Startle modulation by heat pain with varying threat levels in chronic pain patients and pain-free controls
C Horn-Hofmann,1 D Wolf,1 S Wolff,1 M Heesen,2 K Knippenberg-Bigge,3 P M Lang,3 S Lautenbacher1 1Department of Physiological Psychology, University of Bamberg, Germany; 2Department of Anesthesiology and Pain Therapy, Kantonsspital Baden, Switzerland; 3Department of Anesthesiology and Pain Therapy, S...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2017-07-01
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| Series: | Journal of Pain Research |
| Subjects: | |
| Online Access: | https://www.dovepress.com/startle-modulation-by-heat-pain-with-varying-threat-levels-in-chronic--peer-reviewed-article-JPR |
| _version_ | 1818558721652948992 |
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| author | Horn-Hofmann C Wolf D Wolff S Heesen M Knippenberg-Bigge K Lang PM Lautenbacher S |
| author_facet | Horn-Hofmann C Wolf D Wolff S Heesen M Knippenberg-Bigge K Lang PM Lautenbacher S |
| author_sort | Horn-Hofmann C |
| collection | DOAJ |
| description | C Horn-Hofmann,1 D Wolf,1 S Wolff,1 M Heesen,2 K Knippenberg-Bigge,3 P M Lang,3 S Lautenbacher1 1Department of Physiological Psychology, University of Bamberg, Germany; 2Department of Anesthesiology and Pain Therapy, Kantonsspital Baden, Switzerland; 3Department of Anesthesiology and Pain Therapy, Sozialstiftung Bamberg, Bamberg, Germany Background: Empirical evidence suggests that affective responses to pain are changed in chronic pain. The investigation of startle responses to pain might contribute to clarifying whether such alterations also expand to motivational defensive reactions. We aimed at comparing startle responses to tonic heat pain with high threat (HT) or low threat (LT) in patients with chronic musculoskeletal pain and controls. As pain-related anxiety and catastrophizing are typically elevated in chronic pain, we expected to find stronger startle responses in patients specifically under experimental HT. Methods: Patients with chronic musculoskeletal, preferentially, back pain (N = 19) and matched pain-free controls (N = 19) underwent two pain-related threat conditions (high and low) in balanced order. Only, in the HT condition, 50% of the trials were announced to include a short further noxious temperature increase at the end. Startle responses to loud tones were always assessed prior to a potential temperature increase in the phase of anticipation and were recorded by surface electromyogram. Results: Surprisingly, we observed no differences in startle responses and ratings of emotional and pain responses between patients and controls despite significantly higher pain-related anxiety and catastrophizing in the patients. Overall, startle was potentiated in the HT condition, but only in participants who started with this condition. Conclusion: Our results suggest that, in general, patients with pain are not more responsive emotionally to experimental threat manipulations despite elevated pain anxiety and catastrophizing. Instead, exaggerated responses in patients might be triggered only by individual concerns relating to pain, which are not sufficiently mirrored by our threat paradigm. Keywords: musculoskeletal pain, catastrophizing, anxiety, defensive motivation, experimental pain, startle reflex, threat induction |
| first_indexed | 2024-12-14T00:16:00Z |
| format | Article |
| id | doaj.art-9d89818c2beb4b25babf88df9fde78bf |
| institution | Directory Open Access Journal |
| issn | 1178-7090 |
| language | English |
| last_indexed | 2024-12-14T00:16:00Z |
| publishDate | 2017-07-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Pain Research |
| spelling | doaj.art-9d89818c2beb4b25babf88df9fde78bf2022-12-21T23:25:33ZengDove Medical PressJournal of Pain Research1178-70902017-07-01Volume 101787180034009Startle modulation by heat pain with varying threat levels in chronic pain patients and pain-free controlsHorn-Hofmann CWolf DWolff SHeesen MKnippenberg-Bigge KLang PMLautenbacher SC Horn-Hofmann,1 D Wolf,1 S Wolff,1 M Heesen,2 K Knippenberg-Bigge,3 P M Lang,3 S Lautenbacher1 1Department of Physiological Psychology, University of Bamberg, Germany; 2Department of Anesthesiology and Pain Therapy, Kantonsspital Baden, Switzerland; 3Department of Anesthesiology and Pain Therapy, Sozialstiftung Bamberg, Bamberg, Germany Background: Empirical evidence suggests that affective responses to pain are changed in chronic pain. The investigation of startle responses to pain might contribute to clarifying whether such alterations also expand to motivational defensive reactions. We aimed at comparing startle responses to tonic heat pain with high threat (HT) or low threat (LT) in patients with chronic musculoskeletal pain and controls. As pain-related anxiety and catastrophizing are typically elevated in chronic pain, we expected to find stronger startle responses in patients specifically under experimental HT. Methods: Patients with chronic musculoskeletal, preferentially, back pain (N = 19) and matched pain-free controls (N = 19) underwent two pain-related threat conditions (high and low) in balanced order. Only, in the HT condition, 50% of the trials were announced to include a short further noxious temperature increase at the end. Startle responses to loud tones were always assessed prior to a potential temperature increase in the phase of anticipation and were recorded by surface electromyogram. Results: Surprisingly, we observed no differences in startle responses and ratings of emotional and pain responses between patients and controls despite significantly higher pain-related anxiety and catastrophizing in the patients. Overall, startle was potentiated in the HT condition, but only in participants who started with this condition. Conclusion: Our results suggest that, in general, patients with pain are not more responsive emotionally to experimental threat manipulations despite elevated pain anxiety and catastrophizing. Instead, exaggerated responses in patients might be triggered only by individual concerns relating to pain, which are not sufficiently mirrored by our threat paradigm. Keywords: musculoskeletal pain, catastrophizing, anxiety, defensive motivation, experimental pain, startle reflex, threat inductionhttps://www.dovepress.com/startle-modulation-by-heat-pain-with-varying-threat-levels-in-chronic--peer-reviewed-article-JPRchronic painback painstartlepain catastrophizingthreat |
| spellingShingle | Horn-Hofmann C Wolf D Wolff S Heesen M Knippenberg-Bigge K Lang PM Lautenbacher S Startle modulation by heat pain with varying threat levels in chronic pain patients and pain-free controls Journal of Pain Research chronic pain back pain startle pain catastrophizing threat |
| title | Startle modulation by heat pain with varying threat levels in chronic pain patients and pain-free controls |
| title_full | Startle modulation by heat pain with varying threat levels in chronic pain patients and pain-free controls |
| title_fullStr | Startle modulation by heat pain with varying threat levels in chronic pain patients and pain-free controls |
| title_full_unstemmed | Startle modulation by heat pain with varying threat levels in chronic pain patients and pain-free controls |
| title_short | Startle modulation by heat pain with varying threat levels in chronic pain patients and pain-free controls |
| title_sort | startle modulation by heat pain with varying threat levels in chronic pain patients and pain free controls |
| topic | chronic pain back pain startle pain catastrophizing threat |
| url | https://www.dovepress.com/startle-modulation-by-heat-pain-with-varying-threat-levels-in-chronic--peer-reviewed-article-JPR |
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