Pain relief through expectation supersedes descending inhibitory deficits in fibromyalgia patients
Abstract
In healthy adults, expectations can modulate the activity of inhibitory bulbo-spinal projections, and can even block the analgesic properties of counter-irritation - a phenomenon that triggers descending inhibition. Since descending inhibition is known to be deficient in fibromyalgia (FM) patients, we tested the possibility that expectancy-mediated analgesia would improve, or even kick-start, the deficient inhibitory responses of FM patients. By measuring subjective pain ratings, spinal withdrawal reflexes, and somatosensory evoked potentials (SEP), it was possible to test whether or not expectancy-mediated analgesia involved descending inhibition in FM patients. Here, we show that expectations of analgesia radically change the subjective experience of pain, but do not eliminate evidence of spinal hyperexcitability in FM patients. We found that expectations of analgesia reduce subjective pain ratings and decrease SEP amplitudes, confirming that expectations influence thalamocortical processes. However, even when analgesia was experienced, the spinal activity of FM patients was abnormal, showing heightened reflex responses. This demonstrates that, unlike healthy subjects, the modulation of pain by expectations in FM fails to influence spinal activity. These results indicate that FMs are capable of expectancy-induced analgesia but that, for them, this form of analgesia does not depend on the recruitment of descending inhibitory projections.
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Expectancies play an important role for pain modification in fibromyalgia.
“Given that expectancies play an important role for pain modification in fibromyalgia [6]”
From Nocebo hyperalgesia and other expectancy-related factors in daily fibromyalgia pain: Combining experimental and electronic diary methods (2024) · cites this paper as [6]
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- Authors
- Goffaux, P., de Souza, J. B., Potvin, S., & Marchand, S.
- Affiliations
- Université de Sherbrooke (CA)
- Venue
- Pain
- Published
- 2009-09
- Volume
- 145
- Issue
- 1
- Pages
- 18-23
- ISSN
- 0304-3959 (ISSN-L)
- OpenAlex
- W2021042430
- Cited by
- 67
- References
- 36
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 1 · 2022: 3 · 2021: 1 · 2020: 1 · 2019: 3 · 2018: 7 · 2017: 7 · 2016: 3 · 2015: 7 · 2014: 3 · 2013: 7 · 2012: 10
- FWCI
- 4.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Keywords
- fibromyalgia, descending inhibition, descending pain modulation, spinal hyperexcitability, somatosensory evoked potentials, counter-irritation, pain anticipation
- MeSH terms
- Afferent Pathways, Analgesics, Electric Stimulation, Electroencephalography, Evoked Potentials, Somatosensory, Female, Fibromyalgia, Humans, Neural Inhibition, Pain, Pain Measurement, Sural Nerve, Pain Threshold, Statistics, Nonparametric, Pain Management
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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