An Exploratory Study Testing Autonomic Reactivity to Pain in Women with Sensory Over-Responsiveness

Abstract

Background: Difficulty modulating sensory input related to multi-sensory integration dysfunction, specifically the sensory over-responsive (SOR) type, is associated with psychological distress and hyperalgesia in children and adults. Scares reports suggest atypical autonomic nervous system (ANS) reactivity to innocuous sensory stimuli in children with SOR. Thus, the ANS may contribute to sensory stimuli responses and psychological distress. This exploratory study aimed to characterize the ANS reactivity to single and dual pain stimulation, and in relation to psychological distress in adults with SOR. Methods: Healthy women with SOR (n = 9) vs. without SOR (n = 9) underwent two runs of single pain stimulation and a third run comprised of dual pain stimulation. Pain was self-rated, while heart rate variability was measured and analyzed in the time and frequency domains. In addition, questionnaires assessing anxiety and somatization were utilized. Results: While controls demonstrated a vagal tone withdrawal (root mean square of successive differences in R-R-intervals; (RMSSD)) p = 0.029 from base-line to the third run, this was absent in the SOR group. However, no group differences were found in pain ratings. Furthermore, groups differed in the correlations between R-R mean and the level of both anxiety (p = 0.006) and somatization (p < 0.001); while in the SOR group, higher levels of anxiety and somatization correlated with shorter R-R intervals, the opposite was found in the control group. Conclusions: This is the first study to demonstrate in women with SOR atypical vagal tone reactivity to challenging pain load. Vagal tone reactivity is related to both pain ratings and psychological distress.

Investigating autonomic biomarkers of sensory processing patterns in young adults

“…However, the study was limited to a sample of 20 adults who were classified as having extreme scores in one of the four sensory processing patterns. In the study by Bar-Shalita et al (2020), nine women classified as having sensory over-responsiveness exhibited a smaller change in parasympathetic nervous system activity during a pain elicitation task, compared to nine women who were not overly responsive to sensory stimuli. The researchers concluded that sensory over-responsiveness may be underpinned by inefficient regulation of autonomic activity (Bar-Shalita et al, 2020).…”

“…Sensory processing fundamentally shapes how individuals experience the world and affects engagement in daily occupations (Koenig and Rudney, 2010). A growing body of research with children (Christensen et al, 2020; Gomez et al, 2017) and adults (Bar-Shalita et al, 2020; Brown et al, 2001) suggests that sensory processing differences may be linked to patterns of autonomic nervous system (ANS) activity. This research has primarily used biomarkers of either the sympathetic or parasympathetic branches of the ANS; however, recent recommendations suggest that studies should concurrently measure both systems (Christensen et al, 2020; Gomez et al, 2017).…”

“…children; Schaaf et al, 2015; Schoen et al, 2009). However, psychophysiological research on sensory processing in adults has been limited to using a single biomarker of either sympathetic or parasympathetic activity (Brown et al, 2001; Bar-Shalita et al, 2020).…”

Neurofeedback Therapy for Sensory Over-Responsiveness—A Feasibility Study

“…Additionally, testing daily pain revealed enhanced pain sensitivity in individuals with SOR compared with normoresponsive people [5,6]. Furthermore, utilizing experimental pain via psychophysical testing indicated hyperalgesia (amplified pain intensity) and lingering pain sensation [7][8][9][10], as well as altered physiological reactivity [11,12], which may suggest compromised endogenous pain modulation in otherwise healthy children and adults with SOR [10,13]. Moreover, SOR has been widely reported to be associated with psychological distress and emotionality, e.g., [14][15][16], and both are also considered to be factors in phenotyping pain [17].…”

Cross-cultural adaptation, reliability, and validity of the Turkish Adult Sensory Processing Scale

“…Individuals can feel overwhelmed by sensory bombardment; therefore, they may need to escape from their environment to ‘be recharged’. This condition could result in an increased tendency to develop stress, anxiety and depression symptoms (Abernethy, 2010; Bar-Shalita et al, 2020; Benham, 2006; Engel-Yeger and Shochat, 2012; Kinnealey and Fuiek, 1999; Kinnealey et al, 1995, 2011), whereas people with sensory sensitivity can be as healthy as those who are not sensitive when in low-stress conditions. It is therefore important to determine the sensory sensitivity of adults (Ayres, 1972; Benham, 2006).…”