Conditioned Pain Modulation in Women With Irritable Bowel Syndrome

Jarrett, Monica; Shulman, Robert J.; Cain, Kevin C.; Deechakawan, Wimon; Smith, Lynne T.; Richebé, Philippe; Eugenio, Margaret D.; Heitkemper, Margaret

doi:10.1177/1099800413520486

Cited by 29 publications

(23 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Endogenous inhibitory mechanisms are found attenuated in patients with irritable bowel syndrome (King et al, 2009;Heymen et al, 2010;Piche et al, 2011;Jarrett et al, 2014).…”

Section: Descending Pain Inhibitionmentioning

confidence: 99%

Assessment and manifestation of central sensitisation across different chronic pain conditions

Arendt-Nielsen

Morlion

Perrot

et al. 2017

European Journal of Pain

517

494

View full text Add to dashboard Cite

Different neuroplastic processes can occur along the nociceptive pathways and may be important in the transition from acute to chronic pain and for diagnosis and development of optimal management strategies. The neuroplastic processes may result in gain (sensitisation) or loss (desensitisation) of function in relation to the incoming nociceptive signals. Such processes play important roles in chronic pain, and although the clinical manifestations differ across condition processes, they share some common mechanistic features. The fundamental understanding and quantitative assessment of particularly some of the central sensitisation mechanisms can be translated from preclinical studies into the clinic. The clinical perspectives are implementation of such novel information into diagnostics, mechanistic phenotyping, prevention, personalised treatment, and drug development. The aims of this paper are to introduce and discuss (1) some common fundamental central pain mechanisms, (2) how they may translate into the clinical signs and symptoms across different chronic pain conditions, (3) how to evaluate gain and loss of function using quantitative pain assessment tools, and (4) the implications for optimising prevention and management of pain. The chronic pain conditions selected for the paper are neuropathic pain in general, musculoskeletal pain (chronic low back pain and osteoarthritic pain in particular), and visceral pain (irritable bowel syndrome in particular). The translational mechanisms addressed are local and widespread sensitisation, central summation, and descending pain modulation. Significance Central sensitisation is an important manifestation involved in many different chronic pain conditions. Central sensitisation can be different to assess and evaluate as the manifestations vary from pain condition to pain condition. Understanding central sensitisation may promote better profiling and diagnosis of pain patients and development of new regimes for mechanism based therapy. Some of the mechanisms underlying central sensitisation can be translated from animals to humans providing new options in development of therapies and profiling drugs under development.

show abstract

“…Endogenous inhibitory mechanisms are found attenuated in patients with irritable bowel syndrome (King et al, 2009;Heymen et al, 2010;Piche et al, 2011;Jarrett et al, 2014).…”

Section: Descending Pain Inhibitionmentioning

confidence: 99%

Assessment and manifestation of central sensitisation across different chronic pain conditions

Arendt-Nielsen

Morlion

Perrot

et al. 2017

European Journal of Pain

517

494

View full text Add to dashboard Cite

show abstract

“…Diminished CPM (relative to control samples) has been observed in a variety of chronic pain conditions, including fibromyalgia [19,22], temporomandibular disorder [17], and chronic headache [32]. Impaired CPM has also been found in adults with IBS [14,17,31,51] and is linked to greater distress and discomfort in these individuals [15]. …”

mentioning

confidence: 99%

Impaired conditioned pain modulation in youth with functional abdominal pain

Morris

Walker

Bruehl

et al. 2016

Pain

View full text Add to dashboard Cite

Functional abdominal pain (FAP) is associated with enhanced pain responsiveness. Although impaired conditioned pain modulation (CPM) characterizes adults with a variety of chronic pain conditions, relatively little is known about CPM in youth with FAP. The present study assessed CPM to evoked thermal pain in 140 youth (ages 10 to 17), 63 of whom had FAP and 77 of whom were healthy controls. Multilevel models demonstrated weaker CPM effects in FAP than healthy youth, as evident in slower within-person decreases in pain ratings during the conditioning phase. Weaker CPM effects were associated with greater somatic symptom severity and functional disability. Pain responses in FAP youth were heterogeneous, with 43% of youth showing an unexpected increase in pain ratings during the conditioning phase, suggesting sensitization rather than CPM-related pain inhibition. These findings highlight directions for future research on the emergence and maintenance of FAP in youth.

show abstract

“…Increased pain sensitivity in IBS may be due to several mechanisms including afferent pain signaling and alterations in spinal and central processing of pain sensory information. Descending inhibitory pain modulation may be dysfunctional in subgroups of IBS patients . The ability to inhibit sensory input can be measured by conditioned pain modulation (CPM) testing .…”

Section: Introductionmentioning

confidence: 99%

“…The ability to inhibit sensory input can be measured by conditioned pain modulation (CPM) testing . Conditioned pain modulation efficiency is determined by the degree to which the perception of a painful stimulus is decreased after a second painful stimulus is applied . A decrease in the ability to reduce pain sensitivity in the presence of a second test stimulus is referred to as decreased CPM efficiency.…”

Section: Introductionmentioning

confidence: 99%