“Chronic Pain and the Brain” Impairment: Introducing a Translational Neuroscience-Based Metric

Asymmetries in reciprocal baroreflex mechanisms and chronic pain severity: Focusing on irritable bowel syndrome

“…Cut‐off points for disease chronicity giving the best‐fitting models showed that after the collapse of the purported “pain resilience” mechanism, longer disease duration transferred decompensated physiological regulation to two independent mechanisms interpreted as adaptation to or aggravation of chronic pain severity through sustained elevation in BP or through affective comorbidity (higher negative affect), respectively. Considerations of high BP as an indicator of adaptation (“pain killing”) mechanism and high negative affect as an indicator of aggravation mechanism in this chronic pain syndrome are consistent with other studies . The associations between longer disease duration and greater systolic BP and between longer disease duration and higher negative affect were found to be mediated by the same shifting of the BP start point for baroreceptor activation to a higher value (ie, resetting baroreceptor activation).…”

“…The findings may be a starting point for validating this autonomic metrics of pain suffering in other chronic pain syndromes. If validated in a prospective study of IBS treatment in a separate cohort and with respect to its substitution by simpler, less complex, and less expensive procedures, eg, orthostatic CV measures obtained using standard office‐based BP measurement techniques or recent mobile technologies, these metrics may be translated to routine clinical practice for reliably assessing the severity of IBS as a disorder associated with chronic pain. It would help to specify its pathophysiological mechanisms and thus to improve and personalize treatment.…”

“…8,18,40 Besides various specific physical symptoms, pain severity assessment is additionally confounded by less specific emotional symptoms associated with it. 18,40,41 CV measures associated with vagus activity are considered transdiagnostic biomarkers integrating sensed and perceived severity of allcause morbidity for phenotyping the health impairment in general, 42 and therefore they are considered suitable for the assessment of pain severity of different origins and complexities. 43 The main aim of the study was to test a specific hypothesis that some central regulation mechanisms associated with asymmetry in baroreceptor activation and inhibition during a resting baseline period were recruited for this study by community advertisement.…”

“…The subjective experience of pain is considered a universal signal of imbalance in the body that when paired with a physical sensation or symptom at a localized spot or area of origin on the body indicates that something needs to be attended to . Besides various specific physical symptoms, pain severity assessment is additionally confounded by less specific emotional symptoms associated with it . CV measures associated with vagus activity are considered transdiagnostic biomarkers integrating sensed and perceived severity of all‐cause morbidity for phenotyping the health impairment in general, and therefore they are considered suitable for the assessment of pain severity of different origins and complexities …”

Cardiovascular phenotyping for personalized lifestyle treatments of chronic abdominal pain in Irritable Bowel Syndrome: A randomized pilot study

“…Symptom outcomes were assessed both as a simple difference score (baseline − post‐treatment) and as a baseline adjusted difference score ([baseline − post‐treatment]/baseline). The adjustment was used to control for absolute pain rating scales non‐linearly and interindividual inconsistency . For example, subjects may rate the present painful experience in comparison with prior ones or to a non‐painful condition.…”