Individual variability and sex differences in conditioned pain modulation and the impact of resilience, and conditioning stimulus pain unpleasantness and salience

Pain
Shahrzad FirouzianKaren D Davis

Abstract

Distinct pain experiences are shaped both by personal attributes and characteristics of noxious stimuli. An individual's capacity for endogenous pain inhibition (reflected by conditioned pain modulation (CPM)), their resilience, and the pain unpleasantness and salience of painful stimuli can impact their pain perception. Here, we aimed to determine how individual variability in CPM relates to sex and resilience as personal attributes, and pain unpleasantness and salience of the CPM conditioning stimulus (CS). We evaluated CPM in 106 healthy participants (51 female, 55 male) based on the change in test stimulus (TS) pain applied concurrently with a painful CS, both delivered by painful heat. The CS reduced TS pain in only half of the participants (CPM subgroup), but did not do so for the other half (no-CPM subgroup), many who exhibited pain facilitation. A regression model explained CPM effects after accounting for sex, resilience, CS pain unpleasantness and salience. In the CPM subgroup regression model, the CPM effect was positively related to CS pain unpleasantness, while the CPM effect was not related to any variable in the no-CPM subgroup model. Correlation analyses revealed that the CPM effect was anti-correlated with resi...Continue Reading

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