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. 2013 Aug 7;8(8):e69460.
doi: 10.1371/journal.pone.0069460. eCollection 2013.

Stress-induced allodynia--evidence of increased pain sensitivity in healthy humans and patients with chronic pain after experimentally induced psychosocial stress

Benjamin Crettaz  1 , Martin Marziniak, Peter Willeke, Peter Young, Dirk Hellhammer, Astrid Stumpf, Markus Burgmer
Affiliations

Stress-induced allodynia--evidence of increased pain sensitivity in healthy humans and patients with chronic pain after experimentally induced psychosocial stress

Benjamin Crettaz et al. PLoS One. .

Abstract

Background: Experimental stress has been shown to have analgesic as well as allodynic effect in animals. Despite the obvious negative influence of stress in clinical pain conditions, stress-induced alteration of pain sensitivity has not been tested in humans so far. Therefore, we tested changes of pain sensitivity using an experimental stressor in ten female healthy subjects and 13 female patients with fibromyalgia.

Methods: Multiple sensory aspects of pain were evaluated in all participants with the help of the quantitative sensory testing protocol before (60 min) and after (10 and 90 min) inducing psychological stress with a standardized psychosocial stress test ("Trier Social Stress Test").

Results: Both healthy subjects and patients with fibromyalgia showed stress-induced enhancement of pain sensitivity in response to thermal stimuli. However, only patients showed increased sensitivity in response to pressure pain.

Conclusions: Our results provide evidence for stress-induced allodynia/hyperalgesia in humans for the first time and suggest differential underlying mechanisms determining response to stressors in healthy subjects and patients suffering from chronic pain. Possible mechanisms of the interplay of stress and mediating factors (e.g. cytokines, cortisol) on pain sensitivity are mentioned. Future studies should help understand better how stress impacts on chronic pain conditions.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Experimental procedure.
QST  =  Quantitative Sensory Testing, VAS  =  Subjects’ rating of anxiety (healthy controls and FMS) and clinical pain (FMS only) on a visual analogue scale, ECG  =  Recording of stress-induced changes of the heart rate and sympathovagal balance, TSST  =  Trier Social Stress Test.
Figure 2
Figure 2. Changes of sensory pain thresholds (QST) during experimentally induced stress in healthy subjects (HC) and patients with fibromyalgia syndrome (FMS).
CDT  =  cold detection threshold, WDT  =  warm detection threshold, CPT  =  cold pain threshold, HPT  =  heat pain threshold, MPT  =  mechanical pain threshold, WUR  =  wind-up ratio, PPT  =  pressure pain threshold, HC  =  healthy controls, FMS  =  fibromyalgia patients.
See this image and copyright information in PMC

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