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PubMed1992

Pain perception in self-injurious patients with borderline personality disorder.

Pain ratings during the cold pressor test were significantly lower in female inpatients with borderline personality disorder who report that they do not experience pain during self-injury (BPD-NP group, n = 11), compared with similar patients who report that they do experience pain during self-injury (BPD-P group, n = 11), and normal female subjects (n = 6). Pain ratings were not significantly different in the BPD-P and normal control groups. Self-report ratings of depression, anger, anxiety, and confusion were significantly lower, and ratings of vigor significantly higher following the cold pressor test in the BPD-NP group, but not in the BPD-P group. Only anxiety was significantly lower in the normal control group following the cold pressor test. The implications and limitations of these preliminary findings are discussed.

Adolescent↗
PubMed1985

[Pain, perception and expression: an ethological perspective].

To better understand the pain phenomenon, its occurrence and its functional significance, pain should be considered as a part of a behaviour system which activates two functions: defensive and aversive behaviour on the one hand, and recuperative behaviour on the other. In the former especially the more short-lasting primary pain plays a role, in recuperative behaviour more chronic secondary pain is of importance. Pain should not be seen primarily as the unconditioned stimulus in the fear system, but as one of the independent behaviour systems. Within the framework of this ethological model both the facilitative and inhibitive influences which 'pain' and 'fear' exert on each other can be more satisfactorily explained. We assume that animals feel pain on the grounds of the so-called 'analogy decision'. The only objective measure, of course, is the behaviour which is observable as a consequence of harmful influences. This behaviour varies greatly with the nature and localisation of the harmful effects; the variation is dependent on the degree to which behavioural responses can be effective in avoiding damage and promoting recovery, and also on the animal species considered. In some species expressions of pain have been selected for and adapted as social signals which elicit consideration, help and care of conspecifics. In other species social and other factors have precluded stimulation of such a development. All this means that the extent to which spontaneous behavioural expressions can serve as valid pain measures is a complicated question; it leads to consideration of the feasibility of more meaningful experimental measurement methods.

Animals↗
PubMed2002

Pain perception, hypnosis and 40 Hz oscillations.

A number of brain regions are associated with the subjective experience of pain. This study adds to our understanding of the neural mechanisms involved in pain by considering the relation between cortical oscillations in response to pain, with and without hypnosis and hypnotic analgesia, and the subjective experience of pain. Thirty-three subjects' neural responses (EEG) were measured during the 40-540 ms period following phasic electrical stimulations to the right hand, under control and hypnosis conditions. Resultant FFT amplitudes for frequencies ranging from 8 to 100 Hz were computed. These were grouped into 7 scalp topographies, and for each frequency, relations between these topographies and pain ratings, performance and stimulus intensity measures were assessed. Gamma activity (32-100 Hz) over prefrontal scalp sites predicted subject pain ratings in the control condition (r=0.50, P=0.004), and no other frequency/topography combination did. This relation was present in both high and low hypnotisable subjects and was independent of performance and stimulus intensity measures. This relation was unchanged by hypnosis in the low hypnotisable subjects but was not present in the highs during hypnosis, suggesting that hypnosis interferes with this pain/gamma relation. This study provides evidence for the role of gamma oscillations in the subjective experience of pain. Further, it is in keeping with the view that hypnosis involves the dissociation of prefrontal cortex from other neural functions.

Adolescent↗
PubMed2005

From nociception to pain perception: imaging the spinal and supraspinal pathways.

Functional imaging techniques have allowed researchers to look within the brain, and revealed the cortical representation of pain. Initial experiments, performed in the early 1990s, revolutionized pain research, as they demonstrated that pain was not processed in a single cortical area, but in several distributed brain regions. Over the last decade, the roles of these pain centres have been investigated and a clearer picture has emerged of the medial and lateral pain system. In this brief article, we review the imaging literature to date that has allowed these advances to be made, and examine the new frontiers for pain imaging research: imaging the brainstem and other structures involved in the descending control of pain; functional and anatomical connectivity studies of pain processing brain regions; imaging models of neuropathic pain-like states; and going beyond the brain to image spinal function. The ultimate goal of such research is to take these new techniques into the clinic, to investigate and provide new remedies for chronic pain sufferers.

Brain↗
PubMed1984

Pain perception and alleviation in animals.

In the last 2 decades there have been substantial advances in our knowledge of the scientific basis of the mechanisms of pain. Nociceptors or pain receptors are widespread in the skin and tissues of animals; chemical mediation of nociceptor excitation may provide a key for understanding the peripheral phenomena related to pain. The expression of pain in animals involves multiple ascending and descending branches, as well as specialized pain-signaling mechanisms in the spinal cord. The importance of these different pathways varies with species and circumstances. Endogenous neural systems in the brain stem and forebrain including both opioid and nonopioid mechanisms may modulate the central transmission of nociceptive signals in animals. Noxious stimuli mediate a variety of different functions; each animal has a consistent response to noxious stimuli or a consistent pattern of escape from pain. As we better understand the mechanisms of pain, the humane treatment and alleviation of pain in experimental animals can be placed on a much firmer scientific basis.

Afferent Pathways↗
PubMed2000

Muscle pain perception and sympathetic nerve activity to exercise during opioid modulation.

The purpose of this experiment was to examine the effects of the endogenous opioid system on forearm muscle pain and muscle sympathetic nerve activity (MSNA) during dynamic fatiguing exercise. Twelve college-age men (24 +/- 4 yr) performed graded (1-min stages; 30 contractions/min) handgrip to fatigue 1 h after the ingestion of either 60 mg codeine, 50 mg naltrexone, or placebo. Pain (0-10 scale) and exertion (0-10 and 6-20 scales) intensities were measured during the last 15 s of each minute of exercise and every 15 s during recovery. MSNA was measured continuously from the peroneal nerve in the left leg. Pain threshold occurred earlier [1.8 +/- 1, 2. 2 +/- 1, 2.2 +/- 1 J: codeine, naltrexone, and placebo, respectively] and was associated with a lower rating of perceived exertion (RPE) (2.7 +/- 2, 3.6 +/- 2, 3.8 +/- 2: codeine, naltrexone, and placebo, respectively) in the codeine condition compared with either the naltrexone or placebo conditions. There were no main effects (i.e., drugs) or interaction (i.e., drugs x time) for either forearm muscle pain or RPE during exercise [pain: F (2, 22) = 0.69, P = 0.51]. There was no effect of drug on MSNA, heart rate, or blood pressure during baseline, exercise, or recovery. Peak exercise MSNA responses were 21 +/- 1, 21 +/- 2.0, and 21 +/- 2.0 bursts/30 s for codeine, naltrexone, and placebo conditions, respectively. Peak mean arterial pressure responses were 135 +/- 4, 131 +/- 3, and 132 +/- 4 mmHg for codeine, naltrexone, and placebo conditions, respectively. It is concluded that neither 60 mg codeine nor 50 mg naltrexone has an effect on forearm muscle pain, exertion, or MSNA during high- intensity handgrip to fatigue.

Adolescent↗
PubMed1994

Baroreceptor stimulation: pain perception and sensory thresholds.

Baroreceptor activity has been implicated in the modulation of pain. Sensory detection thresholds and pain ratings were measured in a group of 28 men during carotid baroreceptor manipulation with the PRES (phase-related external suction) neck suction technique. Brief, cardiac phase-related electrical impulses were delivered intracutaneously to the finger. The results indicate that minimum baroreceptor activity was associated with more severe pain, but had no effect on sensory detection threshold. The results are discussed in terms of the learned model of hypertension.

Adult↗
PubMed1978

Pain perception and endorphin levels in cerebrospinal fluid.

In 45 consecutive patients with chronic pain syndromes endorphins, fraction I of the cerebrospinal fluid and pain measures by means of electric stimulation via saline electrodes were investigated. In patients with high levels of fraction I (above median) pain threshold, PT and tolerance level, TL, in condition C (continuous stimulation increase) were found to be significantly higher than in patients with low levels of fraction I (below median). The results indicate that the endorphins are one of the physiological factors that contribute to the pain threshold and the tolerance level.

Adult↗
PubMed1991

Interethnic differences in pain perception.

While several investigators have reported relationships between ethnic background and expression of pain, such relationships are in fact highly problematical. Few studies of pain and ethnicity have used quantitative measures of pain combined with multivariate methods of data analysis. Most have focussed on populations which, unlike many in the United States today, are characterized by highly distinct ethnic groups. The study reported here interviewed 536 persons recently treated for forms of cancer known to cause significant pain. Pain was assessed using standard, well validated instruments, including Graphic Rating Scales anchored in several alternative time-frames and the McGill Pain Questionnaire. The study took place in an area with a low proportion of recent immigrants and only small concentrations of distinct ethnic minorities. No statistically significant relationships were observed between ethnic identity and measures of pain sensation. However, pain described in affective terms according to the McGill Pain Questionnaire did vary among ethnicities. This observation suggests that cultures associated with specific ethnic identities still condition individual expression of pain despite the high degree of assimilation that has occurred among ethnic groups in the United States.

Adult↗
PubMed2005

Sex differences in pain perception.

BACKGROUND: A number of studies have demonstrated a higher prevalence of chronic pain states and greater pain sensitivity among women compared with men. Pain sensitivity is thought to be mediated by sociocultural, psychological, and biological factors. OBJECTIVE: This article reviews laboratory studies that provide evidence of sex differences in pain sensitivity and the response to analgesic drugs in animals and humans. The biological basis of such differences is emphasized. METHODS: The literature from this relatively new field was surveyed, and studies that clearly illustrate the differences in pain mechanisms between the sexes are presented. Using the search terms sex, gender, and pain, a review was conducted of English-language literature published on MEDLINE between January 1980 and August 2004. RESULTS: Although differences in pain sensitivity between women and men are partly attributable to social conditioning and to psychosocial factors, many laboratory studies of humans have described sex differences in sensitivity to noxious stimuli, suggesting that biological mechanisms underlie such differences. In addition, sex hormones influence pain sensitivity; pain threshold and pain tolerance in women vary with the stage of the menstrual cycle. Imaging studies of the brain have shown differences between men and women in the spatial pattern and intensity of response to acute pain. Among rodents, females are more sensitive than males to noxious stimuli and have lower levels of stress-induced analgesia. Male rodents generally have stronger analgesic response to mu-opioid receptor agonists than females. Research on transgenic mice suggests that normal males have a higher level of activity in the endogenous analgesic system compared with normal females, and a human study has found that mu-receptors in the healthy female brain are activated differently from those in the healthy male brain. The response to kappa-opioids, which is mediated by the melanocortin-1 receptor gene in both mice and humans, is also different for each sex. CONCLUSION: Continued research at the genetic and receptor levels may support the need to develop gender-specific drug therapies.

Analgesics↗
PubMed2006

Canine visitation (pet) therapy: pilot data on decreases in child pain perception.

PURPOSE: To explore the effectiveness of canine visitation therapy (CVT) in pediatric pain management in a tertiary care children's hospital, a descriptive pilot study was conducted. METHOD: A convenience sample of 25 English-speaking children ages 5 to 18 years who underwent surgery and experienced acute postoperative pain participated in a standard, one-time CVT intervention. Each child completed a pre-post survey and a post intervention interview. FINDINGS: Quantitative pre-post findings indicate that CVT significantly reduced perceived pain. Qualitative findings suggest that one mechanism that makes CVT effective may be cognitive. That is, CVTdistracts children from pain-related cognition and possibly activates comforting thoughts regarding companionship or home. CONCLUSION: The study findings suggest that CVT may be a useful adjunct to traditional pain management for children. IMPLICATIONS: Nurses may better serve their patients when CVT is an option.

Acute Disease↗
PubMed1991

[The evaluation of anxiety and the analysis of pain perception in Down's syndrome patients undergoing dental procedures].

Twenty Down's syndrome dental patients between 9 and 20 years of age have been identified in order to evaluate anxiety and pain induced by various kinds of dental treatment such as some "moderately painful" dental out-patient procedures (10 subjects), general anaesthesia dental treatment (5 subjects) and painless out-patient visit or routine orthodontic services (5 subjects). Each patient received a previous psychological evaluation to assess his intellectual and cognitive developmental degree. Anxiety was assessed twice, before and after intervention by means of a questionnaire; pain was tested in a subjective way during the procedure (or the control oral visit 12 hours after the g.a. treatment) and by a questionnaire in the post-treatment phase. This investigation indicates that anxiety increased in Down's syndrome subjects receiving out-patient interventions, remained at the original level in the general anaesthesia hospitalized patients, while it showed a clear reduction in the out-patient painless control group. Anxiety, however, proves to be influenced also by the patient's effective mental age so it my be lessened after painful dental treatment when the intellectual development is about or above that of a 7 year old boy. Our study could prove to be important since it underlines the need to assess, at least approximately, the Down's syndrome patient's cognitive development before giving dental treatment, especially if it is an out-patient intervention. This may not be necessary for routine free of pain dental visits.

Adolescent↗
PubMed1999

Peripherally administered sufentanil inhibits pain perception after postpartum tubal ligation.

The clinical effectiveness of locally administered opioids is still under discussion; in particular, the potency of morphine in settings other than intra-articular arthroscopy has been questioned. We developed another pain model, postpartum resection of the fallopian tubes for sterilisation, in which each patient serves as her own control when one side is infiltrated with the active drug (in this study sufentanil 5 mg) and the contralateral side with normal saline. In the control group both sides are infiltrated with plain saline. After 30 min from the end of anaesthesia onwards, 26 out of 30 patients observed significant pain relief on the side of the sufentanil infiltration, which in 11 patients lasted until the end of the observation period 24 h postoperatively; no difference was observed in the control group. In our pain model with a high assay sensitivity, the infiltration of one side with the lipophilic test drug, sufentanil, caused local analgesia in primarily non-inflamed tissue. The use of each patient as her own control excluded inter-subject bias.

Adult↗
PubMed1991

Psychophysical measurement on pain perception after administration of a topical anesthetic.

Topical anesthetics are routinely used to reduce the discomfort that patients perceive during dental injections. The purpose of this investigation was to correlate the expectancy of pain and the effect of pretreatment instructions with the severity of pain perceived upon topical anesthetic use and dental injection. The treatment, topical placebo versus topical anesthetic, was administered in a double-blind manner. Following testing for expectations, the administration of instructions, and placement of the topical, the injection was given. The patients were then asked to rate their injection experience on a posttreatment questionnaire. The results of this investigation reinforce the importance of psychological variables in the mediation of pain perceived during dental procedures.

Administration, Topical↗