/s13104-019-4612-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 09/06/2019] [Indexed: 12/03/2022] Open
Abstract
Objectives The study objectives are to describe the sensory processing patterns of women diagnosed with genito-pelvic pain/penetration disorder (GPPPD), to explore the level of anxiety when both GPPPD and sensory processing disorder (SPD) are present and to investigate participants’ experience of participating in a sensory-based home programme. Methods A descriptive two-phased study design will be used. Phase one is a quantitative, cross sectional non-experimental descriptive study, using the Adolescent/Adult Sensory History (ASH) and Hospital Anxiety and Depression Scales (HADS) to obtain data from purposive sampling. Phase two is an exploratory qualitative study involving participants who were identified with SPD in phase one. They will participate in a sensory-based home programme and their experience thereof will be established during semi-structured interviews. Outcomes Descriptive studies are known to be useful in planning health services and to develop hypotheses for future testing. This study could improve practitioners’ understanding of GPPPD and SPD and make alternative, non-invasive, non-pharmacological treatment options available to better assist these patients. The study could further clarify the role of the occupational therapist in sexuality. Exploring participants’ anxiety has important implications for treatment protocols in occupational therapy and assisting in describing the signs and symptoms of GPPPD.
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Affiliation(s)
- Elsie Labuschagne
- Department of Occupational Therapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of Witwatersrand, 7 York Road, Johannesburg, 2193, South Africa.
| | - Matty van Niekerk
- Department of Occupational Therapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of Witwatersrand, 7 York Road, Johannesburg, 2193, South Africa
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22
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Kalig-Amir M, Berger I, Rigbi A, Bar-Shalita T. An exploratory study of parent-child association in sensory modulation disorder involving ADHD-related symptoms. Pediatr Res 2019; 86:221-226. [PMID: 30986817 DOI: 10.1038/s41390-019-0397-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 04/07/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Sensory modulation disorder (SMD) and attention deficit hyperactivity disorder (ADHD) can co-occur and have overlapping symptoms, thus challenging practitioners. This study aimed to phenotypically explore parent-child associations in SMD, and the interplay between SMD- and ADHD-related symptoms in children with SMD and their parents. METHODS A cross-sectional study examined 70 parents (n = 35 mothers; n = 35 fathers) and their 35 children with and without SMD, aged 4-6 years. Parents completed care-giver reports: The Short Sensory Profile (SSP) and the ADHD Rating Scale, and self-reports: The Sensory Responsiveness Questionnaire (SRQ) and the ADHD Self-Report Scale (ASRS). RESULTS In the entire sample, we found a mother-offspring correlation between SSP and SRQ-Aversive scores (rs = -0.68; p < 0.001), but no such father-offspring correlation. However, when testing the ADHD Rating Scale and ASRS scores, we found correlations between mothers and offspring (rs = 0.54, p = 0.0008), and between fathers and offspring (rs = 0.34, p = 0.0494). In the entire sample a high correlation was found between SSP and ADHD Rating Scale scores (rs = -0.837, p < 0.001). We further found a high correlation in mothers (rs = 0.70, p < 0.001), and a moderate correlation in fathers (rs = 0.40, p = 0.019) between SRQ-Aversive and ASRS scores. CONCLUSIONS Novel findings reveal that parents-offspring heritability patterns differ in both these related conditions. These may contribute to familial practice and research.
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Affiliation(s)
- Merav Kalig-Amir
- Child Development Unit, Clalit Health Services, Jerusalem, Israel
| | - Itai Berger
- Pediatric Neurology Service, Pediatric Division, Asssuta Ashdod University Hospital Faculty of Health Sciences, Ben-Gurion University, Beer-Sheba, Israel
| | - Amihai Rigbi
- Faculty of Education, Beit-Berl Academic College, Kfar Saba, Israel
| | - Tami Bar-Shalita
- Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. .,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
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Bar-Shalita T, Granovsky Y, Parush S, Weissman-Fogel I. Sensory Modulation Disorder (SMD) and Pain: A New Perspective. Front Integr Neurosci 2019; 13:27. [PMID: 31379526 PMCID: PMC6659392 DOI: 10.3389/fnint.2019.00027] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 07/01/2019] [Indexed: 01/17/2023] Open
Abstract
Sensory modulation disorder (SMD) affects sensory processing across single or multiple sensory systems. The sensory over-responsivity (SOR) subtype of SMD is manifested clinically as a condition in which non-painful stimuli are perceived as abnormally irritating, unpleasant, or even painful. Moreover, SOR interferes with participation in daily routines and activities (Dunn, 2007; Bar-Shalita et al., 2008; Chien et al., 2016), co-occurs with daily pain hyper-sensitivity, and reduces quality of life due to bodily pain. Laboratory behavioral studies have confirmed abnormal pain perception, as demonstrated by hyperalgesia and an enhanced lingering painful sensation, in children and adults with SMD. Advanced quantitative sensory testing (QST) has revealed the mechanisms of altered pain processing in SOR whereby despite the existence of normal peripheral sensory processing, there is enhanced facilitation of pain-transmitting pathways along with preserved but delayed inhibitory pain modulation. These findings point to central nervous system (CNS) involvement as the underlying mechanism of pain hypersensitivity in SOR. Based on the mutual central processing of both non-painful and painful sensory stimuli, we suggest shared mechanisms such as cortical hyper-excitation, an excitatory-inhibitory neuronal imbalance, and sensory modulation alterations. This is supported by novel findings indicating that SOR is a risk factor and comorbidity of chronic non-neuropathic pain disorders. This is the first review to summarize current empirical knowledge investigating SMD and pain, a sensory modality not yet part of the official SMD realm. We propose a neurophysiological mechanism-based model for the interrelation between pain and SMD. Embracing the pain domain could significantly contribute to the understanding of this condition’s pathogenesis and how it manifests in daily life, as well as suggesting the basis for future potential mechanism-based therapies.
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Affiliation(s)
- Tami Bar-Shalita
- Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Yelena Granovsky
- Laboratory of Clinical Neurophysiology, Department of Neurology, Faculty of Medicine, Technion-Israel Institute of Technology, Rambam Health Care Campus, Haifa, Israel
| | - Shula Parush
- School of Occupational Therapy, Faculty of Medicine of Hadassah, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Irit Weissman-Fogel
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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24
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Granovsky Y, Weissman-Fogel I, Bar-Shalita T. Resting-State Electroencephalography in Participants With Sensory Overresponsiveness: An Exploratory Study. Am J Occup Ther 2019; 73:7301205100p1-7301205100p11. [PMID: 30839265 DOI: 10.5014/ajot.2019.029231] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE People with sensory overresponsiveness (SOR) perceive nonpainful stimuli as noxious and demonstrate hyperalgesia and lingering sensation to laboratory pain stimuli. Electroencephalography (EEG) of cortical activity at rest is widely used to explore endophenotypes but has not yet been tested in people with SOR. Therefore, we investigated the characteristics of resting-state EEG in participants with SOR. METHOD Resting-state EEG (5-min, eyes-closed recording) was compared in participants with (n = 9) and without (n = 12) SOR. RESULTS Participants with SOR demonstrated a global reduction of the EEG activity, including significantly lower θ and α1 activity as well as faster peak α frequency. Higher sensory-responsiveness scores were associated with high peak α power in participants without SOR. CONCLUSION Reduced α activity is commonly interpreted as an electrophysiological indicator of arousal and sensitivity to pain. The EEG pattern of response may partly explain the reported ongoing daily alertness to environmental stimuli in participants with SOR.
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Affiliation(s)
- Yelena Granovsky
- Yelena Granovsky, PhD, is Senior Lecturer, Rambam Health Care Campus, Haifa, Israel, and Technion Medical Faculty, Haifa, Israel
| | - Irit Weissman-Fogel
- Irit Weissman-Fogel, PhD, is Senior Lecturer, University of Haifa, Haifa, Israel
| | - Tami Bar-Shalita
- Tami Bar-Shalita, PhD, is Lecturer, Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel;
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Mazor-Karsenty T, Shalev L, Parush S, Bonneh Y. Perception of Aversive Auditory Stimuli Is Different in Sensory Modulation Disorder and Attention Deficit Hyperactivity Disorder. Am J Occup Ther 2018; 72:7206205020p1-7206205020p8. [DOI: 10.5014/ajot.2018.022327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Tal Mazor-Karsenty
- Tal Mazor-Karsenty, PhD, OT, is Teaching Fellow, School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel;
| | - Lilach Shalev
- Lilach Shalev, PhD, is Professor, School of Education and School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Shula Parush
- Shula Parush, PhD, OT, is Professor Emeritus, School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yoram Bonneh
- Yoram Bonneh, PhD, is Visiting Scientist, Department of Optometry and Vision Science, Bar-Ilan University, Tel Aviv, Israel
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Bar-Shalita T, Livshitz A, Levin-Meltz Y, Rand D, Deutsch L, Vatine JJ. Sensory modulation dysfunction is associated with Complex Regional Pain Syndrome. PLoS One 2018; 13:e0201354. [PMID: 30091986 PMCID: PMC6084887 DOI: 10.1371/journal.pone.0201354] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 07/14/2018] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Complex Regional Pain Syndrome (CRPS), a chronic pain condition, develops mainly after limb trauma and severely inhibits function. While early diagnosis is essential, factors for CRPS onset are elusive. Therefore, identifying those at risk is crucial. Sensory modulation dysfunction (SMD), affects the capacity to regulate responses to sensory input in a graded and adaptive manner and was found associated with hyperalgesia in otherwise healthy individuals, suggestive of altered pain processing. AIM To test SMD as a potential risk factor for CRPS. METHODS In this cross-sectional study, forty-four individuals with CRPS (29.9±11 years, 27 men) and 204 healthy controls (27.4±3.7 years, 105 men) completed the Sensory Responsiveness Questionnaire-Intensity Scale (SRQ-IS). A physician conducted the CRPS Severity Score (CSS), testing individuals with CRPS. RESULTS Thirty-four percent of the individuals with CRPS and twelve percent of the healthy individuals were identified to have SMD (χ2 (1) = 11.95; p<0.001). Logistic regression modeling revealed that the risk of CRPS is 2.68 and 8.21 times higher in individuals with sensory over- and sensory under-responsiveness, respectively, compared to non-SMD individuals (p = 0.03 and p = 0.01, respectively). CONCLUSIONS SMD, particularly sensory under-responsiveness, might serve as a potential risk factor for CRPS and therefore screening for SMD is recommended. This study provides the risk index probability clinical tool a simple evaluation to be applied by clinicians in order to identify those at risk for CRPS immediately after injury. Further research is needed.
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Affiliation(s)
- Tami Bar-Shalita
- Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Anatoly Livshitz
- Center for Rehabilitation of Pain Syndromes, Reuth Rehabilitation Hospital, Tel Aviv, Israel
| | - Yulia Levin-Meltz
- Center for Rehabilitation of Pain Syndromes, Reuth Rehabilitation Hospital, Tel Aviv, Israel
| | - Debbie Rand
- Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Lisa Deutsch
- BioStats Statistical Consulting Ltd, Modiin, Israel
| | - Jean-Jacques Vatine
- Center for Rehabilitation of Pain Syndromes, Reuth Rehabilitation Hospital, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Kuperman P, Granovsky Y, Granot M, Bahouth H, Fadel S, Hyams G, Ben Lulu H, Aspis O, Salame R, Begal J, Hochstein D, Grunner S, Honigman L, Reshef M, Sprecher E, Bosak N, Sterling M, Yarnitsky D. Psychophysic-psychological dichotomy in very early acute mTBI pain: A prospective study. Neurology 2018; 91:e931-e938. [PMID: 30068635 DOI: 10.1212/wnl.0000000000006120] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 06/06/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To characterize the pain-related somatosensory and psychological presentation of very early acute patients with a mild traumatic brain injury (mTBI). METHODS Patients with an mTBI participated in a prospective observational study undergoing clinical, psychophysic, and psychological assessment within 72 hours after the accident. Healthy controls underwent similar protocol. RESULTS One hundred acute patients with an mTBI (age 36 ± 12.5 [SD] years, range 19-67 years, 42 women) and 80 healthy controls (age 43 ± 14.3 years, range 24-74 years, 40 women) participated. Patients with an mTBI demonstrated a pronociceptive psychophysic response in most tests such as less efficient pressure-pain threshold-conditioned pain modulation (0.19 ±0.19±.09 vs. 0.91±.10 kg, p < 0.001) and lower temperature needed to elicit a Pain50 response (44.72 ± 0.26°C vs 46.41 ± 0.30°C, p < 0.001). Their psychophysic findings correlated with clinical pain measures, e.g., Pain50 temperature and mean head (r = -0.21, p = 0.045) and neck (r = -0.26, p = 0.011) pain. The pain-catastrophizing magnification subscale was the only psychological variable to show a difference from the controls, while no significant correlations were found between any psychological measures and the clinical or psychophysic pain measures. CONCLUSIONS There appears to be a dichotomy between somatosensory and psychological findings in the very early acute post-mTBI stage; while the first is altered and is associated with the clinical picture, the second is unchanged. In the context of the ongoing debate on the pathophysiologic nature of the post-mTBI syndrome, our findings support its "physical" basis, free of mental influence, at least in the short time window after the injury.
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Affiliation(s)
- Pora Kuperman
- From the Faculty of Medicine (P.K., Y.G., S.F., L.H., M.R.), Technion-Israel Institute of Technology; Department of Nursing (M.G.), Faculty of Welfare and Health Sciences, University of Haifa; TraumaEmergency Surgery (H.B., H.B.L.), Nursing (G.H.), ICU (O.A.), Department of Emergency Medicine (R.S.), General Surgery Department (J.B., D.H., S.G.), Department of Neurology (E.S., N.B., D.Y.), and Faculty of Medicine (D.Y.), Rambam Health Care Campus, Haifa, Israel; and RECOVER Injury Research Centre (M.S.), NHMRC Centre of Research Excellence in Road Traffic Injury Recovery, University of Queensland, Brisbane, Australia
| | - Yelena Granovsky
- From the Faculty of Medicine (P.K., Y.G., S.F., L.H., M.R.), Technion-Israel Institute of Technology; Department of Nursing (M.G.), Faculty of Welfare and Health Sciences, University of Haifa; TraumaEmergency Surgery (H.B., H.B.L.), Nursing (G.H.), ICU (O.A.), Department of Emergency Medicine (R.S.), General Surgery Department (J.B., D.H., S.G.), Department of Neurology (E.S., N.B., D.Y.), and Faculty of Medicine (D.Y.), Rambam Health Care Campus, Haifa, Israel; and RECOVER Injury Research Centre (M.S.), NHMRC Centre of Research Excellence in Road Traffic Injury Recovery, University of Queensland, Brisbane, Australia
| | - Michal Granot
- From the Faculty of Medicine (P.K., Y.G., S.F., L.H., M.R.), Technion-Israel Institute of Technology; Department of Nursing (M.G.), Faculty of Welfare and Health Sciences, University of Haifa; TraumaEmergency Surgery (H.B., H.B.L.), Nursing (G.H.), ICU (O.A.), Department of Emergency Medicine (R.S.), General Surgery Department (J.B., D.H., S.G.), Department of Neurology (E.S., N.B., D.Y.), and Faculty of Medicine (D.Y.), Rambam Health Care Campus, Haifa, Israel; and RECOVER Injury Research Centre (M.S.), NHMRC Centre of Research Excellence in Road Traffic Injury Recovery, University of Queensland, Brisbane, Australia
| | - Hany Bahouth
- From the Faculty of Medicine (P.K., Y.G., S.F., L.H., M.R.), Technion-Israel Institute of Technology; Department of Nursing (M.G.), Faculty of Welfare and Health Sciences, University of Haifa; TraumaEmergency Surgery (H.B., H.B.L.), Nursing (G.H.), ICU (O.A.), Department of Emergency Medicine (R.S.), General Surgery Department (J.B., D.H., S.G.), Department of Neurology (E.S., N.B., D.Y.), and Faculty of Medicine (D.Y.), Rambam Health Care Campus, Haifa, Israel; and RECOVER Injury Research Centre (M.S.), NHMRC Centre of Research Excellence in Road Traffic Injury Recovery, University of Queensland, Brisbane, Australia
| | - Shiri Fadel
- From the Faculty of Medicine (P.K., Y.G., S.F., L.H., M.R.), Technion-Israel Institute of Technology; Department of Nursing (M.G.), Faculty of Welfare and Health Sciences, University of Haifa; TraumaEmergency Surgery (H.B., H.B.L.), Nursing (G.H.), ICU (O.A.), Department of Emergency Medicine (R.S.), General Surgery Department (J.B., D.H., S.G.), Department of Neurology (E.S., N.B., D.Y.), and Faculty of Medicine (D.Y.), Rambam Health Care Campus, Haifa, Israel; and RECOVER Injury Research Centre (M.S.), NHMRC Centre of Research Excellence in Road Traffic Injury Recovery, University of Queensland, Brisbane, Australia
| | - Gila Hyams
- From the Faculty of Medicine (P.K., Y.G., S.F., L.H., M.R.), Technion-Israel Institute of Technology; Department of Nursing (M.G.), Faculty of Welfare and Health Sciences, University of Haifa; TraumaEmergency Surgery (H.B., H.B.L.), Nursing (G.H.), ICU (O.A.), Department of Emergency Medicine (R.S.), General Surgery Department (J.B., D.H., S.G.), Department of Neurology (E.S., N.B., D.Y.), and Faculty of Medicine (D.Y.), Rambam Health Care Campus, Haifa, Israel; and RECOVER Injury Research Centre (M.S.), NHMRC Centre of Research Excellence in Road Traffic Injury Recovery, University of Queensland, Brisbane, Australia
| | - Hen Ben Lulu
- From the Faculty of Medicine (P.K., Y.G., S.F., L.H., M.R.), Technion-Israel Institute of Technology; Department of Nursing (M.G.), Faculty of Welfare and Health Sciences, University of Haifa; TraumaEmergency Surgery (H.B., H.B.L.), Nursing (G.H.), ICU (O.A.), Department of Emergency Medicine (R.S.), General Surgery Department (J.B., D.H., S.G.), Department of Neurology (E.S., N.B., D.Y.), and Faculty of Medicine (D.Y.), Rambam Health Care Campus, Haifa, Israel; and RECOVER Injury Research Centre (M.S.), NHMRC Centre of Research Excellence in Road Traffic Injury Recovery, University of Queensland, Brisbane, Australia
| | - Osnat Aspis
- From the Faculty of Medicine (P.K., Y.G., S.F., L.H., M.R.), Technion-Israel Institute of Technology; Department of Nursing (M.G.), Faculty of Welfare and Health Sciences, University of Haifa; TraumaEmergency Surgery (H.B., H.B.L.), Nursing (G.H.), ICU (O.A.), Department of Emergency Medicine (R.S.), General Surgery Department (J.B., D.H., S.G.), Department of Neurology (E.S., N.B., D.Y.), and Faculty of Medicine (D.Y.), Rambam Health Care Campus, Haifa, Israel; and RECOVER Injury Research Centre (M.S.), NHMRC Centre of Research Excellence in Road Traffic Injury Recovery, University of Queensland, Brisbane, Australia
| | - Rabia Salame
- From the Faculty of Medicine (P.K., Y.G., S.F., L.H., M.R.), Technion-Israel Institute of Technology; Department of Nursing (M.G.), Faculty of Welfare and Health Sciences, University of Haifa; TraumaEmergency Surgery (H.B., H.B.L.), Nursing (G.H.), ICU (O.A.), Department of Emergency Medicine (R.S.), General Surgery Department (J.B., D.H., S.G.), Department of Neurology (E.S., N.B., D.Y.), and Faculty of Medicine (D.Y.), Rambam Health Care Campus, Haifa, Israel; and RECOVER Injury Research Centre (M.S.), NHMRC Centre of Research Excellence in Road Traffic Injury Recovery, University of Queensland, Brisbane, Australia
| | - Julia Begal
- From the Faculty of Medicine (P.K., Y.G., S.F., L.H., M.R.), Technion-Israel Institute of Technology; Department of Nursing (M.G.), Faculty of Welfare and Health Sciences, University of Haifa; TraumaEmergency Surgery (H.B., H.B.L.), Nursing (G.H.), ICU (O.A.), Department of Emergency Medicine (R.S.), General Surgery Department (J.B., D.H., S.G.), Department of Neurology (E.S., N.B., D.Y.), and Faculty of Medicine (D.Y.), Rambam Health Care Campus, Haifa, Israel; and RECOVER Injury Research Centre (M.S.), NHMRC Centre of Research Excellence in Road Traffic Injury Recovery, University of Queensland, Brisbane, Australia
| | - David Hochstein
- From the Faculty of Medicine (P.K., Y.G., S.F., L.H., M.R.), Technion-Israel Institute of Technology; Department of Nursing (M.G.), Faculty of Welfare and Health Sciences, University of Haifa; TraumaEmergency Surgery (H.B., H.B.L.), Nursing (G.H.), ICU (O.A.), Department of Emergency Medicine (R.S.), General Surgery Department (J.B., D.H., S.G.), Department of Neurology (E.S., N.B., D.Y.), and Faculty of Medicine (D.Y.), Rambam Health Care Campus, Haifa, Israel; and RECOVER Injury Research Centre (M.S.), NHMRC Centre of Research Excellence in Road Traffic Injury Recovery, University of Queensland, Brisbane, Australia
| | - Shahar Grunner
- From the Faculty of Medicine (P.K., Y.G., S.F., L.H., M.R.), Technion-Israel Institute of Technology; Department of Nursing (M.G.), Faculty of Welfare and Health Sciences, University of Haifa; TraumaEmergency Surgery (H.B., H.B.L.), Nursing (G.H.), ICU (O.A.), Department of Emergency Medicine (R.S.), General Surgery Department (J.B., D.H., S.G.), Department of Neurology (E.S., N.B., D.Y.), and Faculty of Medicine (D.Y.), Rambam Health Care Campus, Haifa, Israel; and RECOVER Injury Research Centre (M.S.), NHMRC Centre of Research Excellence in Road Traffic Injury Recovery, University of Queensland, Brisbane, Australia
| | - Liat Honigman
- From the Faculty of Medicine (P.K., Y.G., S.F., L.H., M.R.), Technion-Israel Institute of Technology; Department of Nursing (M.G.), Faculty of Welfare and Health Sciences, University of Haifa; TraumaEmergency Surgery (H.B., H.B.L.), Nursing (G.H.), ICU (O.A.), Department of Emergency Medicine (R.S.), General Surgery Department (J.B., D.H., S.G.), Department of Neurology (E.S., N.B., D.Y.), and Faculty of Medicine (D.Y.), Rambam Health Care Campus, Haifa, Israel; and RECOVER Injury Research Centre (M.S.), NHMRC Centre of Research Excellence in Road Traffic Injury Recovery, University of Queensland, Brisbane, Australia
| | - Maya Reshef
- From the Faculty of Medicine (P.K., Y.G., S.F., L.H., M.R.), Technion-Israel Institute of Technology; Department of Nursing (M.G.), Faculty of Welfare and Health Sciences, University of Haifa; TraumaEmergency Surgery (H.B., H.B.L.), Nursing (G.H.), ICU (O.A.), Department of Emergency Medicine (R.S.), General Surgery Department (J.B., D.H., S.G.), Department of Neurology (E.S., N.B., D.Y.), and Faculty of Medicine (D.Y.), Rambam Health Care Campus, Haifa, Israel; and RECOVER Injury Research Centre (M.S.), NHMRC Centre of Research Excellence in Road Traffic Injury Recovery, University of Queensland, Brisbane, Australia
| | - Elliot Sprecher
- From the Faculty of Medicine (P.K., Y.G., S.F., L.H., M.R.), Technion-Israel Institute of Technology; Department of Nursing (M.G.), Faculty of Welfare and Health Sciences, University of Haifa; TraumaEmergency Surgery (H.B., H.B.L.), Nursing (G.H.), ICU (O.A.), Department of Emergency Medicine (R.S.), General Surgery Department (J.B., D.H., S.G.), Department of Neurology (E.S., N.B., D.Y.), and Faculty of Medicine (D.Y.), Rambam Health Care Campus, Haifa, Israel; and RECOVER Injury Research Centre (M.S.), NHMRC Centre of Research Excellence in Road Traffic Injury Recovery, University of Queensland, Brisbane, Australia
| | - Noam Bosak
- From the Faculty of Medicine (P.K., Y.G., S.F., L.H., M.R.), Technion-Israel Institute of Technology; Department of Nursing (M.G.), Faculty of Welfare and Health Sciences, University of Haifa; TraumaEmergency Surgery (H.B., H.B.L.), Nursing (G.H.), ICU (O.A.), Department of Emergency Medicine (R.S.), General Surgery Department (J.B., D.H., S.G.), Department of Neurology (E.S., N.B., D.Y.), and Faculty of Medicine (D.Y.), Rambam Health Care Campus, Haifa, Israel; and RECOVER Injury Research Centre (M.S.), NHMRC Centre of Research Excellence in Road Traffic Injury Recovery, University of Queensland, Brisbane, Australia
| | - Michele Sterling
- From the Faculty of Medicine (P.K., Y.G., S.F., L.H., M.R.), Technion-Israel Institute of Technology; Department of Nursing (M.G.), Faculty of Welfare and Health Sciences, University of Haifa; TraumaEmergency Surgery (H.B., H.B.L.), Nursing (G.H.), ICU (O.A.), Department of Emergency Medicine (R.S.), General Surgery Department (J.B., D.H., S.G.), Department of Neurology (E.S., N.B., D.Y.), and Faculty of Medicine (D.Y.), Rambam Health Care Campus, Haifa, Israel; and RECOVER Injury Research Centre (M.S.), NHMRC Centre of Research Excellence in Road Traffic Injury Recovery, University of Queensland, Brisbane, Australia
| | - David Yarnitsky
- From the Faculty of Medicine (P.K., Y.G., S.F., L.H., M.R.), Technion-Israel Institute of Technology; Department of Nursing (M.G.), Faculty of Welfare and Health Sciences, University of Haifa; TraumaEmergency Surgery (H.B., H.B.L.), Nursing (G.H.), ICU (O.A.), Department of Emergency Medicine (R.S.), General Surgery Department (J.B., D.H., S.G.), Department of Neurology (E.S., N.B., D.Y.), and Faculty of Medicine (D.Y.), Rambam Health Care Campus, Haifa, Israel; and RECOVER Injury Research Centre (M.S.), NHMRC Centre of Research Excellence in Road Traffic Injury Recovery, University of Queensland, Brisbane, Australia.
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Granovsky Y, Shor M, Shifrin A, Sprecher E, Yarnitsky D, Bar-Shalita T. Assessment of Responsiveness to Everyday Non-Noxious Stimuli in Pain-Free Migraineurs With Versus Without Aura. THE JOURNAL OF PAIN 2018; 19:943-951. [PMID: 29597079 DOI: 10.1016/j.jpain.2018.03.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 02/11/2018] [Accepted: 03/16/2018] [Indexed: 12/11/2022]
Abstract
Migraineurs with aura (MWA) express higher interictal response to non-noxious and noxious experimental sensory stimuli compared with migraineurs without aura (MWoA), but whether these differences also prevail in response to everyday non-noxious stimuli is not yet explored. This is a cross-sectional study testing 53 female migraineurs (30 MWA; 23 MWoA) who underwent a wide battery of noxious psychophysical testing at a pain-free phase, and completed a Sensory Responsiveness Questionnaire and pain-related psychological questionnaires. The MWA group showed higher questionnaire-based sensory over-responsiveness (P = .030), higher magnitude of pain temporal summation (P = .031) as well as higher monthly attack frequency (P = .027) compared with the MWoA group. Overall, 45% of migraineurs described abnormal sensory (hyper- or hypo-) responsiveness; its incidence was higher among MWA (19 of 30, 63%) versus MWoA (6 of 23, 27%, P = .012), with an odds ratio of 3.58 for MWA. Sensory responsiveness scores were positively correlated with attack frequency (r = .361, P = .008) and temporal summation magnitude (r = .390, P = .004), both regardless of migraine type. MWA express higher everyday sensory responsiveness than MWoA, in line with higher response to experimental noxious stimuli. Abnormal scores of sensory responsiveness characterize people with sensory modulation dysfunction, suggesting possible underlying mechanisms overlap, and possibly high incidence of both clinical entities. PERSPECTIVE This article presents findings distinguishing MWA, showing enhanced pain amplification, monthly attack frequency, and over-responsiveness to everyday sensations, compared with MWoA. Further, migraine is characterized by a high incidence of abnormal responsiveness to everyday sensation, specifically sensory over-responsiveness, that was also found related to pain.
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Affiliation(s)
- Yelena Granovsky
- Department of Neurology, Rambam Medical Center, Haifa, Israel; The Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
| | - Merav Shor
- Department of Neurology, Rambam Medical Center, Haifa, Israel
| | - Alla Shifrin
- Department of Neurology, Rambam Medical Center, Haifa, Israel; The Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Elliot Sprecher
- Department of Neurology, Rambam Medical Center, Haifa, Israel
| | - David Yarnitsky
- Department of Neurology, Rambam Medical Center, Haifa, Israel; The Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Tami Bar-Shalita
- Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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Weissman-Fogel I, Granovsky Y, Bar-Shalita T. Sensory Over-Responsiveness among Healthy Subjects is Associated with a Pronociceptive State. Pain Pract 2017; 18:473-486. [PMID: 28782305 DOI: 10.1111/papr.12619] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 07/28/2017] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Chronic pain patients show hypersensitivity to sensory nonpainful stimuli. Sensory over-responsiveness (SOR) to innocuous daily stimuli, experienced as painful, is prevalent in 10% of the healthy population. This altered sensory processing may be an expression of overfacilitation, or a less efficient pain-inhibitory process in the pain pathways. We therefore aimed to investigate specifically the pain-inhibitory system of subjects with SOR who are otherwise healthy, not studied as of yet. METHODS Thirty healthy subjects, divided into an SOR group (n = 14) and a non-SOR group (n = 16) based on responses to the Sensory Responsiveness Questionnaire, were psychophysically tested in order to evaluate (1) hyperalgesic responses; (2) adaptation/sensitization to 14 phasic heat stimuli; (3) habituation; (4) 6-minute after-sensations; and (5) conditioned pain modulation (CPM) (ie, phasic heat stimuli applied with and without hand immersion in a hot water bath). RESULTS The SOR group differed from the non-SOR group in (1) a steeper escalation in NPS ratings to temperature increase (P = 0.003), indicating hyperalgesia; (2) increased sensitization (P < 0.001); (3) habituation responses (P < 0.001); (4) enhanced pain ratings during the after-sensation (P = 0.006); and (5) no group difference was found in CPM. CONCLUSIONS SOR is associated with a pronociceptive state, expressed by amplification of experimental pain, yet with sufficient inhibitory processes. Our results support previous findings of enhanced facilitation of pain-transmitting pathways but also reveal preserved inhibitory mechanisms, although they were slower to react.
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Affiliation(s)
- Irit Weissman-Fogel
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Yelena Granovsky
- Department of Neurology, Rambam Health Care Campus and the Laboratory of Clinical Neurophysiology, Faculty of Medicine, Technion, Haifa, Israel
| | - Tami Bar-Shalita
- Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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Bar-Shalita T, Cermak SA. Atypical Sensory Modulation and Psychological Distress in the General Population. Am J Occup Ther 2016; 70:7004250010. [PMID: 27294988 DOI: 10.5014/ajot.2016.018648] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Atypical sensory modulation (ASM) is characterized by over- or underresponsiveness to sensory stimuli in one or more sensory systems. Faulty sensory information processing could result in anxiety. Because the relation between ASM and psychological distress has not been examined, we explored psychological distress and ASM in the general population. METHOD A community-based sample of 204 adults (105 men; mean age = 27.4 yr, standard deviation = 3.71) completed the Sensory Responsiveness Questionnaire--Intensity Scale (SRQ-IS; Bar-Shalita, Seltzer, Vatine, Yochman, & Parush, 2009); the Brief Symptom Inventory (BSI; Derogatis & Coons, 1993); and the Short Form--36 Health Survey, Version 2 (SF-36; Ware, Kosinski, & Gandek, 2005). RESULTS The ASM group displayed considerably more distress symptoms than the comparison group. Multivariate linear regression showed SRQ-IS and SF-36 scores as significant predictors of BSI score (r = .64). CONCLUSION ASM may be a risk factor for developing other mental health concerns.
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Affiliation(s)
- Tami Bar-Shalita
- Tami Bar-Shalita, PhD, OT, is Lecturer, Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine, and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel;
| | - Sharon A Cermak
- Sharon A. Cermak, EdD, OTR/L, is Professor, Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles
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