Interplay between noxious heat sensitivity and temporal summation magnitude in patients with fibromyalgia and long-term opioid use
IntroductionIn chronic pain conditions such as fibromyalgia (FM), pain amplification within the central nervous system, or “central sensitization,” may contribute to the development and maintenance of chronic pain. Chronic pain treatments include opioid therapy, and opioid therapy may maladaptively...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-10-01
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| Series: | Frontiers in Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnins.2023.1275921/full |
| _version_ | 1827795018216112128 |
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| author | Jason D. Bao Jason D. Bao Morgan A. Rosser Su Hyoun Park Su Hyoun Park Anne K. Baker Anne K. Baker Katherine T. Martucci Katherine T. Martucci |
| author_facet | Jason D. Bao Jason D. Bao Morgan A. Rosser Su Hyoun Park Su Hyoun Park Anne K. Baker Anne K. Baker Katherine T. Martucci Katherine T. Martucci |
| author_sort | Jason D. Bao |
| collection | DOAJ |
| description | IntroductionIn chronic pain conditions such as fibromyalgia (FM), pain amplification within the central nervous system, or “central sensitization,” may contribute to the development and maintenance of chronic pain. Chronic pain treatments include opioid therapy, and opioid therapy may maladaptively increase central sensitization, particularly in patients who take opioids long-term. However, it has remained unknown how central sensitization is impacted in patients who use opioids long-term.MethodsTo investigate how long-term opioid therapy affects central sensitization, we used the validated measure of temporal summation. The temporal summation measurement consists of applying a series of noxious stimuli to a patient’s skin and then calculating changes in the patient’s pain rating to each stimulus. Using this measurement, we evaluated temporal summation in study participants with fibromyalgia who take opioids long-term (i.e., greater than 90 days duration; n = 24, opioid-FM). We compared opioid-FM responses to 2 control groups: participants with fibromyalgia who do not take opioids (n = 33, non-opioid FM), and healthy controls (n = 31). For the temporal summation measurement, we applied a series of 10 noxious heat stimuli (sensitivity-adjusted temperatures) to the ventral forearm (2s duration of each stimulus, applied once every 3 s). Additionally, we collected responses to standard pain and cognitive-affective questionnaires to assess pain severity and other factors.Results and discussionGroup differences in sensitivity-adjusted stimulus temperatures were observed, with only the non-opioid FM group requiring significantly lower stimulus temperatures (The opioid-FM group also required lower temperatures, but not significantly different from the control group). However, all 3 groups exhibited similar magnitudes of temporal summation. Across combined FM groups, temporal summation negatively correlated with pain severity (r = −0.31, p = 0.021). Within the opioid-FM group, higher pain sensitivity to heat (i.e., lower sensitivity-adjusted temperatures) showed a trend relationship with higher opioid dosage (r = −0.45, p = 0.036), potentially reflective of opioid-related hyperalgesia. Our findings also indicated that heightened pain severity may skew sensitivity-adjusted temporal summation, thereby limiting its utility for measuring central sensitization. Overall, in participants taking opioids, temporal summation may be influenced by hypersensitivity to heat pain, which appeared to vary with opioid dosage. |
| first_indexed | 2024-03-11T18:43:13Z |
| format | Article |
| id | doaj.art-f1ab84853397446cacd0b7b0318c6817 |
| institution | Directory Open Access Journal |
| issn | 1662-453X |
| language | English |
| last_indexed | 2024-03-11T18:43:13Z |
| publishDate | 2023-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neuroscience |
| spelling | doaj.art-f1ab84853397446cacd0b7b0318c68172023-10-12T09:22:12ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2023-10-011710.3389/fnins.2023.12759211275921Interplay between noxious heat sensitivity and temporal summation magnitude in patients with fibromyalgia and long-term opioid useJason D. Bao0Jason D. Bao1Morgan A. Rosser2Su Hyoun Park3Su Hyoun Park4Anne K. Baker5Anne K. Baker6Katherine T. Martucci7Katherine T. Martucci8Human Affect and Pain Neuroscience Laboratory, Department of Anesthesiology, Duke University Medical Center, Durham, NC, United StatesCenter for Translational Pain Medicine, Duke University Medical Center, Durham, NC, United StatesDepartment of Anesthesiology, Biostatistics Group, Duke University School of Medicine, Durham, NC, United StatesHuman Affect and Pain Neuroscience Laboratory, Department of Anesthesiology, Duke University Medical Center, Durham, NC, United StatesCenter for Translational Pain Medicine, Duke University Medical Center, Durham, NC, United StatesHuman Affect and Pain Neuroscience Laboratory, Department of Anesthesiology, Duke University Medical Center, Durham, NC, United StatesCenter for Translational Pain Medicine, Duke University Medical Center, Durham, NC, United StatesHuman Affect and Pain Neuroscience Laboratory, Department of Anesthesiology, Duke University Medical Center, Durham, NC, United StatesCenter for Translational Pain Medicine, Duke University Medical Center, Durham, NC, United StatesIntroductionIn chronic pain conditions such as fibromyalgia (FM), pain amplification within the central nervous system, or “central sensitization,” may contribute to the development and maintenance of chronic pain. Chronic pain treatments include opioid therapy, and opioid therapy may maladaptively increase central sensitization, particularly in patients who take opioids long-term. However, it has remained unknown how central sensitization is impacted in patients who use opioids long-term.MethodsTo investigate how long-term opioid therapy affects central sensitization, we used the validated measure of temporal summation. The temporal summation measurement consists of applying a series of noxious stimuli to a patient’s skin and then calculating changes in the patient’s pain rating to each stimulus. Using this measurement, we evaluated temporal summation in study participants with fibromyalgia who take opioids long-term (i.e., greater than 90 days duration; n = 24, opioid-FM). We compared opioid-FM responses to 2 control groups: participants with fibromyalgia who do not take opioids (n = 33, non-opioid FM), and healthy controls (n = 31). For the temporal summation measurement, we applied a series of 10 noxious heat stimuli (sensitivity-adjusted temperatures) to the ventral forearm (2s duration of each stimulus, applied once every 3 s). Additionally, we collected responses to standard pain and cognitive-affective questionnaires to assess pain severity and other factors.Results and discussionGroup differences in sensitivity-adjusted stimulus temperatures were observed, with only the non-opioid FM group requiring significantly lower stimulus temperatures (The opioid-FM group also required lower temperatures, but not significantly different from the control group). However, all 3 groups exhibited similar magnitudes of temporal summation. Across combined FM groups, temporal summation negatively correlated with pain severity (r = −0.31, p = 0.021). Within the opioid-FM group, higher pain sensitivity to heat (i.e., lower sensitivity-adjusted temperatures) showed a trend relationship with higher opioid dosage (r = −0.45, p = 0.036), potentially reflective of opioid-related hyperalgesia. Our findings also indicated that heightened pain severity may skew sensitivity-adjusted temporal summation, thereby limiting its utility for measuring central sensitization. Overall, in participants taking opioids, temporal summation may be influenced by hypersensitivity to heat pain, which appeared to vary with opioid dosage.https://www.frontiersin.org/articles/10.3389/fnins.2023.1275921/fulltemporal summationsensitivity-adjusted temperatureopioidsfibromyalgiachronic painopioid-related hyperalgesia |
| spellingShingle | Jason D. Bao Jason D. Bao Morgan A. Rosser Su Hyoun Park Su Hyoun Park Anne K. Baker Anne K. Baker Katherine T. Martucci Katherine T. Martucci Interplay between noxious heat sensitivity and temporal summation magnitude in patients with fibromyalgia and long-term opioid use Frontiers in Neuroscience temporal summation sensitivity-adjusted temperature opioids fibromyalgia chronic pain opioid-related hyperalgesia |
| title | Interplay between noxious heat sensitivity and temporal summation magnitude in patients with fibromyalgia and long-term opioid use |
| title_full | Interplay between noxious heat sensitivity and temporal summation magnitude in patients with fibromyalgia and long-term opioid use |
| title_fullStr | Interplay between noxious heat sensitivity and temporal summation magnitude in patients with fibromyalgia and long-term opioid use |
| title_full_unstemmed | Interplay between noxious heat sensitivity and temporal summation magnitude in patients with fibromyalgia and long-term opioid use |
| title_short | Interplay between noxious heat sensitivity and temporal summation magnitude in patients with fibromyalgia and long-term opioid use |
| title_sort | interplay between noxious heat sensitivity and temporal summation magnitude in patients with fibromyalgia and long term opioid use |
| topic | temporal summation sensitivity-adjusted temperature opioids fibromyalgia chronic pain opioid-related hyperalgesia |
| url | https://www.frontiersin.org/articles/10.3389/fnins.2023.1275921/full |
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