Highlights
- •Stress induced decrease in conditioned pain modulation (CPM) and increase in pain adaptation.
- •Decreased CPM occurred only among high stress responders.
- •Increased pain adaptation occurred only among low stress responders.
- •Acute stress affects pain modulation according to Individual stress responsiveness.
Abstract
The effect of acute stress on pain threshold and intolerance threshold are reported
as producing either hypoalgesia or hyperalgesia. Yet, the contribution of individual
stress reactivity in this respect has not been established. The aim was to test 2
pain modulation paradigms under acute stress manipulation, to our knowledge, for the
first time, to study whether stress differentially affects pain modulation, and whether
the effect is related to individual stress response. Participants were 31 healthy
subjects. Conditioned pain modulation (CPM) and pain adaptation were measured before
and after inducing an acute stress response using the Montreal Imaging Stress Task.
Subjects' stress response was evaluated according to salivary cortisol, autonomic
function, and perceived stress and anxiety. The Montreal Imaging Stress Task induced
a validated stress response. On a group level, stress induced reduction in CPM magnitude
and increase in pain adaptation compared with baseline. These responses correlated
with stress reactivity. When the group was subdivided according to stress reactivity,
only high stress responders exhibited reduced CPM whereas only low stress responders
exhibited increased pain adaptation. The results suggest that acute stress may induce
opposite effects on pain modulation, depending on individual stress reactivity magnitude,
with an advantage to low stress responders.
Perspective
This study evaluated the effect of acute stress on pain modulation. Pain modulation
under stress is affected by individual stress responsiveness; decreased CPM occurs
in high stress responders whereas increased pain adaptation occurs in low stress responders.
Identification of high stress responders may promote better pain management.
Key words
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Article info
Publication history
Published online: December 11, 2017
Accepted:
November 14,
2017
Received in revised form:
October 17,
2017
Received:
July 1,
2017
Footnotes
This work is part of the PhD thesis of Nirit Geva, Sackler Faculty of Medicine, Tel Aviv University.
The authors have no conflicts of interest to declare.
Identification
Copyright
© 2017 by the American Pain Society
