Clinical correlates of stress-induced analgesia: Evidence from pharmacological studies

Exposure to aversive stimuli or contexts results in profound analgesia. Beecher [3] observed that World War II soldiers suffering from battle wounds often experienced little pain, whereas similar injuries in a non-threatening environment would be perceived as highly painful. These initial observations gave rise to the concept that the perception of pain is heavily influenced by context. The development of well-characterised, animal models of analgesia associated with aversion (unconditioned or conditioned stress-induced analgesia (SIA)), provided the first opportunity to study the neurobiological mechanisms underpinning this evolutionarily significant phenomenon. Clinical studies of SIA have substantiated evidence from animal studies and enhanced our knowledge of this phenomenon in humans. An increased understanding of the neurobiological mechanisms underpinning this extremely potent form of endogenous analgesia is of both fundamental physiological importance and potential therapeutic significance. Here we provide a brief initial overview and update of preclinical studies of SIA and then examine the extent to which the pharmacological mechanisms identified also apply in humans.

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