A family-based investigation of cold pain tolerance

Abstract

In the present study the question was addressed whether sensitivity to experimental pain stimuli differs between families, which are previously characterized by the degree of cold tolerance (very insensitive or very sensitive) of one family member. A total of 232 healthy medical students were screened for cold pain tolerance employing a cold pressor test. Subsequently 50 of them were investigated in detail under laboratory conditions. The water temperature was 1 degrees C, the maximum time in water 3 min, cold pain was rated on a 101 step numerical rating scale every 10s. Two of the most cold pain sensitive (shortest time in ice water) and insensitive (lowest ratings) students were selected and as many as possible of their family members were recruited. In all of them cold pressor test, pinprick pain threshold, pressure pain threshold, skin temperature, hospital anxiety and depression scale and COMT val158met polymorphism (with the exception of three individuals) were assessed. Analysis (ANOVA) revealed that the cold pressor results of the students predicted the mean ratings (p<0.04) and the time in ice water (p<0.03) of their own families. Furthermore, pinprick pain threshold (p<0.002) and to a lesser extent pressure pain thresholds (p<0.03) were significantly related to cold pain tolerance. The other variables, including the COMT polymorphism, were not related to cold pain tolerance in our study. In conclusion our results suggest that cold pain tolerance may be at least partially inherited. Genetic or environmental factors might explain family clustering of cold pain sensitivity.

Negative Affect Heightens Opiate Withdrawal-Induced Hyperalgesia in Heroin Dependent Individuals

“…Although the exact mechanisms remain to be elucidated, higher neuronal affective circuits are thought to play a major role in determining pain tolerance (e.g. descending control) 71 compared to pain thresholds 70 . Thus, centrally mediated processes, involved in the opponent-processes mechanisms, should have a larger impact on pain tolerance than on pain thresholds as reflected in this and other studies.…”

Progress in Genetic Studies of Pain and Analgesia

“…More worrisome, however, are studies by Kim and colleagues (10, 157), much more highly powered than their predecessors, which failed to see an association of either rs4680 or the high pain sensitivity COMT haplotype with either experimental pain or postsurgical pain in the third molar model. Further, using a family-based design, Birklein and colleagues (165) did not see an association of rs4680 to cold-pressor pain. In addressing the contradictory literature, Kim & Dionne (166) point to very small sample sizes [ n = 3 in the val / val homozygote group in Zubieta et al (162); n ≈ 10/haplotype in the TMD patients of Diatchenko et al (115)], possible ethnic stratification, and the dangers of combining measures of pain threshold and pain tolerance into a single score.…”

The Catechol-O-Methyltransferase (COMT) val158met Polymorphism Affects Brain Responses to Repeated Painful Stimuli

“…Despite these intriguing results, the existence of an effect of COMT variation on pain sensitivity is still strongly debated, as some subsequent behavioral studies using larger sample size have failed to show a substantial association (e.g. [13]–[17]). In the last few years, evidence produced by several groups has suggested that the effect of COMT polymorphism on pain sensitivity is generally not observed for the initial pain provocations, but rather becomes apparent in later phases of a testing session [8], [18], [19].…”