De Schoenmacker, Iara; Costa Marques, David; Scheuren, Paulina S.; Lütolf, Robin; Gorrell, Lindsay M; Mehli, Sarah C; Curt, Armin; Rosner, Jan; Hubli, Michèle (2024). Novel neurophysiological evidence for preserved pain habituation across chronic pain conditions. Clinical neurophysiology, 166, pp. 31-42. Elsevier 10.1016/j.clinph.2024.07.007
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OBJECTIVE
The present study aimed to investigate whether subjective and objective measures of pain habituation can be used as potential markers for central sensitization across various chronic pain patients.
METHODS
Two blocks of contact-heat stimuli were applied to a non-painful area in 93 chronic pain patients (low back pain, neuropathic pain, and complex regional pain syndrome) and 60 healthy controls (HC). Habituation of pain ratings, contact-heat evoked potentials (CHEP), and sympathetic skin responses (SSR) was measured.
RESULTS
There was no significant difference in any measure of pain habituation between patients and HC. Even patients with apparent clinical signs of central sensitization showed no reduced pain habituation. However, prolonged baseline CHEP and SSR latencies (stimulation block 1) were found in patients compared to HC (CHEP: Δ-latency = 23 ms, p = 0.012; SSR: Δ-latency = 100 ms, p = 0.022).
CONCLUSION
Given the performed multimodal neurophysiological testing protocol, we provide evidence indicating that pain habituation may be preserved in patients with chronic pain and thereby be of limited use as a sensitive marker for central sensitization. These results are discussed within the framework of the complex interactions between pro- and antinociceptive mechanism as well as methodological issues. The prolonged latencies of CHEP and SSR after stimulation in non-painful areas may indicate subclinical changes in the integrity of thermo-nociceptive afferents, or a shift towards antinociceptive activity. This shift could potentially affect the relay of ascending signals.
SIGNIFICANCE
Our findings challenge the prevailing views in the literature and may encourage further investigations into the peripheral and central components of pain habituation, using advanced multimodal neurophysiological techniques.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology |
UniBE Contributor: |
Scheuren, Paulina, Rosner, Jan |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1872-8952 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
06 Aug 2024 10:38 |
Last Modified: |
15 Sep 2024 00:16 |
Publisher DOI: |
10.1016/j.clinph.2024.07.007 |
PubMed ID: |
39094528 |
Uncontrolled Keywords: |
Chronic pain Contact-heat evoked potentials Neurophysiological measures Pain habituation Pain ratings Sympathetic skin responses |
BORIS DOI: |
10.48350/199471 |
URI: |
https://boris.unibe.ch/id/eprint/199471 |
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