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Scandinavian Journal of Pain

Official Journal of the Scandinavian Association for the Study of Pain

Editor-in-Chief: Breivik, Harald

4 Issues per year

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Volume 2, Issue 4

The inter- and intra-individual variance in descending pain modulation evoked by different conditioning stimuli in healthy men

Yuka Oono
  • Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Fredrik Bajers Vej 7, Bld. D3, DK-9220 Aalborg E, Aalborg, Denmark
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Hongling Nie
  • Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Fredrik Bajers Vej 7, Bld. D3, DK-9220 Aalborg E, Aalborg, Denmark
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Renata Lima Matos
  • Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Fredrik Bajers Vej 7, Bld. D3, DK-9220 Aalborg E, Aalborg, Denmark
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Kelun Wang
  • Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Fredrik Bajers Vej 7, Bld. D3, DK-9220 Aalborg E, Aalborg, Denmark
  • Department of Oral & Maxillofacial Surgery, Aalborg Hospital, Aalborg, Denmark
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Lars Arendt-Nielsen
  • Corresponding author
  • Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Fredrik Bajers Vej 7, Bld. D3, DK-9220 Aalborg E, Aalborg, Denmark
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  • Other articles by this author:
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Published Online: 2011-10-01 | DOI: https://doi.org/10.1016/j.sjpain.2011.05.006


Background and purpose

Conditioned pain modulation (CPM) is a phenomenon in which pain is inhibited by heterotopic noxious stimulation. It is not known how the experimental condition affects the magnitude of the CPM response and the inter-and intra-individual variations. It is important to get the information of the test–retest reliability and inter–individual variations of CPM to apply CPM as a diagnostic tool or for screening analgesic compounds. This study evaluated (1) the magnitude of CPM, (2) the inter-individual coefficient of variation (inter-CV) and (3) the intra-individual coefficient of variation (intra-CV) to (A) different stimulus modalities to evoke CPM and (B) different assessment sites.


Twelve healthy men (age 19–38 years) participated in this study. Cold pressor pain (CPP) (immersing the hand into cold water), tourniquet pain (cuff around the upper arm) and mechanical pressure pain (craniofacial region) were used in randomized order as conditioning stimuli (CS). The test stimulus (TS) was pressure pain applied to the right masseter muscle, left forearm and leg (bilateral tibialis anterior: TA). The responses were pressure pain thresholds (PPT), pressure pain tolerance (PPTol) thresholds and the pain intensity which was assessed on a visual analogue scale (VAS, 0–10 cm) following 1.4 and 1.6 × PPT applied to TA. The TS was applied before, during and 10 min after the CS. The intra-individual CV was estimated between different days.


CPP induced the most powerful CPM on PPT (66.3 ± 10.0% increase), VAS ratings (41.5 ± 5.3% reduction) and PPTol (32.6±4.6% increase), especially at TA, and resulted in the smallest inter-CV (41.4–60.1%). Independently of the CS, the inter-CV in general showed that the recordings from the orofacial region and the forearm had smaller values than from the leg. The smallest intra-CV value was obtained in pain ratings with CPP (27.0%).


This study suggests that (1) the CPP evokes the largest CPM, (2) the leg as the assessment site results in the largest CPM responses and (3) the CPP causes the smallest inter- and intra-CV.


The present investigation implicates that the CPP is the most efficient conditioning stimulus to induce CPM when assessed by pressure pain thresholds.

Keywords: Experimental pain; Conditioned pain modulation (CPM); Inter-individual coefficient of variation; Intra-individual coefficient of variation; Human volunteers

DOI of refers to article: 10.1016/j.sjpain.2011.08.002.


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About the article

Tel.: +45 99408830; fax: +45 98154008.

Received: 2011-01-26

Revised: 2011-03-07

Accepted: 2011-05-22

Published Online: 2011-10-01

Published in Print: 2011-10-01

Declaration of financial relationship: There are no relationships to be declared.

Conflict of interest: It is confirmed that there are no financial or other arrangements that might lead to a conflict of interest for this paper.

Citation Information: Scandinavian Journal of Pain, Volume 2, Issue 4, Pages 162–169, ISSN (Online) 1877-8879, ISSN (Print) 1877-8860, DOI: https://doi.org/10.1016/j.sjpain.2011.05.006.

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