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Autonomic responses to tonic pain are more closely related to stimulus intensity than to pain intensity

Nickel, Moritz M.; May, Elisabeth S.; Tiemann, Laura; Postorino, Martina; Ta Dinh, Son; Ploner, Markus*

doi: 10.1097/j.pain.0000000000001010
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Pain serves the protection of the body by translating noxious stimulus information into a subjective percept and protective responses. Such protective responses rely on autonomic responses that allocate energy resources to protective functions. However, the precise relationship between objective stimulus intensity, subjective pain intensity, autonomic responses, and brain activity is not fully clear yet. Here, we addressed this question by continuously recording pain ratings, skin conductance, heart rate, and electroencephalography during tonic noxious heat stimulation of the hand in 39 healthy human subjects. The results confirmed that pain intensity dissociates from stimulus intensity during 10 minutes of noxious stimulation. Furthermore, skin conductance measures were significantly related to stimulus intensity but not to pain intensity. Correspondingly, skin conductance measures were significantly related to alpha and beta oscillations in contralateral sensorimotor cortex, which have been shown to encode stimulus intensity rather than pain intensity. No significant relationships were found between heart rate and stimulus intensity or pain intensity. The findings were consistent for stimulation of the left and the right hands. These results suggest that sympathetic autonomic responses to noxious stimuli in part directly result from nociceptive rather than from perceptual processes. Beyond, these observations support concepts of pain and emotions in which sensory, motor, and autonomic components are partially independent processes that together shape emotional and painful experiences.

Autonomic responses are more closely related to noxious stimulus intensity than to pain intensity, suggesting that they result from nociceptive rather than from perceptual processes.

Department of Neurology, TUM-Neuroimaging Center, Technische Universität München, Munich, Germany

*Corresponding author. Address: Department of Neurology, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany. Tel:. +49-89-4140-4608; fax +49-89-4140-4867. E-mail address: markus.ploner@tum.de (M. Ploner).

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

© 2017 International Association for the Study of Pain
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