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Schliessbach, Jürg and Lütolf, Christian and Streitberger, Konrad and Scaramozzino, Pasquale and Arendt-Nielsen, Lars and Curatolo, Michele (2019) 'Reference Values of Conditioned Pain Modulation.' Scandinavian Journal of Pain, 19 (2). pp. 279-286.

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Abstract

BACKGROUND AND AIMS: Endogenous pain modulation can be studied in humans by conditioned pain modulation (CPM): pain induced by a test stimulus is attenuated by a distantly applied noxious conditioning stimulus. The detection of impaired CPM in individual patients is of potential importance to understand the pathophysiology and predict outcomes. However, it requires the availability of reference values. // METHODS: We determined reference values of CPM in 146 pain-free subjects. Pressure and electrical stimulation were the test stimuli. For electrical stimuli, we recorded both pain threshold and threshold for the nociceptive withdrawal reflex. Cold pressor test was the conditioning stimulus. The 5th, 10th and 25th percentiles for the three tests were computed by quantile regression analyses. // RESULTS: The average thresholds increased after the conditioning stimulus for all three tests. However, a subset of subjects displayed a decrease in thresholds during the conditioning stimulus. This produced negative values for most of the computed percentiles. // CONCLUSIONS: This study determined percentile reference values of CPM that can be used to better phenotype patients for clinical and research purposes. The negative value of percentiles suggests that a slightly negative CPM effect can be observed in pain-free volunteers. // IMPLICATIONS: Pain facilitation rather than inhibition during the conditioning stimulus occurs in some pain-free volunteers and may not necessarily represent an abnormal finding.

Item Type: Journal Article
Keywords: conditioned pain modulation; references values; cold pressor test; pressure pain thresholds; electrical pain thresholds
SOAS Departments & Centres: Departments and Subunits > School of Finance & Management
Subjects: R Medicine > R Medicine (General)
ISSN: 18778879
Copyright Statement: ©2019 Scandinavian Association for the Study of Pain. Published by Walter de Gruyter GmbH, Berlin/Boston. All rights reserved. This is the published version of record. For information on re-use, please refer to the publisher’s terms and conditions.
DOI (Digital Object Identifier): https://doi.org/10.1515/sjpain-2018-0356
Date Deposited: 02 Jan 2019 15:28
URI: https://eprints.soas.ac.uk/id/eprint/30105
Funders: Other

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