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PubMed1992

Psychophysical features of the transition from pure heat perception to heat pain perception.

The psychophysical features of the transition from the pure heat to the heat pain range were studied in 25 healthy subjects (mean age 28.8 years). Thirty short heat stimuli from -1.6 degrees C to +1.6 degrees C relative to the pain threshold were applied to the thenar of the left hand with an apparatus containing a Peltier thermode (nine different temperatures at 0.4 degrees C intervals). The subjects rated the sensation intensity on a visual analogue scale. The resulting stimulus/sensation intensity relations could be explained equally well (same goodness of fit) by a model with a power function (PF) and by a model with two linear regression lines (TLR), one for stimulus intensities below and one for those above the pain threshold and intersecting at the pain threshold. The slopes of the TLR model were significantly larger above the pain threshold than below it. The PF model produced exponents between 1.8 and 1.9. We conclude that to describe the transition area, it is sufficient to use simple linear models for both the pure heat and the heat pain ranges.

Adult↗
PubMed2003

Gender differences in predator induced pain perception in rats.

Pain is an unpleasant sensation. It warns the living being about the impending damage to the tissues. The perception of pain is influenced by physical and psychological factors. The impact of chronic intermittent psychological stress on pain perception and the differences in antinociceptive responses have been studied in male and anestrous female albino rats. Fifteen rats in each group were subjected to psychological stress, by exposing them to their natural predator--cat, for a duration of 20 min daily for 12 consecutive days. Tail flick response latency to radiant heat was used as a measure to evaluate pain perception. It was observed that both the groups had a relatively high pain threshold at the beginning of exposure schedule due to the modulation of opioid analgesic system by the higher level of circulating testosterone in males and low level of estrogen in anaestrous females. However, the threshold for pain perception showed a gradually declining trend in both the groups over the next 11 days to reach the control values. This increase in sensitivity to pain or decreased pain threshold could be attributed to the phenomenon of habituation.

Animals↗
PubMed2004

Laboratory pain perception and clinical pain in post-menopausal women and age-matched men with osteoarthritis: relationship to pain coping and hormonal status.

The present study examined relationships between pain coping, hormone replacement therapy, and laboratory and clinical pain reports in post-menopausal women and age-matched men with osteoarthritis. Assessment of nociceptive flexion reflex threshold was followed by an assessment of electrocutaneous pain threshold and tolerance. Participants rated their arthritis pain using the Arthritis Impact Measurement Scales. To assess pain coping, participants completed measures of emotion-focused coping, problem-focused coping, and pain catastrophizing. Results indicated that women were more likely than men to report using emotion-focused pain strategies, and that emotion-focused coping was associated with more arthritic pain and lower electrocutaneous pain tolerance. Correlations between coping measures and pain reports revealed that catastrophizing was associated with greater arthritis pain and lower pain threshold and tolerance levels. However, catastrophizing was not related to nociceptive flexion reflex threshold, suggesting that the observed relationship between catastrophizing and subjective pain does not rely on elevated nociceptive input. A comparison of men (n=58), post-menopausal women receiving hormone replacement therapy (n=32), and post-menopausal women not receiving hormone replacement therapy (n=42) revealed no significant group differences in arthritis pain, electrocutaneous pain threshold or tolerance, or nociceptive flexion reflex threshold. Thus, older adults with osteoarthritis do not exhibit the pattern of sex differences in response to experimental pain procedures observed in prior studies, possibly due to the development of disease-related changes in pain coping strategies. Accordingly, individual differences in clinical and experimental pain may be better predicted by pain coping than by sex or hormonal differences.

Adaptation, Psychological↗
PubMed1988

[Pain perception and peripheral pain localization in angina pectoris].

Cardiac nociceptive afferences are mainly transmitted by sympathetic nervous tracts. After passing the ganglion stellatum and neighbouring ganglia, the nerves enter the dorsal horn of the spinal cord at C8-Th9 (especially Th2-Th6). Here the nerve synapses for the first time, mainly to neurons which run up to the thalamus contralaterally by the tractus spinothalamicus. Apart from atypically localised pain (jaw, head, neck), the nervus vagus is rarely involved in transmitting angina pectoris pain. There is no close relation between peripheral pain localisation and localisation of coronary stenosis or myocardial ischemia areas. The localisation of angina pectoris is decided by viscero-somatic summation (convergence-projection-theory). Almost all the ascending tracts of the tractus spinothalamicus with visceral inflow also receive inflow from somatic afferences, from skin areas of the dermatome from the same segment level, and especially from deep somatic structures such as muscle and ligaments (Head's zones). Additional reflex mechanisms, where the efferent part is probably sympathetic, explain transferred effects in the matching dermatome such as hypothermic skin zones, cutaneous hyperalgesia, higher pressure sensitivity of the muscles and occasionally even dystrophic changes. The amount of spinal visceral afferences is relatively small (only 1.5-2.5% of all somatic spinal afferences). The low amount, the pronounced divergence and, compared to converging somatic afferences, the larger receptive fields in the organ explain the diffuse, barely localisable character of angina pectoris pain. Cardiac afferences are tonically and phasically inhibited at spinal and supraspinal levels, especially by descending tracts. This explains why angina pectoris can be missing in spite of pronounced peripheral nociceptive impulse rates. Patients with silent myocardial ischemia have a higher central pain threshold than patients with symptomatic myocardial ischemia. Endogenous opioids are involved in the body's own analgesia system. The beta-endorphin level in the serum rises significantly in many patients during exercise diagnostic tests. Patients with silent myocardial ischemia have higher beta-endorphin levels compared to symptomatic patients at the same exercise level. This can be interpreted as expressing quantitative differences in a superior pain regulation system. Myocardial ischemia is experienced as angina pectoris pain when the peripheral nociceptive impulse rate is so pronounced that the prevailing inhibitory pain threshold can be overcome and when the pain pathways are intact.

Angina Pectoris↗
PubMed2005

Intra-operative pain perception in tooth extraction--possible causes.

OBJECTIVES: To elicit the perception of pain in patients undergoing dental extraction under local anaesthesia and also to identify factors that might contribute to this experience despite the administration of local anaesthesia. SETTING: Ile-Ife, Southwestern Nigeria. PARTICIPANTS: 122 randomly selected single-tooth extraction patients. METHODS: Informed consent was obtained from patients who subsequently completed a questionnaire on the Corah Dental Anxiety Scale prior to treatment. Details documented for each patient included the demographics, history of previous tooth extraction and the status of the operator. The extraction was timed from the application of instrument until tooth delivery. Immediately after extractions, patients were asked to indicate on a Visual Analogue Scale (VAS) scores graded 0-10, the level of pain perceived during extraction. The data were subjected to simple descriptive and statistical analysis using SPSS for Windows 11.0. RESULTS: Positive correlations were found between the VAS and the anxiety scores, the attending surgeons' status, patients' anxiety score and the duration of surgery. A significant difference was found between the anxiety and the VAS scores in the different occupational groups. CONCLUSIONS: These results suggest that the status of the attending surgeon may affect the level of anxiety in patients undergoing tooth extractions prior to surgery. While patient's occupational group and duration of surgery could contribute to patient's intraoperative pain perception despite the administration of local anaesthesia.

Adolescent↗
PubMed2005

Vagal stomach afferents inhibit somatic pain perception.

Vagal stimulation inhibits systemic pain perception in animals, probably via the nucleus tractus solitarius and its connections with descending nuclei in the brainstem which inhibit pain. Pain-inhibiting effects of such stimulation in humans, obtained from epileptic patients treated by vagal stimulation, are controversial. The aim of our study was to evaluate whether vagal stomach afferent activation inhibits pain perception in healthy humans. Pain thresholds, magnitude of tonic heat pain at 46 degrees C stimulation, pain temporal summation and laser pain evoked potentials were measured at the hand before and immediately after rapid drinking of 1500 ml water in 31 volunteers. We found an increase in heat pain threshold from 43.3+/-2.6 to 44.7+/-2.2 degrees C, P<0.0001, a decrease of peak pain magnitude to tonic heat from 56.3+/-26.2 to 43.7+/-25.8 (on 0-100 VAS), P<0.0001, a lowering of area under the curve during tonic noxious heat stimulus from 1962+/-984 to 1411+/-934, P<0.001. Additionally, we observed a decrease in the peak to peak evoked potential amplitude from 19.2 microV+/-1.2 to 15.6 microV+/-1.2 (P=0.005) together with a decrease in the estimation of mean laser induced pain from 52.28+/-18.00 to 48.14+/-20.18 (P=0.025). Mechanical pain thresholds and temporal summation did not change significantly. We conclude that vagal stomach afferents exert an inhibitory effect on somatic pain perception in humans.

Adult↗
PubMed1999

Decreased pain perception and risk for hypertension: considering a common physiological mechanism.

For almost two decades, researchers have demonstrated that hypertension is reliably associated with decreased perception of pain. More recently, a growing body of evidence has begun to suggest that hypoalgesia is not a consequence of high blood pressure, as the phenomenon precedes the onset of hypertension in individuals at risk for the disorder. This article provides a review of empirical evidence of decreased pain perception in normotensive persons with a family history of hypertension, elevated resting blood pressure, or exaggerated cardiovascular reactivity to stress. Based on the existing evidence, hypoalgesia is argued to be a correlate of dysregulation of central nervous system structures involved in both pain control and cardiovascular regulation in individuals who are genetically predisposed to develop high blood pressure. As such, hypoalgesia may serve as a valuable method of identifying individuals at greatest risk for hypertension.

Animals↗
PubMed2004

[Influence of pain perception, morbidity and mood on functional impairment in elderly chronic pain patients].

The purpose of the study was to address the impact of pain perception, morbidity and mood on functional impairment in elderly chronic pain patients. Multimorbid pain patients beyond the age of 65 in two geriatric hospitals (n = 84), a pain clinic (n = 60) and three general practices (n = 117) provided information about pain perception, comorbidity, additional symptoms and mood by means of the "Structured Pain Interview for Geriatric Patients", the "Cumulative Illness Rating Scale" and a list of symptoms. Data analysis relied on stepwise multiple regression with variables of pain perception entered in the first step, of morbidity entered in the second step and of mood entered in the third step. Although patients believe that pain is the main reason for their functional impairment (71.3%), the data do not support this assumption. Increasing morbidity and bad mood have more impact to reduced functional performance than the pain perception. Our results support the recommendation that a multimodal program should be offered to even multimorbid and older people with chronic pain in order to achieve a maximum of functional rehabilitation.

Activities of Daily Living↗
PubMed1992

Differences in pain perception and sensory discrimination between chronic low back pain patients and healthy controls.

Pain perception threshold (PPT), maximal pain tolerance (MPT) and pain discrimination of CLBP patients and controls were tested. Pain perception threshold was significantly higher in the patient group for two different pain stimuli (electrical and pressure pain). Maximal pain tolerance was significantly higher in CLBP patients only for the pressure pain stimulus. There was no difference between the groups in their capacity to discriminate between painful stimuli of different intensity, as measured by a forced-choice task. It is concluded that CLBP patients have a decreased sensitivity for experimental pain. Two theories which might explain this decreased sensitivity are discussed.

Adult↗
PubMedDate not supplied

Influence of gender and hemispheric lateralization on heat pain perception in major depression.

Increased incidence of clinical pain complaints from patients with major depression, as well as increased experimental pain thresholds have been reported. The basis of this phenomenon remains unclear, as well as its relation to medication, clinical recovery, gender and lateralization of hemispheric function. We aimed to further elucidate heat pain perception in depression applying a testing battery including assessment (on both arms) of warmth perception, heat pain perception and heat pain tolerance, and the jaw opening reflex (duration of ES2 component) as a putative indicator of descending pain inhibition. The battery was applied to 20 patients and 20 age- and sex-matched controls. Patients were assessed: on admission (acutely depressed, off-medication), few days after admission (depressed, on medication), and after clinical recovery (mostly on medication), and controls at corresponding intervals. Significant elevated heat pain thresholds were found off and on medication in the acute stage (mainly in women) and after recovery on the right arm only. Elevated heat pain tolerance (on the right arm only) was seen in medicated patients in the acute and recovered stage. Significant prolongation of ES2 duration was only found in acutely depressed patients off medication. While confirming hypalgesia to heat pain in major depression, our findings demonstrate a close relation to gender and strong influence of lateralization after recovery. Altered pain processing at brain stem level might only partially be responsible for the observed finding.

Adult↗
PubMed2006

Sleep deprivation and pain perception.

Chronically painful conditions are frequently associated with sleep disturbances, i.e. changes in sleep continuity and sleep architecture as well as increased sleepiness during daytime. A new hypothesis, which has attracted more and more attention, is that disturbances of sleep cause or modulate acute and chronic pain. Since it is well-known that pain disturbs sleep the relationship between the two has since recently been seen as reciprocal. To fathom the causal direction from sleep to pain we have reviewed experimental human and animal studies on the effects of sleep deprivation on pain processing. According to the majority of the studies, sleep deprivation produces hyperalgesic changes. Furthermore, sleep deprivation can interfere with analgesic treatments involving opioidergic and serotoninergic mechanisms of action. The still existing inconsistency of the human data and the exclusive focus on REM sleep deprivation in animals so far do not allow us to draw firm conclusions as to whether the hyperalgesic effects are due to the deprivation of specific sleep stages or whether they result from a generalized disruption of sleep continuity.

Animals↗
PubMed1981

Pain perception in competitive swimmers.

The pain perception of 30 competitive swimmers was studied using experimentally induced ischaemic pain. The pain thresholds and tolerances of this group were compared with those of 30 club swimmers and 26 non-competitive athletes. While pain thresholds showed little difference between the groups, pain tolerances were considerably different. Pain tolerances of the competitive swimmers varied according to the stage of the training season. The relation between ischaemic pain and that experienced during swimming training was studied using a pain questionnaire composed of several systematically structured verbal categories. Both types of pain were classified along similar dimensions, and it was concluded that the experimentally demonstrated pain tolerances could be generalized to the normal pain perception of the subjects. The origins of the enhanced pain tolerances of the competitive swimmers would seem to lie in their systematic exposure to brief periods of intense pain. These data could have relevance for the treatment of chronic pain in certain diseases.

Arm↗
PubMed1993

Pain perception threshold in major depression.

Somatosensory perception threshold (SPT) and pain perception threshold (PPT) were studied in 16 patients with major depression, compared to the findings in an age-matched and gender-matched control group and related to the psychopathological state evaluated by means of the Hamilton Depression Scale. Perception thresholds were assessed by means of a noninvasive high-frequency electric skin stimulation. Absolute perception thresholds were increased in the patients. However, the relative pain perception threshold (RPPT = PPT: SPT) was significantly reduced. RPPT was positively correlated with retardation. It was negatively correlated with anxiety, suggesting that a reduction of pain perception thresholds in depressive patients may be attributed to anxiety and impaired stress-coping.

Adult↗
PubMed2006

Influence of antipsychotic medication on pain perception in schizophrenia.

A number of clinical observations indicate that pain processing might be disturbed in psychotic disorders such as schizophrenia. Only a few studies have investigated pain perception in schizophrenia. The main objective of this study was the investigation of thresholds of warmth perception (WP), thermal pain onset (TPO) and thermal pain tolerance (TPT) in acute schizophrenic patients and the influence of antipsychotic medication on the patients' responses. We investigated 23 schizophrenic subjects who had been not received antipsychotic treatment for 8 weeks, and we then reassessed them 3 days later after the introduction of neuroleptics. Acute symptoms of schizophrenia were measured using the Scales for the Assessment of Positive and Negative Symptoms. Thresholds were determined by a contact thermode on both volar wrists. Schizophrenic patients showed significantly increased thresholds of WP and TPO relative to healthy controls. Antipsychotics did not alter pain thresholds. We found no correlation between pain perception and psychometric scales. Our findings demonstrate altered warmth and heat pain perception in acute schizophrenia. We believe that our findings can be attributed to information-processing abnormalities of the disorder and that they are not specific to pain processing, per se, since both WP and TPO were significantly different. Future studies should evaluate attentional deficits in schizophrenia in relation to pain perception.

Adult↗
PubMed1994

Southwestern Internal Medicine Conference: the syndrome of angina pectoris: role of visceral pain perception.

Angina pectoris is a pain syndrome caused by coronary arteriosclerosis but also by a number of other disorders, including microvascular angina, gastroesophageal reflux (GER), and esophageal dysmotility. The relationship between abnormal physiology and pain in these conditions is complex. Simultaneous ambulatory monitoring of esophageal pH and motility has demonstrated that patients may have identical episodes of chest pain with acid reflux, dysmotility, both types of events, or neither. Patients may have anginal chest pain with inflation of an esophageal balloon, and patients with microvascular angina may have pain with catheter manipulation in the right atrium. Recent evidence suggests that disorders of visceral pain perception may play a role in both chest pain of esophageal origin and microvascular angina. The physiology of visceral pain is reviewed, including concepts of convergence of somatic and visceral afferent input, descending modulation of pain perception, and sensitization of visceral pain afferents. An approach to evaluation and treatment of chest pain in patients with angiographically normal coronary arteries is outlined.

Angina Pectoris↗