Abstract
Temporal summation (TS) refers to the increased perception of pain with repetitive
noxious stimuli. It is a behavioral correlate of wind-up, the spinal facilitation
of recurring C-fiber stimulation. In order to utilize TS in clinical pain research,
it is important to characterize TS in a wide range of individuals and to establish
its test-retest reliability. Building on a fixed-parameter protocol, we developed
an individually adjusted protocol to broadly capture thermally generated TS. We then
examined the test-retest reliability of TS within-day (intertrial intervals ranging
from 2 to 30 minutes) and between-days (intersession interval of 7 days). We generated
TS-like effects in 19 of the 21 participants. Strong correlations were observed across
all trials over both days (intraclass correlation [ICC] [A, 10] = .97, 95% confidence
level [CL] = .94–.99) and across the initial trials between days (ICC [A, 1] = .83,
95% CL = .58–.93). Repeated measures mixed-effects modeling demonstrated no significant
within-day variation and only a small (5 out of 100 points) between-day variation.
Finally, a Bland-Altman analysis suggested that TS is reliable across the range of
observed scores. Without intervention, thermally-generated TS is generally stable
within day and between days.
Perspective
Our study introduces a new strategy to generate thermal TS in a high proportion of
individuals. This study confirms the test-retest reliability of thermal TS, supporting
its use as a consistent behavioral correlate of central nociceptive facilitation.
Key words
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Article info
Publication history
Accepted:
October 8,
2012
Received in revised form:
September 28,
2012
Received:
June 19,
2012
Footnotes
We acknowledge funding support by NIH K24 DA029262 (S.M.), NIH T32 GM 89626-2 training grant (J.K.), and Chris Redlich Endowment in Pain Research (S.M.).
No conflicts of interest exist for any of the authors, nor is there commercial interest to be disclosed in the execution or the experiment or in the preparation of the manuscript.
Supplementary data accompanying this article are available online at www.jpain.org and www.sciencedirect.com.
Identification
Copyright
© 2013 American Pain Society. Published by Elsevier Inc. All rights reserved.
