Conditioned pain modulation in children and adolescents: effects of sex and age

Tsao, Jennie C.I., Seidman, Laura C., Evans, Subhadra, Lung, Kirsten C., Zeltzer, Lonnie K. and Naliboff, Bruce D. 2013, Conditioned pain modulation in children and adolescents: effects of sex and age, Journal of pain, vol. 14, no. 6, pp. 558-567, doi: 10.1016/j.jpain.2013.01.010.

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Title Conditioned pain modulation in children and adolescents: effects of sex and age
Author(s) Tsao, Jennie C.I.
Seidman, Laura C.
Evans, SubhadraORCID iD for Evans, Subhadra
Lung, Kirsten C.
Zeltzer, Lonnie K.
Naliboff, Bruce D.
Journal name Journal of pain
Volume number 14
Issue number 6
Start page 558
End page 567
Total pages 10
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2013-06
ISSN 1528-8447
Keyword(s) Adolescent
Conditioning (Psychology)
Heart Rate
Pain Measurement
Pain Threshold
Physical Stimulation
Sex Characteristics
Summary Conditioned pain modulation (CPM) refers to the diminution of perceived pain intensity for a test stimulus following application of a conditioning stimulus to a remote area of the body, and is thought to reflect the descending inhibition of nociceptive signals. Studying CPM in children may inform interventions to enhance central pain inhibition within a developmental framework. We assessed CPM in 133 healthy children (mean age = 13 years; 52.6% girls) and tested the effects of sex and age. Participants were exposed to 4 trials of a pressure test stimulus before, during, and after the application of a cold water conditioning stimulus. CPM was documented by a reduction in pressure pain ratings during cold water administration. Older children (12-17 years) exhibited greater CPM than younger children (8-11 years). No sex differences in CPM were found. Lower heart rate variability at baseline and after pain induction was associated with less CPM, controlling for child age. The findings of greater CPM in the older age cohort suggest a developmental improvement in central pain inhibitory mechanisms. The results highlight the need to examine developmental and contributory factors in central pain inhibitory mechanisms in children to guide effective, age appropriate pain interventions.

PERSPECTIVE: In this healthy sample, younger children exhibited less CPM than did older adolescents, suggesting a developmental improvement in CPM. Cardiac vagal tone was associated with CPM across age. The current findings may inform the development of targeted, developmentally appropriate pain interventions for children.
Language eng
DOI 10.1016/j.jpain.2013.01.010
Field of Research 170102 Developmental Psychology and Ageing
Socio Economic Objective 920401 Behaviour and Health
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2013, American Pain Society
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Document type: Journal Article
Collections: Faculty of Health
School of Psychology
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