Conditioned Pain Modulation Effectiveness: An Experimental Study Comparing Test Paradigms and Analyzing Potential Predictors in a Healthy Population

Ibancos-Losada, María del Rocío; Osuna-Pérez, María Catalina; Castellote-Caballero, Yolanda; Díaz-Fernández, Ángeles

doi:10.3390/brainsci10090599

Cited by 23 publications

(31 citation statements)

References 47 publications

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“…41, and 0.40, respectively). Although no previous studies have analyzed this relationship, some studies have examined the influence of this variable on pain modulation processes and suggested that the degree of affinity to a specific stimulus could interact in these processes [ 56 , 57 ].…”

Section: Discussionmentioning

confidence: 99%

“…It is possible that other studies did not find a strong correlation between CPT and the other variables because these populations are accustomed to cold, and, therefore, they could have a greater tolerance to cold and would be adapted to this stimulus. For this reason, the measurement of the ‘unpleasant variable’ is recommendable because the affinity for the stimulus could explain many of the results (high affinity for the stimulus would imply a greater tolerance to it and vice versa) [ 56 , 57 ].…”

Section: Discussionmentioning

confidence: 99%

“…For this purpose, we used a digital algometer with a 1.0 cm² probe (Wagner Instruments, Force TENTM Digital Force Gage FDX 50, Greenwich, CT, USA). The pressure was applied to three different points on the neck (two on the trapezius muscle and one on the scalene muscle) following the same sequence [ 57 ]. The investigator applied the pressure and the participants indicated when the sensation of pressure changed to pain, at which point the investigator immediately stopped the stimulus and noted the pressure supported.…”

Section: Methodsmentioning

confidence: 99%

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Validation and Cross-Cultural Adaptation of the Spanish Version of the Pain Sensitivity Questionnaire (PSQ-S)

Ibancos-Losada

Osuna-Pérez

Cortés‐Pérez

et al. 2021

JCM

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Experimental pain testing requires specific equipment and may be uncomfortable for patients. The Pain Sensitivity Questionnaire (PSQ) was developed to assess pain sensitivity, based on the pain intensity ratings (range: 0–10) of painful situations that occur in daily life. The main objective of this study was to carry out a cross-cultural adaptation and validation of the Spanish version of the PSQ (PSQ-S). A total of 354 subjects (296 healthy and 58 chronic pain patients) filled in the PSQ-S. A subgroup of 116 subjects performed experimental pain testing, including two modalities (cold and pressure), with different measures: pain intensity rating, pressure pain threshold, and tolerance. The validation results showed two factors: PSQ-S-moderate and PSQ-S-minor and, for the total scale and the two factors, an excellent internal consistency (Cronbach’s alpha coefficient > 0.9) and a substantial reliability (Intraclass Correlation Coefficient > 0.8). We obtained strong correlations with all the experimental pain rating parameters, catastrophizing, and depression variables, as well as moderate correlations with anxiety, central sensibilization, and impact on the quality of life. Chronic pain patients received elevated PSQ-S scores compared to healthy controls, and three cut-off values (PSQ-S-total = 7.00, PSQ-S-moderate = 7.57, and PSQ-S-minor = 6.29) based on ROC curve analyses were shown to be able to discriminate between healthy adults and adults with chronic pain. Therefore, PSQ-S may be a simple alternative to experimental pain procedures for clinical and experimental pain research.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Validation and Cross-Cultural Adaptation of the Spanish Version of the Pain Sensitivity Questionnaire (PSQ-S)

Ibancos-Losada

Osuna-Pérez

Cortés‐Pérez

et al. 2021

JCM

Self Cite

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“…However, on the intraindividual level, neither the early nor the late effects correlated significantly between both testing paradigms. Although it has been recently recommended to enrich studies and perform different CPM protocols with the same subjects [50], only a few studies have compared the magnitude of the CPM-effect between different CS [51][52][53] or different combinations of CS and TS [54,55]. Significantly different CPM magnitudes were evoked in the same individual depending on the nature of the CS, even when the TS-induced and the CS-induced pain intensity were similar [51].…”

Section: Modality Specific Effectsmentioning

confidence: 99%

Painful Cutaneous Electrical Stimulation vs. Heat Pain as Test Stimuli in Conditioned Pain Modulation

et al. 2020

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Different paradigms can assess the effect of conditioned pain modulation (CPM). The aim of the present study was to compare heat pain, as an often used test stimulus (TS), to painful cutaneous electrical stimulation (PCES), having the advantage of the additional recording of PCES-related evoked potentials. In 28 healthy subjects we applied heat and PCES at the dominant hand as test stimulus (TS) to compare the CPM-effect elicited by hand immersion into cold water (10 °C) as conditioning stimulus (CS). Subjects rated the pain intensity of TS at baseline, during and 5 min after CS application and additionally of CS, on a numerical rating scale (NRS) (0–100). The ‘early’ (during CS–before CS) and ‘late’ (after CS–before CS) CPM-effects were analyzed. Parallel to the PCES, the related evoked potentials were recorded via Cz to evaluate any changes in PCES-amplitudes. CS reduced significantly the pain intensity of both PCES and heat pain as TS. On a group level, the CPM-effect did not differ significantly between both paradigms. Both early and late CPM-effect based on PCES correlated significantly with the CS pain intensity (r = −0.630 and −0.503, respectively), whereas using heat pain the correlation was not significant. We found a significant reduction of PCES-amplitudes during CS, but this did not correlate with the PCES-induced pain intensity. Correlation with the CS painfulness (r = −0.464) did not achieve the significance level after Bonferroni correction. The extent of the CPM effects was similar in both testing paradigms at group level, despite intraindividual differences. Future studies should further elicit the exact mechanisms explaining the modality of these specific differences.

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“…Little is known however about potential differences in the magnitude of the CPM effect between a sequential or parallel design. Indirect studies reported conflicting results, showing no differences between both designs ( Ibancos-Losada et al, 2020 ), larger effects for either a parallel ( Nahman-Averbuch et al, 2013 ; Ram et al, 2008 ) or sequential ( Enax-Krumova et al, 2020 ) design. Moreover, statistical comparisons between the two designs were often not performed ( Enax-Krumova et al, 2020 ; Nahman-Averbuch et al, 2013 ; Ram et al, 2008 ).…”

Section: Introductionmentioning

confidence: 99%

No relevant differences in conditioned pain modulation effects between parallel and sequential test design. A cross-sectional observational study

Reezigt

Kielstra

Coppieters

et al. 2021

PeerJ

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Background Conditioned pain modulation (CPM) is measured by comparing pain induced by a test stimulus with pain induced by the same test stimulus, either during (parallel design) or after (sequential design) the conditioning stimulus. Whether design, conditioning stimulus intensity and test stimulus selection affect CPM remains unclear. Methods CPM effects were evaluated in healthy participants (N = 89) at the neck, forearm and lower leg using the cold pressor test as the conditioning stimulus. In three separate experiments, we compared the impact of (1) design (sequential versus parallel), (2) conditioning stimulus intensity (VAS 40/100 versus VAS 60/100), and (3) test stimulus selection (single versus dual, i.e., mechanical and thermal). Statistical analyses of the main effect of design (adjusted for order) and experiment were conducted using linear mixed models with random intercepts. Results No significant differences were identified in absolute CPM data. In relative CPM data, a sequential design resulted in a slightly lower CPM effect compared to a parallel design, and only with a mechanical test stimulus at the neck (−6.1%; 95% CI [−10.1 to −2.1]) and lower leg (−5.9%; 95% CI [−11.7 to −0.1]) but not forearm (−4.5%; 95% CI [−9.0 to 0.1]). Conditioning stimulus intensity and test stimulus selection did not influence the CPM effect nor the difference in CPM effects derived from parallel versus sequential designs. Conclusions Differences in CPM effects between protocols were minimal or absent. A parallel design may lead to a minimally higher relative CPM effect when using a mechanical test stimulus. The conditioning stimulus intensities assessed in this study and performing two test stimuli did not substantially influence the differences between designs nor the magnitude of the CPM effect.

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Conditioned Pain Modulation Effectiveness: An Experimental Study Comparing Test Paradigms and Analyzing Potential Predictors in a Healthy Population

Cited by 23 publications

References 47 publications

Validation and Cross-Cultural Adaptation of the Spanish Version of the Pain Sensitivity Questionnaire (PSQ-S)

Validation and Cross-Cultural Adaptation of the Spanish Version of the Pain Sensitivity Questionnaire (PSQ-S)

Painful Cutaneous Electrical Stimulation vs. Heat Pain as Test Stimuli in Conditioned Pain Modulation

No relevant differences in conditioned pain modulation effects between parallel and sequential test design. A cross-sectional observational study

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