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Lang-Illievich K, Klivinyi C, Ranftl J, Elhelali A, Hammer S, Szilagyi IS, Bornemann-Cimenti H. Change in Endogenous Pain Modulation Depending on Emotional States in Healthy Subjects: A Randomized Controlled Trial. Pain Ther 2024; 13:1287-1298. [PMID: 39102098 DOI: 10.1007/s40122-024-00642-1] [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: 05/21/2024] [Accepted: 07/19/2024] [Indexed: 08/06/2024] Open
Abstract
INTRODUCTION Chronic pain is a public health issue, leading to substantial healthcare costs and diminished quality of life for sufferers. While the role of anxiety in pain modulation has been extensively studied, the effects of other emotional states on the body's pain control mechanisms remain less understood. This study sought to explore how different emotions (happiness, anger, sadness, and interest) affect conditioned pain modulation (CPM) and the wind-up phenomenon in healthy adults. METHODS This randomized controlled, cross-over trial involved 28 healthy participants aged 18-60. Participants watched video clips designed to induce specific emotions: happiness, anger, sadness, and interest. Emotional states were assessed using a 7-point Likert scale. Pain modulation was measured using CPM and the wind-up phenomenon. CPM was assessed with a hot water bath as the conditioning stimulus and pressure pain tolerance as the test stimulus. Wind-up was measured using pinprick needle stimulators and a visual analog scale. Data were analyzed using paired t tests to compare pre- and post-emotion induction values. RESULTS Significant changes in emotional self-assessment values were observed for all emotions. Happiness increased CPM (4.6 ± 11.4, p = 0.04277), while sadness - 9.9 ± 23.1, p = 0.03211) and anger - 9.1 ± 23.3, p = 0.04804) decreased it. Interest did not significantly alter CPM (- 5.1 ± 25.8, p = 0.31042). No significant effects were found for the wind-up phenomenon across any emotional states. CONCLUSION This study shows that emotional states significantly affect the body's ability to modulate pain. Positive emotions like happiness enhance pain inhibition, while negative emotions such as sadness and anger impair it. These findings suggest that emotional modulation techniques could be integrated into pain management strategies to improve patient outcomes. Further research should explore a broader range of emotions and include objective measures to validate these results.
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Affiliation(s)
- Kordula Lang-Illievich
- Department of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria
- Department of Anaesthesia and Intensive Care Medicine, State Hospital Güssing, Güssing, Austria
| | - Christoph Klivinyi
- Department of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria
| | - Julia Ranftl
- Department of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria
| | - Ala Elhelali
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, MD, USA
| | - Sascha Hammer
- Department of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria
- Department of Psychiatry, Psychosomatics and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Istvan S Szilagyi
- Department of Psychiatry, Psychosomatics and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Helmar Bornemann-Cimenti
- Department of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria.
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Boissoneault J, Stennett-Blackmon B, Gilmour C, Blaes S. Neural and Psychosocial Mechanisms Underlying Alcohol Use and Pain Interactions: Overview of Current Evidence and Future Directions. CURRENT ADDICTION REPORTS 2023; 10:677-689. [PMID: 38645279 PMCID: PMC11031255 DOI: 10.1007/s40429-023-00518-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2023] [Indexed: 04/23/2024]
Abstract
Purpose of Review A growing body of research indicates bidirectional associations between alcohol use and pain. In this review, we highlight common neural and psychosocial mechanisms underlying pain and alcohol use and identify current gaps in the literature regarding alcohol/pain interactions. We also suggest future directions for the field moving forward, including more nuanced conceptualization of alcohol's negative reinforcing effects in the context of pain, broader use of clinically-relevant experimental pain induction modalities, and characterization of age, biological sex, gender, race, and ethnicity as moderators of pain/alcohol interactions. Recent Findings Acute alcohol intake has analgesic and negative-reinforcing effects in the context of pain, and chronic heavy alcohol use appears to increase risk for development of chronic pain. At the same time, pain, both acute and chronic, acts as a proximal antecedent for alcohol use and is associated with relapse risk for individuals in recovery from alcohol use disorder. Summary Although the links between alcohol use and pain are increasingly appreciated, significant gaps in understanding remain and systematic study of alcohol/pain interactions at all levels, including basic, preclinical, translational, and interventional, is needed.
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Affiliation(s)
- Jeff Boissoneault
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
- Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL, USA
- Department of Anesthesiology, University of Minnesota, Minneapolis, MN, USA
| | - Bethany Stennett-Blackmon
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
- Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL, USA
| | - Christina Gilmour
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
- Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL, USA
| | - Shelby Blaes
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
- Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL, USA
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Dreismickenbecker E, Zinn S, Romero-Richter M, Kohlhaas M, Fricker LR, Petzel-Witt S, Walter C, Kreuzer M, Toennes SW, Anders M. Electroencephalography-Based Effects of Acute Alcohol Intake on the Pain Matrix. Brain Sci 2023; 13:1659. [PMID: 38137107 PMCID: PMC10741681 DOI: 10.3390/brainsci13121659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 11/24/2023] [Accepted: 11/28/2023] [Indexed: 12/24/2023] Open
Abstract
The effects of acute and chronic intakes of high doses of alcohol on pain perception are well known, ranging from short-term analgesic effects to long-term sensitization and polyneuropathies. The short-term analgesic effects of ethanol consumption on subjective pain perception have been well studied in the literature. Recent advances in neuroimaging allow for an insight into pain-related structures in the brain, fostering the mechanistic understanding of the processing of nociceptive input and pain. We aimed to utilize EEG, combined with standardized noxious mechanical/thermal stimulation and subjective pain testing, to research the effects of acute alcohol intake on nociceptive processing and pain perception. We recruited 12 healthy subjects in an unblinded cross-over study design and aimed at achieving a blood alcohol level of 0.1%. Our data revealed a significant reduction in subjective pain ratings to noxious thermal and mechanical stimuli after alcohol ingestion. Our EEG data revealed suppressing effects on the cortical structures responsible for processing pain, the "pain matrix". We conclude that in addition to its analgesic effects, as expressed by the reduction in subjective pain, alcohol has a further impact on the "pain matrix" and directly affects the salience to a nociceptive stimulus.
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Affiliation(s)
- Elias Dreismickenbecker
- Center for Pediatric and Adolescent Medicine, Department of Pediatric Hematology/Oncology, University Medical Center Mainz, 55131 Mainz, Germany
- Clinical Development and Human Pain Models, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, 60596 Frankfurt, Germany
| | - Sebastian Zinn
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Goethe University Frankfurt, University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Mara Romero-Richter
- Clinical Development and Human Pain Models, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, 60596 Frankfurt, Germany
| | - Madeline Kohlhaas
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Goethe University Frankfurt, University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Lukas R. Fricker
- Clinical Development and Human Pain Models, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, 60596 Frankfurt, Germany
| | - Silvana Petzel-Witt
- Institute of Legal Medicine, University Hospital, Goethe University, 60590 Frankfurt, Germany
| | - Carmen Walter
- Clinical Development and Human Pain Models, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, 60596 Frankfurt, Germany
| | - Matthias Kreuzer
- Department of Anesthesiology and Intensive Care, School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany
| | - Stefan W. Toennes
- Institute of Legal Medicine, University Hospital, Goethe University, 60590 Frankfurt, Germany
| | - Malte Anders
- Clinical Development and Human Pain Models, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, 60596 Frankfurt, Germany
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Najem C, Meeus M, Cagnie B, Ayoubi F, Al Achek M, Van Wilgen P, Van Oosterwijck J, De Meulemeester K. The Effect of Praying on Endogenous Pain Modulation and Pain Intensity in Healthy Religious Individuals in Lebanon: A Randomized Controlled Trial. JOURNAL OF RELIGION AND HEALTH 2023; 62:1756-1779. [PMID: 36495356 PMCID: PMC9739350 DOI: 10.1007/s10943-022-01714-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/29/2022] [Indexed: 05/15/2023]
Abstract
Prayer is considered to be the most common therapy used in alternative medicine. This study aimed to explore the effect of prayers on endogenous pain modulation, pain intensity, and sensitivity in healthy religious participants. A total of 208 healthy religious participants were enrolled in this study and randomly distributed into two groups, a prayer group (n = 156) and a poem reading or control group (n = 52). Participants from the prayer group were then selectively allocated using the prayer function scale to either an active prayer group (n = 94) receiving an active type of praying or to a passive prayer group (n = 62) receiving a passive type of praying. Pain assessments were performed before and following the interventions and included pressure pain threshold assessment (PPT), conditioned pain modulation (CPM), and a numerical pain rating scale. A significant group-by-time interaction for PPT (p = 0.014) indicated post-intervention increases in PPT in the prayer group but not in the poem reading control group. Participants experienced a decrease in CPM efficacy (p = 0.030) and a reduction in their NPRS (p < 0.001) following the interventions, independent of their group allocation. The results showed that prayer, irrespective of the type, can positively affect pain sensitivity and intensity, but does not influence endogenous pain inhibition during hot water immersion. Future research should focus on understanding the mechanism behind "prayer-induced analgesia."
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Affiliation(s)
- Charbel Najem
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
- Department of Physiotherapy, Faculty of Public Health, Antonine University, Hadat, Lebanon.
- Pain in Motion International Research Group, Ghent, Belgium.
| | - Mira Meeus
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Pain in Motion International Research Group, Ghent, Belgium
- MOVANT Research Group, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Barbara Cagnie
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Farah Ayoubi
- Department of Physiotherapy, Faculty of Public Health, Antonine University, Hadat, Lebanon
- Department of Physiotherapy, Faculty of Public Health, Lebanese University, Beirut, Lebanon
| | - Mikel Al Achek
- Department of Physiotherapy, Faculty of Public Health, Antonine University, Hadat, Lebanon
| | - Paul Van Wilgen
- Pain in Motion International Research Group, Ghent, Belgium
- Transcare Transdisciplinary Pain Management Center, Groningen, The Netherlands
- PAIN-VUB Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jessica Van Oosterwijck
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Pain in Motion International Research Group, Ghent, Belgium
- MOVANT Research Group, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Research Foundation-Flanders (FWO), Brussels, Belgium
| | - Kayleigh De Meulemeester
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Pain in Motion International Research Group, Ghent, Belgium
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Vitus D, Williams MK, Rizk M, Neubert JK, Robinson M, Boissoneault J. Analgesic effects of alcohol in adults with chronic jaw pain. Alcohol Clin Exp Res 2022; 46:1515-1524. [PMID: 35989585 PMCID: PMC9427671 DOI: 10.1111/acer.14883] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/05/2022] [Accepted: 06/07/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Although recent literature provides promising support for the analgesic properties of alcohol, potential differences in alcohol analgesia as a function of chronic pain status are not well understood. Thus, this study examined chronic pain status as a potential moderator of alcohol analgesia and distinguished between multiple aspects of pain experience and sensitivity: pain threshold, pain intensity, pain unpleasantness, and perceived relief. METHODS Social drinkers with (N = 19) and without (N = 29) chronic jaw pain completed two testing sessions in a counterbalanced order: alcohol (target BrAC = 0.08 g/dl) and placebo. In each, pressure algometry was performed at the insertion of the masseter. Alcohol analgesia was assessed by examining the main and interactive effects of beverage condition, pressure level (4, 5, or 6 pound-feet [lbf]), and chronic jaw pain status (chronic pain vs. pain-free control) on quantitative sensory testing measures and pain relief ratings following noxious stimuli. RESULTS Analyses indicated significant increases in pain threshold and pain relief and reductions in pain unpleasantness and pain intensity, under the alcohol condition. Chronic pain participants demonstrated lower pain thresholds and greater pain intensity and pain unpleasantness ratings than controls. There were no interactive effects of alcohol and pain conditions on any pain measure. CONCLUSIONS Findings provide experimental evidence of alcohol's analgesic and pain-relieving effects and suggest that these effects do not significantly differ by chronic pain status. Individuals, who self-medicate pain via alcohol consumption, irrespective of pain status, may be at increased risk to engage in hazardous drinking patterns and thus experience adverse alcohol-related consequences.
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Affiliation(s)
- Darya Vitus
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, 32610
- Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL, 32610
| | - Michelle K. Williams
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, 32610
- Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL, 32610
| | - Mehdi Rizk
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, 32610
- Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL, 32610
| | - John K. Neubert
- Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL, 32610
- Department of Orthodontics, University of Florida, Gainesville, FL, 32610
| | - Michael Robinson
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, 32610
- Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL, 32610
| | - Jeff Boissoneault
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, 32610
- Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL, 32610
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Karimi R, Mallah N, Nedjat S, Beasley MJ, Takkouche B. Association between alcohol consumption and chronic pain: a systematic review and meta-analysis. Br J Anaesth 2022; 129:355-365. [DOI: 10.1016/j.bja.2022.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/27/2022] [Accepted: 03/10/2022] [Indexed: 12/20/2022] Open
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Mehesz E, Karoui H, Strutton PH, Hughes SW. Exposure to an Immersive Virtual Reality Environment can Modulate Perceptual Correlates of Endogenous Analgesia and Central Sensitization in Healthy Volunteers. THE JOURNAL OF PAIN 2021; 22:707-714. [PMID: 33465506 DOI: 10.1016/j.jpain.2020.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 12/14/2020] [Accepted: 12/29/2020] [Indexed: 11/26/2022]
Abstract
Virtual reality (VR) has been shown to produce analgesic effects during different experimental and clinical pain states. Despite this, the top-down mechanisms are still poorly understood. In this study, we examined the influence of both a real and sham (ie, the same images in 2D) immersive arctic VR environment on conditioned pain modulation (CPM) and in a human surrogate model of central sensitization in 38 healthy volunteers. CPM and acute heat pain thresholds were assessed before and during VR/sham exposure in the absence of any sensitization. In a follow-on study, we used the cutaneous high frequency stimulation model of central sensitization and measured changes in mechanical pain sensitivity in an area of heterotopic sensitization before and during VR/sham exposure. There was an increase in CPM efficiency during the VR condition compared to baseline (P < .01). In the sham condition, there was a decrease in CPM efficiency compared to baseline (P < .01) and the real VR condition (P < .001). Neither real nor sham VR had any effect on pain ratings reported during the conditioning period or on heat pain threshold. There was also an attenuation of mechanical pain sensitivity during the VR condition indicating a lower sensitivity compared to sham (P < .05). We conclude that exposure to an immersive VR environment has no effect over acute pain thresholds but can modulate dynamic CPM responses and mechanical hypersensitivity in healthy volunteers. PERSPECTIVE: This study has demonstrated that exposure to an immersive virtual reality environment can modulate perceptual correlates of endogenous pain modulation and secondary hyperalgesia in a human surrogate pain model. These results suggest that virtual reality could provide a novel mechanism-driven analgesic strategy in patients with altered central pain processing.
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Affiliation(s)
- Erzsebet Mehesz
- The Nick Davey Laboratory, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Hajer Karoui
- The Nick Davey Laboratory, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Paul H Strutton
- The Nick Davey Laboratory, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Sam W Hughes
- The Pain Neuroplasticity and Modulation Laboratory, Brain Research and Imaging Centre (BRIC), School of Psychology, Faculty of Health, University of Plymouth, Plymouth, UK.
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Kunz M, Bunk SF, Karmann AJ, Bär KJ, Lautenbacher S. Conditioned Pain Modulation (CPM) Effects Captured in Facial Expressions. J Pain Res 2021; 14:793-803. [PMID: 33790641 PMCID: PMC8001584 DOI: 10.2147/jpr.s300313] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 02/26/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Conditioned pain modulation (CPM) is most often assessed using self-report of pain. However, self-report of pain is not always available (eg in individuals with cognitive impairment) and is susceptible to report bias. In comparison, the facial expression of pain is more reflex-like and represents one of the most sensitive and specific non-verbal signals of pain. The aim of the present study was to investigate whether the facial expression of pain is sensitive enough to capture endogenous pain inhibition as elicited during CPM paradigms. Patients and Methods In total, 26 female participants took part in this study. Facial and verbal responses to phasic heat pain were assessed once while participants immersed their hand in a hot water bath and once without additional stimulation. Facial responses were analyzed using the Facial Action Coding System (FACS). Verbal responses were assessed using a Numerical Rating Scale (NRS). Results Pain-relevant facial responses as well as pain ratings to phasic heat pain were significantly reduced when participants simultaneously immersed their hand in a hot water bath compared to baseline. Thus, CPM effects could be demonstrated both on subjective as well as on facial responses. Moreover, CPM-induced changes in pain-relevant facial responses and in NRS ratings were significantly correlated. Conclusion The present study shows that facial expressions of pain are sensitive enough to capture CPM effects. Given the proven clinical usefulness of assessing CPM, the parallel assessment of verbal and facial CPM effects might be a promising approach with wider scope of applications. Further research in other demographic healthy participant and clinical cohorts is warranted.
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Affiliation(s)
- Miriam Kunz
- Department of Medical Psychology and Sociology, University of Augsburg, Augsburg, Germany
| | - Stefanie F Bunk
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Anna J Karmann
- Physiological Psychology, Otto-Friedrich University Bamberg, Bamberg, Germany
| | - Karl-Jürgen Bär
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Jena, Germany
| | - Stefan Lautenbacher
- Physiological Psychology, Otto-Friedrich University Bamberg, Bamberg, Germany
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9
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Vincenot M, Coulombe-Lévêque A, Sean M, Camirand Lemyre F, Gendron L, Marchand S, Léonard G. Development and Validation of a Predictive Model of Pain Modulation Profile to Guide Chronic Pain Treatment: A Study Protocol. FRONTIERS IN PAIN RESEARCH 2021; 2:606422. [PMID: 35295452 PMCID: PMC8915565 DOI: 10.3389/fpain.2021.606422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 01/13/2021] [Indexed: 11/27/2022] Open
Abstract
Introduction: Quantitative sensory testing is frequently used in research to assess endogenous pain modulation mechanisms, such as Temporal Summation (TS) and Conditioned Pain Modulation (CPM), reflecting excitatory and inhibitory mechanisms, respectively. Numerous studies found that a dysregulation of these mechanisms is associated with chronic pain conditions. In turn, such a patient's “profile” (increased TS and/or weakened CPM) could be used to recommend different pharmacological treatments. However, the procedure to evaluate these mechanisms is time-consuming and requires expensive equipment that is not available in the clinical setting. In this study, we aim to identify psychological, physiological and socio-demographic markers that could serve as proxies to allow healthcare professionals to identify these pain phenotypes in clinic, and consequently optimize pharmacological treatments. Method: We aim to recruit a healthy participant cohort (n = 360) and a chronic pain patient cohort (n = 108). Independent variables will include psychological questionnaires, pain measurements, physiological measures and sociodemographic characteristics. Dependent variables will include TS and CPM, which will be measured using quantitative sensory testing in a single session. We will evaluate one prediction model and two validation models (for healthy and chronic pain participants) using multiple regression analysis between TS/CPM and our independent variables. The significance thresholds will be set at p = 0.05, respectively. Perspectives: This study will allow us to develop a predictive model to compute the pain modulation profile of individual patients based on their biopsychosocial characteristics. The development of the predictive model is the first step toward the overarching goal of providing clinicians with a set of quick and cheap tests, easily applicable in clinical practice to orient pharmacological treatments.
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Affiliation(s)
- Matthieu Vincenot
- Research Center on Aging, Université de Sherbrooke, Sherbrooke, QC, Canada
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Alexia Coulombe-Lévêque
- Research Center on Aging, Université de Sherbrooke, Sherbrooke, QC, Canada
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Monica Sean
- Research Center on Aging, Université de Sherbrooke, Sherbrooke, QC, Canada
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Félix Camirand Lemyre
- Centre de Recherche du Centre Hospitaliser Universitaire de Sherbrooke, Sherbrooke, QC, Canada
- Département de Mathématiques, Faculté des Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Louis Gendron
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de Recherche du Centre Hospitaliser Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Serge Marchand
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Guillaume Léonard
- Research Center on Aging, Université de Sherbrooke, Sherbrooke, QC, Canada
- Faculty of Medicine and Health Sciences, School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC, Canada
- *Correspondence: Guillaume Léonard
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10
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Capito ES, Lautenbacher S, Wolstein J, Horn-Hofmann C. Effects of oral alcohol administration on heat pain threshold and ratings of supra-threshold stimuli. Scand J Pain 2020; 20:623-634. [PMID: 32755104 DOI: 10.1515/sjpain-2019-0144] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 01/27/2020] [Indexed: 12/15/2022]
Abstract
Background and aims Evidence for analgesic effects of oral alcohol consumption on heat pain has recently been documented in a placebo-controlled, randomized and double-blind design. We aimed at further investigating these effects and now set the focus on pain threshold and the ratings of supra-threshold pain to cover most of the pain range. Moreover, we now firstly evaluated sex differences in these effects. Methods We investigated 41 healthy participants (22 females) in a randomized, double-blind and placebo-controlled design and targeted two different moderate breath-alcohol levels of 0.06% and 0.08%. Before and after an alcoholic or placebo drink, contact heat was applied at the forearm. Subjects evaluated pain threshold (method of adjustment) and rated pain intensity and pain unpleasantness of supra-threshold stimuli (intensity: threshold +3 °C; duration: 5 s). Results Analgesic effects taking the form of increased pain thresholds were found after both alcohol doses, surprisingly with more pronounced effects for the lower dose. While the high alcohol dose exerted small analgesic effects on pain intensity ratings (i.e. decrease), slightly increased ratings of pain intensity and pain unpleasantness after the low alcohol dose rather suggest pain enhancement. Alcohol did not affect intensity vs. unpleasantness ratings differentially. We found no evidence for sex differences in any of these effects. Conclusions Overall, acute alcohol effects on pain were subtle. Our findings suggest that while low alcohol doses already exert analgesic effects on pain threshold, stronger doses are required for pain reduction on supra-threshold pain levels. Furthermore, sex differences could not be detected within our experimental paradigm but should be further explored in future research. Implications Analgesic effects of sub-toxic alcohol doses - as normally occurring during social drinking - might be weak; however, susceptibility to pain relieving effects of alcohol might be a risk factor for the use of alcohol as self-medication in acute pain states.
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Affiliation(s)
- Eva Susanne Capito
- Physiological Psychology, University of Bamberg, Markusplatz 3, 96045 Bamberg, Germany, Phone: +49 951 863-1847
| | | | - Jörg Wolstein
- Pathopsychology, University of Bamberg, Bamberg, Germany
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11
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Lockwood S, Dickenson AH. What goes up must come down: insights from studies on descending controls acting on spinal pain processing. J Neural Transm (Vienna) 2020; 127:541-549. [PMID: 31515656 PMCID: PMC7148257 DOI: 10.1007/s00702-019-02077-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 09/03/2019] [Indexed: 12/25/2022]
Abstract
Descending controls link higher processing of noxious signals to modulation of spinal cord responses to their noxious inputs. It has become possible to study one key inhibitory system in animals and humans using one painful stimulus to attenuate another distant response and so eliciting diffuse noxious inhibitory controls (DNIC) or the human counterpart, conditioned pain modulation (CPM). Here, we discuss the neuronal pathways in both species, their pharmacology and examine changes in descending controls with a focus on osteoarthritis. We will also discuss the opposing descending facilitatory system. Strong parallels between DNIC and CPM emphasize the possibility of forward and reverse translation.
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Affiliation(s)
- Stevie Lockwood
- Department of Neuroscience, Physiology and Pharmacology, University College London, Gower St., London, WC1E6BT, UK
| | - Anthony H Dickenson
- Department of Neuroscience, Physiology and Pharmacology, University College London, Gower St., London, WC1E6BT, UK.
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