Nahman-Averbuch Hadas, Yarnitsky David, Granovsky Yelena, Gerber Ezra, Dagul Pnina, Granot Michal
The Laboratory of Clinical Neurophysiology, The Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
Department of Neurology, Rambam Medical Center, Haifa, Israel.
Scand J Pain. 2013 Jan 1;4(1):10-14. doi: 10.1016/j.sjpain.2012.08.001.
Background and purpose Conditioned pain modulation (CPM) is a testing paradigm representing features of diffuse noxious inhibitory control. There is large diversity in the paradigms applied to induce CPM, and the consistency in CPM responses assessed by different paradigms is largely unknown. We aimed to characterize and explore the associations between the CPM responses assessed by different paradigms in the same cohort. Methods Thirty-three healthy middle-aged subjects underwent six CPM paradigms. The 'test-stimuli', consisted of thermal and mechanical modalities, using pain thresholds, suprathreshold pain and temporal summation types of measurements. The 'conditioning-stimulus' consisted of a contact heat stimulus applied to the thener of the left hand for 60s at an intensity of 46.5°C. Results Large variability was observed among the responses to the different CPM paradigms. Surprisingly, no correlations were found between the various CPM responses. Conclusions The variability in the CPM responses may suggest that the capacity of pain modulation is a multifaceted trait, whose expression varies with the application of different CPM paradigms. Implications Considering that CPM responses may represent different processes when assessed by different paradigms, we encourage the use of more than one CPM paradigm.
背景与目的 条件性疼痛调制（CPM）是一种代表弥漫性伤害性抑制控制特征的测试范式。用于诱导CPM的范式存在很大差异，不同范式评估的CPM反应的一致性在很大程度上尚不清楚。我们旨在对同一队列中不同范式评估的CPM反应进行特征描述并探索它们之间的关联。方法 33名健康中年受试者接受了六种CPM范式。“测试刺激”包括热刺激和机械刺激，采用疼痛阈值、阈上疼痛和时间总和类型的测量。“条件刺激”包括以46.5°C的强度在左手小鱼际施加接触热刺激60秒。结果 观察到不同CPM范式的反应之间存在很大差异。令人惊讶的是，各种CPM反应之间未发现相关性。结论 CPM反应的变异性可能表明疼痛调制能力是一个多方面的特征，其表达随不同CPM范式的应用而变化。启示 考虑到不同范式评估CPM反应时可能代表不同的过程，我们鼓励使用不止一种CPM范式。
