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Heart rate variability is not suitable as a surrogate marker for pain intensity in patients with chronic pain

Maarten Moens1,2,3,4,5, Bart Billet1,6, Geert Molenberghs7,8

  • 1STIMULUS Research Group (reSearch and TeachIng neuroModULation Uz bruSsel), Vrije Universiteit Brussel, Brussels, Belgium.

Pain
|February 1, 2023
PubMed

Insights

Heart rate variability (HRV) was explored as a pain biomarker in chronic pain patients. Results show HRV parameters are not suitable pain intensity surrogates, necessitating further research for objective pain measures.

Area of Science:

  • Biomedical Engineering
  • Pain Medicine
  • Cardiology

Background:

  • Objective pain measurement remains a challenge, with a lack of validated biomarkers.
  • Heart rate variability (HRV) has been investigated as a potential surrogate marker for pain intensity.

Purpose of the Study:

  • To evaluate the utility of HRV parameters as surrogate markers for pain intensity in a chronic pain population.
  • To assess the correlation between various HRV metrics and self-reported pain scores.

Main Methods:

  • A cross-sectional, multicenter study involving 366 chronic pain patients.
  • Collected pain intensity data using Visual Analogue Scale (VAS) and Numeric Rating Scale (NRS).
  • Derived 16 statistical HRV parameters and employed canonical correlation analysis to assess surrogacy.

Main Results:

  • Weak correlations were observed between most HRV parameters and pain intensity scores.
  • Mean heart rate showed the highest, yet low, surrogacy for average pain intensity (NRS: 0.0961 without medication, 0.0209 with medication).
  • Individual HRV parameters demonstrated limited suitability as pain intensity surrogates.

Conclusions:

  • Current HRV parameters are inadequate as standalone surrogate markers for pain intensity in chronic pain patients.
  • Further investigation into novel surrogate candidates and robust clinical endpoints is required for objective pain assessment.

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