Pain-autonomic interaction is a reliable measure of pain habituation in healthy subjects.
Journal
European journal of pain (London, England)
ISSN: 1532-2149
Titre abrégé: Eur J Pain
Pays: England
ID NLM: 9801774
Informations de publication
Date de publication:
09 2022
09 2022
Historique:
revised:
16
05
2022
received:
12
01
2022
accepted:
04
06
2022
pubmed:
8
6
2022
medline:
17
8
2022
entrez:
7
6
2022
Statut:
ppublish
Résumé
Habituation is a response decrement resulting from repeated stimuli. Reduced habituation to noxious stimuli is considered to be a proxy for central sensitization in subjects with chronic pain. Despite numerous investigations of pain habituation in relation to central sensitization, there is no consensus on the most sensitive and reliable readout, as well as analysis approach. Therefore, this study compared the usability and reliability of different readouts and habituation analysis approaches to measure pain habituation in response to repetitive heat simulation. Three blocks of 20 contact heat stimuli were applied on the volar forearm of 20 healthy subjects on two separate visits. Habituation was assessed by three different readouts: pain ratings, contact heat evoked potentials (CHEPs) and heat-induced sympathetic skin responses (SSRs). In addition, two different habituation analysis approaches were used: between the three stimulation blocks (between-block) and within the first stimulation block (within-block). Significant between-block habituation for SSRs (p < 0.001), but not for pain ratings (p = 1.000) and CHEPs (p = 0.078) was found. There was significant within-block habituation for pain ratings (p = 0.012) and SSRs (p < 0.001), but not for CHEPs (p = 0.246). Only the between-block habituation of heat-induced SSR was reliable between the two visits (first to second block: intraclass correlation coefficient [ICC] = 0.58, p = 0.030; first to third block: ICC = 0.64, p = 0.015). Heat-induced SSR as a measure of pain-autonomic interaction revealed the strongest pain habituation and showed the highest test-retest reliability.
Sections du résumé
BACKGROUND
Habituation is a response decrement resulting from repeated stimuli. Reduced habituation to noxious stimuli is considered to be a proxy for central sensitization in subjects with chronic pain. Despite numerous investigations of pain habituation in relation to central sensitization, there is no consensus on the most sensitive and reliable readout, as well as analysis approach. Therefore, this study compared the usability and reliability of different readouts and habituation analysis approaches to measure pain habituation in response to repetitive heat simulation.
METHODS
Three blocks of 20 contact heat stimuli were applied on the volar forearm of 20 healthy subjects on two separate visits. Habituation was assessed by three different readouts: pain ratings, contact heat evoked potentials (CHEPs) and heat-induced sympathetic skin responses (SSRs). In addition, two different habituation analysis approaches were used: between the three stimulation blocks (between-block) and within the first stimulation block (within-block).
RESULTS
Significant between-block habituation for SSRs (p < 0.001), but not for pain ratings (p = 1.000) and CHEPs (p = 0.078) was found. There was significant within-block habituation for pain ratings (p = 0.012) and SSRs (p < 0.001), but not for CHEPs (p = 0.246). Only the between-block habituation of heat-induced SSR was reliable between the two visits (first to second block: intraclass correlation coefficient [ICC] = 0.58, p = 0.030; first to third block: ICC = 0.64, p = 0.015).
CONCLUSION
Heat-induced SSR as a measure of pain-autonomic interaction revealed the strongest pain habituation and showed the highest test-retest reliability.
Identifiants
pubmed: 35671124
doi: 10.1002/ejp.1990
pmc: PMC9544564
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1679-1690Informations de copyright
© 2022 The Authors. European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation - EFIC®.
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