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 language | English (US) |
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Pages (from-to) | 1757-1768 |
Number of pages | 12 |
Journal | Pain Medicine |
Volume | 14 |
Issue number | 11 |
DOIs | |
State | Published - Nov 2013 |
Externally published | Yes |
Keywords
- Catastrophizing
- Chronic Pain
- Conditioned Pain Modulation
- DNIC
- Negative Affect
ASJC Scopus subject areas
- Clinical Neurology
- Anesthesiology and Pain Medicine