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Correlative study of pain perception and masticatory muscle reflexes in man.

An attempt was made to explore the possibility of using the masticatory muscle reflexes as pain indices in human subjects. It was found that the digastric reflex, so readily evoked by electrodental stimulation in experimental animals, could not be consistently elicited in man. The reflex silent period of the masseteric muscles, on the other hand, may be used as a pain index for evaluating dental analgesia, provided that analgesic interference is anticipated at points along the reflex arc.

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Pain perception in mice lacking the beta3 subunit of voltage-activated calcium channels.

The importance of voltage-activated calcium channels in pain processing has been suggested by the spinal antinociceptive action of blockers of N- and P/Q-type calcium channels as well as by gene targeting of the alpha1B subunit (N-type). The accessory beta3 subunits of calcium channels are preferentially associated with the alpha1B subunit in neurones. Here we show that deletion of the beta3 subunit by gene targeting affects strongly the pain processing of mutant mice. We pinpoint this defect in the pain-related behavior and ascending pain pathways of the spinal cord in vivo and at the level of calcium channel currents and proteins in single dorsal root ganglion neurones in vitro. The pain induced by chemical inflammation is preferentially damped by deletion of beta3 subunits, whereas responses to acute thermal and mechanical harmful stimuli are reduced moderately or not at all, respectively. The defect results in a weak wind-up of spinal cord activity during intense afferent nerve stimulation. The molecular mechanism responsible for the phenotype was traced to low expression of N-type calcium channels (alpha1B) and functional alterations of calcium channel currents in neurones projecting to the spinal cord.

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Neuroimaging of pain perception in Dutch veterans with and without posttraumatic stress disorder: preliminary results.

This article presents initial data on the application of a pain protocol in posttraumatic stress disorder (PTSD) to assess the neural circuitry that is involved in the disorder, with a special interest in the role of the anterior cingulate cortex (ACC). Preliminary analysis demonstrated a specific and differentiated role for the ACC. Fixed affects analysis demonstrated that stimuli subjectively perceived as more painful resulted in increased activation of the caudal ACC, whereas less painful stimuli resulted in increased activation of the rostral ACC in both groups.

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Can a sexually dimorphic index of prenatal hormonal exposure be used to examine cold pressor pain perception in men and women?

There is considerable evidence to suggest that important differences exist between men and women in their experience of pain. Research has now turned to determine what the mechanisms of such differences actually are. One potential explanation is the effect of sex hormones, especially those typically found in greater concentration within women, e.g., estrogen, progesterone. However, it is also possible that other hormones, such as testosterone may be important. The current study employed a non-invasive sexually dimorphic index (digit ratio) that is believed to reflect prenatal exposure to testosterone, and related this to the cold pressor pain experiences of 23 men and 27 healthy women. As expected, females had greater symmetry between the second and fourth digits, and also reported lower pain tolerance levels. Although some significant relationships were found between digit ratio/digit length and cold pressor pain reports they were relatively inconsistent. Furthermore, the main finding, that pain thresholds were positively related to digit ratio in women but not men, is somewhat inconsistent with predictions. The results are discussed in light of methods for investigating the effect of prenatal hormonal exposure on pain sensitivity in men and women.

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Is self-reported childhood abuse history associated with pain perception among healthy young women and men?

OBJECTIVE: A self-reported history of childhood physical and/or sexual abuse is frequently reported among chronic pain populations and has been associated with poorer adjustment to pain. In addition, self-reported abuse history has been related to increased pain complaints in population-based studies. One possible explanation for the association between abuse and clinical pain is that abuse victims may display enhanced sensitivity to painful stimuli, which increases the risk of developing clinical pain. However, the limited evidence addressing this issue has been mixed. The purpose of this study was to examine the association between self-reported history of childhood sexual or physical abuse and experimental pain responses in a nonclinical sample of generally healthy young adults. DESIGN: Participants were 110 (56 female, 54 male) college students who completed a series of questionnaires assessing abuse history, recent pain, health care utilization, perceived health, and psychologic variables. Also, measures of thermal and ischemic pain threshold and tolerance were obtained in all participants. In addition, a procedure assessing temporal summation of heat pain was conducted in which intensity and unpleasantness ratings of repetitive thermal stimuli were obtained. Systolic and diastolic blood pressure and heart rate were assessed at resting and during the ischemic pain task. RESULTS: Participants with a positive childhood abuse history were oversampled, yielding 21 out of 56 (37.5%) women with a positive history of abuse and 13 out of 54 (24.1%) PHA men. No abuse group differences emerged for thermal or ischemic pain thresholds or tolerances (P values>0.05). However, compared to women with no childhood abuse history, women with a positive history of abuse provided significantly lower average pain unpleasantness and peak pain unpleasantness ratings and lower unpleasantness ratings of the first trial during the temporal summation procedure, whereas no abuse group differences emerged for men. Also, compared to participants with no childhood abuse history, participants of both genders with a positive history of abuse demonstrated smaller increases (ie, less temporal summation) in pain unpleasantness ratings across trials of thermal stimulation, and participants with a positive history of abuse showed greater decreases in pain intensity and unpleasantness after reaching their peak pain level (ie, greater wind-down) compared to participants with no childhood abuse history. In addition, participants with a positive history of abuse reported more sites of recent pain, poorer perceived health, greater somatization, and more negative affect. No group differences in resting cardiovascular measures or cardiovascular reactivity were observed. CONCLUSION: These findings indicate that a self-reported history of childhood abuse is associated with decreased sensitivity to experimentally induced pain, especially among women. However, abuse history was associated with increased pain complaints, poorer self-reported health, and greater negative affect. These data highlight the complexity of the relationship between abuse history and pain and illustrate the need for further investigation of potential pain-related correlates of abuse.

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Argon laser induced single cortical responses: a new method to quantify pre-pain and pain perceptions.

The shape (amplitude and latency) of single cortical responses to argon laser stimulation was found to match six perceptual classes: three pre-pain and three pain. The amplitude of the pain related single cortical responses correlated with the perceived feeling of pain. Easy detectable responses were obtained because habituation to the stimuli was reduced and a high degree of attention was given to each stimulus. Single cortical responses to argon laser stimuli are suggested as a new quantitative technique with application in the assessment of function in the thermal and nociceptive pathways.

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Ratio scaling of pain perception with the submaximum effort tourniquet technique.

The submaximum effort tourniquet technique (SETT) is becoming more widely used as part of the clinical assessment of chronic pain patients despite little information about the scaling of this technique. Ratio scaling procedures resulted in a linear function, presumed to underlie clinical application of the SETT, for only 11% of the subjects. Therefore, current clinical use of the tourniquet ratio score should be questioned. Normals also obtained significantly more negatively accelerated power functions than pain patients with no difference in tolerances. Differences in these growth curves are discussed with reference to the concept of pain endurance. Continued needs for standardized pain evaluation techniques suggest that this type of psychophysical scaling procedure may improve the precision of some clinical pain assessments.

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[Psychosomatic aspects of pain perception by the elderly--results of the ELDERMEN Study].

115 geriatric in-patients are included in the current study examining relationships between regions of experienced pain, subjective pain intensity, and psychological variables. An investigation of the connection between psychosomatic limitations (BSS) and pain indicated, that pain patients do not necessarily require psychosomatic-psychotherapeutic treatment (in our study only 21.6%). 61.7% of the study sample reported intense pain at least one body region. These patients differed significantly from those with less pain in terms of their level of functional capacity and need for assistance in daily activities (ADL/IADL). They also displayed a significantly more negative attitude towards aging (PGC) than patients with minimal pain. Hierarchical cluster analyses for applied coping strategies produced five groups within the subgroup of patients suffering from extreme pain. Only within one group "depression" was a significant reaction to health-problems. These results make clear that most of the patients with extreme pain are able to cope effectively with pain.

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