Effect of expectation on pain assessment of lower- and higher-intensity stimuli

2017 ◽  
Vol 14 (1) ◽  
pp. 9-14 ◽  
Author(s):  
Valentina Ružić ◽  
Dragutin Ivanec ◽  
Koraljka Modić Stanke
Keyword(s):  
Pain Intensity ◽  
Pain Perception ◽  
Pain Modulation ◽  
The Other ◽  
Moderate Intensity ◽  
Lower Intensity ◽  
Intensity Assessment ◽  
Potential Benefits ◽  
Electrical Stimuli ◽  
Experimentally Induced

AbstractBackground and aimsPain modulation via expectation is a well-documented phenomenon. So far it has been shown that expectations about effectiveness of a certain treatment enhance the effectiveness of different analgesics and of drug-free pain treatments. Also, studies demonstrate that people assess same-intensity stimuli differently, depending on the experimentally induced expectations regarding the characteristics of the stimuli. Prolonged effect of expectation on pain perception and possible symmetry in conditions of lower- and higher-intensity stimuli is yet to be studied. Aim of this study is to determine the effect of expectation on the perception of pain experimentally induced by the series of higher- and lower-intensity stimuli.Methods192 healthy participants were assigned to four experimental groups differing by expectations regarding the intensity of painful stimuli series. Expectations of two groups were congruent with actual stimuli; one group expected and received lower-intensity stimuli and the other expected and received higher-intensity stimuli. Expectations of the remaining two groups were not congruent with actual stimuli; one group expected higher-intensity stimuli, but actually received lower-intensity stimuli while the other group expected lower-intensity stimuli, but in fact received higher-intensity ones. Each group received a series of 24 varied-intensity electrical stimuli rated by the participants on a 30° intensity scale.ResultsExpectation manipulation had statistically significant effect on pain intensity assessment. When expecting lower-intensity stimuli, the participants underestimated pain intensity and when expecting higher-intensity stimuli, they overestimated pain intensity. The effect size of expectations upon pain intensity assessment was equal for both lower- and higher-intensity stimuli.ConclusionThe obtained results imply that expectation manipulation can achieve the desired effect of decreasing or increasing both slight and more severe pain for a longer period of time. Manipulation via expectation before the stimuli series was proven to be effective for pain modulation in the entire series of stimuli which lasted around 10 min. The results suggest a potential benefit of manipulating expectations to alleviate emerging pain, since the obtained effects are moderate to large.ImplicationsIt seems that expectation effect is strong enough to “overcome” even the direct effect of stimulus intensity (at least in the low to moderate intensity range), which suggests potential benefits of verbal instructions even in rather painful stimuli.

Pain perception in chronic knee osteoarthritis with varying levels of pain inhibitory control: an exploratory study

2020 ◽  
Vol 20 (4) ◽  
pp. 651-661
Author(s):  
Paulo E. P. Teixeira ◽  
Hanan I. Zehry ◽  
Swapnali Chaudhari ◽  
Laura Dipietro ◽  
Felipe Fregni
Keyword(s):  
Knee Osteoarthritis ◽  
Pain Intensity ◽  
Pain Perception ◽  
Small Sample Size ◽  
Linear Regression Analysis ◽  
Small Sample ◽  
Pain Modulation ◽  
Clinical Variables ◽  
Pain Scores ◽  
Intensity Perception

AbstractBackground and aimsPain is a disabling symptom in knee osteoarthritis (KOA) and its underlying mechanism remains poorly understood. Dysfunction of descending pain modulatory pathways and reduced pain inhibition enhance pain facilitation in many chronic pain syndromes but do not fully explain pain levels in chronic musculoskeletal conditions. The objective of this study is to explore the association of clinical variables with pain intensity perception in KOA individuals with varying levels of Conditioned Pain Modulation (CPM) response.MethodsThis is a cross-sectional, exploratory analysis using baseline data of a randomized clinical trial investigating the effects of a non-invasive brain stimulation treatment on the perception of pain and functional limitations due to KOA. Sixty-three subjects with KOA were included in this study. Data on pain perception, mood perception, self-reported depression, physical function, quality of life, and quantitative sensory testing was collected. Multiple linear regression analysis was performed to explore the association between the clinical variables with pain perception for individuals with different levels of CPM response.ResultsFor KOA patients with limited CPM response, perception of limitations at work/other activities due to emotional problems and stress scores were statistically significantly associated with pain scores, F(2, 37) = 7.02, p < 0.01. R-squared = 0.275. For KOA patients with normal CPM response, general health perception scores were statistically significantly associated with pain scores, F(1, 21) = 5.60, p < 0.05. R-squared = 0.2104. Limitations of this study include methodology details, small sample size and study design characteristics.ConclusionsPain intensity perception is associated differently with clinical variables according to the individual CPM response. Mechanistic models to explain pain perception in these two subgroups of KOA subjects are discussed.

scholarly journals The dosing of aerobic exercise therapy on experimentally-induced pain in healthy female participants

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Anna M. Polaski ◽  
Amy L. Phelps ◽  
Kimberly A. Szucs ◽  
Austin M. Ramsey ◽  
Matthew C. Kostek ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Constant Pressure ◽  
Treadmill Walking ◽  
Moderate Intensity ◽  
High Dose ◽  
Moderate Dose ◽  
Pressure Pain ◽  
The Impact ◽  
Pain Unpleasantness ◽  
Experimentally Induced

Abstract Knowledge of efficacious dosing respective to exercise type and pain condition is extremely limited in the literature. This study aimed to determine the impact of dose of moderate intensity treadmill walking on experimentally-induced pain in healthy human participants. Forty females were divided into 4 groups: control (no exercise), low dose exercise (3×/wk), moderate dose exercise (5×/wk) or high dose exercise (10×/wk). Over a 7-day period, subjects performed treadmill walking during assigned exercise days. Both qualitative and quantitative measures of pain were measured at baseline, during the trial, and 24 hrs post-final intervention session via sensitivity thresholds to painful thermal and painful pressure stimulation. Significant effects of treatment were found post-intervention for constant pressure pain intensity (p = 0.0016) and pain unpleasantness ratings (p = 0.0014). Post-hoc tests revealed significant differences between control and moderate and control and high dose groups for constant pressure pain intensity (p = 0.0015), (p = 0.0094), respectively and constant pressure pain unpleasantness (p = 0.0040), (p = 0.0040), respectively. Moderate and high dose groups had the greatest reductions in ratings of pain, suggesting that our lowest dose of exercise was not sufficient to reduce pain and that the moderate dose of exercise may be a sufficient starting dose for exercise-based adjuvant pain therapy.

scholarly journals Abnormal Local Brain Activity Beyond the Pain Matrix in Postherpetic Neuralgia Patients: A Resting-State Functional MRI Study

2017 ◽  
Vol 2 (20;2) ◽  
pp. E303-E314 ◽  
Author(s):  
Buwei Yu
Keyword(s):  
Pain Intensity ◽  
Emotional Disorders ◽  
Postherpetic Neuralgia ◽  
Resting State ◽  
Pain Perception ◽  
Brain Activity ◽  
Brain Regions ◽  
Pain Modulation ◽  
Pain Matrix ◽  
Local Brain

Background: Postherpetic neuralgia (PHN) patients suffer debilitating chronic pain, hyperalgesia, and allodynia, as well as emotional disorders such as insomnia, anxiety, and depression. The brain structure and functional basis of PHN are still not fully understood. Objectives: To identify the changes of regional brain activity in resting-state PHN patients using regional homogeneity (ReHo) and fractional aptitude of low-frequency fluctuation (fALFF) methods. Correlations between spontaneous pain intensity and ReHo or fALFF were analyzed. Study Design: Observational study. Setting: University hospital. Methods: ReHo, fALFF change was analyzed in 19 PHN patients and 19 healthy controls to detect the functional abnormality in the brains of PHN patients. Correlations between ReHo, fALFF, and PHN pain intensity were assessed in the PHN group. Results: PHN patients exhibited significantly abnormal ReHo and fALFF intensity in several brain regions, including the brainstem, thalamus, limbic system, temporal lobe, prefrontal lobe, and cerebellum compared with healthy controls. Correlation analysis showed that most of the ReHo values of the aforementioned brain regions positively correlated with visual analog scale (VAS) values. But much less correlation was found between fALFF and VAS. Limitations: (a) No specific emotional assessment was given for PHN patients before fMRI scans, therefore we cannot exclude whether the emotional disorders exist in these patients. (b) Relatively short pain duration (mean 5.4 months) and small sample size (n = 19) for the PHN group. Conclusions: For PHN patients, the local brain activity abnormality was not restricted to the pain matrix. Besides regions related to pain perception, areas in charge of affective processes, emotional activity, and pain modulation also showed abnormal local brain activity in a resting state, which may suggest complicated supraspinal function and plasticity change in PHN patients. ReHo was more closely correlated with pain intensity of PHN patients than fALFF. This work indicates that besides physical and emotional pain perception, mood disorder and pain modulation could be characteristics of PHN patients. This also supports the potential use of therapeutic interventions not only restricted to pain alleviation, but also those that attempt to ameliorate the cognitive and emotional comorbidities. Key words: Postherpetic neuralgia, resting-state fMRI (rs-fMRI), mood disorder, limbic sy

Clinical Use of Toxic Proteins and Peptides from Tian Hua Fen and Scorpion Venom

2019 ◽  
Vol 20 (3) ◽  
pp. 285-295
Author(s):  
Chen Ling ◽  
Yuanhui Zhang ◽  
Jun Li ◽  
Wenli Chen ◽  
Changquan Ling
Keyword(s):  
Herbal Medicines ◽  
Scorpion Venom ◽  
The Other ◽  
Western World ◽  
Chinese Government ◽  
Clinical Use ◽  
Potential Benefits ◽  
Scientific Results ◽  
Proteins And Peptides ◽  
Toxic Proteins

Traditional Chinese Medicine (TCM) has been practiced in China for thousands of years. As a complementary and alternative treatment, herbal medicines that are frequently used in the TCM are the most accepted in the Western world. However, animal materials, which are equally important in the TCM practice, are not well-known in other countries. On the other hand, the Chinese doctors had documented the toxic profiles of hundreds of animals and plants thousand years ago. Furthermore, they saw the potential benefits of these materials and used their toxic properties to treat a wide variety of diseases, such as heavy pain and cancer. Since the 50s of the last century, efforts of the Chinese government and societies to modernize TCM have achieved tremendous scientific results in both laboratory and clinic. A number of toxic proteins have been isolated and their functions identified. Although most of the literature was written in Chinese, this review provide a summary, in English, regarding our knowledge of the clinical use of the toxic proteins isolated from a plant, Tian Hua Fen, and an animal, scorpion, both of which are famous toxic prescriptions in TCM.

Apocalypticism as Radical Realism? On the Dangers and Benefits of Wishful Thinking in Prefigurative Politics

2021 ◽  
pp. 003232172110184
Author(s):  
Ben Cross
Keyword(s):  
The Other ◽  
Wishful Thinking ◽  
Pivotal Role ◽  
Bernard Williams ◽  
Other Hand ◽  
Mutual Interest ◽  
Potential Benefits ◽  
Prefigurative Politics ◽  
Political Question

In this article, I aim to bring apocalypticism and radical realism into conversation, with a view to their mutual interest in prefigurative politics. On one hand, radical realists may worry that an apocalyptic approach to prefigurative politics may be marred by wishful thinking. On the other hand, radical realists can (and sometimes do) acknowledge that wishful thinking is sometimes desirable. I argue that an apocalyptic approach to prefigurative politics suggests one way of guarding against the dangers of wishful thinking, while allowing space for its potential benefits; prefigurativists have reason to pay at least some attention to what Bernard Williams calls ‘The First Political Question’. I will argue for this claim with reference to the case of Omar Aziz, a Syrian activist who played a pivotal role in the construction of local councils in the aftermath of the 2011 protests.

Stress Testing to Assess Recovery from Extreme Events

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
M. John Plodinec
Keyword(s):  
Climate Change ◽  
United States ◽  
Financial Institutions ◽  
Extreme Events ◽  
Stress Testing ◽  
The United States ◽  
The Other ◽  
New Approach ◽  
Rapid Spread ◽  
Potential Benefits

Abstract Over the last decade, communities have become increasingly aware of the risks they face. They are threatened by natural disasters, which may be exacerbated by climate change and the movement of land masses. Growing globalization has made a pandemic due to the rapid spread of highly infectious diseases ever more likely. Societal discord breeds its own threats, not the least of which is the spread of radical ideologies giving rise to terrorism. The accelerating rate of technological change has bred its own social and economic risks. This widening spectrum of risk poses a difficult question to every community – how resilient will the community be to the extreme events it faces. In this paper, we present a new approach to answering that question. It is based on the stress testing of financial institutions required by regulators in the United States and elsewhere. It generalizes stress testing by expanding the concept of “capital” beyond finance to include the other “capitals” (e.g., human, social) possessed by a community. Through use of this approach, communities can determine which investments of its capitals are most likely to improve its resilience. We provide an example of using the approach, and discuss its potential benefits.

Informed Consent for Online Research—Is Anybody Reading?: Assessing Comprehension and Individual Differences in Readings of Digital Consent Forms

2021 ◽  
pp. 155626462110201
Author(s):  
Caitlin Geier ◽  
Robyn B. Adams ◽  
Katharine M. Mitchell ◽  
Bree E. Holtz
Keyword(s):  
Individual Differences ◽  
Informed Consent ◽  
Research Process ◽  
The Other ◽  
Consent Form ◽  
Online Research ◽  
Consent Forms ◽  
Potential Benefits

Informed consent is an important part of the research process; however, some participants either do not read or skim the consent form. When participants do not read or comprehend informed consent, then they may not understand the potential benefits, risks, or details of the study before participating. This study used previous research to develop experimentally manipulated online consent forms utilizing various presentations of the consent form and interactive elements. Participants ( n = 576) were randomly exposed to one of six form variations. Results found that the highly interactive condition was significantly better for comprehension than any of the other conditions. The highly interactive condition also performed better for readability, though not significantly. Further research should explore the effects of interactive elements to combat habituation and to engage participants with the parts of the consent form unique to the study.

scholarly journals The European Green Capital Award—Is It a Dream or Reality for Belgrade (Serbia)?

2021 ◽  
Vol 13 (11) ◽  
pp. 6182
Author(s):  
Marijana Pantić ◽  
Saša Milijić
Keyword(s):  
Urban Transformation ◽  
The Other ◽  
Transmission Of Knowledge ◽  
Current State ◽  
Transitional Countries ◽  
Great Hope ◽  
Environmentally Responsible ◽  
Potential Benefits ◽  
The City ◽  
Insight Into

An agreement of cooperation and transmission of knowledge regarding the nomination for the European Green Capital Award (EGCA) was signed between the mayors of Belgrade and Ljubljana (EGCA 2016 winner) in September 2018. The candidacy of Belgrade was finally realized in October 2019. Great hope was placed in this endeavour because internationally recognized awards, such as the EGCA, represent enormous capital for both the city and the state. The EGCA requires serious preparation and significant fulfilment of preconditions. Many economically strong and environmentally responsible cities competed for the award, but did not win. On the other hand, the capital of Serbia does not appear to be an obvious winning candidate, especially as it is differentiated from the previous winners by being a non-EU city and by the fact that it is still undergoing an intense urban transformation, characteristic of transitional countries. Therefore, the main aim of this article is to present a review of the current state of Belgrade’s environmental qualities and its comparison with the EGCA criteria and with Grenoble as one of the winning competitors. The article gives a full overview of the EGCA requirements with certain details on required indicators, gives relevant insight into the procedure, which could be of use for any future candidacy, and discusses potential benefits for winners, losers and repeat candidacies.

scholarly journals Office-Cycling: A Promising Way to Raise Pain Thresholds and Increase Metabolism with Minimal Compromising of Work Performance

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Rebecca Tronarp ◽  
André Nyberg ◽  
Mattias Hedlund ◽  
Charlotte K. Häger ◽  
Suzanne McDonough ◽  
...  
Keyword(s):  
Cognitive Performance ◽  
Work Performance ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Pain Modulation ◽  
Moderate Intensity ◽  
Thermal Pain ◽  
Metabolic Expenditure ◽  
Pointing Precision ◽  
Mouse Pointing

Aim.Establishing the effects of low intensity cycling (LC), moderate intensity cycling (MC), and standing at a simulated office workstation on pain modulation, work performance, and metabolic expenditure.Methods.36 healthy adults (21 females), mean age 26.8 (SD 7.6) years, partook in this randomized3×3crossover trial with 75 minutes of LC on 20% of maximum aerobic power (MAP) output, 30 minutes of MC on 50% of MAP, and standing 30 minutes with 48-hour wash-out periods. Outcome measures were pain modulation (pressure pain threshold (PPT) and thermal pain threshold)), work performance (transcription, mouse pointing, and cognitive performance), and metabolic expenditure.Results.PPTs increased in all conditions. PPT trapezius showed the highest increase after LC, 39.3 kilopascals (kPa) (15.6; 78.6), compared to MC, 17.0 kPa (2.8; 49.9), and standing, 16.8 kPa (−5.6; 39.4),p=0.015. Transcription was reduced during LC and MC. Mouse pointing precision was best during standing and worst and slowest during MC. Cognitive performance did not differ between conditions. Metabolic expenditure rates were 1.4 (1.3; 1.7), 3.3 (2.3; 3.7), and 7.5 (5.8; 8.7) kcal/minute during standing, LC, and MC, respectively(p<0.001).Conclusions.LC seems to be the preferred option; it raised PPTs, more than doubled metabolic expenditure, whilst minimally influencing work performance.

Dyspnea-pain counterirritation induced by inspiratory threshold loading: a laser-evoked potentials study

2012 ◽  
Vol 112 (7) ◽  
pp. 1166-1173 ◽  
Author(s):  
Guillaume Bouvier ◽  
Louis Laviolette ◽  
Felix Kindler ◽  
Lionel Naccache ◽  
André Mouraux ◽  
...  
Keyword(s):  
Evoked Potentials ◽  
Somatosensory Evoked Potentials ◽  
Normal Male ◽  
Work Effort ◽  
Top Down ◽  
Laser Evoked Potentials ◽  
Brain Potentials ◽  
Nociceptive Flexion Reflex ◽  
Electrical Stimuli ◽  
Experimentally Induced

Background: experimentally induced dyspnea of the work/effort type inhibits, in a top-down manner, the spinal transmission of nociceptive inputs (dyspnea-pain counterirritation). Previous studies have demonstrated that this inhibition can be assessed by measuring the nociceptive flexion reflex (RIII). However, its clinical application is limited because of the strong discomfort associated with the electrical stimuli required to elicit the RIII reflex. Study objectives: we examined whether the dyspnea-pain counterirritation phenomenon can be evaluated by measuring the effect of work/effort type dyspnea on the magnitude of laser-evoked brain potentials (LEPs). Methods: 10 normal male volunteers were studied (age: 19–30 years). LEPs were elicited using a CO2 laser stimulator delivering 10- to 15-ms stimuli of 6 ± 0.7 W over a 12.5 mm2 area. The EEG was recorded using nine scalp channels. Non-nociceptive somatosensory-evoked potentials (SEPs) served as control. LEPs and SEPs were recorded before, during, and after 10 min of experimentally induced dyspnea [inspiratory threshold loading (ITL)]. Results: pain caused by the nociceptive laser stimulus was mild. ITL consistently induced dyspnea, mostly of the “excessive effort” type. Amplitude of the N2-P2 wave of LEPs decreased by 37.6 ± 13.8% during ITL and was significantly correlated with the intensity of dyspnea [ r = 0.66, CI 95% (0.08–0.92, P = 0.0319)]. In contrast, ITL had no effect on the magnitude of non-nociceptive SEPs. Discussion: experimentally induced dyspnea of the work/effort type reduces the magnitude of LEPs. This reduction correlates with the intensity of dyspnea. The recording of LEPs could constitute a clinically applicable approach to assess the dyspnea-pain counterirritation phenomenon in patients.

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