EMOTIONAL AND COGNITIVE MODULATION OF PAIN PERCEPTION
WHAT IS PAIN?
Life without pain: zeldzame ziekte (genetic mutation): voelen geen pijn
à deze mensen hebben veel verwondingen en gaan eerder dood
à pain has a very important function
Pain = “unpleasant sensory and emotional experience associated with actual or potential
tissue damage, or described in terms of such damage” (International Association for the
Study of Pain, 1994)
à functioneel mechanisme om ons te beschermen
Sensory and affective component/experience:
- How intense, what quality?
à sensorisch: hoe intens is pijn en wat voor pijn is het
- How unpleasant, annoying, distressing?
à affectieve dimensie: hoe onaangenaam is pijn, hoe vervelend, hoe distressing
Phases of (acute) pain:
1. Transductie
2. Conductie
3. Transmissie
4. Perceptie
5. Modulatie
= nociceptie
Trauma à signal à pain: painful event is detected by nociceptors, transmitted along nerves
to the spinal cord and from there to the brain
à Basiscomponenten:
- Nociceptors: trauma/injury detecteren
- Spinal cord
- Brain
= ascending pain system
1
,How to measure pain?
- vragenlijsten: gaat over chronsiche pijn terwijl in labo acute pijn w gemeten
- facial expression
- fMRI: brain activity
- Behaviour: how long people endure pain
- Autonomous nervous system activity: heart rate, skin conductance
Pain measures:
- Numberscale
à selfreport: numerical scale from no pain to extremely intense
- 4-pointcategoryscale
- Visual analog scale
- Combined verbal - numerical scale
- Assessment of the two dimensions of pain (Sensory and Affective):
o Radio Metaphor by Price: How loud vs. how annoying is the sound?
o Intensity = How painful?
2
, o Unpleasantness = How unpleasant?
Neurophysiology (EEG): Somatosensory-evoked potentials (SEPs)
à Brain activity
à Distinct topography
Neurophysiology: Laser-evoked potentials:
à pain was evoked via laser on finger
à hot enough = pain à pain evoked brain potentials
Psychophysiology of Pain Heart rate and skin conductance:
- autonomous reaction to pain
- here: study with differently intens heat pain stimuli for 5 sec
- skin conductance and heart rate were measured
- pp rated the hottest temperature as most painfull
- also highest respons/heart rate for most painfull stimulus
3
WHAT IS PAIN?
Life without pain: zeldzame ziekte (genetic mutation): voelen geen pijn
à deze mensen hebben veel verwondingen en gaan eerder dood
à pain has a very important function
Pain = “unpleasant sensory and emotional experience associated with actual or potential
tissue damage, or described in terms of such damage” (International Association for the
Study of Pain, 1994)
à functioneel mechanisme om ons te beschermen
Sensory and affective component/experience:
- How intense, what quality?
à sensorisch: hoe intens is pijn en wat voor pijn is het
- How unpleasant, annoying, distressing?
à affectieve dimensie: hoe onaangenaam is pijn, hoe vervelend, hoe distressing
Phases of (acute) pain:
1. Transductie
2. Conductie
3. Transmissie
4. Perceptie
5. Modulatie
= nociceptie
Trauma à signal à pain: painful event is detected by nociceptors, transmitted along nerves
to the spinal cord and from there to the brain
à Basiscomponenten:
- Nociceptors: trauma/injury detecteren
- Spinal cord
- Brain
= ascending pain system
1
,How to measure pain?
- vragenlijsten: gaat over chronsiche pijn terwijl in labo acute pijn w gemeten
- facial expression
- fMRI: brain activity
- Behaviour: how long people endure pain
- Autonomous nervous system activity: heart rate, skin conductance
Pain measures:
- Numberscale
à selfreport: numerical scale from no pain to extremely intense
- 4-pointcategoryscale
- Visual analog scale
- Combined verbal - numerical scale
- Assessment of the two dimensions of pain (Sensory and Affective):
o Radio Metaphor by Price: How loud vs. how annoying is the sound?
o Intensity = How painful?
2
, o Unpleasantness = How unpleasant?
Neurophysiology (EEG): Somatosensory-evoked potentials (SEPs)
à Brain activity
à Distinct topography
Neurophysiology: Laser-evoked potentials:
à pain was evoked via laser on finger
à hot enough = pain à pain evoked brain potentials
Psychophysiology of Pain Heart rate and skin conductance:
- autonomous reaction to pain
- here: study with differently intens heat pain stimuli for 5 sec
- skin conductance and heart rate were measured
- pp rated the hottest temperature as most painfull
- also highest respons/heart rate for most painfull stimulus
3
