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Savitha D, Anto T, Thomas T. Effects of repeated exposures to experimental cold pain stimulus on pain perception in healthy young Indian men. Med J Armed Forces India 2022; 78:S238-S245. [PMID: 36147410 PMCID: PMC9485853 DOI: 10.1016/j.mjafi.2021.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/05/2021] [Indexed: 11/15/2022] Open
Abstract
Background The influence of repeated exposures to cold pain stimulus, a surrogate of clinical pain, has remained largely unexplored. The study was planned to test the effect of repeated exposures to cold pain through cold pressor task on pain sensitivity and vascular reactivity. Methods Single-group experimental study. Thirty-seven healthy male volunteers (18-25 years) were exposed to cold pressor tasks for seven consecutive days and on the 14th day on the nondominant hand. The same was repeated on dominant hand on first and seventh days; 31 completed the protocol. Results Pain threshold and tolerance in the nondominant hand increased from day 1 to day 7 (p < 0.001) and were positively correlated on day 1 ( ρ =0.45, p = 0.011) and day 7 ( ρ =0.38, p = 0.036). Diastolic blood pressure response was found to increase by day 7 (p < 0.0024) and positively correlated with tolerance. On the dominant hand, the threshold reduced from day 1 to day 7, while tolerance increased. Both threshold and tolerance remained lower than that of nondominant hand. Day 14 values of threshold and tolerance were in between day 1 and day 7 values but not significantly different from both. Conclusion Habituation in pain threshold and tolerance was observed on repeated exposure to cold pain, which was not significantly retained till the 14th day. The same was not observed with subjective feeling of pain perception. The increased diastolic blood pressure response is suggestive of peripheral vasoconstriction. Increased tolerance in the dominant hand by day 7 demonstrates a systemic effect in habituation.
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Affiliation(s)
- D. Savitha
- Associate Professor (Physiology), St John’s Medical College, St. John’s National Academy of Health Sciences, Bengaluru, India
| | - Taniya Anto
- Tutor/Lecturer (Physiology), St John’s Medical College, St. John’s National Academy of Health Sciences, Bengaluru, India
| | - Tinku Thomas
- Professor (Biostatistics), St John’s Medical College, St. John’s National Academy of Health Sciences, Bengaluru, India
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Candia-Rivera D, Catrambone V, Barbieri R, Valenza G. Functional assessment of bidirectional cortical and peripheral neural control on heartbeat dynamics: a brain-heart study on thermal stress. Neuroimage 2022; 251:119023. [PMID: 35217203 DOI: 10.1016/j.neuroimage.2022.119023] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 02/16/2022] [Accepted: 02/18/2022] [Indexed: 12/12/2022] Open
Abstract
The study of functional brain-heart interplay (BHI) from non-invasive recordings has gained much interest in recent years. Previous endeavors aimed at understanding how the two dynamical systems exchange information, providing novel holistic biomarkers and important insights on essential cognitive aspects and neural system functioning. However, the interplay between cardiac sympathovagal and cortical oscillations still has much room for further investigation. In this study, we introduce a new computational framework for a functional BHI assessment, namely the Sympatho-Vagal Synthetic Data Generation Model, combining cortical (electroencephalography, EEG) and peripheral (cardiac sympathovagal) neural dynamics. The causal, bidirectional neural control on heartbeat dynamics was quantified on data gathered from 26 human volunteers undergoing a cold-pressor test. Results show that thermal stress induces heart-to-brain functional interplay sustained by EEG oscillations in the delta and gamma bands, primarily originating from sympathetic activity, whereas brain-to-heart interplay originates over central brain regions through sympathovagal control. The proposed methodology provides a viable computational tool for the functional assessment of the causal interplay between cortical and cardiac neural control.
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Affiliation(s)
- Diego Candia-Rivera
- Bioengineering and Robotics Research Center E. Piaggio & Department of Information Engineering, School of Engineering, University of Pisa, 56122, Pisa, Italy.
| | - Vincenzo Catrambone
- Bioengineering and Robotics Research Center E. Piaggio & Department of Information Engineering, School of Engineering, University of Pisa, 56122, Pisa, Italy
| | - Riccardo Barbieri
- Department of Electronics, Informatics, and Bioengineering, Politecnico di Milano, 20133, Milano, Italy
| | - Gaetano Valenza
- Bioengineering and Robotics Research Center E. Piaggio & Department of Information Engineering, School of Engineering, University of Pisa, 56122, Pisa, Italy
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Abstract
OBJECTIVE Spontaneous or experimentally induced high blood pressure (BP) is associated with reduced pain perception, known as BP-related hypoalgesia. Despite its clinical implications, such as the interference with early detection of myocardial infarction in 'at risk' groups, the size of the association between high BP and pain has not yet been quantified. Moreover, the distinct association between high BP and physiological or psychological components of pain has not yet been considered so far. The aim of this study was to overcome this gap by performing separate meta-analyses on nociceptive response versus quantifiable perceptual measures of pain in relation to high BP. METHODS PubMed and Web of Knowledge databases were searched for English language studies conducted in humans. Fifty-nine studies were eligible for the analyses. Pooled effect sizes (Hedges' g) were compared. Random effect models were used. Results show that higher BP is significantly associated with lower nociceptive response (g = 0.38; k = 6) and reduced pain perception, assessed by quantifiable measures (g = 0.48; k = 59). RESULTS The association between BP and pain perception, derived from highly heterogeneous studies, was characterized by significant publication bias. BP assessment, pain assessment, site of pain stimulation, percentage of female participants in the sample, and control for potential confounders were significant moderators. CONCLUSION Current meta-analytic results confirm the presence of BP-related hypoalgesia and point towards the need for a better understanding of its underlying mechanisms.
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Shukla M, Pandey R, Lau JYF. Assessing emotional processing difficulties in normotensive individuals with high and isolated blood pressure elevations. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2017; 54:214-222. [PMID: 28961317 DOI: 10.1002/ijop.12462] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 08/29/2017] [Indexed: 11/12/2022]
Abstract
This study examined the effect of sense modality (auditory/visual) on emotional dampening (reduced responsiveness to emotions with elevation in blood pressure). Fifty-six normotensive participants were assessed on tasks requiring labelling and matching of emotions in faces and voices. Based on median split of systolic and diastolic blood pressures (SBP and DBP, respectively), participants were divided into low BP, high BP and isolated BP groups. On emotion-labelling tasks, analysis revealed reduced emotion recognition in the high BP than the low BP group. On emotion-matching tasks, reduced emotion recognition was noted in high and also isolated BP group as compared to low BP group for the task that required matching a visual target with one of the four auditory distractors. Our findings show for the first time that even isolated elevations in either SBP or DBP may result in emotional dampening. Furthermore, the study highlights that the emotional dampening effect generalises to explicit processing (labelling) of emotional information in both faces and voices-and that these effects tentatively occur during more pragmatic and covert (matching) emotion recognition processes too. These findings require replication in clinical hypertensives.
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Affiliation(s)
- Meenakshi Shukla
- Department of Psychology, Banaras Hindu University, Varanasi, UP, India.,Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Rakesh Pandey
- Department of Psychology, Banaras Hindu University, Varanasi, UP, India
| | - Jennifer Y F Lau
- Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
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Scheuren R, Duschek S, Schulz A, Sütterlin S, Anton F. Blood pressure and the perception of illusive pain. Psychophysiology 2016; 53:1282-91. [DOI: 10.1111/psyp.12658] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 03/11/2016] [Indexed: 01/03/2023]
Affiliation(s)
- Raymonde Scheuren
- Institute for Health and Behavior, Integrative Research Unit on Social and Individual Development (INSIDE), University of Luxembourg; Luxembourg Luxembourg
| | - Stefan Duschek
- Institute of Psychology, UMIT-University for Health Sciences, Medical Informatics and Technology; Hall in Tirol Austria
| | - André Schulz
- Institute for Health and Behavior, Integrative Research Unit on Social and Individual Development (INSIDE), University of Luxembourg; Luxembourg Luxembourg
| | - Stefan Sütterlin
- Section of Psychology, Lillehammer University College; Lillehammer Norway
- Department of Psychosomatic Medicine, Division of Surgery and Clinical Neuroscience; Oslo University Hospital-Rikshospitalet; Oslo Norway
| | - Fernand Anton
- Institute for Health and Behavior, Integrative Research Unit on Social and Individual Development (INSIDE), University of Luxembourg; Luxembourg Luxembourg
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Wang H, Cai Y, Liu J, Dong Y, Lai J. Pain sensitivity: a feasible way to predict the intensity of stress reaction caused by endotracheal intubation and skin incision? J Anesth 2015; 29:904-11. [DOI: 10.1007/s00540-015-2040-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Accepted: 06/21/2015] [Indexed: 11/24/2022]
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7
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Stress in crisis managers: evidence from self-report and psychophysiological assessments. J Behav Med 2015; 38:970-83. [DOI: 10.1007/s10865-015-9654-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 06/19/2015] [Indexed: 12/20/2022]
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8
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Delfino AE, de la Fuente N, Echevarría GC, Altermatt FR, Cortinez LI. Effect of acute arterial hypertension on morphine requirements and postsurgical pain. J Clin Anesth 2015; 27:226-32. [DOI: 10.1016/j.jclinane.2014.11.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 10/17/2014] [Accepted: 11/21/2014] [Indexed: 10/24/2022]
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Reyes del Paso GA, Muñoz Ladrón de Guevara C, Montoro CI. Breath-Holding During Exhalation as a Simple Manipulation to Reduce Pain Perception. PAIN MEDICINE 2015; 16:1835-41. [PMID: 25930190 DOI: 10.1111/pme.12764] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 03/15/2015] [Accepted: 03/22/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Baroreceptor stimulation yields antinociceptive effects. In this study, baroreceptors were stimulated by a respiratory maneuver, with the effect of this manipulation on pain perception subsequently measured. METHODS Thirty-eight healthy participants were instructed to inhale slowly (control condition) and to hold the air in lungs after a deep inhalation (experimental condition). It was expected that breath-holding would increases blood pressure (BP) and thus stimulate the baroreceptors, which in turn would reduce pain perception. Pain was induced by pressure algometry on the nail of the left-index finger, at three different pressure intensities, and quantified by visual analogue scales. Heart rate (HR) and BP were continuously recorded. RESULTS Pain perception was lower when pain pressure was administered during the breath-holding phase versus the slow inhalation phase, regardless of the pressure intensity. During breath-holding, a rapid increase in BP and decrease in HR were observed, demonstrating activation of the baroreceptor reflex. CONCLUSION Pain perception is reduced when painful stimulation is applied during breath-holding immediately following a deep inhalation. These results suggest that a simple and easy-to-perform respiratory maneuver could be used to reduce acute pain perception.
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10
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Reyes Del Paso GA, Montoro CI, Duschek S. Reaction time, cerebral blood flow, and heart rate responses in fibromyalgia: Evidence of alterations in attentional control. J Clin Exp Neuropsychol 2015; 37:414-28. [PMID: 25825849 DOI: 10.1080/13803395.2015.1023265] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The study investigated cerebral blood flow (CBF) and heart rate (HR) responses during a cued reaction time (RT) task in patients with fibromyalgia syndrome (FMS). CBF velocities in the middle (MCA) and anterior (ACA) cerebral arteries of both hemispheres were recorded in 46 patients and 32 healthy control participants using functional transcranial Doppler sonography (fTCD). Patients exhibited markedly longer RT than healthy participants. Group differences in CBF responses were mainly observed for both ACAs, with greater right hemispherical increases but lower left hemispherical increases in FMS patients than in healthy participants. HR deceleration around the imperative stimulus was more pronounced in healthy participants. RT was inversely related to increases in CBF in both right arteries and in the left ACA in the FMS group, but was positively associated with CBF responses in all four arteries in healthy participants. The magnitude of task-induced HR deceleration correlated negatively with RT in both groups. Patients' clinical pain severity was positively associated with RT and CBF responses; trait anxiety and insomnia were secondary negative predictors of CBF responses. The study provided evidence of a deficit in the alertness component of attention in FMS at behavioral, CBF, and autonomic levels. These results may be interpreted in terms of the neural efficiency hypothesis of intelligence (i.e., less efficient brain activation during cognition in FMS) and the interfering effect of clinical factors on cognition. Clinical factors such as pain, anxiety, and sleep disturbances can affect cognition in FMS by interfering with CBF adjustment to cognitive demands.
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Reyes del Paso GA, Montoro C, Muñóz Ladrón de Guevara C, Duschek S, Jennings JR. The effect of baroreceptor stimulation on pain perception depends on the elicitation of the reflex cardiovascular response: evidence of the interplay between the two branches of the baroreceptor system. Biol Psychol 2014; 101:82-90. [PMID: 25038302 DOI: 10.1016/j.biopsycho.2014.07.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Revised: 07/02/2014] [Accepted: 07/04/2014] [Indexed: 11/25/2022]
Abstract
We examined the impact of baroreceptor stimulation on pain and cardiovascular responses in 39 healthy participants. Carotid baroreceptors were stimulated with external suction (-50 mmHg, stimulation) or pressure (+8 mmHg, control). Pain was induced by pressure to the nail of the left-index finger and quantified by a visual analog scale. Pain decreased heart rate (HR) and increased blood pressure (BP). Baroreceptor stimulation further decreased HR and reduced the BP increase. Pain experience failed to differ between baroreceptor stimulation conditions. However, significant results were obtained when trials were categorized according to the magnitude of the HR deceleration elicited by baroreceptor stimulation. In trials with strong baroreceptor-elicited HR deceleration pain intensity was lower than in trials both with inactive baroreceptor stimulation (pressure trials) or trials with small baroreceptor-elicited HR responses. Anti-nociceptive effects of baroreceptor stimulation depend on the activation of the reflex cardiovascular response. Central nervous inhibition due to baroreceptor stimulation only occurs if the peripheral cardiovascular response is engaged.
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Affiliation(s)
| | | | | | - Stefan Duschek
- UMIT - University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - J Richard Jennings
- Department of Psychiatry, School of Medicine, University of Pittsburgh, USA
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12
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Proneness to worry is negatively associated with blood pressure and baroreflex sensitivity: Further evidence of the blood pressure emotional dampening hypothesis. Biol Psychol 2014; 96:20-7. [DOI: 10.1016/j.biopsycho.2013.11.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 11/12/2013] [Accepted: 11/12/2013] [Indexed: 11/19/2022]
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Duschek S, Werner NS, Reyes Del Paso GA. The behavioral impact of baroreflex function: a review. Psychophysiology 2013; 50:1183-93. [PMID: 24033333 DOI: 10.1111/psyp.12136] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 07/07/2013] [Indexed: 01/21/2023]
Abstract
The baroreflex consists of a negative feedback loop adjusting heart activity to blood pressure fluctuations. This review is concerned with interactions between baroreflex function and behavior. In addition to changes in baroreflex cardiac control subject to behavioral manipulations, interindividual differences in reflex function predicted psychological and central nervous features. The sensitivity of the reflex was inversely related to cognitive performance, evoked potential amplitudes, experimental pain sensitivity, and the severity of clinical pain. Possible variables moderating the strength of the associations are tonic blood pressure, gender, and psychiatric disease. It is suggested that these observations reflect inhibition of higher brain function by baroreceptor afferents. While in many cases increased baroreflex function implies stronger inhibition, individual and situational factors modulate the behavioral impact of cardiac regulation.
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Affiliation(s)
- Stefan Duschek
- UMIT-University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
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Drouin S, McGrath JJ. Blood pressure and pain sensitivity in children and adolescents. Psychophysiology 2013; 50:513-20. [DOI: 10.1111/psyp.12036] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 12/04/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Sammantha Drouin
- Pediatric Public Health Psychology Laboratory, Department of Psychology; Concordia University; Montréal; Quebec; Canada
| | - Jennifer J. McGrath
- Pediatric Public Health Psychology Laboratory, Department of Psychology; Concordia University; Montréal; Quebec; Canada
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15
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Duschek S, Dietel A, Schandry R, Paso GAR. Increased sensitivity to heat pain in chronic low blood pressure. Eur J Pain 2012; 13:28-34. [DOI: 10.1016/j.ejpain.2008.02.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2008] [Revised: 02/06/2008] [Accepted: 02/20/2008] [Indexed: 11/12/2022]
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Reyes del Paso G, Pulgar Á, Duschek S, Garrido S. Cognitive impairment in fibromyalgia syndrome: The impact of cardiovascular regulation, pain, emotional disorders and medication. Eur J Pain 2011; 16:421-9. [DOI: 10.1002/j.1532-2149.2011.00032.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2011] [Indexed: 11/11/2022]
Affiliation(s)
| | - Á. Pulgar
- Department of Psychology; University of Jaén; Jaen; Spain
| | - S. Duschek
- Department of Psychology; University of Munich; Munich; Germany
| | - S. Garrido
- Department of Psychology; University of Jaén; Jaen; Spain
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Conde-Guzón PA, Bartolomé-Albistegui MT, Quirós P, Cabestrero R. Thermal sensitivity and cardiovascular reactivity to stress in healthy males. THE SPANISH JOURNAL OF PSYCHOLOGY 2011; 14:600-607. [PMID: 22059306 DOI: 10.5209/rev_sjop.2011.v14.n2.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This paper examines the association of cardiovascular reactivity with thermal thresholds (detection and unpleasantness). Heart period (HP), systolic (SBP) and diastolic (DBP) blood pressure of 42 health young males were recorded during a cardiovascular reactivity task (a videogame based upon Sidman's avoidance paradigm). Thermal sensitivity, assessing detection and unpleasantness thresholds with radiant heat in the forearm was also estimated for participants. Participants with differential scores in the cardiovascular variables from base line to task > or = P65 were considered as reactors and those how have differential scores < or = P35 were considered as non-reactors. Significant differences were observed between groups in the unpleasantness thresholds in blood pressure (BP) but not in HP. Reactors exhibited significant higher unpleasantness thresholds than non-reactors. No significant differences were obtained in detection thresholds between groups.
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Affiliation(s)
- Pablo Antonio Conde-Guzón
- Departamento de Psicología, Sociología y Filosofía, Universidad de León, Campus de Vegazana s/n. 24071 León, Spain.
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Reyes del Paso GA, Garrido S, Pulgar Á, Duschek S. Autonomic cardiovascular control and responses to experimental pain stimulation in fibromyalgia syndrome. J Psychosom Res 2011; 70:125-34. [PMID: 21262414 DOI: 10.1016/j.jpsychores.2010.09.012] [Citation(s) in RCA: 118] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2010] [Revised: 09/14/2010] [Accepted: 09/28/2010] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study involves a comprehensive investigation of autonomic cardiovascular regulation in fibromyalgia syndrome (FMS) at rest and during painful stimulation and its association with pain indices. METHODS In 35 patients and 29 healthy controls, electrocardiography, impedance cardiography, and finger continuous blood pressure measurements were conducted. For the purpose of experimental pain induction, a cold pressor test was applied. RESULTS FMS patients showed lower pain threshold and tolerance, as well as higher ratings of pain intensity and unpleasantness on visual analogue scales. Resting stroke volume, myocardial contractility, R-R interval, heart rate variability, and sensitivity of the cardiac baroreflex were reduced in the patients, and increases in stroke volume and myocardial contractility during cold pressor stimulation were less pronounced. In the whole sample as well as in the FMS group, baroreflex sensitivity was inversely associated with subjective pain intensity, and a higher number of baroreflex operations per unit of time predicted higher pain tolerance. CONCLUSIONS The data suggest impaired autonomic cardiovascular regulation in FMS in terms of reduced sympathetic and parasympathetic influences, as well as blunted sympathetic reactivity to acute stress. The association between baroreflex function and pain experience reflects the pain inhibition mediated by the baroreceptor system. Given the reduced baroreflex sensitivity in FMS, one may assume deficient ascending pain inhibition arising from the cardiovascular system, which may contribute to the exaggerated pain sensitivity of FMS.
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Duschek S, Heiss H, Werner N, Reyes del Paso GA. Modulations of autonomic cardiovascular control following acute alpha-adrenergic treatment in chronic hypotension. Hypertens Res 2009; 32:938-43. [DOI: 10.1038/hr.2009.115] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Duschek S, Heiss H, Buechner B, Schandry R. Reduction in Pain Sensitivity from Pharmacological Elevation of Blood Pressure in Persons with Chronically Low Blood Pressure. J PSYCHOPHYSIOL 2009. [DOI: 10.1027/0269-8803.23.3.104] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Recent studies have revealed evidence for increased pain sensitivity in individuals with chronically low blood pressure. The present trial explored whether pain sensitivity can be reduced by pharmacological elevation of blood pressure. Effects of the sympathomimetic midodrine on threshold and tolerance to heat pain were examined in 52 hypotensive persons (mean blood pressure 96/61 mmHg) based on a randomized, placebo-controlled, double-blind design. Heat stimuli were applied to the forearm via a contact thermode. Confounding of drug effects on pain perception with changes in skin temperature, temperature sensitivity, and mood were statistically controlled for. Compared to placebo, higher pain threshold and tolerance, increased blood pressure, as well as reduced heart rate were observed under the sympathomimetic condition. Increases in systolic blood pressure between points of measurement correlated positively with increases in pain threshold and tolerance, and decreases in heart rate were associated with increases in pain threshold. The findings underline the causal role of hypotension in the augmented pain sensitivity related to this condition. Pain reduction as a function of heart rate decrease suggests involvement of a baroreceptor-related mechanism in the pain attrition. The increased proneness of persons with chronic hypotension toward clinical pain is discussed.
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Affiliation(s)
| | - Heike Heiss
- Ludwig Maximilian University, Munich, Germany
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