Abstract
Evidence of support for sensory changes during minor depression and sadness is scarce
and the neural mechanisms are unclear. We assessed central pain processing engaged
in nociceptive C-fiber polymodal activity by examining the perception of a non-noxious
unpleasant burning sensation induced by a thermal grill illusion, in 26 nonpatients
with minor depression (19 females) and 28 healthy subjects (18 females), between 19
and 61 years old and pain free at the study. Controls were also subjected to induction
of transient moods. Subjects with depression reported increased pain perception; this
increase was more pronounced for the affective dimension of pain (unpleasantness)
than for its sensory dimension (intensity). The perception of pain unpleasantness,
pain intensity, and overall pain showed positive and linear correlations with depression
levels measured by Zung’s and Beck’s scales. In controls, sad mood induction only
increased the scores assigned to negative mood-describing adjectives; the perception
of pain intensity, unpleasantness, and overall pain were significantly increased following
sad, but not neutral or elevated, mood inductions. Yet, pain intensity and unpleasantness
were correlated linearly and reciprocally to positive, instead of negative, mood-describing
adjective scores. Thus, there is a central thermal hyperalgesia in subjects with minor
depression and sadness.
Perspective
There is a central thermal hyperalgesia in subjects with minor depression, probably
associated with an enhanced central processing of nociceptive C-fiber polymodal activity
at anterior cingulate cortex, that is predominately expressed as an increased unpleasantness
and that could be in part counteracted by behavioral therapies leading to mood elevation.
Key words
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References
- Validity of the Beck Depression Inventory, Hospital Anxiety and Depression Scale, SCL-90, and Hamilton Depression Rating Scale as Screening Instruments for Depression in Stroke Patients.Psychosomatics. 2002; 43: 386-393
American Psychiatric Association: Diagnostic and statistical manual of mental dosorders (DSM-IV), edited by APA. Washington, D.C. APA, 1995
- Pain perception in major depression depends on pain modality.Pain. 2005; 117: 97-103
- Comparison of Beck Depression Inventories -IA and -II in psychiatric outpatients.J Personal Assess. 1996; 67: 588-597
- Depression, disability days and days lost from work in a prospective epidemiologic survey.JAMA. 1990; 264: 2524-2528
- Expression of c-fos like protein as a marker for neuronal activity following noxious stimulation in the rat.J Comp Neurol. 1990; 296: 517-530
- Fibromyalgia, chronic fatigue syndrome, and myofascial pain syndrome.Curr Opin Rheumatol. 2001; 13: 117-127
- The thermal grill illusion: Unmasking the burn of cold pain.Science. 1994; 265: 252-255
- Functional imaging of an illusion of pain.Nature. 1996; 384: 258-260
- Depressive headaches.Headache. 1964; 4: 255-258
- Impact of depression on experimental pain perception: A systematic review of the literature with meta-analysis.Psychosom Med. 2003; 65: 369-375
- Expanding hypnotic pain management to the affective dimension of pain.Am J Clin Hypn. 2009; 51: 235-254
- Depression and pain: A neurobiological model.Neuropsych Neurophysiol Behav Neurol. 1991; 4: 83-92
- The relationship of depression and somatic focus to experimental and clinical pain in chronic pain patients.Psychol Health. 1993; 8: 405-415
- The relationship between depression, clinical pain, and experimental pain in a chronic pain cohort.Arthritis Rheum. 2005; 52: 1577-1584
- Pain catastrophizing and neural responses to pain among persons with fibromyalgia.Brain. 2004; 127: 835-843
- Contribucion al estudio de la influencia de las condiciones socioeconomicas sobre el desarrollo y el crecimiento del nino.Rev Chi Ped. 1966; 37: 801-802
- Burning mouth syndrome.Int J Dermatol. 1995; 34: 483-487
- Cognitive impairment in patients with chronic pain: The significance of stress.Curr Pain Headache Rep. 2003; 7: 116-126
- Depression increases onset of tension-type headache following laboratory stress.Pain. 2004; 111: 230-238
- Pharmacological dissection of the paradoxical pain induced by a thermal grill.Pain. 2008; 135: 291-299
- Depression and changed pain perception: Hints for a central disinhibition mechanism.Pain. 2008; 140: 332-343
- A motivational analysis of emotion: Reflex-cortex connections.Psychol Sci. 1992; 3: 44-49
- Looking at pictures: Affective, facial, visceral and behavioral reaction.Psychophysiol. 2000; 30: 261-273
- Pain perception in psychiatric disorders: A review of the literature.J Psych Res. 1994; 18: 109-122
- Pain perception in depression: Relationship to symptomatology and naloxone-sensitive mechanisms.Psychosom Med. 1994; 56: 345-352
- Pain Perception in Psychiatric Disorders.in: Lautenbacher S. Fillingim R.B. Pathophysiology of Pain Perception, 1st ed. Kluwer Academic/Plenum Publishers, New York, NY2004: 163-184
- Activation of group IV afferent units from muscle by algesic agents.Brain Res. 1974; 72: 305-310
- Baroreceptor cortical effects, emotions and pain.Int J Psychophysiol. 1995; 19: 67-77
- Somatic focus/awareness: Relationship to negative affect and pain in chronic pain patients.Eur J Pain. 2008; 12: 104-115
- Paresthesia from ectopic impulse generation in human sensory nerves.Brain. 1980; 103: 835-853
- Haemodynamic brain responses to acute pain in humans: Sensory and attentional networks.Brain. 1999; 122: 1765-1780
- Reduced tolerance and cardiovascular response to ischemic pain in minor depression.J Affect Dis. 1999; 56: 119-126
- Prevalence and recognition of depression among primary care outpatients.J Fam Pract. 1987; 25: 67-72
- Enhanced temporal summation of second pain and its central modulation in fibromyalgia patients.Pain. 2002; 99: 49-59
- Peripheral Neural Mechanisms of Nociception.in: Wall P.D. Melzack R. Textbook of Pain, 4th ed. Churchill Livingstone, Edinburgh, UK2000: 11-57
- A descriptive analysis of minor depression.Am J Psychiatry. 2002; 159: 637-643
- Cortical responses to pain in healthy individuals depends on pain catastrophizing.Pain. 2006; 120: 297-306
- Association of major depressive disorder with altered functional brain response during anticipation and processing of heat pain.Arch Gen Psychiatry. 2008; 65: 1275-1284
- Increased perception of post-ischemic paresthesias in individuals with minor depression.J Psychosom Res. 2003; 55: 253-257
- Effects of mood on pain responses and pain tolerance: An experimental study in chronic back pain patients.Pain. 2008; 138: 392-401
- Mood influences supraspinal pain processing separately from attention.J Neurosci. 2009; 29: 705-715
- Reduced heat pain thresholds after sad-mood induction are associated with changes in thalamic activity.Neuropsychologia. 2009; 47: 980-987
- Psychobiological markers in coexisting pain and depression: Toward a unified theory.J Clin Psychol. 1982; 43: 32-39
- Relationship between oral sensory thresholds and depressive moods.J Med Dent Sci. 2005; 52: 73-80
- The effect of laboratory-induced depressed mood state on responses to pain.Behav Med. 2002; 28: 23-31
- Somatic symptons: A major feature of depression in a family practice.J Affect Disord. 1983; 5: 199-207
- Cultural variations in response to painful stimuli.Psychosom Med. 1990; 52: 544-557
- The effect of induced mood on laboratory pain.Pain. 1991; 46: 105-111
- Drama-induced affect and pain sensitivity.Psychosom Med. 1996; 58: 333-341
- A self-rating depressive scale.Arch Gen Psychiatry. 1965; 12: 63-70
Article info
Publication history
Published online: September 24, 2010
Accepted:
August 3,
2010
Received:
June 30,
2010
Footnotes
Supported by grants from CONDES-LUZ 0293-09 and LOCTI-LUZ-Policlinica D’Empaire to H.S.R.
Identification
Copyright
© 2011 American Pain Society. Published by Elsevier Inc. All rights reserved.
