TY - JOUR
T1 - Psychophysiological responses to pain identify reproducible human clusters
AU - Farmer, Adam D.
AU - Coen, Steven J.
AU - Kano, Michiko
AU - Paine, Peter A.
AU - Shwahdi, Mustafa
AU - Jafari, Jafar
AU - Kishor, Jessin
AU - Worthen, Sian F.
AU - Rossiter, Holly E.
AU - Kumari, Veena
AU - Williams, Steven C.R.
AU - Brammer, Michael
AU - Giampietro, Vincent P.
AU - Droney, Joanne
AU - Riley, Julia
AU - Furlong, Paul L.
AU - Knowles, Charles H.
AU - Lightman, Stafford L.
AU - Aziz, Qasim
N1 - Funding Information:
This research was funded by a Medical Research Council project grant, number MGAB1A1R .
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2013/11
Y1 - 2013/11
N2 - Pain is a ubiquitous yet highly variable experience. The psychophysiological and genetic factors responsible for this variability remain unresolved. We hypothesised the existence of distinct human pain clusters (PCs) composed of distinct psychophysiological and genetic profiles coupled with differences in the perception and the brain processing of pain. We studied 120 healthy subjects in whom the baseline personality and anxiety traits and the serotonin transporter-linked polymorphic region (5-HTTLPR) genotype were measured. Real-time autonomic nervous system parameters and serum cortisol were measured at baseline and after standardised visceral and somatic pain stimuli. Brain processing reactions to visceral pain were studied in 29 subjects using functional magnetic resonance imaging (fMRI). The reproducibility of the psychophysiological responses to pain was assessed at 1 year. In group analysis, visceral and somatic pain caused an expected increase in sympathetic and cortisol responses and activated the pain matrix according to fMRI studies. However, using cluster analysis, we found 2 reproducible PCs: at baseline, PC1 had higher neuroticism/anxiety scores (P ≤ 0.01); greater sympathetic tone (P < 0.05); and higher cortisol levels (P ≤ 0.001). During pain, less stimulus was tolerated (P ≤ 0.01), and there was an increase in parasympathetic tone (P ≤ 0.05). The 5-HTTLPR short allele was over-represented (P ≤ 0.005). PC2 had the converse profile at baseline and during pain. Brain activity differed (P ≤ 0.001); greater activity occurred in the left frontal cortex in PC1, whereas PC2 showed greater activity in the right medial/frontal cortex and right anterior insula. In health, 2 distinct reproducible PCs exist in humans. In the future, PC characterization may help to identify subjects at risk for developing chronic pain and may reduce variability in brain imaging studies.
AB - Pain is a ubiquitous yet highly variable experience. The psychophysiological and genetic factors responsible for this variability remain unresolved. We hypothesised the existence of distinct human pain clusters (PCs) composed of distinct psychophysiological and genetic profiles coupled with differences in the perception and the brain processing of pain. We studied 120 healthy subjects in whom the baseline personality and anxiety traits and the serotonin transporter-linked polymorphic region (5-HTTLPR) genotype were measured. Real-time autonomic nervous system parameters and serum cortisol were measured at baseline and after standardised visceral and somatic pain stimuli. Brain processing reactions to visceral pain were studied in 29 subjects using functional magnetic resonance imaging (fMRI). The reproducibility of the psychophysiological responses to pain was assessed at 1 year. In group analysis, visceral and somatic pain caused an expected increase in sympathetic and cortisol responses and activated the pain matrix according to fMRI studies. However, using cluster analysis, we found 2 reproducible PCs: at baseline, PC1 had higher neuroticism/anxiety scores (P ≤ 0.01); greater sympathetic tone (P < 0.05); and higher cortisol levels (P ≤ 0.001). During pain, less stimulus was tolerated (P ≤ 0.01), and there was an increase in parasympathetic tone (P ≤ 0.05). The 5-HTTLPR short allele was over-represented (P ≤ 0.005). PC2 had the converse profile at baseline and during pain. Brain activity differed (P ≤ 0.001); greater activity occurred in the left frontal cortex in PC1, whereas PC2 showed greater activity in the right medial/frontal cortex and right anterior insula. In health, 2 distinct reproducible PCs exist in humans. In the future, PC characterization may help to identify subjects at risk for developing chronic pain and may reduce variability in brain imaging studies.
KW - Autonomic nervous system
KW - Hypothalamic-pituitary- adrenal axis
KW - Personality traits
KW - Serotonin transporter genotype
KW - Somatic pain
KW - Visceral pain
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U2 - 10.1016/j.pain.2013.05.016
DO - 10.1016/j.pain.2013.05.016
M3 - Article
C2 - 23714265
AN - SCOPUS:84886290936
VL - 154
SP - 2266
EP - 2276
JO - Pain
JF - Pain
SN - 0304-3959
IS - 11
ER -