The Cognitive Modulation of Nociceptive Hypersensitivity

Secondary hyperalgesia is a common symptom in certain chronic pain conditions, contributing to major psychological, social, and economical consequences. It can be experimentally induced in healthy participants using specific protocols of low, middle, and high frequency electrical stimulation.

The main objective of this doctoral research is to examine the effect of cognitive interventions on the development of experimentally induced secondary hyperalgesia of mechanical pinprick stimulation. 

Study 1, which is now completed and in the writing process, aimed to examine whether the execution of a high demanding working memory task during low-frequency stimulation (LFS), in contrast to a low demanding working memory task, attenuates the development of secondary hyperalgesia of mechanical pinpricks. In addition, the role of sympathetic autonomic sympathetic arousal as well as sex differences were investigated.

The purpose of study 2, which is currently ongoing, is to investigate whether secondary hyperalgesia of mechanical pinprick stimulation, induced by middle-frequency stimulation (MFS), is attenuated more by the concomitant execution of a high demanding working memory task (individually tailored n-back task) or by a low demanding reaction time task (0-back task) than when presented without a task. In addition, individual differences in both attentional factors as psychological factors and their roles in the development of secondary hyperalgesia are explored.

Study 3, for which we have received ethical clearance, aims to examine whether inducing pain expectations impact the development of secondary hyperalgesia of mechanical pinprick stimulation, induced by high-frequency stimulation (HFS). A secondary objective is to explore the role of fear of pain. In addition, I was involved in a study of Diana Torta, which has been completed and is in the writing process. This study aimed to investigate whether the observation of an actor in high pain result in more intense secondary hyperalgesia of mechanical pinpricks compared to the observation of an actor in low pain and to explore the role of fear of pain and empathy.

The idea of study 4, which still needs to be fully developed, is to investigate whether a brief mindfulness-based intervention attenuates the development of secondary hyperalgesia of mechanical pinprick stimulation. The specific aims, hypotheses, design, and measurements are still to be discussed.

The findings of these studies will broaden our understanding of both cognitive as psychological factors influencing the development of secondary hyperalgesia, which may provide more insight in potential suitable interventions to cope with this major chronic pain symptom.