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

Publikation: Bidrag til tidsskriftReview (oversigtsartikel)Forskningpeer review

Resumé

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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Pain Measurement
Chronic Pain
Healthy Volunteers
Pain
Catastrophization
Postoperative Pain
Opioid Analgesics

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abstract = "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.",
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T2 - manifestations and implications for pain progression

AU - Petersen, Kristian Kjær

AU - McPhee, Megan Elizabeth

AU - Høgh, Morten Sebastian

AU - Graven-Nielsen, Thomas

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