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Increased sensitivity to supra-threshold painful stimuli in patients with multiple functional somatic symptoms (MFS)

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Kuzminskyte, Ruta ; Kupers, Ron ; Videbech, Poul ; Gjedde, Albert ; Fink, Per. / Increased sensitivity to supra-threshold painful stimuli in patients with multiple functional somatic symptoms (MFS). In: Brain Research Bulletin. 2010 ; Vol. 82, No. 1-2. pp. 135-40.

Bibtex

@article{a01dcb81893f49468b84fa999a1b120c,
title = "Increased sensitivity to supra-threshold painful stimuli in patients with multiple functional somatic symptoms (MFS)",
abstract = "Many patients in a variety of medical settings suffer from persistently painful bodily symptoms that are not explained by known pathophysiological mechanisms. In the most severe cases, these patients complain of multiple functional somatic symptoms (MFS). We tested the hypothesis of reduced pain threshold and pain tolerance levels in patients with MFS. Twenty-two patients with MFS and 27 age- and sex-matched healthy control subjects volunteered for this study. The subjects received innocuous and noxious thermal stimuli to the volar forearm by means of a Peltier contact heat probe. We assessed pain threshold and pain tolerance with an ascending staircase method. Anxiety levels and hemodynamic (blood pressure, pulse rate) and endocrine (cortisol and prolactin release) responses were measured before and after pain testing. We found no group differences for any of the physiological or self-rated subjective emotional responses to the pain stressor. Contrary to the hypothesis, the pain threshold was not lower in MFS; the data even showed a trend in the opposite direction. Pain tolerance scores were identical in the two groups but they correlated negatively with the number of functional somatic symptoms in MFS patients. Importantly, patients had a smaller temperature range between their pain threshold and pain tolerance scores, suggesting that they differentiate poorly within the noxious range. Minor increases in stimulus intensity of supra-threshold painful stimuli may lead to disproportionate increases in pain intensity in MFS patients, suggesting a defunct endogenous pain modulatory system.",
keywords = "Adult, Female, Humans, Pain/physiopathology, Pain Measurement/psychology, Pain Threshold/physiology, Physical Stimulation, Sensory Thresholds",
author = "Ruta Kuzminskyte and Ron Kupers and Poul Videbech and Albert Gjedde and Per Fink",
note = "Copyright 2010 Elsevier Inc. All rights reserved.",
year = "2010",
month = "4",
day = "29",
doi = "10.1016/j.brainresbull.2010.03.002",
language = "English",
volume = "82",
pages = "135--40",
journal = "Brain Research Bulletin",
issn = "0361-9230",
publisher = "Elsevier Inc",
number = "1-2",

}

RIS

TY - JOUR

T1 - Increased sensitivity to supra-threshold painful stimuli in patients with multiple functional somatic symptoms (MFS)

AU - Kuzminskyte, Ruta

AU - Kupers, Ron

AU - Videbech, Poul

AU - Gjedde, Albert

AU - Fink, Per

N1 - Copyright 2010 Elsevier Inc. All rights reserved.

PY - 2010/4/29

Y1 - 2010/4/29

N2 - Many patients in a variety of medical settings suffer from persistently painful bodily symptoms that are not explained by known pathophysiological mechanisms. In the most severe cases, these patients complain of multiple functional somatic symptoms (MFS). We tested the hypothesis of reduced pain threshold and pain tolerance levels in patients with MFS. Twenty-two patients with MFS and 27 age- and sex-matched healthy control subjects volunteered for this study. The subjects received innocuous and noxious thermal stimuli to the volar forearm by means of a Peltier contact heat probe. We assessed pain threshold and pain tolerance with an ascending staircase method. Anxiety levels and hemodynamic (blood pressure, pulse rate) and endocrine (cortisol and prolactin release) responses were measured before and after pain testing. We found no group differences for any of the physiological or self-rated subjective emotional responses to the pain stressor. Contrary to the hypothesis, the pain threshold was not lower in MFS; the data even showed a trend in the opposite direction. Pain tolerance scores were identical in the two groups but they correlated negatively with the number of functional somatic symptoms in MFS patients. Importantly, patients had a smaller temperature range between their pain threshold and pain tolerance scores, suggesting that they differentiate poorly within the noxious range. Minor increases in stimulus intensity of supra-threshold painful stimuli may lead to disproportionate increases in pain intensity in MFS patients, suggesting a defunct endogenous pain modulatory system.

AB - Many patients in a variety of medical settings suffer from persistently painful bodily symptoms that are not explained by known pathophysiological mechanisms. In the most severe cases, these patients complain of multiple functional somatic symptoms (MFS). We tested the hypothesis of reduced pain threshold and pain tolerance levels in patients with MFS. Twenty-two patients with MFS and 27 age- and sex-matched healthy control subjects volunteered for this study. The subjects received innocuous and noxious thermal stimuli to the volar forearm by means of a Peltier contact heat probe. We assessed pain threshold and pain tolerance with an ascending staircase method. Anxiety levels and hemodynamic (blood pressure, pulse rate) and endocrine (cortisol and prolactin release) responses were measured before and after pain testing. We found no group differences for any of the physiological or self-rated subjective emotional responses to the pain stressor. Contrary to the hypothesis, the pain threshold was not lower in MFS; the data even showed a trend in the opposite direction. Pain tolerance scores were identical in the two groups but they correlated negatively with the number of functional somatic symptoms in MFS patients. Importantly, patients had a smaller temperature range between their pain threshold and pain tolerance scores, suggesting that they differentiate poorly within the noxious range. Minor increases in stimulus intensity of supra-threshold painful stimuli may lead to disproportionate increases in pain intensity in MFS patients, suggesting a defunct endogenous pain modulatory system.

KW - Adult

KW - Female

KW - Humans

KW - Pain/physiopathology

KW - Pain Measurement/psychology

KW - Pain Threshold/physiology

KW - Physical Stimulation

KW - Sensory Thresholds

U2 - 10.1016/j.brainresbull.2010.03.002

DO - 10.1016/j.brainresbull.2010.03.002

M3 - Journal article

VL - 82

SP - 135

EP - 140

JO - Brain Research Bulletin

JF - Brain Research Bulletin

SN - 0361-9230

IS - 1-2

ER -

ID: 55791326