Assessment of conditioned pain modulation in healthy participants and patients with chronic pain: manifestations and implications for pain progression

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PURPOSE OF REVIEW: The purpose of this review is to summarize recent findings on conditioned pain modulation (CPM) in humans with a focus on methodology, factors modulating CPM, and the potential for CPM as a clinical marker for pain progression. RECENT FINDINGS: CPM can be evoked by combining different stimulus modalities with good reliability; sequential CPM effects are stable over time with limited carryover effects. Optimism and pain catastrophizing might influence pain inhibition. Further, studies suggest that the CPM effect can be improved by gabapentinoids, transcranial direct current stimulation to cortical structures, and exercise and that long-term opioid use might impair CPM in patients with chronic pain. Clinical evidence suggests that preoperative impaired CPM may predict more severe chronic postoperative pain. The effect of pain duration on CPM impairment has been challenged by recent studies. SUMMARY: As CPM methodology is optimized, studies are revealing factors that can modulate descending pain inhibitory pathways. Understanding underlying mechanisms of CPM will improve the utility of CPM in a clinical setting and potentially lead to personalized treatments for chronic pain patients.

OriginalsprogEngelsk
TidsskriftCurrent Opinion in Supportive and Palliative Care
Vol/bind13
Udgave nummer2
Sider (fra-til)99-106
Antal sider8
ISSN1751-4258
DOI
StatusUdgivet - 1 jun. 2019

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  • Publikation

    • 1 Ph.d.-afhandling

    PROVOKING THE PLASTICITY OF DESCENDING MODULATION IN HEALTHY HUMANS: TEMPORAL AND COGNITIVE INFLUENCES ON CONDITIONED PAIN MODULATION (CPM)

    Bidragets oversatte titel: Provokation af plasticiteten i den descenderende smertemodulering i raske mænd: Effekter af gentagelse og kognitive udfordringer på konditioneret smertemodulationHøgh, M. S., 2 jul. 2019, Aalborg Universitetsforlag. 123 s. (Aalborg Universitet. Det Sundhedsvidenskabelige Fakultet. Ph.D.-Serien).

    Publikation: Bog/antologi/afhandling/rapportPh.d.-afhandling

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