Sex differences in the stability of conditioned pain modulation (cpm) among patients with chronic pain

Marc O. Martel, Ajay D. Wasan, Robert R. Edwards

Research output: Contribution to journalArticle

Abstract

Objectives: To examine the temporal stability of conditioned pain modulation (CPM), formerly termed diffuse noxious inhibitory controls, among a sample of patients with chronic pain. The study also examined the factors that might be responsible for the stability of CPM. Design, Subjects, and Methods: In this test-retest study, patients underwent a series of standardized psychophysical pain-testing procedures designed to assess CPM on two separate occasions (i.e., baseline and follow up). Patients also completed self-report measures of catastrophizing (Pain Catastrophizing Scale [PCS] and negative affect [NA]). Results: Overall, results provided evidence for the stability of CPM among patients with chronic pain. Results, however, revealed considerable sex differences in the stability of CPM. For women, results revealed a significant test-retest correlation between baseline and follow-up CPM scores. For men, however, the test-retest correlation between baseline and follow-up CPM scores was not significant. Results of a Fisher's Z-test revealed that the stability of CPM was significantly greater for women than for men. Follow-up analyses revealed that the difference between men and women in the stability of CPM could not be accounted for by any demographic (e.g., age) and/or psychological factors (PCS and NA). Conclusions: Our findings suggest that CPM paradigms possess sufficient reliability to be incorporated into bedside clinical evaluation of patients with chronic pain, but only among women. The lack of CPM reproducibility/stability observed among men places limits on the potential use of CPM paradigms in clinical settings for the assessment of men's endogenous pain-inhibitory function.

Original languageEnglish (US)
Pages (from-to)1757-1768
Number of pages12
JournalPain Medicine
Volume14
Issue number11
DOIs
StatePublished - Nov 2013
Externally publishedYes

Keywords

  • Catastrophizing
  • Chronic Pain
  • Conditioned Pain Modulation
  • DNIC
  • Negative Affect

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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