Slow temporal summation of pain for assessment of central pain sensitivity and clinical pain of fibromyalgia patients.

<h4>Background</h4>In healthy individuals slow temporal summation of pain or wind-up (WU) can be evoked by repetitive heat-pulses at frequencies of ≥.33 Hz. Previous WU studies have used various stimulus frequencies and intensities to characterize central sensitization of human subjects...

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Autores principales:	Roland Staud, Elizabeth E Weyl, Joseph L Riley, Roger B Fillingim
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/3df277392f754ea5a83090cbea68e943
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spelling	oai:doaj.org-article:3df277392f754ea5a83090cbea68e9432021-11-18T08:32:11ZSlow temporal summation of pain for assessment of central pain sensitivity and clinical pain of fibromyalgia patients.1932-620310.1371/journal.pone.0089086https://doaj.org/article/3df277392f754ea5a83090cbea68e9432014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24558475/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>In healthy individuals slow temporal summation of pain or wind-up (WU) can be evoked by repetitive heat-pulses at frequencies of ≥.33 Hz. Previous WU studies have used various stimulus frequencies and intensities to characterize central sensitization of human subjects including fibromyalgia (FM) patients. However, many trials demonstrated considerable WU-variability including zero WU or even wind-down (WD) at stimulus intensities sufficient for activating C-nociceptors. Additionally, few WU-protocols have controlled for contributions of individual pain sensitivity to WU-magnitude, which is critical for WU-comparisons. We hypothesized that integration of 3 different WU-trains into a single WU-response function (WU-RF) would not only control for individuals' pain sensitivity but also better characterize their central pain responding including WU and WD.<h4>Methods</h4>33 normal controls (NC) and 38 FM patients participated in a study of heat-WU. We systematically varied stimulus intensities of.4 Hz heat-pulse trains applied to the hands. Pain summation was calculated as difference scores of 1st and 5th heat-pulse ratings. WU-difference (WU-Δ) scores related to 3 heat-pulse trains (44°C, 46°C, 48°C) were integrated into WU-response functions whose slopes were used to assess group differences in central pain sensitivity. WU-aftersensations (WU-AS) at 15 s and 30 s were used to predict clinical FM pain intensity.<h4>Results</h4>WU-Δ scores linearly accelerated with increasing stimulus intensity (p<.001) in both groups of subjects (FM>NC) from WD to WU. Slope of WU-RF, which is representative of central pain sensitivity, was significantly steeper in FM patients than NC (p<.003). WU-AS predicted clinical FM pain intensity (Pearson's r = .4; p<.04).<h4>Conclusions</h4>Compared to single WU series, WU-RFs integrate individuals' pain sensitivity as well as WU and WD. Slope of WU-RFs was significantly different between FM patients and NC. Therefore WU-RF may be useful for assessing central sensitization of chronic pain patients in research and clinical practice.Roland StaudElizabeth E WeylJoseph L RileyRoger B FillingimPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 2, p e89086 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Roland Staud Elizabeth E Weyl Joseph L Riley Roger B Fillingim Slow temporal summation of pain for assessment of central pain sensitivity and clinical pain of fibromyalgia patients.
description	<h4>Background</h4>In healthy individuals slow temporal summation of pain or wind-up (WU) can be evoked by repetitive heat-pulses at frequencies of ≥.33 Hz. Previous WU studies have used various stimulus frequencies and intensities to characterize central sensitization of human subjects including fibromyalgia (FM) patients. However, many trials demonstrated considerable WU-variability including zero WU or even wind-down (WD) at stimulus intensities sufficient for activating C-nociceptors. Additionally, few WU-protocols have controlled for contributions of individual pain sensitivity to WU-magnitude, which is critical for WU-comparisons. We hypothesized that integration of 3 different WU-trains into a single WU-response function (WU-RF) would not only control for individuals' pain sensitivity but also better characterize their central pain responding including WU and WD.<h4>Methods</h4>33 normal controls (NC) and 38 FM patients participated in a study of heat-WU. We systematically varied stimulus intensities of.4 Hz heat-pulse trains applied to the hands. Pain summation was calculated as difference scores of 1st and 5th heat-pulse ratings. WU-difference (WU-Δ) scores related to 3 heat-pulse trains (44°C, 46°C, 48°C) were integrated into WU-response functions whose slopes were used to assess group differences in central pain sensitivity. WU-aftersensations (WU-AS) at 15 s and 30 s were used to predict clinical FM pain intensity.<h4>Results</h4>WU-Δ scores linearly accelerated with increasing stimulus intensity (p<.001) in both groups of subjects (FM>NC) from WD to WU. Slope of WU-RF, which is representative of central pain sensitivity, was significantly steeper in FM patients than NC (p<.003). WU-AS predicted clinical FM pain intensity (Pearson's r = .4; p<.04).<h4>Conclusions</h4>Compared to single WU series, WU-RFs integrate individuals' pain sensitivity as well as WU and WD. Slope of WU-RFs was significantly different between FM patients and NC. Therefore WU-RF may be useful for assessing central sensitization of chronic pain patients in research and clinical practice.
format	article
author	Roland Staud Elizabeth E Weyl Joseph L Riley Roger B Fillingim
author_facet	Roland Staud Elizabeth E Weyl Joseph L Riley Roger B Fillingim
author_sort	Roland Staud
title	Slow temporal summation of pain for assessment of central pain sensitivity and clinical pain of fibromyalgia patients.
title_short	Slow temporal summation of pain for assessment of central pain sensitivity and clinical pain of fibromyalgia patients.
title_full	Slow temporal summation of pain for assessment of central pain sensitivity and clinical pain of fibromyalgia patients.
title_fullStr	Slow temporal summation of pain for assessment of central pain sensitivity and clinical pain of fibromyalgia patients.
title_full_unstemmed	Slow temporal summation of pain for assessment of central pain sensitivity and clinical pain of fibromyalgia patients.
title_sort	slow temporal summation of pain for assessment of central pain sensitivity and clinical pain of fibromyalgia patients.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/3df277392f754ea5a83090cbea68e943
work_keys_str_mv	AT rolandstaud slowtemporalsummationofpainforassessmentofcentralpainsensitivityandclinicalpainoffibromyalgiapatients AT elizabetheweyl slowtemporalsummationofpainforassessmentofcentralpainsensitivityandclinicalpainoffibromyalgiapatients AT josephlriley slowtemporalsummationofpainforassessmentofcentralpainsensitivityandclinicalpainoffibromyalgiapatients AT rogerbfillingim slowtemporalsummationofpainforassessmentofcentralpainsensitivityandclinicalpainoffibromyalgiapatients
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Slow temporal summation of pain for assessment of central pain sensitivity and clinical pain of fibromyalgia patients.

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