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    Analysis of Meaningful Conditioned Pain Modulation Effect in a Pain-Free Adult Population

    Access Status
    Fulltext not available
    Authors
    Locke, David
    Gibson, William
    Moss, Penny
    Munyard, Kylie
    Mamotte, Cyril
    Wright, Tony
    Date
    2014
    Type
    Journal Article
    
    Metadata
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    Citation
    Locke, D. and Gibson, W. and Moss, P. and Munyard, K. and Mamotte, C. and Wright, T. 2014. Analysis of Meaningful Conditioned Pain Modulation Effect in a Pain-Free Adult Population. The Journal of Pain. 15 (11): pp. 1190-1198.
    Source Title
    The Journal of Pain
    DOI
    10.1016/j.jpain.2014.09.001
    ISSN
    15265900
    School
    School of Physiotherapy
    URI
    http://hdl.handle.net/20.500.11937/4031
    Collection
    • Curtin Research Publications
    Abstract

    Conditioned pain modulation (CPM) encompasses the effects of inhibitory and facilitatory pain modulatory systems and is inefficient in some chronic pain states. A proportion of healthy subjects also exhibit little or no CPM, perhaps suggesting that inherent factors such as gender or geneticsmay be influential. However, there is no consensus on how best to determine a meaningful CPMeffect. This study aimed to determine the proportion of pain-free subjects exhibiting a meaningfulCPM effect. Analyses of associations between 5HTTLPR (serotonin transporter-linked polymorphic region) polymorphisms on the serotonin transporter gene (SLC6A4), gender, and CPM effect were also carried out. A total of 125 healthy subjects (47 male; 78 female) underwent pressure pain threshold testing before, during, and after a cold pressor conditioning stimulus. A buccal cell sample was collected for analysis of 5HTTLPR genotype. Meaningful CPM effect was determined as an increase in pressure pain threshold values from baseline greater than the inherent error of measurement, calculated as 5.3%. During the conditioning stimulus, 116 subjects (92.8%) exhibited a CPM effect whereas 9 did not. CPM effect did not differ significantly between genders or between 5HTTLPR genotypes. This provides a clear basis on which to determine the proportion of patients with a chronic pain disorder that exhibit a meaningful CPM effect.Perspective: This study proposes a method for calculating meaningful CPM effect and reports theproportion and magnitude of effect elicited in a large sample. Associations between CPM, gender,and genotype were also analyzed. Clarification of normal CPM response may help to elucidate themechanisms driving CPM inefficiency in chronic pain.

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