Conditioned pain modulation using painful cutaneous electrical stimulation or simply habituation?

L. Eitner; Ö.S. Özgül; E.K. Enax‐Krumova; J. Vollert; C. Maier; O. Höffken

doi:10.1002/ejp.1215

journal article Apr 11, 2018

Conditioned pain modulation using painful cutaneous electrical stimulation or simply habituation?

L. Eitner Ö.S. Özgül E.K. Enax‐Krumova J. Vollert C. Maier O. Höffken

European Journal of Pain Vol. 22 No. 7 pp. 1281-1290 · Wiley

View at Publisher Save 10.1002/ejp.1215

Abstract

AbstractBackground and AimsCold pressor test was recently reported to significantly reduce painful cutaneous electrical stimulation (PCES)‐induced pain and corresponding evoked potentials (PCES‐EPs), but whether this reduction is an effect of conditioned pain modulation (CPM) remains unknown. To what extent these findings are confounded by habituation is also unknown. We thus compared the effect of CPM and habituation on PCES‐induced pain and PCES‐EPs and analysed whether increased attention by a random change of electric stimulation would intensify this possible habituation effect.MethodsThree custom‐built concentric surface electrodes were used to induce a pain intensity of 60 on a 0–100 numerical rating scale (NRS) among 29 healthy subjects (age 20–35y, 16 females). PCES‐EPs (including P0N1 and N1P1 amplitudes, N1 latencies) were assessed over Cz. Group A received 14 min of electrical stimulation with constant intensity followed by 14 min of electrical stimulation with variable intensities, group B vice versa. Afterwards, subjects perceived cold‐water pain (10 °C) contralaterally as conditioning stimulus to assess CPM. Statistical analysis was conducted with ANOVA and t‐test.ResultsIn both groups, N1 latencies remain unchanged, but the intensity of PCES‐induced pain (12 ± 17%; p < 0.01) and N1P1 amplitudes of PCES‐EPs (10 ± 16%; p < 0.05) decreased significantly during the 14‐min PCES with constant current intensity. CPM also significantly reduced pain ratings (36 ± 19%; p < 0.001) and amplitudes (37.2 ± 15.8%), p < 0.001). A significant decline of P0N1 amplitudes occurred only during CPM (18 ± 61%; p < 0.001).ConclusionWe found a significant effect of habituation on PCES‐induced pain and PCES‐EPs, although the effect of CPM was significantly larger and could not be explained by habituation alone.SignificancePainful cutaneous electrical stimulation leads to moderate habituation of pain and evoked potential amplitudes, but the conditioned pain modulation effect using this method is significantly larger, which might indicate a different mechanism in central processing.

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Metrics

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Citations

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References

Details

Published: Apr 11, 2018
Vol/Issue: 22(7)
Pages: 1281-1290
License: View

Authors

L

L. Eitner

Department of Pain Medicine Ruhr‐University Bochum Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil gGmbH Bochum Germany; Department of Neuropediatrics Ruhr‐University Bochum University Children's Hospital Germany

�

Ö.S. Özgül

Department of Neurology Ruhr‐University Bochum Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil gGmbH Bochum Germany

E

E.K. Enax‐Krumova

Department of Neurology Ruhr‐University Bochum Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil gGmbH Bochum Germany

J

J. Vollert

Department of Pain Medicine Ruhr‐University Bochum Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil gGmbH Bochum Germany; Pain Research Department of Surgery and Cancer Imperial College London UK; Center of Biomedicine and Medical Technology Mannheim CBTM Medical Faculty Mannheim Heidelberg University Germany

C

C. Maier

Department of Pain Medicine Ruhr‐University Bochum Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil gGmbH Bochum Germany

O

O. Höffken

Department of Neurology Ruhr‐University Bochum Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil gGmbH Bochum Germany

Funding

Georgius Agricola Stiftung Ruhr - Institut für Pathologie

FoRUM-Forschungsförderung of the Medical Faculty at the Ruhr-University Bochum

Cite This Article

L. Eitner, Ö.S. Özgül, E.K. Enax‐Krumova, et al. (2018). Conditioned pain modulation using painful cutaneous electrical stimulation or simply habituation?. European Journal of Pain, 22(7), 1281-1290. https://doi.org/10.1002/ejp.1215

Conditioned pain modulation using painful cutaneous electrical stimulation or simply habituation?

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