Peripheral and electrocortical responses to painful and non-painful stimulation in chronic pain patients, tension headache patients and healthy controls

Sixteen chronic back pain (CBP) patients, 16 tension headache (THA) patients and 16 healthy controls (HC) were exposed to four series of ten electric stimuli at perception threshold, pain threshold and 10% below pain tolerance. The EEG was recorded from three sites, in addition, the EMG from the m. frontalis and m. erector spinae, heart rate and skin conductance were assessed. The CBP patients showed significantly lower pain threshold and pain tolerance values than the HC and the THA patients whereas the THA patients displayed a higher pain tolerance. Habituation was reduced in the CBP group. N150, P260, P300 and N500 were not significantly different between the groups nor were there significant group differences in the peripheral measures. However, since the stimulation intensity was significantly lower in the CBP patients, these data are indicative of both enhanced central and peripheral reactivity. The observed lack of habituation may contribute to the persistence of chronic pain.

[1]  S. Porges,et al.  Committee report. Publication guidelines for heart rate studies in man. , 1981, Psychophysiology.

[2]  A. J. Fridlund,et al.  Guidelines for human electromyographic research. , 1986, Psychophysiology.

[3]  H. Helson Adaptation-level theory : an experimental and systematic approach to behavior , 1964 .

[4]  J. Willer,et al.  Encoding of nociceptive thermal stimuli by diffuse noxious inhibitory controls in humans. , 1989, Journal of Neurophysiology.

[5]  Dieter Kleinböhl,et al.  Psychophysical measures of sensitization to tonic heat discriminate chronic pain patients , 1999, Pain.

[6]  P. Lehrer,et al.  Stress reactivity and perception of pain among tension headache sufferers. , 1991, Behaviour research and therapy.

[7]  Andrew C. N. Chen,et al.  The McGill pain questionnaire in the assessment of phasic and tonic experimental pain: behavioral evaluation of the ‘pain inhibiting pain’ effect , 1985, Pain.

[8]  J. Vlaeyen,et al.  Is pain-related fear a predictor of somatosensory hypervigilance in chronic low back pain patients? , 2002, Behaviour research and therapy.

[9]  P. Venables,et al.  Publication recommendations for electrodermal measurements. , 1981 .

[10]  H. Merskey,et al.  Classification of chronic pain. Descriptions of chronic pain syndromes and definitions of pain terms. Prepared by the International Association for the Study of Pain, Subcommittee on Taxonomy. , 1994, Pain. Supplement.

[11]  M. Peters,et al.  Differences in pain perception and sensory discrimination between chronic low back pain patients and healthy controls. , 1992, Journal of psychosomatic research.

[12]  B. Bromm,et al.  The intracutaneous stimulus: a new pain model for algesimetric studies. , 1984, Methods and findings in experimental and clinical pharmacology.

[13]  Niels Birbaumer,et al.  The role of operant conditioning in chronic pain: an experimental investigation , 2002, Pain.

[14]  Jürgen Sandkühler,et al.  Learning and memory in pain pathways , 2000, Pain.