A Psychophysical Study of Auditory and Pressure Sensitivity in Patients With Fibromyalgia and Healthy Controls

Geisser, Michael E.; Glass, Jennifer M.; Rajcevska, Ljubinka D.; Clauw, Daniel J.; Williams, David A.; Kileny, Paul R.; Gracely, Richard H.

doi:10.1016/j.jpain.2007.12.006

Cited by 183 publications

(169 citation statements)

References 23 publications

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“…[32][33][34][35] While no clear consensus presently exists on the terminology, the hallmark of this type of pain appears to be generalized hypersensitivity to a variety of stimuli including mechanical, thermal, olfactory, auditory, and visual cues. [36][37][38][39] Unlike traditional central sensitization triggered by persistent nociceptive and/or neuropathic input, it is often impossible to pinpoint the cause of sensory hypersensitivity. It is thought to occur throughout the CNS and may involve additional mechanisms such as a decrease in descending inhibition and neuroplasticity in pain processing areas of the brain.…”

Section: Understanding Chronic Painmentioning

confidence: 99%

Rethinking chronic pain in a primary care setting

Stanos

Brodsky

Argoff

et al. 2016

Postgraduate Medicine

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Chronic pain substantially impacts patient function and quality of life and is a burden to society at large in terms of increased health care utilization and loss of productivity. As a result, there is an increasing recognition of chronic pain as a public health crisis. However, there remains wide variability in clinical practices related to the prevention, assessment, and treatment of chronic pain. Certain fundamental aspects of chronic pain are often neglected including the contribution of the psychological, social, and contextual factors associated with chronic pain. Also commonly overlooked is the importance of understanding the likely neurobiological mechanism(s) of the presenting pain and how they can guide treatment selection. Finally, physicians may not recognize the value of using electronic medical records to systematically capture data on pain and its impact on mood, function, and sleep. Such data can be used to monitor onset and maintenance of treatments effects at the patient level and evaluate costs at the systems level. In this review we explain how these factors play a critical role in the development of a coordinated, evidence-based treatment approach tailored to meet specific needs of the patient. We also discuss some practical approaches and techniques that can be implemented by clinicians in order to enhance the assessment and management of individuals with chronic pain in primary care settings. ARTICLE HISTORY

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Section: Understanding Chronic Painmentioning

confidence: 99%

Rethinking chronic pain in a primary care setting

Stanos

Brodsky

Argoff

et al. 2016

Postgraduate Medicine

Self Cite

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“…Instead, it may also involve cortical mechanisms affecting other sensory modalities, if the information conveyed by that sensory system is relevant for the injured body part, for instance, visual input predicting imminent contact of an object with that body part. Supporting this possibility, patients with chronic pain often report hypersensitivity to a broad range of stimuli including non-somatosensory stimuli [11,44].…”

Section: Introductionmentioning

confidence: 99%

Intense pain influences the cortical processing of visual stimuli projected onto the sensitized skin

Torta¹,

Broeke²,

Filbrich³

et al. 2016

Pain

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Sensitization is a form of implicit learning produced by the exposure to a harmful stimulus. In humans and other mammals, sensitization following skin injury increases the responsiveness of peripheral nociceptors, and enhances the synaptic transmission of nociceptive input in the central nervous system (CNS). Here, we show that sensitization-related changes in the CNS are not restricted to nociceptive pathways and, instead, also affect other sensory modalities, especially if that modality conveys information relevant for the sensitized body part. Specifically, we show that after sensitizing the forearm using high-frequency electrical stimulation of the skin (HFS), visual stimuli projected onto the sensitized forearm elicit significantly enhanced brain responses. Whereas mechanical hyperalgesia was present both 20 and 45 minutes after HFS, the enhanced responsiveness to visual stimuli was present only 20 minutes after HFS. Taken together, our results indicate that sensitization involves both nociceptive-specific and multimodal mechanisms, having distinct time courses.

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“…In fact, patients with FM seem to be more sensitive to multiple different stimuli, including heat, cold, and electrical stimulation [6]. Interestingly, these patients have also been noted to have hypersensitivity to auditory and visual stimuli, which suggests that FM patients experience a global altered sensory processing that is not specific to painful stimuli alone [7]. In a study comparing brain magnetic resonance imaging (MRI) scans of FM patients and controls, those with FM showed an increase in activation of neurons with low-intensity painful stimulation when compared to the control group [8].…”

Section: Pathogenesismentioning

confidence: 99%