Continuous pain report demonstrates time delay of pain ratings in Fibromyalgia

ABSTRACTBackgroundEnhanced temporal summation (TS), measured through self-reported pain ratings, has been interpreted as indicative of central sensitisation in fibromyalgia. Greater TS in patients, however, has not been universally observed. It is also unclear whether increased pain report maintains beyond the TS period.MethodsIn this study, we measured TS through continuously reported pain ratings. Fibromyalgia-diagnosed patients (n = 17) and matched pain-free controls (n = 13) rated painful transcutaneous electrical stimulation of various intensity levels in 18 one-minute-long blocks. Pain was rated on a 101-point visual analogue scale. The resulting continuous response was divided into TS (< 15s) and adaptation (15 – 60s) periods. Average pain values were extracted for each period alongside the timing of key events such as maximal pain ratings. The difference in temporal summation and adaptation measures between fibromyalgia and control participants was analysed using mixed-effects modelling.ResultsThe average pain ratings for TS and adaptation periods were not significantly associated with fibromyalgia diagnosis but were with stimulation intensity. The same was true for the magnitude of the maximal rating during TS and the slope leading to that peak rating. The presence of fibromyalgia, however, did predict the time of the maximal TS rating, as well as the value and the time of the maximal adaptation rating.ConclusionsOur study did not find homogeneously increased TS pain ratings. Instead, by utilising continuous pain data we demonstrate for the first time that the time of TS peak rating, as well as the magnitude and time of adaptation peak rating are linked to fibromyalgia diagnosis.

Neural and sociocultural mediators of ethnic differences in pain

© 2020, The Author(s), under exclusive licence to Springer Nature Limited. Understanding ethnic differences in pain is important for addressing disparities in pain care. A common belief is that African Americans are hyposensitive to pain compared to Whites, but African Americans show increased pain sensitivity in clinical and laboratory settings. The neurobiological mechanisms underlying these differences are unknown. We studied an ethnicity- and gender-balanced sample of African Americans, Hispanics and non-Hispanic Whites using functional magnetic resonance imaging during thermal pain. Higher pain report in African Americans was mediated by discrimination and increased frontostriatal circuit activations associated with pain rating, discrimination, experimenter trust and extranociceptive aspects of pain elsewhere. In contrast, the neurologic pain signature, a neuromarker sensitive and specific to nociceptive pain, mediated painful heat effects on pain report largely similarly in African American and other groups. Findings identify a brain basis for higher pain in African Americans related to interpersonal context and extranociceptive central pain mechanisms and suggest that nociceptive pain processing may be similar across ethnicities.

Neural and sociocultural mediators of ethnic differences in pain

© 2020, The Author(s), under exclusive licence to Springer Nature Limited. Understanding ethnic differences in pain is important for addressing disparities in pain care. A common belief is that African Americans are hyposensitive to pain compared to Whites, but African Americans show increased pain sensitivity in clinical and laboratory settings. The neurobiological mechanisms underlying these differences are unknown. We studied an ethnicity- and gender-balanced sample of African Americans, Hispanics and non-Hispanic Whites using functional magnetic resonance imaging during thermal pain. Higher pain report in African Americans was mediated by discrimination and increased frontostriatal circuit activations associated with pain rating, discrimination, experimenter trust and extranociceptive aspects of pain elsewhere. In contrast, the neurologic pain signature, a neuromarker sensitive and specific to nociceptive pain, mediated painful heat effects on pain report largely similarly in African American and other groups. Findings identify a brain basis for higher pain in African Americans related to interpersonal context and extranociceptive central pain mechanisms and suggest that nociceptive pain processing may be similar across ethnicities.

EATING THE PAIN AWAY: THE USE OF FOOD AS A COPING MECHANISM IN OLDER ADULTS EXPERIENCING CHRONIC PAIN

Individuals experiencing pain rely on impulse to make decisions, including choices regarding food consumption (Darbor, Lench, & Carter-Sowell, 2016). This study examined whether older adults experiencing chronic pain report higher instances of emotional eating in comparison to a population of older adults not experiencing chronic pain. Data stemmed from the Midlife in the United States study was analyzed to investigate whether individuals used food as a coping mechanism for chronic pain symptoms (Ryff et al., 2017). The sample consisted of Americans aged 60 to 74 years of age. Pain conditions included: has chronic pain (n=686) and does not have chronic pain (n=1036). Results of the Independent Samples T-Test indicated that participants were found to be engaging in emotional eating when experiencing chronic pain symptoms, as hypothesized. Participants in the has chronic pain condition reported relying on food as a coping mechanism more (M= 3.66, SD= 1.87) than participants in the does not have chronic pain condition (M= 3.42, SD= 1.71); t(1370)= 2.71, p= .007, d= 0.13. Results suggest that older adults experiencing chronic pain report utilizing food as a coping mechanism more than older adults that do not experience chronic pain. These findings have health implications given the rising obesity rates associated with persistent pain. Future directions may include studies on the negative health outcomes that result from high instances of emotional eating in older adults experiencing chronic pain. Additionally, investigating alternative coping mechanisms for chronic pain would be beneficial to diminish the harmful health effects of emotional eating.