Characterization of a novel capsaicin/heat ongoing pain model.

BACKGROUND: Human experimental pain models provide an important translational link between pre-clinical models and clinical pain. Using topical capsaicin and continuous heat application, the novel capsaicin/heat ongoing pain (CHOP) model induces long-lasting experimental pain of which the perceived intensity can be individually adjusted. METHODS: In the CHOP model, capsaicin or control cream is applied to a 10 × 10 cm skin area and a heating pad is applied over the area after cream removal. Two experiments in healthy participants were performed for model characterization. In Experiment 1, a constant temperature was applied for 60 min; in Experiment 2, temperature was adjusted to maintain a constant perceived intensity for 60 min. RESULTS: Experiment 1: across participants, constant temperature induced initial habituation followed by an increase in sensation back to baseline. Cluster analysis revealed that half the participants sensitized to the constant temperature, while the other half did not. The degree of sensitization was related to the baseline pain unpleasantness, relative to pain intensity. Experiment 2: constant perceived intensity was achieved in the painful and a non-painful control condition. The two conditions did not differ regarding possibly confounding variables, including blood pressure, heart rate, inflammation or physiological stress as measured by surrogate markers. Secondary allodynia and hyperalgesia were reported more following painful compared to control stimulation. Sensitizers as determined in Experiment 1 were also more pain sensitive in Experiment 2. CONCLUSION: The CHOP model reproduces some aspects of clinical pain, such as longer duration, sensitization, secondary allodynia and hyperalgesia. SIGNIFICANCE: Here we demonstrate a novel pain model that can be applied for up to an hour without tissue damage. The CHOP model allows for investigation of primary and secondary hyperalgesia as well as top-down influences on sensitization, thereby providing an experimental model that can be used to assess clinically-oriented questions.

Pain increases motivational drive to obtain reward, but does not affect associated hedonic responses: a behavioural study in healthy volunteers.

BACKGROUND: Pain and reward have been suggested to interact, and some evidence is provided by a rodent study showing that acutely injured animals are more motivated to reach a food reward while they do not increase food consumption, pointing at unaltered reward liking. Since no data exist in humans, we conducted a psychophysical experiment to test the effects of experimentally induced tonic pain on (1) the motivation to receive reward and (2) hedonic responses when being rewarded. METHODS: Forty healthy participants underwent two experimental sessions: in one, painful heat stimulation was continuously applied while participants played a monetary reward task; in the other, participants experienced non-painful warm stimulation while playing the task. In the task, participants needed to react quickly enough to a target cue to win the money associated with the particular trial ($0.04, $1 or $4). Reaction time to the target cue served as measure of motivation. Ratings after each trial on how much the participant liked the trial's outcome served as a measure of hedonic responses. RESULTS: Pain increased the motivation to obtain reward when the incentive was high, indexed by decreased reaction times (repeated-measures analysis of variance, interaction pain × incentive; p = 0.009). In contrast to motivational drive, hedonic ratings of the rewarding stimuli were not influenced by pain. CONCLUSION: Similar to existing rodent data, our results suggest a pain-induced mismatch of increased motivational drive with a lack of increased hedonic responses. This mismatch is discussed as perhaps reflecting a failed coping attempt, which is potentially relevant for chronic pain patients.