Change in Endogenous Pain Modulation Depending on Emotional States in Healthy Subjects: A Randomized Controlled Trial.

IF 4.1 2区医学 Q1 CLINICAL NEUROLOGY Pain and Therapy Pub Date : 2024-10-01 Epub Date: 2024-08-05 DOI:10.1007/s40122-024-00642-1

Kordula Lang-Illievich, Christoph Klivinyi, Julia Ranftl, Ala Elhelali, Sascha Hammer, Istvan S Szilagyi, Helmar Bornemann-Cimenti

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Abstract

Introduction: Chronic pain is a public health issue, leading to substantial healthcare costs and diminished quality of life for sufferers. While the role of anxiety in pain modulation has been extensively studied, the effects of other emotional states on the body's pain control mechanisms remain less understood. This study sought to explore how different emotions (happiness, anger, sadness, and interest) affect conditioned pain modulation (CPM) and the wind-up phenomenon in healthy adults.

Methods: This randomized controlled, cross-over trial involved 28 healthy participants aged 18-60. Participants watched video clips designed to induce specific emotions: happiness, anger, sadness, and interest. Emotional states were assessed using a 7-point Likert scale. Pain modulation was measured using CPM and the wind-up phenomenon. CPM was assessed with a hot water bath as the conditioning stimulus and pressure pain tolerance as the test stimulus. Wind-up was measured using pinprick needle stimulators and a visual analog scale. Data were analyzed using paired t tests to compare pre- and post-emotion induction values.

Results: Significant changes in emotional self-assessment values were observed for all emotions. Happiness increased CPM (4.6 ± 11.4, p = 0.04277), while sadness - 9.9 ± 23.1, p = 0.03211) and anger - 9.1 ± 23.3, p = 0.04804) decreased it. Interest did not significantly alter CPM (- 5.1 ± 25.8, p = 0.31042). No significant effects were found for the wind-up phenomenon across any emotional states.

Conclusion: This study shows that emotional states significantly affect the body's ability to modulate pain. Positive emotions like happiness enhance pain inhibition, while negative emotions such as sadness and anger impair it. These findings suggest that emotional modulation techniques could be integrated into pain management strategies to improve patient outcomes. Further research should explore a broader range of emotions and include objective measures to validate these results.

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健康受试者内源性疼痛调节随情绪状态的变化：随机对照试验

导言：慢性疼痛是一个公共卫生问题，会导致大量的医疗费用和患者生活质量的下降。虽然焦虑在疼痛调节中的作用已被广泛研究，但其他情绪状态对人体疼痛控制机制的影响仍鲜为人知。本研究试图探讨不同情绪（快乐、愤怒、悲伤和兴趣）如何影响健康成年人的条件性疼痛调节（CPM）和上卷现象：这项随机对照交叉试验涉及 28 名 18-60 岁的健康参与者。参与者观看了旨在诱发特定情绪的视频剪辑：快乐、愤怒、悲伤和兴趣。情绪状态采用 7 点李克特量表进行评估。疼痛调节采用 CPM 和上发条现象进行测量。CPM 以热水浴作为调节刺激，以压力疼痛耐受性作为测试刺激。上风现象使用针刺针刺激器和视觉模拟量表进行测量。数据采用配对 t 检验进行分析，以比较情绪诱导前后的数值：结果：所有情绪的自我评估值都发生了显著变化。快乐增加了 CPM（4.6 ± 11.4，p = 0.04277），而悲伤 - 9.9 ± 23.1，p = 0.03211）和愤怒 - 9.1 ± 23.3，p = 0.04804）降低了 CPM。兴趣没有明显改变 CPM（- 5.1 ± 25.8，p = 0.31042）。在任何情绪状态下，上发条现象都没有发现明显的影响：本研究表明，情绪状态会对人体调节疼痛的能力产生重大影响。快乐等积极情绪会增强疼痛抑制能力，而悲伤和愤怒等消极情绪则会削弱疼痛抑制能力。这些研究结果表明，可以将情绪调节技术融入疼痛管理策略中，以改善患者的治疗效果。进一步的研究应该探索更广泛的情绪，并采用客观的测量方法来验证这些结果。

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来源期刊

Pain and Therapy CLINICAL NEUROLOGY-

CiteScore

6.60

自引率

5.00%

发文量

110

审稿时长

6 weeks

期刊介绍： Pain and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of pain therapies and pain-related devices. Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, acute pain, cancer pain, chronic pain, headache and migraine, neuropathic pain, opioids, palliative care and pain ethics, peri- and post-operative pain as well as rheumatic pain and fibromyalgia. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports, trial protocols, short communications such as commentaries and editorials, and letters. The journal is read by a global audience and receives submissions from around the world. Pain and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.