Conditioned Pain Modulation (CPM) Effects Captured in Facial Expressions
Miriam Kunz,1 Stefanie F Bunk,2 Anna J Karmann,3 Karl-Jürgen Bär,4 Stefan Lautenbacher3 1Department of Medical Psychology and Sociology, University of Augsburg, Augsburg, Germany; 2Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, Univer...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2021-03-01
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| Series: | Journal of Pain Research |
| Subjects: | |
| Online Access: | https://www.dovepress.com/conditioned-pain-modulation-cpm-effects-captured-in-facial-expressions-peer-reviewed-article-JPR |
| _version_ | 1818608358494568448 |
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| author | Kunz M Bunk SF Karmann AJ Bär KJ Lautenbacher S |
| author_facet | Kunz M Bunk SF Karmann AJ Bär KJ Lautenbacher S |
| author_sort | Kunz M |
| collection | DOAJ |
| description | Miriam Kunz,1 Stefanie F Bunk,2 Anna J Karmann,3 Karl-Jürgen Bär,4 Stefan Lautenbacher3 1Department of Medical Psychology and Sociology, University of Augsburg, Augsburg, Germany; 2Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; 3Physiological Psychology, Otto-Friedrich University Bamberg, Bamberg, Germany; 4Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Jena, GermanyCorrespondence: Miriam KunzDepartment of Medical Psychology and Sociology, University of Augsburg, Augsburg, GermanyTel +49 821 598-3720Fax +49 821 598-5116Email Miriam.kunz@med.uni-augsburg.dePurpose: Conditioned pain modulation (CPM) is most often assessed using self-report of pain. However, self-report of pain is not always available (eg in individuals with cognitive impairment) and is susceptible to report bias. In comparison, the facial expression of pain is more reflex-like and represents one of the most sensitive and specific non-verbal signals of pain. The aim of the present study was to investigate whether the facial expression of pain is sensitive enough to capture endogenous pain inhibition as elicited during CPM paradigms.Patients and Methods: In total, 26 female participants took part in this study. Facial and verbal responses to phasic heat pain were assessed once while participants immersed their hand in a hot water bath and once without additional stimulation. Facial responses were analyzed using the Facial Action Coding System (FACS). Verbal responses were assessed using a Numerical Rating Scale (NRS).Results: Pain-relevant facial responses as well as pain ratings to phasic heat pain were significantly reduced when participants simultaneously immersed their hand in a hot water bath compared to baseline. Thus, CPM effects could be demonstrated both on subjective as well as on facial responses. Moreover, CPM-induced changes in pain-relevant facial responses and in NRS ratings were significantly correlated.Conclusion: The present study shows that facial expressions of pain are sensitive enough to capture CPM effects. Given the proven clinical usefulness of assessing CPM, the parallel assessment of verbal and facial CPM effects might be a promising approach with wider scope of applications. Further research in other demographic healthy participant and clinical cohorts is warranted.Keywords: pain, CPM, conditioned pain modulation, facial expression, FACS |
| first_indexed | 2024-12-16T14:41:23Z |
| format | Article |
| id | doaj.art-d248b1992e88415195fef2b6f58e5128 |
| institution | Directory Open Access Journal |
| issn | 1178-7090 |
| language | English |
| last_indexed | 2024-12-16T14:41:23Z |
| publishDate | 2021-03-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Pain Research |
| spelling | doaj.art-d248b1992e88415195fef2b6f58e51282022-12-21T22:27:54ZengDove Medical PressJournal of Pain Research1178-70902021-03-01Volume 1479380363326Conditioned Pain Modulation (CPM) Effects Captured in Facial ExpressionsKunz MBunk SFKarmann AJBär KJLautenbacher SMiriam Kunz,1 Stefanie F Bunk,2 Anna J Karmann,3 Karl-Jürgen Bär,4 Stefan Lautenbacher3 1Department of Medical Psychology and Sociology, University of Augsburg, Augsburg, Germany; 2Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; 3Physiological Psychology, Otto-Friedrich University Bamberg, Bamberg, Germany; 4Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Jena, GermanyCorrespondence: Miriam KunzDepartment of Medical Psychology and Sociology, University of Augsburg, Augsburg, GermanyTel +49 821 598-3720Fax +49 821 598-5116Email Miriam.kunz@med.uni-augsburg.dePurpose: Conditioned pain modulation (CPM) is most often assessed using self-report of pain. However, self-report of pain is not always available (eg in individuals with cognitive impairment) and is susceptible to report bias. In comparison, the facial expression of pain is more reflex-like and represents one of the most sensitive and specific non-verbal signals of pain. The aim of the present study was to investigate whether the facial expression of pain is sensitive enough to capture endogenous pain inhibition as elicited during CPM paradigms.Patients and Methods: In total, 26 female participants took part in this study. Facial and verbal responses to phasic heat pain were assessed once while participants immersed their hand in a hot water bath and once without additional stimulation. Facial responses were analyzed using the Facial Action Coding System (FACS). Verbal responses were assessed using a Numerical Rating Scale (NRS).Results: Pain-relevant facial responses as well as pain ratings to phasic heat pain were significantly reduced when participants simultaneously immersed their hand in a hot water bath compared to baseline. Thus, CPM effects could be demonstrated both on subjective as well as on facial responses. Moreover, CPM-induced changes in pain-relevant facial responses and in NRS ratings were significantly correlated.Conclusion: The present study shows that facial expressions of pain are sensitive enough to capture CPM effects. Given the proven clinical usefulness of assessing CPM, the parallel assessment of verbal and facial CPM effects might be a promising approach with wider scope of applications. Further research in other demographic healthy participant and clinical cohorts is warranted.Keywords: pain, CPM, conditioned pain modulation, facial expression, FACShttps://www.dovepress.com/conditioned-pain-modulation-cpm-effects-captured-in-facial-expressions-peer-reviewed-article-JPRpaincpmconditioned pain modulationfacial expressionfacs |
| spellingShingle | Kunz M Bunk SF Karmann AJ Bär KJ Lautenbacher S Conditioned Pain Modulation (CPM) Effects Captured in Facial Expressions Journal of Pain Research pain cpm conditioned pain modulation facial expression facs |
| title | Conditioned Pain Modulation (CPM) Effects Captured in Facial Expressions |
| title_full | Conditioned Pain Modulation (CPM) Effects Captured in Facial Expressions |
| title_fullStr | Conditioned Pain Modulation (CPM) Effects Captured in Facial Expressions |
| title_full_unstemmed | Conditioned Pain Modulation (CPM) Effects Captured in Facial Expressions |
| title_short | Conditioned Pain Modulation (CPM) Effects Captured in Facial Expressions |
| title_sort | conditioned pain modulation cpm effects captured in facial expressions |
| topic | pain cpm conditioned pain modulation facial expression facs |
| url | https://www.dovepress.com/conditioned-pain-modulation-cpm-effects-captured-in-facial-expressions-peer-reviewed-article-JPR |
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