Evidence for acute central sensitization to prolonged experimental pain in posttraumatic stress disorder

Pain Med. 2014 May;15(5):762-71. doi: 10.1111/pme.12424. Epub 2014 Apr 16.

Abstract

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.

Keywords: Capsaicin; Central Sensitization; Experimental Pain; PTSD; Quantitative Sensory Testing.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Pain / epidemiology
  • Acute Pain / psychology*
  • Adult
  • Anxiety / epidemiology
  • Anxiety / psychology
  • Capsaicin / administration & dosage
  • Catastrophization / epidemiology
  • Catastrophization / psychology
  • Central Nervous System Sensitization*
  • Chronic Pain / epidemiology
  • Chronic Pain / psychology*
  • Comorbidity
  • Depression / epidemiology
  • Depression / psychology
  • Evidence-Based Medicine
  • Humans
  • Hyperalgesia / psychology
  • Male
  • Pain Threshold / psychology*
  • Pressure / adverse effects
  • Quality of Life
  • Sensory System Agents / administration & dosage
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / psychology*
  • Surveys and Questionnaires
  • Young Adult

Substances

  • Sensory System Agents
  • Capsaicin