Cardiac-Gated Neuromodulation Increased Baroreflex Sensitivity and Reduced Pain Sensitivity in Female Fibromyalgia Patients
The study presents a novel approach of programing pain inhibition in chronic pain patients based on the hypothesis that pain perception is modulated by dysfunctional dorsal medial nucleus tractus solitarii (dmNTS) reflex arcs that produce diminished baroreflex sensitivity (BRS) resulting from a cond...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-10-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/20/6220 |
| _version_ | 1797407034799292416 |
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| author | Kati Thieme Kathrin Jung Marc G. Mathys Richard H. Gracely Dennis C. Turk |
| author_facet | Kati Thieme Kathrin Jung Marc G. Mathys Richard H. Gracely Dennis C. Turk |
| author_sort | Kati Thieme |
| collection | DOAJ |
| description | The study presents a novel approach of programing pain inhibition in chronic pain patients based on the hypothesis that pain perception is modulated by dysfunctional dorsal medial nucleus tractus solitarii (dmNTS) reflex arcs that produce diminished baroreflex sensitivity (BRS) resulting from a conditioned response. This study tested whether administration of noxious and non-noxious electrical stimuli synchronized with the cardiac cycle resets BRS, reestablishing pain inhibition. A total of 30 pain-free normotensives controls (NC) and 32 normotensives fibromyalgia (FM) patients received two, ≈8 min-epochs of cardiac-gated, peripheral electrical stimuli. Non-painful and painful electrical stimuli were synchronized to the cardiac cycle as the neuromodulation experimental protocol (EP) with two control conditions (CC1, CC2). BRS, heart-rate-variability (HRV), pain threshold and tolerance, and clinical pain intensity were assessed. Reduced BRS in FM at baseline increased by 41% during two, ≈8 min-epochs of stimulation. Thresholds in FM increased significantly during the experimental protocol (all Ps < 0.001) as did HRV. FM levels of clinical pain significantly decreased by 35.52% during the experimental protocol but not during control stimulations (<i>p</i> < 0.001). Baroreceptor training may reduce FM pain by BRS-mediated effects on intrinsic pain regulatory systems and autonomic responses. |
| first_indexed | 2024-03-09T03:35:25Z |
| format | Article |
| id | doaj.art-4e6b753e4d89447b88a571d22a36269c |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T03:35:25Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-4e6b753e4d89447b88a571d22a36269c2023-12-03T14:49:12ZengMDPI AGJournal of Clinical Medicine2077-03832022-10-011120622010.3390/jcm11206220Cardiac-Gated Neuromodulation Increased Baroreflex Sensitivity and Reduced Pain Sensitivity in Female Fibromyalgia PatientsKati Thieme0Kathrin Jung1Marc G. Mathys2Richard H. Gracely3Dennis C. Turk4Department of Medical Psychology, Philipps-University Marburg, 35037 Marburg, GermanyDepartment of Medical Psychology, Philipps-University Marburg, 35037 Marburg, GermanyDepartment of Medical Psychology, Philipps-University Marburg, 35037 Marburg, GermanyCenter for Pain Research and Innovation, University of North Carolina, Chapel Hill, NC 27599, USADepartment of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA 98195, USAThe study presents a novel approach of programing pain inhibition in chronic pain patients based on the hypothesis that pain perception is modulated by dysfunctional dorsal medial nucleus tractus solitarii (dmNTS) reflex arcs that produce diminished baroreflex sensitivity (BRS) resulting from a conditioned response. This study tested whether administration of noxious and non-noxious electrical stimuli synchronized with the cardiac cycle resets BRS, reestablishing pain inhibition. A total of 30 pain-free normotensives controls (NC) and 32 normotensives fibromyalgia (FM) patients received two, ≈8 min-epochs of cardiac-gated, peripheral electrical stimuli. Non-painful and painful electrical stimuli were synchronized to the cardiac cycle as the neuromodulation experimental protocol (EP) with two control conditions (CC1, CC2). BRS, heart-rate-variability (HRV), pain threshold and tolerance, and clinical pain intensity were assessed. Reduced BRS in FM at baseline increased by 41% during two, ≈8 min-epochs of stimulation. Thresholds in FM increased significantly during the experimental protocol (all Ps < 0.001) as did HRV. FM levels of clinical pain significantly decreased by 35.52% during the experimental protocol but not during control stimulations (<i>p</i> < 0.001). Baroreceptor training may reduce FM pain by BRS-mediated effects on intrinsic pain regulatory systems and autonomic responses.https://www.mdpi.com/2077-0383/11/20/6220neuromodulationbaroreflex sensitivitydmNTSpain inhibitionfibromyalgia |
| spellingShingle | Kati Thieme Kathrin Jung Marc G. Mathys Richard H. Gracely Dennis C. Turk Cardiac-Gated Neuromodulation Increased Baroreflex Sensitivity and Reduced Pain Sensitivity in Female Fibromyalgia Patients Journal of Clinical Medicine neuromodulation baroreflex sensitivity dmNTS pain inhibition fibromyalgia |
| title | Cardiac-Gated Neuromodulation Increased Baroreflex Sensitivity and Reduced Pain Sensitivity in Female Fibromyalgia Patients |
| title_full | Cardiac-Gated Neuromodulation Increased Baroreflex Sensitivity and Reduced Pain Sensitivity in Female Fibromyalgia Patients |
| title_fullStr | Cardiac-Gated Neuromodulation Increased Baroreflex Sensitivity and Reduced Pain Sensitivity in Female Fibromyalgia Patients |
| title_full_unstemmed | Cardiac-Gated Neuromodulation Increased Baroreflex Sensitivity and Reduced Pain Sensitivity in Female Fibromyalgia Patients |
| title_short | Cardiac-Gated Neuromodulation Increased Baroreflex Sensitivity and Reduced Pain Sensitivity in Female Fibromyalgia Patients |
| title_sort | cardiac gated neuromodulation increased baroreflex sensitivity and reduced pain sensitivity in female fibromyalgia patients |
| topic | neuromodulation baroreflex sensitivity dmNTS pain inhibition fibromyalgia |
| url | https://www.mdpi.com/2077-0383/11/20/6220 |
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