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Fiol-deRoque MA, Serrano-Ripoll MJ, Mira-Martínez S, Pastor-Moreno G, Sitges C, García-Buades ME, Gervilla E, Garcia-Toro M, Zamanillo-Campos R, Ricci-Cabello I. Process evaluation of PsyCovidApp, a digital tool for mobile devices aimed at protecting the mental health of healthcare professionals during the COVID-19 pandemic: a mixed method study. Front Psychol 2024; 15:1378372. [PMID: 38577118 PMCID: PMC10994142 DOI: 10.3389/fpsyg.2024.1378372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/05/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction PsyCovidApp, a digital intervention aimed at safeguarding the mental health of healthcare workers during the COVID-19 pandemic, demonstrated in a randomized clinical trial to yield significant improvements solely among healthcare workers undergoing psychotherapy or receiving psychotropic medication. Objectives (1) To identify contextual factors and mechanisms of action that influenced the impact of PsyCovidApp during the aforementioned trial; (2) To pinpoint enhancements for optimizing its efficacy. Materials and methods For the first objective, a process evaluation was conducted, amalgamating quantitative techniques (surveying 216 healthcare professionals who had utilized PsyCovidApp during the trial) and qualitative methods (in-depth interviews with 16 healthcare workers). The second objective involved a panel of seven experts, utilizing the RAND-UCLA methodology. Results The quantitative study (response rate = 40%) revealed that 22% of respondents had not fully accessed the content of PsyCovidApp. The average usage time was 22.7 min/day, being higher (p < 0.05) among consumers of psychotropic medications. Contents related to relaxation and mindfulness were most highly rated. Acceptability and usefulness scores ranged between 7.3-7.5/10 points, with higher ratings (p < 0.05) among women and older healthcare workers. The qualitative study uncovered that the primary barriers to using PsyCovidApp were workload, lack of time, and exhaustion. Its primary mechanisms of action included emotion identification, mental health regulation (e.g., insomnia, intense emotions), and learning of techniques and skills. The expert panel reached a consensus on 29 proposals to optimize PsyCovidApp. Conclusion The knowledge derived from this study could inform the design and implementation of future similar digital tools.
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Affiliation(s)
- Maria A. Fiol-deRoque
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Primary Care Research Unit of Majorca, Palma, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
| | - Maria J. Serrano-Ripoll
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Primary Care Research Unit of Majorca, Palma, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
| | | | - Guadalupe Pastor-Moreno
- Andalusian School of Public Health, Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Granada Biosanitary Research Institute, Granada, Spain
| | - Carolina Sitges
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- University of the Balearic Islands, Palma, Spain
| | | | - Elena Gervilla
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- University of the Balearic Islands, Palma, Spain
| | - Mauro Garcia-Toro
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
- University of the Balearic Islands, Palma, Spain
| | - Rocío Zamanillo-Campos
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Primary Care Research Unit of Majorca, Palma, Spain
| | - Ignacio Ricci-Cabello
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Primary Care Research Unit of Majorca, Palma, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
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García-Dopico N, Terrasa JL, González-Roldán AM, Velasco-Roldán O, Sitges C. Unraveling the Left-Right Judgment Task in Chronic Low Back Pain: Insights Through Behavioral, Electrophysiological, Motor Imagery, and Bodily Disruption Perspectives. J Pain 2024:S1526-5900(24)00365-1. [PMID: 38307439 DOI: 10.1016/j.jpain.2024.01.349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 02/04/2024]
Abstract
Bodily disruptions have been consistently demonstrated in individuals with chronic low back pain. The performance on the left-right judgment task has been purposed as an indirect measure of the cortical proprioceptive representation of the body. It has been suggested to be dependent on implicit motor imagery, although the available evidence is conflicting. Hence, the aim of this case-control observational study was to examine the performance (accuracy and reaction times) and event-related potentials while performing the left-right judgment task for back and hand images in individuals with chronic low back pain versus healthy controls, along with its relationship with self-reported measurements and quantitative sensory testing. While self-reported data suggested bodily disruptions in the chronic low back pain sample, this was not supported by quantitative sensory testing. Although both groups displayed the same performance, our results suggested an increased attentional load on participants with chronic low back pain to achieve equal performance, measured by a higher N1 peak amplitude in occipital electrodes, especially when the effect of contextual images arises. The absence of differences in the reaction times for the left-right judgment task between both groups, along with inconsistencies in self-reported and quantitative sensory testing data, could question the involvement of implicit motor imagery in solving the task. In conclusion, our results suggest disrupted attentional processing in participants with chronic low back pain to solve the left-right judgment task. PERSPECTIVE: Although there are no differences in the performance of the left-right judgment task (hits, reaction times) between chronic low back pain patients and controls, the analysis of event-related potentials revealed that patients require a higher cognitive load, measured by N1 peak amplitude.
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Affiliation(s)
- Nuria García-Dopico
- Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Palma, Spain; Research Institute of Health Sciences (IUNICS), Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Juan L Terrasa
- Research Institute of Health Sciences (IUNICS), Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain; Department of Psychology, University of the Balearic Islands (UIB), Palma, Spain
| | - Ana M González-Roldán
- Research Institute of Health Sciences (IUNICS), Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain; Department of Psychology, University of the Balearic Islands (UIB), Palma, Spain
| | - Olga Velasco-Roldán
- Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Palma, Spain; Research Institute of Health Sciences (IUNICS), Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Carolina Sitges
- Research Institute of Health Sciences (IUNICS), Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain; Department of Psychology, University of the Balearic Islands (UIB), Palma, Spain
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Sitges C, García-Retortillo S, Van der Meulen M, González-Roldán AM. Editorial: Lifestyle and self-management of chronic pain across the lifespan. Front Hum Neurosci 2023; 17:1249897. [PMID: 38021244 PMCID: PMC10679751 DOI: 10.3389/fnhum.2023.1249897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- Carolina Sitges
- Department of Psychology, Research Institute of Health Sciences (IUNICS), Health Research Institute of the Balearic Islands (IdISBa), University of the Balearic Islands, Palma, Spain
| | - Sergi García-Retortillo
- Department of Health and Exercise Science (HES), Wake Forest University, Winston-Salem, NC, United States
| | - Marian Van der Meulen
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Ana M. González-Roldán
- Department of Psychology, Research Institute of Health Sciences (IUNICS), Health Research Institute of the Balearic Islands (IdISBa), University of the Balearic Islands, Palma, Spain
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García-Dopico N, De La Torre-Luque A, Wand BM, Velasco-Roldán O, Sitges C. The cross-cultural adaptation, validity, and reliability of the Spanish version of the Fremantle Back Awareness Questionnaire. Front Psychol 2023; 14:1070411. [PMID: 36935999 PMCID: PMC10017493 DOI: 10.3389/fpsyg.2023.1070411] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 01/26/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction In chronic low back pain (CLBP), disturbed body image has been highlighted as a contributor to the condition and a potential target for treatment. The Fremantle Back Awareness Questionnaire (FreBAQ) allows its assessment. Following international guidelines for the cross-cultural translation of questionnaires, we aimed to translate the FreBAQ into Spanish (FreBAQ-S) and validate the new questionnaire in a sample of Spanish-speaking people with CLBP. Methods Two hundred and sixty-four adults with CLBP (91 males) and 128 healthy controls (34 males) completed an online form including the FreBAQ-S and questionnaires related to the pain experience. All participants were Spanish and no gender identities differing from biological sex were reported. A week later, 113 CLBP participants and 45 healthy controls (41 and 13 males, respectively), re-answered the FreBAQ-S to evaluate test-retest reliability. Confirmatory factor and multigroup analysis assessed the scale consistency on the patient sample. Discriminant and convergent validity were explored by between-group differences and the relationship with clinical characteristics. Reliability relied on Cronbach's alpha estimates and test-retest (intraclass correlation coefficient, standard error of measurement, minimal detectable change). Results and discussion Confirmatory factor analysis showed a one-factor structure of the questionnaire, without supporting evidence for item deletion (CFI = 0.97; TLI = 0.96; RMSEA = 0.06; SRMR = 0.07; SRMRu = 0.064). Multigroup analyses do not support mean invariance between groups regarding health condition or sex. The FreBAQ-S demonstrated good discriminant and convergent validity, internal consistency (α = 0.82), and test-retest reliability (ICC = 0.78; SE = 3.41; MDC = 5.12). The FreBAQ-S is a valid and reliable tool to assess back awareness in clinical and non-clinical samples.
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Affiliation(s)
- Nuria García-Dopico
- University of the Balearic Islands (UIB), Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), Palma, Spain
- Department and Faculty of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Palma, Spain
- *Correspondence: Nuria García-Dopico,
| | - Alejandro De La Torre-Luque
- Department of Legal Medicine, Psychiatry and Pathology, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
| | - Benedict Martin Wand
- Faculty of Medicine, Nursing and Midwifery and Health Sciences, University of Notre Dame Australia, Fremantle, WA, Australia
| | - Olga Velasco-Roldán
- University of the Balearic Islands (UIB), Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), Palma, Spain
- Department and Faculty of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Palma, Spain
| | - Carolina Sitges
- University of the Balearic Islands (UIB), Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), Palma, Spain
- Department and Faculty of Psychology, University of the Balearic Islands (UIB), Palma, Spain
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Sitges C, Terrasa JL, García-Dopico N, Segur-Ferrer J, Velasco-Roldán O, Crespí-Palmer J, González-Roldán AM, Montoya P. An Educational and Exercise Mobile Phone–Based Intervention to Elicit Electrophysiological Changes and to Improve Psychological Functioning in Adults With Nonspecific Chronic Low Back Pain (BackFit App): Nonrandomized Clinical Trial. JMIR Mhealth Uhealth 2022; 10:e29171. [PMID: 35289758 PMCID: PMC8965676 DOI: 10.2196/29171] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/28/2021] [Accepted: 01/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background
Concomitant psychological and cognitive impairments modulate nociceptive processing and contribute to chronic low back pain (CLBP) maintenance, poorly correlated with radiological findings. Clinical practice guidelines recommend self-management and multidisciplinary educational and exercise-based interventions. However, these recommendations are based on self-reported measurements, which lack evidence of related electrophysiological changes. Furthermore, current mobile health (mHealth) tools for self-management are of low quality and scarce evidence. Thus, it is necessary to increase knowledge on mHealth and electrophysiological changes elicited by current evidence-based interventions.
Objective
The aim of this study is to investigate changes elicited by a self-managed educational and exercise-based 4-week mHealth intervention (BackFit app) in electroencephalographic and electrocardiographic activity, pressure pain thresholds (PPTs), pain, disability, and psychological and cognitive functioning in CLBP versus the same intervention in a face-to-face modality.
Methods
A 2-arm parallel nonrandomized clinical trial was conducted at the University of the Balearic Islands (Palma, Spain). A total of 50 patients with nonspecific CLBP were assigned to a self-managed group (23/50, 46%; mean age 45.00, SD 9.13 years; 10/23, 43% men) or a face-to-face group (27/50, 54%; mean age 48.63, SD 7.54 years; 7/27, 26% men). The primary outcomes were electroencephalographic activity (at rest and during a modified version of the Eriksen flanker task) and heart rate variability (at rest), PPTs, and pressure pain intensity ratings. The secondary outcomes were pain, disability, psychological functioning (mood, anxiety, kinesiophobia, pain catastrophizing, and fear-avoidance beliefs), and cognitive performance (percentage of hits and reaction times).
Results
After the intervention, frequency analysis of electroencephalographic resting-state data showed increased beta-2 (16-23 Hz; 0.0020 vs 0.0024; P=.02) and beta-3 (23-30 Hz; 0.0013 vs 0.0018; P=.03) activity. In addition, source analyses revealed higher power density of beta (16-30 Hz) at the anterior cingulate cortex and alpha (8-12 Hz) at the postcentral gyrus and lower power density of delta (2-4 Hz) at the cuneus and precuneus. Both groups also improved depression (7.74 vs 5.15; P=.01), kinesiophobia (22.91 vs 20.87; P=.002), activity avoidance (14.49 vs 12.86; P<.001), helplessness (6.38 vs 4.74; P=.02), fear-avoidance beliefs (35 vs 29.11; P=.03), and avoidance of physical activity (12.07 vs 9.28; P=.01) scores, but there was an increase in the disability score (6.08 vs 7.5; P=.01). No significant differences between the groups or sessions were found in heart rate variability resting-state data, electroencephalographic data from the Eriksen flanker task, PPTs, subjective ratings, or cognitive performance.
Conclusions
Both intervention modalities increased mainly beta activity at rest and improved psychological functioning. Given the limitations of our study, conclusions must be drawn carefully and further research will be needed. Nevertheless, to the best of our knowledge, this is the first study reporting electroencephalographic changes in patients with CLBP after an mHealth intervention.
Trial Registration
ClinicalTrials.gov NCT04576611; https://clinicaltrials.gov/ct2/show/NCT04576611
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Affiliation(s)
- Carolina Sitges
- Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), Department of Psychology, University of the Balearic Islands (UIB), Palma, Spain
| | - Juan L Terrasa
- Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), Department of Psychology, University of the Balearic Islands (UIB), Palma, Spain
| | - Nuria García-Dopico
- Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Palma, Spain
| | - Joan Segur-Ferrer
- Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
| | - Olga Velasco-Roldán
- Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Palma, Spain
| | - Jaume Crespí-Palmer
- Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
| | - Ana María González-Roldán
- Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), Department of Psychology, University of the Balearic Islands (UIB), Palma, Spain
| | - Pedro Montoya
- Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), Department of Psychology, University of the Balearic Islands (UIB), Palma, Spain
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García-Dopico N, de la Torre-Luque A, Sitges C, Velasco-Roldán O. Proprioceptive acuity is core for back awareness in chronic low back pain: Further analysis of the content validity of the Spanish version of the Fremantle Back Awareness Questionnaire. Front Hum Neurosci 2022; 16:1070402. [PMID: 36875741 PMCID: PMC9983349 DOI: 10.3389/fnhum.2022.1070402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 12/28/2022] [Indexed: 02/19/2023] Open
Abstract
Treatments aimed at increasing self-perception may improve chronic low back pain (CLBP) symptomatology and present novel management approaches. Consequently, it is important to have valid, complete, and reliable tools for its assessment, and to understand which variables influence altered back awareness. We aimed to evaluate the face/content validity of the Spanish version of the Fremantle Back Awareness Questionnaire (FreBAQ-S) among people with and without CLBP, and to explore additional variables suggested to be involved in back awareness. A total of 264 individuals with CLBP and 128 healthy controls (HC) answered an online survey, including the FreBAQ-S, and questions regarding the completeness, comprehensibility, time-to-complete adequacy, and time spent completing it. If participants declared a lack of completeness, they had to report which aspects would be incorporated into the questionnaire to explore additional back-awareness-related variables. A statistically significant difference in completeness emerged between groups (p < 0.01). The questionnaire was comprehensible for more than 85% of participants, regardless of the group (p = 0.45). CLBP participants spent significantly more time in completing the questionnaire than controls (p < 0.01), but no differences were found between groups regarding the time-to-complete adequacy (p = 0.49). Regarding the back-awareness-related variables, 77 suggestions from CLBP group and seven from the HC were received. Most of them were related to proprioceptive acuity such as posture, weight, or movement patterns, among others. The FreBAQ-S demonstrated adequate face/content validity, completeness, comprehensibility, and adequate time of response. The feedback provided will help improve currently available assessment tools.
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Affiliation(s)
- Nuria García-Dopico
- Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Palma, Spain.,Research Institute of Health Sciences (IUNICS), Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Alejandro de la Torre-Luque
- Department of Legal Medicine, Psychiatry and Pathology, CIBERSAM ISCIII, Complutense University of Madrid (UCM), Madrid, Spain
| | - Carolina Sitges
- Research Institute of Health Sciences (IUNICS), Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain.,Department of Psychology, University of the Balearic Islands (UIB), Palma, Spain
| | - Olga Velasco-Roldán
- Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Palma, Spain.,Research Institute of Health Sciences (IUNICS), Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
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Terrasa JL, Montoya P, Sitges C, van der Meulen M, Anton F, González-Roldán AM. Anterior Cingulate Cortex Activity During Rest Is Related to Alterations in Pain Perception in Aging. Front Aging Neurosci 2021; 13:695200. [PMID: 34295241 PMCID: PMC8291150 DOI: 10.3389/fnagi.2021.695200] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/08/2021] [Indexed: 11/13/2022] Open
Abstract
Alterations in the affective component of pain perception are related to the development of chronic pain and may contribute to the increased vulnerability to pain observed in aging. The present study analyzed age-related changes in resting-state brain activity and their possible relation to an increased pain perception in older adults. For this purpose, we compared EEG current source density and fMRI functional-connectivity at rest in older (n = 20, 66.21 ± 3.08 years) and younger adults (n = 21, 20.71 ± 2.30 years) and correlated those brain activity parameters with pain intensity and unpleasantness ratings elicited by painful stimulation. We found an age-related increase in beta2 and beta3 activity in temporal, frontal, and limbic areas, and a decrease in alpha activity in frontal areas. Moreover, older participants displayed increased functional connectivity in the anterior cingulate cortex (ACC) and the insula with precentral and postcentral gyrus. Finally, ACC beta3 activity was positively correlated with pain intensity and unpleasantness ratings in older, and ACC-precentral/postcentral gyrus connectivity was positively correlated with unpleasantness ratings in older and younger participants. These results reveal that ACC resting-state hyperactivity is a stable trait of brain aging and may underlie their characteristic altered pain perception.
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Affiliation(s)
- Juan L Terrasa
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
| | - Pedro Montoya
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
| | - Carolina Sitges
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
| | | | - Fernand Anton
- Institute for Health and Behavior, University of Luxembourg, Luxembourg, Luxembourg
| | - Ana M González-Roldán
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
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Fiol-DeRoque MA, Serrano-Ripoll MJ, Jiménez R, Zamanillo-Campos R, Yáñez-Juan AM, Bennasar-Veny M, Leiva A, Gervilla E, García-Buades ME, García-Toro M, Alonso-Coello P, Pastor-Moreno G, Ruiz-Pérez I, Sitges C, García-Campayo J, Llobera-Cánaves J, Ricci-Cabello I. A Mobile Phone-Based Intervention to Reduce Mental Health Problems in Health Care Workers During the COVID-19 Pandemic (PsyCovidApp): Randomized Controlled Trial. JMIR Mhealth Uhealth 2021; 9:e27039. [PMID: 33909587 PMCID: PMC8133164 DOI: 10.2196/27039] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/08/2021] [Accepted: 03/31/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The global health emergency generated by the COVID-19 pandemic is posing an unprecedented challenge to health care workers, who are facing heavy workloads under psychologically difficult situations. Mental mobile Health (mHealth) interventions are now being widely deployed due to their attractive implementation features, despite the lack of evidence about their efficacy in this specific population and context. OBJECTIVE The aim of this trial is to evaluate the effectiveness of a psychoeducational, mindfulness-based mHealth intervention to reduce mental health problems in health care workers during the COVID-19 pandemic. METHODS We conducted a blinded, parallel-group, controlled trial in Spain. Health care workers providing face-to-face health care to patients with COVID-19 were randomly assigned (1:1) to receive the PsyCovidApp intervention (an app targeting emotional skills, healthy lifestyle behavior, burnout, and social support) or a control app (general recommendations about mental health care) for 2 weeks. The participants were blinded to their group allocation. Data were collected telephonically at baseline and after 2 weeks by trained health psychologists. The primary outcome was a composite of depression, anxiety, and stress (overall score on the Depression Anxiety Stress Scale-21 [DASS-21]). Secondary outcomes were insomnia (Insomnia Severity Index), burnout (Maslach Burnout Inventory Human Services Survey), posttraumatic stress (Davidson Trauma Scale), self-efficacy (General Self-Efficacy Scale), and DASS-21 individual scale scores. Differences between groups were analyzed using general linear modeling according to an intention-to-treat protocol. Additionally, we measured the usability of the PsyCovidApp (System Usability Scale). The outcome data collectors and trial statisticians were unaware of the treatment allocation. RESULTS Between May 14 and July 25, 2020, 482 health care workers were recruited and randomly assigned to PsyCovidApp (n=248) or the control app (n=234). At 2 weeks, complete outcome data were available for 436/482 participants (90.5%). No significant differences were observed between the groups at 2 weeks in the primary outcome (standardized mean difference -0.04; 95% CI -0.11 to 0.04; P=.15) or in the other outcomes. In our prespecified subgroup analyses, we observed significant improvements among health care workers consuming psychotropic medications (n=79) in the primary outcome (-0.29; 95% CI -0.48 to -0.09; P=.004), and in posttraumatic stress, insomnia, anxiety, and stress. Similarly, among health care workers receiving psychotherapy (n=43), we observed improvements in the primary outcome (-0.25; 95% CI -0.49 to -0.02; P=.02), and in insomnia, anxiety, and stress. The mean usability score of PsyCovidApp was high (87.21/100, SD 12.65). After the trial, 208/221 participants in the intervention group (94.1%) asked to regain access to PsyCovidApp, indicating high acceptability. CONCLUSIONS In health care workers assisting patients with COVID-19 in Spain, PsyCovidApp, compared with a control app, reduced mental health problems at 2 weeks only among health care workers receiving psychotherapy or psychotropic medications. TRIAL REGISTRATION ClinicalTrials.gov NCT04393818; https://clinicaltrials.gov/ct2/show/NCT04393818.
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Affiliation(s)
- Maria Antònia Fiol-DeRoque
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma de Mallorca, Spain
| | - Maria Jesús Serrano-Ripoll
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma de Mallorca, Spain
- Department of Psychology, University of the Balearic Islands (UIB), Palma de Mallorca, Spain
| | - Rafael Jiménez
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Department of Psychology, University of the Balearic Islands (UIB), Palma de Mallorca, Spain
| | - Rocío Zamanillo-Campos
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma de Mallorca, Spain
- Department of Health, Valencian International University (VIU), Valencia, Spain
| | - Aina María Yáñez-Juan
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Research Group on Global Health & Human Development, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Miquel Bennasar-Veny
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Alfonso Leiva
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma de Mallorca, Spain
- Primary Care Prevention and Health Promotion Research Network, Madrid, Spain
| | - Elena Gervilla
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Department of Psychology, University of the Balearic Islands (UIB), Palma de Mallorca, Spain
| | - M Esther García-Buades
- Department of Psychology, University of the Balearic Islands (UIB), Palma de Mallorca, Spain
| | - Mauro García-Toro
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
| | - Pablo Alonso-Coello
- CIBER de Epidemiología y Salud Pública, Madrid, Spain
- Department of Clinical Epidemiology and Public Health, Biomedical Research Institute Sant Pau, Iberoamerican Cochrane Centre, Barcelona, Spain
| | - Guadalupe Pastor-Moreno
- CIBER de Epidemiología y Salud Pública, Madrid, Spain
- Andalusian School of Public Health, Granada, Spain
| | - Isabel Ruiz-Pérez
- CIBER de Epidemiología y Salud Pública, Madrid, Spain
- Andalusian School of Public Health, Granada, Spain
| | - Carolina Sitges
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Department of Psychology, University of the Balearic Islands (UIB), Palma de Mallorca, Spain
- Department of Psychology, Research Institute of Health Sciences, Palma de Mallorca, Spain
| | - Javier García-Campayo
- Primary Care Prevention and Health Promotion Research Network, Madrid, Spain
- Aragon Institute for Health Research, Miguel Servet University Hospital, Zaragoza, Spain
| | - Joan Llobera-Cánaves
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma de Mallorca, Spain
- Primary Care Prevention and Health Promotion Research Network, Madrid, Spain
| | - Ignacio Ricci-Cabello
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma de Mallorca, Spain
- CIBER de Epidemiología y Salud Pública, Madrid, Spain
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9
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González-Roldán AM, Terrasa JL, Prats-Sedano MA, Sitges C, van der Meulen M, Anton F, Montoya P. Intact pain modulation through manipulation of controllability and expectations in aging. Eur J Pain 2021; 25:1472-1481. [PMID: 33666318 DOI: 10.1002/ejp.1760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 03/03/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND Pain expectation and controllability can modulate pain processing. However, little is known about age-related effects on these cognitive factors involved in pain control. This study assessed age-related brain changes associated with pain expectation and controllability. METHODS 17 healthy older adults (9 men; 65.65 ± 4.34 years) and 18 healthy younger adults (8 men; 20.56 ± 5.56 years) participated in the study. Pain evoked potentials and pain ratings were recorded while participants received painful electrical stimuli under two different conditions of pain controllability over the intensity of the stimulation (self-controlled vs. computer controlled) and two conditions of pain expectations (high vs. low pain). RESULTS Although the intensity of the painful stimulation was kept constant, all participants showed reduced pain perception in the controllable and low pain expectancy conditions. However, older participants showed reduced amplitudes of pain evoked potentials in the time window between 150 and 500 ms after stimulus onset as compared to younger participants. Moreover, younger participants showed greater negative amplitudes from 80 to 150 ms after stimulus onset for uncontrollable versus controllable pain. CONCLUSIONS These results suggest that although cognitive pain modulation is preserved during ageing, neural processing of pain is reduced in older adults. SIGNIFICANCE This research describes the impact of age on cognitive pain modulation evoked by the manipulation of pain controllability and pain expectations. Our findings constitute a first step in the understanding of the greater vulnerability of older individuals to chronic pain. Moreover, we show that older adults can benefit from cognitive pain control mechanisms to increase the efficacy of pain treatments.
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Affiliation(s)
- Ana María González-Roldán
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
| | - Juan Lorenzo Terrasa
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
| | | | - Carolina Sitges
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
| | - Marian van der Meulen
- Department of Behavioural and Cognitive Sciences, Institute of Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Fernand Anton
- Department of Behavioural and Cognitive Sciences, Institute of Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Pedro Montoya
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
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10
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Serrano-Ripoll MJ, Ricci-Cabello I, Jiménez R, Zamanillo-Campos R, Yañez-Juan AM, Bennasar-Veny M, Sitges C, Gervilla E, Leiva A, García-Campayo J, García-Buades ME, García-Toro M, Pastor-Moreno G, Ruiz-Perez I, Alonso-Coello P, Llobera J, Fiol-deRoque MA. Effect of a mobile-based intervention on mental health in frontline healthcare workers against COVID-19: Protocol for a randomized controlled trial. J Adv Nurs 2021; 77:2898-2907. [PMID: 33675247 PMCID: PMC8250879 DOI: 10.1111/jan.14813] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 12/20/2022]
Abstract
Aim To evaluate the impact of a psychoeducational, mobile health intervention based on cognitive behavioural therapy and mindfulness‐based approaches on the mental health of healthcare workers at the frontline against COVID‐19 in Spain. Design We will carry out a two‐week, individually randomized, parallel group, controlled trial. Participants will be individually randomized to receive the PsyCovidApp intervention or control App intervention. Methods The PsyCovidApp intervention will include five modules: emotional skills, lifestyle behaviour, work stress and burnout, social support, and practical tools. Healthcare workers having attended patients with COVID‐19 will be randomized to receive the PsyCovidApp intervention (intervention group) or a control App intervention (control group). A total of 440 healthcare workers will be necessary to assure statistical power. Measures will be collected telephonically by a team of psychologists at baseline and immediately after the 2 weeks intervention period. Measures will include stress, depression and anxiety (DASS‐21 questionnaire—primary endpoint), insomnia (ISI), burnout (MBI‐HSS), post‐traumatic stress disorder (DTS), and self‐efficacy (GSE). The study was funded in May 2020, and was ethically approved in June 2020. Trial participants, outcome assessors and data analysts will be blinded to group allocation. Discussion Despite the increasing use of mobile health interventions to deliver mental health care, this area of research is still on its infancy. This study will help increase the scientific evidence about the effectiveness of this type of intervention on this specific population and context. Impact Despite the lack of solid evidence about their effectiveness, mobile‐based health interventions are already being widely implemented because of their low cost and high scalability. The findings from this study will help health services and organizations to make informed decisions in relation to the development and implementation of this type of interventions, allowing them pondering not only their attractive implementability features, but also empirical data about its benefits. Clinical trial registration NCT04393818 (ClinicalTrials.gov identifier). Approved funding May 2020.
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Affiliation(s)
- Maria J Serrano-Ripoll
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, Spain.,Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Balearic Islands, Spain.,Department of Psychology, University of the Balearic Islands (UIB), Palma, Balearic Islands, Spain
| | - Ignacio Ricci-Cabello
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, Spain.,Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Balearic Islands, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Rafael Jiménez
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, Spain.,Department of Psychology, University of the Balearic Islands (UIB), Palma, Balearic Islands, Spain
| | - Rocío Zamanillo-Campos
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, Spain.,Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Balearic Islands, Spain.,Department of Health, Valencian International University (VIU), Valencia, Spain
| | - Aina M Yañez-Juan
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, Spain.,Research Group on Global Health & Human Development, University of the Balearic Islands, Palma, Illes Balears, Spain
| | - Miquel Bennasar-Veny
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, Spain.,Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma, Illes Balears, Spain
| | - Carolina Sitges
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, Spain.,Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Balearic Islands, Spain.,Department of Psychology, Research Institute of Health Sciences (IUNICS), UIB, Palma, Balearic Islands, Spain
| | - Elena Gervilla
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, Spain.,Department of Psychology, University of the Balearic Islands (UIB), Palma, Balearic Islands, Spain
| | - Alfonso Leiva
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, Spain.,Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Balearic Islands, Spain.,Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain
| | - Javier García-Campayo
- Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain.,Aragon Institute for Health Research (IIS Aragón), Miguel Servet University Hospital, Zaragoza, Aragón, Spain
| | - M Esther García-Buades
- Department of Psychology, University of the Balearic Islands (UIB), Palma, Balearic Islands, Spain
| | - Mauro García-Toro
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, Spain
| | - Guadalupe Pastor-Moreno
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Andalusian School of Public Health (EASP), Granada, Andalucía, Spain
| | - Isabel Ruiz-Perez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Andalusian School of Public Health (EASP), Granada, Andalucía, Spain
| | - Pablo Alonso-Coello
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Iberoamerican Cochrane Centre, Department of Clinical Epidemiology and Public Health, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Joan Llobera
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, Spain.,Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Balearic Islands, Spain.,Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain
| | - Maria A Fiol-deRoque
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, Spain.,Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Balearic Islands, Spain
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11
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Sitges C, Velasco-Roldán O, Crespí J, García-Dopico N, Segur-Ferrer J, González-Roldán AM, Montoya P. Acute Effects of a Brief Physical Exercise Intervention on Somatosensory Perception, Lumbar Strength, and Flexibility in Patients with Nonspecific Chronic Low-Back Pain. J Pain Res 2021; 14:487-500. [PMID: 33633462 PMCID: PMC7901430 DOI: 10.2147/jpr.s274134] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/14/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Evidence-based clinical guidelines consider physical exercise one of the best nonpharmacological interventions for low-back pain (LBP), but it is necessary to clarify the exercise-induced hypoalgesia effect of different modalities of exercise in chronic pain populations. PURPOSE This study focused on exploring acute changes in tactile and pressure-pain perception and lumbar strength and flexibility in patients with nonspecific chronic LBP (NSCLBP) after performing one of three 20-minute physical exercise modalities. METHODS A total of 81 patients with NSCLBP were pseudorandomly distributed into three groups of 20-minute physical exercise - 1) aerobic (n=21, mean age 42±9.72 years, nine men), 2) stretching (n=21, mean age 40±11.37 years, ten men), and 3) strengthening (n=20, mean age 35.80±11.56 years, ten men) - and 4) a control group (n=19, mean age 38.64±10.24 years, eight men), and completed self-reported questionnaires during the same period. Tactile and pressure-pain thresholds and isometric lumbar muscle endurance and flexibility were assessed before and after this brief exercise-based intervention. RESULTS All groups were comparable in terms of sociodemographic and clinical data, cardiovascular capacity, and self-reported data onphysical disability, mood, motivation, psychological response to stimulus properties of physical exercise, and physical activity enjoyment. Our analyses revealed higher tactile sensitivity (p<0.001) and pressure-pain thresholds (p<0.001) at the forefinger than other body locations. We also found lower pain sensitivity (p=0.010) and pressure pain-intensity ratings (p=0.001) and higher lumbar flexibility (p<0.001) after intervention. After calculation of absolute pre-post differences, higher tactile sensitivity was observed at the gluteus medius muscle than the erector spinal muscle only after aerobic intervention (p=0.046). CONCLUSION These results add some evidence about different modalities of exercise-induced hypoalgesia in NSCLBP. However, the fact that we also found improvements in the control group limits our conclusions.
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Affiliation(s)
- Carolina Sitges
- Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
- Departament of Psychology, UIB, Palma, Spain
| | - Olga Velasco-Roldán
- Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
- Departament of Nursing and Physiotherapy, UIB, Palma, Spain
| | - Jaume Crespí
- Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
| | - Nuria García-Dopico
- Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
| | - Joan Segur-Ferrer
- Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
| | - Ana María González-Roldán
- Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
- Departament of Psychology, UIB, Palma, Spain
| | - Pedro Montoya
- Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
- Departament of Psychology, UIB, Palma, Spain
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12
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González-Roldán AM, Terrasa JL, Sitges C, van der Meulen M, Anton F, Montoya P. Age-Related Changes in Pain Perception Are Associated With Altered Functional Connectivity During Resting State. Front Aging Neurosci 2020; 12:116. [PMID: 32457594 PMCID: PMC7221150 DOI: 10.3389/fnagi.2020.00116] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 04/07/2020] [Indexed: 01/08/2023] Open
Abstract
Aging affects pain experience and brain functioning. However, how aging leads to changes in pain perception and brain functional connectivity has not yet been completely understood. To investigate resting-state and pain perception changes in old and young participants, this study employed region of interest (ROI) to ROI resting-state functional connectivity (rsFC) analysis of imaging data by using regions implicated in sensory and affective dimensions of pain, descending pain modulation, and the default-mode networks (DMNs). Thirty-seven older (66.86 ± 4.04 years; 16 males) and 38 younger healthy participants (20.74 ± 4.15 years; 19 males) underwent 10 min’ eyes-closed resting-state scanning. We examined the relationship between rsFC parameters with pressure pain thresholds. Older participants showed higher pain thresholds than younger. Regarding rsFC, older adults displayed increased connectivity of pain-related sensory brain regions in comparison to younger participants: increased rsFC between bilateral primary somatosensory area (SI) and anterior cingulate cortex (ACC), and between SI(L) and secondary somatosensory area (SII)-(R) and dorsolateral prefrontal cortex (PFC). Moreover, decreased connectivity in the older compared to the younger group was found among descending pain modulatory regions: between the amygdala(R) and bilateral insula(R), thalamus(R), ACC, and amygdala(L); between the amygdala(L) and insula(R) and bilateral thalamus; between ACC and bilateral insula, and between periaqueductal gray (PAG) and bilateral thalamus. Regarding the DMN, the posterior parietal cortex and lateral parietal (LP; R) were more strongly connected in the older group than in the younger group. Correlational analyses also showed that SI(L)-SII(R) rsFC was positively associated with pressure pain thresholds in older participants. In conclusion, these findings suggest a compensatory mechanism for the sensory changes that typically accompanies aging. Furthermore, older participants showed reduced functional connectivity between key nodes of the descending pain inhibitory pathway.
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Affiliation(s)
- Ana M González-Roldán
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
| | - Juan L Terrasa
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
| | - Carolina Sitges
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
| | - Marian van der Meulen
- Institute for Health and Behaviour, University of Luxembourg, Luxembourg, Luxembourg
| | - Fernand Anton
- Institute for Health and Behaviour, University of Luxembourg, Luxembourg, Luxembourg
| | - Pedro Montoya
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
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13
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Abstract
Depression is one of the most common mental health problems which affects more than 10% of the global population. The prevalence of this disorder is higher in fibromyalgia patients. However, the influence of the combination of depression and fibromyalgia in the brain processing is poorly understood.To explore the modifications of EEG power spectrum in women with fibromyalgia when depressive feelings are elicited.Twenty eight women with fibromyalgia participated in this cross-sectional study. They were classified as women with depression or women without depression according to the score in the Geriatric Depression Scale. This questionnaire was used to elicit depression symptoms during the EEG recording. Analyses were performed with the standardized LOw Resolution Electric Tomography (sLORETA) software. Power spectrum were compared in the following frequency bands: delta, theta, alpha-1, alpha-2, beta-1, beta-2, and beta-3.Fibromyalgia patients with untreated depression showed a hypoactivation of the left hemisphere when compared with fibromyalgia patients without depression. In addition, when compared fibromyalgia patients without depression and women with both fibromyalgia and depression who were taking antidepressant medications, differences in EEG power spectrum in the studied frequency bands were not found.The current study contributes to the understanding on the influence of the combination of fibromyalgia and depression in the brain activity patterns. Patients with untreated depression showed a hypoactivation of the left hemisphere while eliciting depression symptoms. However, further research is needed, antidepressant medication might reduce the differences between patients with depression and those who do not suffer from depression symptoms.
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Affiliation(s)
- Santos Villafaina
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Science, University of Extremadura
- EXERNET Research Network on Exercise and Health in Special Populations
| | - Carolina Sitges
- Balearic Islands Health Research Institute (IdISBa), Research Institute on Health Sciences (IUNICS), University of Balearic Islands (UIB
| | - Daniel Collado-Mateo
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Science, University of Extremadura
- EXERNET Research Network on Exercise and Health in Special Populations
- Facultad de Educación, Universidad Autónoma de Chile, Talca, Chile
| | | | - Narcis Gusi
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Science, University of Extremadura
- EXERNET Research Network on Exercise and Health in Special Populations
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14
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Terrasa JL, Montoya P, González-Roldán AM, Sitges C. Corrigendum: Inhibitory Control Impairment on Somatosensory Gating Due to Aging: An Event-Related Potential Study. Front Hum Neurosci 2018; 12:333. [PMID: 30158863 PMCID: PMC6111142 DOI: 10.3389/fnhum.2018.00333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 08/01/2018] [Indexed: 11/17/2022] Open
Affiliation(s)
- Juan L Terrasa
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS), Balearic Islands Health Research Institute, University of the Balearic Islands, Palma, Spain
| | - Pedro Montoya
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS), Balearic Islands Health Research Institute, University of the Balearic Islands, Palma, Spain
| | - Ana M González-Roldán
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS), Balearic Islands Health Research Institute, University of the Balearic Islands, Palma, Spain
| | - Carolina Sitges
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS), Balearic Islands Health Research Institute, University of the Balearic Islands, Palma, Spain
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15
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Terrasa JL, Montoya P, González-Roldán AM, Sitges C. Inhibitory Control Impairment on Somatosensory Gating Due to Aging: An Event-Related Potential Study. Front Hum Neurosci 2018; 12:280. [PMID: 30050421 PMCID: PMC6052091 DOI: 10.3389/fnhum.2018.00280] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 06/21/2018] [Indexed: 01/19/2023] Open
Abstract
The capacity to suppress irrelevant incoming input, termed sensory gating, is one of the most investigated inhibitory processes associated with cognitive impairments due to aging. The aim of this study was to examine the influence of aging on sensory gating by using somatosensory event-related potentials (ERPs) elicited by repetitive non-painful tactile stimulation (paired-pulsed task). Somatosensory ERPs were recorded in 20 healthy young adults and 20 healthy older adults while they received two identical pneumatic stimuli (S1 and S2) of 100 ms duration with an inter-stimulus interval of 550 ± 50 ms on both forefingers. The difference between the somatosensory ERPs amplitude elicited by S1 and S2 was computed as a sensory gating measure. The amplitude and the latency of P50, N100 and late positive complex (LPC) were analyzed as well as the source generators of the gating effect. Reduced sensory gating was found in older individuals for N100 at frontal and centro-parietal electrodes and for LPC at fronto-central electrodes. Source localization analyses also revealed a reduced current density during gating effect in the older group in frontal areas in N100 and LPC. Moreover, older individuals showed delayed latencies in N100. No significant gating effect differences were found between groups in P50. These findings suggest an age-related slowing of processing speed and a reduced efficiency of inhibitory mechanisms in response to repetitive somatosensory information during stimulus evaluation, and a preservation of processing speed and inhibitory control during early stimulus coding in aging.
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Affiliation(s)
- Juan L Terrasa
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS), Balearic Islands Health Research Institute, University of the Balearic Islands, Palma, Spain
| | - Pedro Montoya
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS), Balearic Islands Health Research Institute, University of the Balearic Islands, Palma, Spain
| | - Ana M González-Roldán
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS), Balearic Islands Health Research Institute, University of the Balearic Islands, Palma, Spain
| | - Carolina Sitges
- Cognitive and Affective Neuroscience and Clinical Psychology, Research Institute of Health Sciences (IUNICS), Balearic Islands Health Research Institute, University of the Balearic Islands, Palma, Spain
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16
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Abstract
OBJECTIVE Previous fMRI findings have shown that chronic pain patients display an altered activation and functional connectivity of the pain network. The aim of the present study was to analyze EEG dynamics in fibromyalgia patients (n = 20) and pain-free controls (n = 18) at rest. METHODS Spectral power density, source current density, and intra- and inter-hemispheric coherence were analyzed from 64 EEG channels during 5-minutes eyes-closed rest. RESULTS Results indicated that fibromyalgia patients displayed reduced power density of the delta EEG band (2-4 Hz) over right insula, right superior and middle temporal gyri as compared with pain-free controls. Fibromyalgia patients also exhibited greater power density than pain-free controls in two segments of the beta band (16-23 Hz and 23-30 Hz) over right middle frontal lobe and midcingulate gyrus. Pain duration in fibromyalgia patients was negatively correlated with delta power from right insula. Greater centro-parietal intra-hemispheric coherence was observed at the left hemisphere on theta (4-8 Hz), and beta-3 (23-30 Hz) frequency bands in fibromyalgia patients than in pain-free controls. Individual differences in depression, anxiety or negative affect did not account for these findings. CONCLUSIONS Fibromyalgia leads to an altered dynamic of the brain network involved in the processing of pain even at rest. Furthermore ,: our results provide further support for the feasibility of resting-state EEG analyses as a clinical biomarker for the characterization of chronic pain states.
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Affiliation(s)
- Ana M González-Roldán
- *Research Institute of Health Sciences (IUNICS), University of Balearic Islands, Palma, Spain
| | - Ignacio Cifre
- Facultat de Psicologia, Ciències de l'educació i de l'Esport, Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Carolina Sitges
- *Research Institute of Health Sciences (IUNICS), University of Balearic Islands, Palma, Spain
| | - Pedro Montoya
- *Research Institute of Health Sciences (IUNICS), University of Balearic Islands, Palma, Spain
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17
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Martínez-Jauand M, Sitges C, Femenia J, Cifre I, González S, Chialvo D, Montoya P. Age-of-onset of menopause is associated with enhanced painful and non-painful sensitivity in fibromyalgia. Clin Rheumatol 2013; 32:975-81. [DOI: 10.1007/s10067-013-2212-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2012] [Revised: 01/18/2013] [Accepted: 02/02/2013] [Indexed: 11/28/2022]
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Martínez-Jauand M, González-Roldán AM, Muñoz MA, Sitges C, Cifre I, Montoya P. Somatosensory activity modulation during observation of other's pain and touch. Brain Res 2012; 1467:48-55. [DOI: 10.1016/j.brainres.2012.05.055] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Revised: 05/23/2012] [Accepted: 05/30/2012] [Indexed: 12/14/2022]
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Martínez-Jauand M, Sitges C, Rodríguez V, Picornell A, Ramon M, Buskila D, Montoya P. Pain sensitivity in fibromyalgia is associated with catechol-O-methyltransferase (COMT) gene. Eur J Pain 2012; 17:16-27. [DOI: 10.1002/j.1532-2149.2012.00153.x] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2012] [Indexed: 12/30/2022]
Affiliation(s)
- M. Martínez-Jauand
- University Institute of Health Sciences Research (IUNICS); University of Balearic Islands; Palma; Spain
| | - C. Sitges
- University Institute of Health Sciences Research (IUNICS); University of Balearic Islands; Palma; Spain
| | | | | | | | - D. Buskila
- Division of Internal Medicine; Ben-Gurion University of the Negev; Israel
| | - P. Montoya
- University Institute of Health Sciences Research (IUNICS); University of Balearic Islands; Palma; Spain
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Sánchez-Nàcher N, Campos-Bueno JJ, Sitges C, Montoya P. Event-related brain responses as correlates of changes in predictive and affective values of conditioned stimuli. Brain Res 2011; 1414:77-84. [PMID: 21871611 DOI: 10.1016/j.brainres.2011.07.049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Revised: 07/20/2011] [Accepted: 07/23/2011] [Indexed: 10/17/2022]
Abstract
Previous evidence suggests that the judged predictive strength of one cue may be influenced by the predictive strengths of other pretrained cues (prediction errors). In the present study, we examined affective ratings and event-related brain responses from 18 healthy participants during an aversive conditioning task in which affective values of previously trained conditioned stimuli were modified through a blocking procedure. The task was divided into two phases. During the training phase, single stimulus A (e.g., red square) was always followed by aversive picture stimuli, while single stimulus B (e.g., yellow square) was signaling the absence of aversive stimulation. During the blocking phase, compound stimuli consisted of the combination of one single trained stimulus (A or B) and one new somatosensory stimulus were also followed by the presence of aversive stimulation. Results indicated that single stimulus A elicited greater ERP amplitudes and theta power, and was rated as more unpleasant than single stimulus B during the training phase. Moreover, single stimulus B elicited greater ERP amplitudes than stimulus A, as well as greater theta power and more unpleasant ratings during the blocking as compared with the training phase. By contrast, no changes in ERP amplitudes and theta power were observed for stimulus A. Our findings provide neurophysiological and behavioral evidence for an increased affective processing of conditioned stimuli when compound stimuli were introduced, but only if the target CS was previously trained to signal the absence of aversive stimulation.
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Affiliation(s)
- Noemí Sánchez-Nàcher
- Research Institute on Health Sciences (IUNICS), University of Balearic Islands, Spain
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González-Roldan AM, Martínez-Jauand M, Muñoz-García MA, Sitges C, Cifre I, Montoya P. Temporal dissociation in the brain processing of pain and anger faces with different intensities of emotional expression. Pain 2011; 152:853-859. [DOI: 10.1016/j.pain.2010.12.037] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2010] [Revised: 11/22/2010] [Accepted: 12/21/2010] [Indexed: 10/18/2022]
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Sitges C, Bornas X, Llabrés J, Noguera M, Montoya P. Linear and nonlinear analyses of EEG dynamics during non-painful somatosensory processing in chronic pain patients. Int J Psychophysiol 2010; 77:176-83. [PMID: 20538021 DOI: 10.1016/j.ijpsycho.2010.05.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Revised: 05/23/2010] [Accepted: 05/31/2010] [Indexed: 10/19/2022]
Abstract
The aim of our study was to characterize brain dynamics of affective modulation of somatosensory processing in chronic pain. We hypothesized that chronic pain patients will show abnormal EEG activity under negative mood conditions compared to healthy controls. Nineteen patients with chronic pain and 21 healthy subjects participated in the experiment. Multiscale entropy, fractal dimension, event-related potentials, and fast Fourier transform were used to analyze EEG data. A significant enhancement of entropy was found in pain patients at P4 compared to P3. Analysis of fractal dimension also revealed significantly higher values at P4 than P3 when pain patients were viewing unpleasant pictures. By contrast, no significant differences due to hemisphere or affective condition were found on nonlinear measures for healthy controls. Analyses of somatosensory ERPs showed that P50 amplitudes elicited by pleasant pictures were more reduced in chronic pain patients than in healthy controls. Finally, we observed that EEG band power was lower in pain patients than in healthy controls, in particular for theta and beta bands over sensorimotor cortices and temporal regions when viewing pleasant images. These findings suggest that sustained pain seems to be accompanied by an abnormal activation and dynamic of brain networks related to emotional processing of somatosensory information in chronic pain. Furthermore, our findings suggest that both linear and nonlinear measures of EEG time series may contribute to the understanding of brain dysfunction in chronic pain.
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Affiliation(s)
- Carolina Sitges
- University Institute of Health Sciences Research (IUNICS), University of Balearic Islands (UIB), Palma, Spain
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Montoya P, Larbig W, Sitges C, Veit R, Birbaumer N. 216 SOCIAL SUPPORT MODULATES BRAIN ACTIVATION IN FIBROMYALGIA PATIENTS. Eur J Pain 2009. [DOI: 10.1016/s1090-3801(09)60219-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- P. Montoya
- Research Institute on Health Sciences (IUNICS) University of Balearic Islands, Palma, Spain
| | - W. Larbig
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tuebingen, Tuebingen, Germany
| | - C. Sitges
- Research Institute on Health Sciences (IUNICS) University of Balearic Islands, Palma, Spain
| | - R. Veit
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tuebingen, Tuebingen, Germany
| | - N. Birbaumer
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tuebingen, Tuebingen, Germany
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Sitges C, García-Herrera M, Pericás M, Collado D, Truyols M, Montoya P. Abnormal brain processing of affective and sensory pain descriptors in chronic pain patients. J Affect Disord 2007; 104:73-82. [PMID: 17434596 DOI: 10.1016/j.jad.2007.02.024] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2006] [Revised: 02/21/2007] [Accepted: 02/23/2007] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Previous research has suggested that chronic pain patients might be particularly vulnerable to the effects of negative mood during information processing. However, there is little evidence for abnormal brain processing of affective and sensory pain-related information in chronic pain. Behavioral and brain responses, to pain descriptors and pleasant words, were examined in chronic pain patients and healthy controls during a self-endorsement task. METHODS Eighteen patients with fibromyalgia (FM), 18 patients with chronic musculoskeletal pain due to identifiable physical injury (MSK), and 16 healthy controls were asked to decide whether word targets described their current or past experience of pain. The number of self-endorsed words, elapsed time to endorse the words, and event-related potentials (ERPs) elicited by words, were recorded. RESULTS Data revealed that chronic pain patients used more affective and sensory pain descriptors, and were slower in responding to self-endorsed pain descriptors than to pleasant words. In addition, it was found that affective pain descriptors elicited significantly more enhanced positive ERP amplitudes than pleasant words in MSK pain patients; whereas sensory pain descriptors elicited greater positive ERP amplitudes than affective pain words in healthy controls. CONCLUSIONS These data support the notion of abnormal information processing in chronic pain patients, which might be characterized by a lack of dissociation between sensory and affective components of pain-related information, and by an exaggerated rumination over word meaning during the encoding of self-referent information about pain.
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Affiliation(s)
- Carolina Sitges
- Department of Psychology, University of Balearic Islands, Spain
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Montoya P, Sitges C, García-Herrera M, Izquierdo R, Truyols M, Collado D. [Considerations on alterations in brain activity in patients with fibromyalgia]. Reumatol Clin 2006; 2:251-260. [PMID: 21794338 DOI: 10.1016/s1699-258x(06)73056-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2005] [Accepted: 10/18/2005] [Indexed: 05/31/2023]
Abstract
Fibromyalgia is a chronic musculoskeletal pain disorder of unknown etiology, characterized by widespread pain. Clinical and experimental research has demonstrated that patients with fibromyalgia may have enhanced pain sensitivity at several points of the body, together with neuroendocrine abnormalities, and abnormal activation of pain-related brain regions. Recent data have also shown that affective and cognitive processing of pain-related information could also be disturbed in fibromyalgia. In our opinion, all these findings suggest the existence of abnormal central pain processing, which could be responsible for the persistence of chronic pain in these patients.
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Affiliation(s)
- Pedro Montoya
- Departamento de Psicología e Instituto Universitario de Investigación en Ciencias de la Salud (IUNICS). Universitat de les Illes Balears. Palma de Mallorca. España
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Montoya P, Sitges C, García-Herrera M, Rodríguez-Cotes A, Izquierdo R, Truyols M, Collado D. Reduced brain habituation to somatosensory stimulation in patients with fibromyalgia. ACTA ACUST UNITED AC 2006; 54:1995-2003. [PMID: 16732548 DOI: 10.1002/art.21910] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To examine brain activity elicited by repetitive nonpainful stimulation in patients with fibromyalgia (FM) and to determine possible psychophysiologic abnormalities in their ability to inhibit irrelevant sensory information. METHODS Fifteen female patients with a diagnosis of FM (ages 30-64 years) and 15 healthy women (ages 39-61 years) participated in 2 sessions, during which electrical activity elicited in the brain by presentation of either tactile or auditory paired stimuli was recorded using an electroencephalogram. Each trial consisted of 2 identical stimuli (S1 and S2) delivered with a randomized interstimulus interval of 550 msec (+/-50 msec), which was separated by a fixed intertrain interval of 12 seconds. Event-related potentials (ERPs) elicited by 40 trials were averaged separately for each sensory modality. RESULTS ERP amplitudes elicited by the somatosensory and auditory S2 stimuli were significantly reduced compared with those elicited by S1 stimuli in the healthy controls. Nevertheless, significant amplitude reductions from S1 stimuli to S2 stimuli were observed in FM patients for the auditory, but not the somatosensory, modality. CONCLUSION Our findings suggest that in FM patients, there is abnormal information processing, which may be characterized by a lack of inhibitory control to repetitive nonpainful somatosensory information during stimulus coding and cognitive evaluation.
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Affiliation(s)
- Pedro Montoya
- Research Institute on Health Sciences (IUNICS), University of the Balearic Islands, Palma, Spain.
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Montoya P, Sitges C. Affective modulation of somatosensory-evoked potentials elicited by tactile stimulation. Brain Res 2006; 1068:205-12. [PMID: 16364261 DOI: 10.1016/j.brainres.2005.11.019] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2004] [Revised: 06/17/2005] [Accepted: 11/07/2005] [Indexed: 10/25/2022]
Abstract
The present investigation was aimed to evaluate the influence of emotional valence on brain correlates of non-painful somatosensory processing. For this purpose, we examined changes on the somatosensory-evoked potentials (SEP) elicited by frequent and deviant tactile stimuli (probability 14%) when subjects were viewing affective pictures. Twenty healthy volunteers aged between 19 and 47 years old participated in the study. The P50, N80, and P200 components of the SEP, as well as the P200 component of the visual-evoked potentials (VEP) elicited by the affective pictures were analyzed. Overall, a significant P50 amplitude reduction was observed when subjects were viewing unpleasant pictures, in comparison to pleasant pictures. Furthermore, larger SEP amplitudes were obtained in response to the deviant than to the frequent stimuli. In addition, unpleasant pictures elicited larger P200 amplitudes of the VEP than pleasant. Data suggest that affective stimuli may modulate the early processing of somatosensory information in the brain, probably reflecting the existence of an adaptive perceptual/attentional mechanism to motivationally relevant stimuli.
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Affiliation(s)
- Pedro Montoya
- Department of Psychology, and Research Institute of Health Sciences (IUNICS), University of the Balearic Islands, Carretera de Valldemossa km 7.5, 07122 Palma, Spain.
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Montoya P, Sitges C, García-Herrera M, Izquierdo R, Truyols M, Blay N, Collado D. Abnormal affective modulation of somatosensory brain processing among patients with fibromyalgia. Psychosom Med 2005; 67:957-63. [PMID: 16314601 DOI: 10.1097/01.psy.0000188401.55394.18] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE It is well established that subjective pain perception can be modulated by negative mood states and that patients with chronic pain are characterized by high levels of depression and anxiety. Nevertheless, very little is known about the effects of negative mood induction on brain processing of somatosensory information in fibromyalgia. The objective of the present study was to examine the influence of two emotional states (pleasant and unpleasant) on brain activity of patients with fibromyalgia (FM; n = 27) and with musculoskeletal (MSK) pain resulting from identifiable somatic lesions (n = 16). METHODS For this purpose, somatosensory-evoked potentials (SEPs) elicited by nonpainful pneumatic stimuli, delivered to the right and left hand following an oddball paradigm, were recorded when patients were viewing affective slides. RESULTS As compared with patients with MSK pain, patients with FM displayed overall larger P50 amplitude to tactile stimuli. In addition, significantly larger P50 and smaller N80 amplitudes were found within patients with FM when they were viewing the unpleasant rather than the pleasant slides. CONCLUSION Our data suggest an abnormal processing of nonpainful somatosensory information in FM, especially when somatic signals are arising from the body within an aversive stimulus context. These findings provide further support for the use of biopsychosocial models for understanding FM and other chronic pain states.
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Affiliation(s)
- Pedro Montoya
- Department of Psychology and Research Institute of Health Sciences (IUNICS), University of the Balearic Islands, Palma, Spain.
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