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Reference values of conditioned pain modulation
Jürg Schliessbach1,2, Christian Lütolf3, Konrad Streitberger2
1Institute of Anesthesiology, Zurich University Hospital, University of Zurich, Rämistrasse 100,8091Zurich, Switzerland.
Scandinavian Journal of Pain
|January 31, 2019
Summary
This study established reference values for conditioned pain modulation (CPM), a method to study pain inhibition. Findings reveal that some pain-free individuals exhibit pain facilitation, not inhibition, during CPM testing.
Area of Science:
- Neuroscience
- Pain Research
- Human Physiology
Background:
- Endogenous pain modulation is studied via conditioned pain modulation (CPM).
- CPM involves a test stimulus attenuated by a distant noxious stimulus.
- Detecting impaired CPM is crucial for understanding pain pathophysiology and predicting outcomes.
Purpose of the Study:
- To determine reference values for conditioned pain modulation (CPM) in pain-free individuals.
- To establish percentile values for CPM using various stimuli.
- To facilitate the phenotyping of patients in clinical and research settings.
Main Methods:
- 146 pain-free subjects participated in the study.
- Pressure and electrical stimulation were used as test stimuli.
- Cold pressor test served as the conditioning stimulus; quantile regression computed percentiles.
Main Results:
- Average pain thresholds increased across all tests following conditioning.
- A subset of subjects showed decreased thresholds, indicating pain facilitation.
- Most computed percentiles yielded negative values, suggesting a slight negative CPM effect in some healthy volunteers.
Conclusions:
- Percentile reference values for CPM were successfully determined.
- Negative CPM percentiles indicate that pain facilitation can occur in pain-free individuals.
- This finding suggests that pain facilitation during conditioning may not always be an abnormal indicator.
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