Open AccessEvidence for Acute Central Sensitization to Prolonged Experimental Pain in Posttraumatic Stress Disorder
Author(s) -
MoellerBertram Tobias,
Strigo Irina A.,
Simmons Alan N.,
Schilling Jan M.,
Patel Piyush,
Baker Dewleen G.
Publication year - 2014
Publication title -
pain medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.893
H-Index - 97
eISSN - 1526-4637
pISSN - 1526-2375
DOI - 10.1111/pme.12424
Subject(s) - medicine , sensitization , central sensitization , comorbidity , stimulus (psychology) , quantitative sensory testing , anesthesia , chronic pain , threshold of pain , sensory system , psychiatry , psychology , nociception , neuroscience , receptor , immunology , psychotherapist
Background Post‐traumatic stress disorder ( PTSD ) and pain have a well‐documented high comorbidity; however, the underlying mechanisms of this comorbidity are currently poorly understood. The aim of this psychophysical study was to investigate the behavioral response to a prolonged suprathreshold pain stimulus in subjects with combat‐related PTSD and combat controls ( CC ) for clinical evidence of central sensitization. Methods Ten male subjects with current PTSD related to combat and 11 CC male subjects underwent baseline quantitative sensory testing ( QST ), temporal pain summation, and psychological profiling followed by an intramuscular injection of capsaicin into the quadriceps muscle. Results There was no significant between‐group difference for the initial maximal pain response or an initial pain reduction for the first 15 minutes postinjection on QST or pain ratings. However, we observed significantly higher scores in the PTSD group for the second 15 minutes postinjection on both pain intensity and pain unpleasantness ratings. Assessment of temporal summation to repetitive pressure stimuli showed significantly higher subjective pain in the PTSD group. Conclusion These findings are consistent with a significantly higher degree of acute central sensitization in individuals with PTSD . Increased acute central sensitization may underlie increased vulnerability for developing pain‐related conditions following combat trauma.