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. 2017 Jan 27:10:265-274.
doi: 10.2147/JPR.S121189. eCollection 2017.

Heat pain detection threshold is associated with the area of secondary hyperalgesia following brief thermal sensitization: a study of healthy male volunteers

Morten Sejer Hansen  1 , Jørn Wetterslev  2 , Christian Bressen Pipper  3 , Mohammad Sohail Asghar  1 , Jørgen Berg Dahl  4
Affiliations

Heat pain detection threshold is associated with the area of secondary hyperalgesia following brief thermal sensitization: a study of healthy male volunteers

Morten Sejer Hansen et al. J Pain Res. .

Erratum in

Abstract

Introduction: The area of secondary hyperalgesia following brief thermal sensitization (BTS) of the skin and heat pain detection thresholds (HPDT) may both have predictive abilities in regards to pain sensitivity and clinical pain states. The association between HPDT and secondary hyperalgesia, however, remains unsettled, and the dissimilarities in physiologic properties suggest that they may represent 2 distinctively different pain entities. The aim of this study was to investigate the association between HPDT and BTS-induced secondary hyperalgesia.

Methods: A sample of 121 healthy male participants was included and tested on 2 separate study days with BTS (45°C, 3 minutes), HPDT, and pain during thermal stimulation (45°C, 1 minute). Areas of secondary hyperalgesia were quantified after monofilament pinprick stimulation. The pain catastrophizing scale (PCS) and hospital anxiety and depression scale (HADS) were also applied.

Results: A significant association between HPDT and the size of the area of secondary hyperalgesia (p<0.0001) was found. The expected change in area of secondary hyperalgesia due to a 1-degree increase in HPDT was estimated to be -27.38 cm2, 95% confidence interval (CI) of -37.77 to -16.98 cm2, with an R2 of 0.19. Likewise, a significant association between HADS-depression subscore and area of secondary hyperalgesia (p=0.046) was found, with an estimated expected change in secondary hyperalgesia to a 1-point increase in HADS-depression subscore of 11 cm2, 95% CI (0.19-21.82), and with R2 of 0.03. We found no significant associations between secondary hyperalgesia area and PCS score or pain during thermal stimulation.

Conclusion: HPDT and the area of secondary hyperalgesia after BTS are significantly associated; however, with an R2 of only 19%, HPDT only offers a modest explanation of the inter-participant variation in the size of the secondary hyperalgesia area elicited by BTS.

Keywords: catastrophization; central nervous system sensitization; central sensitization; healthy volunteers; hyperalgesia; pain; pain threshold; secondary hyperalgesia.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Anatomical location of pain model testing. Notes: HPDT was performed on the anterior part of the dominant lower arm, p-TS was performed on the anterior part of the non-dominant lower arm, and BTS was performed centrally on the anterior part of the right thigh in the midline between the anterior superior iliac spine and the base of patella. Abbreviations: BTS, brief thermal sensitization; HPDT, heat pain detection threshold; p-TS, pain during thermal stimulation.
Figure 2
Figure 2
Flowchart of included study participants.
Figure 3
Figure 3
Predictions of areas of secondary hyperalgesia (following BTS) by HPDT. Notes: Points correspond to individual participant measurement of secondary hyperalgesia areas. The solid line corresponds to the predictions of secondary hyperalgesia areas and HPDT, and the dashed line corresponds to 95% prediction limits. Abbreviations: BTS, brief thermal sensitization; HPDT, heat pain detection threshold.
See this image and copyright information in PMC

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