EPV 13. Pain-related evoked potentials depict the effect of conditioned pain modulation in healthy subjects

2016 ◽  
Vol 127 (9) ◽  
pp. e218-e219
Author(s):  
O. Höffken ◽  
Î. Özgül ◽  
E. Enax-Krumova ◽  
M. Tegenthoff ◽  
C. Maier
Keyword(s):  
Evoked Potentials ◽  
Healthy Subjects ◽  
Pain Modulation ◽  
Conditioned Pain Modulation

scholarly journals Distraction by a cognitive task has a higher impact on electrophysiological measures compared with conditioned pain modulation

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
A. T. L. Do ◽  
E. K. Enax-Krumova ◽  
Ö. Özgül ◽  
L. B. Eitner ◽  
S. Heba ◽  
...  
Keyword(s):  
Evoked Potentials ◽  
Pain Intensity ◽  
Rating Scale ◽  
Cold Water ◽  
Cognitive Task ◽  
Pain Modulation ◽  
Conditioned Pain Modulation ◽  
Cognitive Distraction ◽  
Painful Sensation ◽  
Back Task

Abstract Background Conditioned pain modulation (CPM) evaluates the effect of a painful conditioning stimulus (CS) on a painful test stimulus (TS). Using painful cutaneous electrical stimulation (PCES) as TS and painful cold water as CS, the pain relief was paralleled by a decrease in evoked potentials (PCES-EPs). We now aimed to compare the effect of CPM with cognitive distraction on PCES-induced pain and PCES-EP amplitudes. Methods PCES was performed using surface electrodes inducing a painful sensation of 60 (NRS 0–100) on one hand. In a crossover design healthy subjects (included: n = 38, analyzed: n = 23) immersed the contralateral hand into 10 °C cold water (CS) for CPM evaluation and performed the 1-back task for cognitive distraction. Before and during the CS and 1-back task, respectively, subjects rated the pain intensity of PCES and simultaneously cortical evoked potentials were recorded. Results Both CPM and cognitive distraction significantly reduced PCES-EP amplitudes (CPM: 27.6 ± 12.0 μV to 20.2 ± 9.5 μV, cognitive distraction: 30.3 ± 14.2 µV to 13.6 ± 5.2 μV, p < 0.001) and PCES-induced pain (on a 0–100 numerical rating scale: CPM: 58 ± 4 to 41.1 ± 12.3, cognitive distraction: 58.3 ± 4.4 to 38.0 ± 13.0, p < 0.001), though the changes in pain intensity and PCES-amplitude did not correlate. The changes of the PCES-EP amplitudes during cognitive distraction were more pronounced than during CPM (p = 0.001). Conclusions CPM and cognitive distraction reduced the PCES-induced pain to a similar extent. The more pronounced decrease of PCES-EP amplitudes after distraction by a cognitive task implies that both conditions might not represent the general pain modulatory capacity of individuals, but may underlie different neuronal mechanisms with the final common pathway of perceived pain reduction.

scholarly journals Distraction by a cognitive task has a higher impact on electrophysiological measures compared with conditioned pain modulation

2020 ◽  
Author(s):  
A. T. Lisa Do ◽  
Elena Enax-Krumova ◽  
Özüm Özgül ◽  
Lynn B. Eitner ◽  
Stefanie Heba ◽  
...  
Keyword(s):  
Evoked Potentials ◽  
Pain Intensity ◽  
Rating Scale ◽  
Cold Water ◽  
Cognitive Task ◽  
Pain Modulation ◽  
Conditioned Pain Modulation ◽  
Cognitive Distraction ◽  
Painful Sensation ◽  
Back Task

Abstract BackgroundConditioned pain modulation (CPM) evaluates the effect of a painful conditioning stimulus (CS) on a painful test stimulus (TS). Using painful cutaneous electrical stimulation (PCES) as TS and painful cold water as CS, the pain relief was paralleled by a decrease in evoked potentials (PCES-EPs). We now aimed to compare the effect of CPM with cognitive distraction on PCES-induced pain and PCES-EP amplitudes. MethodsPCES was performed using surface electrodes inducing a painful sensation of 60 (NRS 0-100) on one hand. In a crossover design healthy subjects (included: n=38, analyzed: n=23) immersed the contralateral hand into 10°C cold water (CS) for CPM evaluation and performed the 1-back task for cognitive distraction. Before and during the CS and 1-back task, respectively, subjects rated the pain intensity of PCES and simultaneously cortical evoked potentials were recorded. ResultsBoth CPM and cognitive distraction significantly reduced PCES-EP amplitudes (CPM: 27.6±12.0μV to 20.2±9.5μV, cognitive distraction: 30.3±14.2µV to 13.6±5.2μV, p<0.001) and PCES-induced pain (on a 0–100 numerical rating scale: CPM: 58±4 to 41.1±12.3, cognitive distraction: 58.3±4.4 to 38.0±13.0, p<0.001), though the changes in pain intensity and PCES-amplitude did not correlate. The changes of the PCES-EP amplitudes during cognitive distraction were more pronounced than during CPM (p=0.001).ConclusionsCPM and cognitive distraction reduced the PCES-induced pain to a similar extent. The more pronounced decrease of PCES-EP amplitudes after distraction by a cognitive task implies that both conditions might not represent the general pain modulatory capacity of individuals, but may underlie different neuronal mechanisms with the final common pathway of perceived pain reduction.

Conditioned pain modulation affects the N2/P2 complex but not the N1 wave: A pilot study with laser‐evoked potentials

2020 ◽  
Author(s):  
Giovanna Squintani ◽  
Andrea Rasera ◽  
Alessia Segatti ◽  
Elisa Concon ◽  
Bruno Bonetti ◽  
...  
Keyword(s):  
Pilot Study ◽  
Evoked Potentials ◽  
Pain Modulation ◽  
Conditioned Pain Modulation ◽  
Laser Evoked Potentials ◽  
N1 Wave

scholarly journals Cerebral responses and role of the prefrontal cortex in conditioned pain modulation: an fMRI study in healthy subjects

2015 ◽  
Vol 281 ◽  
pp. 187-198 ◽  
Author(s):  
Volodymyr B. Bogdanov ◽  
Alessandro Viganò ◽  
Quentin Noirhomme ◽  
Olena V. Bogdanova ◽  
Nathalie Guy ◽  
...  
Keyword(s):  
Prefrontal Cortex ◽  
Healthy Subjects ◽  
Pain Modulation ◽  
Conditioned Pain Modulation ◽  
Fmri Study

The effect of a mental stressor on conditioned pain modulation in healthy subjects

2012 ◽  
Vol 3 (3) ◽  
pp. 142-148 ◽  
Author(s):  
Kristian B. Nilsen ◽  
Sunniva E. Christiansen ◽  
Line B. Holmen ◽  
Trond Sand
Keyword(s):  
Repeated Measures ◽  
Mental Stress ◽  
Healthy Subjects ◽  
Animal Studies ◽  
Pain Threshold ◽  
Pain Modulation ◽  
Conditioned Pain Modulation ◽  
Heat Pain ◽  
Stressful Task ◽  
Medically Unexplained

AbstractBackground and purposeIn animal studies, enhanced sensitivity to painful stimuli succeeding chronic stress has been reported, while acute stress is reported to induce analgesia. Human studies on the effect of mental stress on pain are more equivocal. A disturbed stress-response resulting in an increased sensitivity to painful stimuli has also been discussed as a potential mechanism for e.g., the fibromyalgia syndrome. Endogenous analgesia may be studied in humans by measuring the analgesic effect of heterotopic noxious conditioning stimulation. In neurophysiological animal studies this phenomenon was originally denoted “diffuse noxious inhibitory controls” (DNIC), but for human studies it has been suggested to use the term conditioned pain modulation (CPM).The clinical relevance of aberrances in CPM is not clear. Inhibitory CPM is reported as being reduced in several medically unexplained syndromes with musculoskeletal pain aggravated by mental stress. However, whether the reported reduced CPM effects are causally related to clinical pain is unknown.In the present study the effect of a mental stressor on CPM is studied.MethodsWith tourniquet-induced pain as the conditioning stimulus we estimated the CPM effect in twenty healthy subjects. Heat pain threshold (HPT), supra-threshold heat pain level (SHPL) and pressure pain threshold (PPT) were used as test stimuli. Measurements were performed at baseline, after a stressful task and after a non-stressful task presented in a blinded cross-over design. We used repeated-measures ANOVAs in the analysis with simple contrasts for post hoc analysis.ResultsWith a ANOVA repeated measures model we found a significant task effect (F = 18.5, p ≤ 0.001), indicating that CPM was successfully induced. In our ANOVA model, we found a significant effect of stress in the contrast analysis (F = 5.2, p = 0.037), indicating that CPM was affected by the stressful task. The effects on PPT could not be analyzed due to a significant carry-over effect (for PPT only).ConclusionsIn the present blinded crossover study, we found a significant small to medium inhibitory effect of mental stress upon the CPM of thermal pain.ImplicationsOur results suggest that previously reported reduced inhibitory CPM in several medically unexplained syndromes with musculoskeletal pain aggravated by mental stress possibly can be related to confounding or clinically relevant stress level differences. However, the result might be modality-specific. Further studies in patients are obviously needed, and the impact of mental stress on CPM should be investigated also with other stressors.

scholarly journals Distraction by a cognitive task has a higher impact on electrophysiological measures compared with conditioned pain modulation

2020 ◽  
Author(s):  
A. T. Lisa Do ◽  
Elena Enax-Krumova ◽  
Özüm Özgül ◽  
Lynn B. Eitner ◽  
Stefanie Heba ◽  
...  
Keyword(s):  
Pain Relief ◽  
Evoked Potentials ◽  
Pain Intensity ◽  
Cold Water ◽  
Cognitive Task ◽  
Pain Modulation ◽  
Conditioned Pain Modulation ◽  
Cognitive Distraction ◽  
Painful Sensation ◽  
Back Task

Abstract Background Conditioned pain modulation (CPM) evaluates the effect of a painful conditioning stimulus (CS) on a painful test stimulus (TS). Using painful cutaneous electrical stimulation (PCES) as TS and painful cold water as CS, the pain relief was paralleled by a decrease in evoked potentials (PCES-EPs). We now aimed to compare the effect of CPM with cognitive distraction on PCES-induced pain and PCES-EP amplitudes. Methods PCES was performed in 38 healthy subjects using surface electrodes inducing a painful sensation of 60 (NRS 0-100) on one hand. In a crossover design subjects immersed the contralateral hand into painful cold water (10 °C, CS) for CPM evaluation and performed the 1-back task for cognitive distraction. Before and during the CS and 1-back task, respectively, subjects rated the pain intensity of PCES and simultaneously cortical evoked potentials were recorded. Results Both CPM and cognitive distraction significantly reduced PCES-EP amplitudes (CPM: from 30.9 ± 9.9 µV to 24.35 ± 8.41 µV, cognitive distraction: from 33.0 ± 8.8 µV to 19.5 ± 6.5 µV, p < 0.05) and PCES-induced pain (CPM: from 58 ± 4 to 39 ± 12, cognitive distraction: from 58 ± 4 to 36 ± 14, p < 0.05), though the changes in pain intensity and PCES-amplitude did not correlate. The changes of the PCES-EP amplitudes during cognitive distraction were significantly more pronounced than during CPM. Conclusions The amount of pain relief induced by CPM and cognitive distraction seems to be similar. However, the even more pronounced decrease of PCES-EP amplitudes after distraction by a cognitive task implies that both conditions do not represent the general pain modulatory capacity of individuals, but may underlie different neuronal mechanisms with the final common pathway of perceived pain reduction.

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