Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We introduce the field of psychoneurocardiology, and cite examples of research into psychosomatic and somatopsychic bases for hypertensive development. Beta-adrenergic hyperreactivity (a possible precursor of hypertension), as indexed by electrocardiographic T-wave amplitude suppression, was greater during active than passive coping tasks. The rise in tonic mean arterial blood pressure in normotensives over a 19-month period was a joint function of self-reported daily stress and baroreceptor-dependent pain dampening (as determined by the PRES method of noninvasive controlled carotid baroreceptor manipulation). The latter finding provides support for the learned model of hypertension. In this model, phasic blood pressure increases stimulate the baroreceptors, which in turn dampen pain and stress. The long-term effect of this relief is initially to increase the frequency of such phasic increases, and eventually to produce a tonic elevation in blood pressure.
 ...
PMID:Psychoneurocardiology: psychosomatic and somatopsychic approaches to hypertension research. 769 31

The specificity of baroreceptor-dependent inhibition of pain reactions to electrical stimuli was investigated during induction of different emotional states in 27 subjects. Baroreceptors were stimulated through the PRES (Phase Related External Suction) technique, while emotions were induced by means of pleasant, neutral and unpleasant slides. The dependent variables were pain ratings, somatic evoked potentials (N150 and P260) recorded from Fz, Cz and Pz, and skin conductance response (SCR), while heart rate was recorded as a PRES requirement. Valence and arousal ratings were obtained in front of each slide. During suction (external baroreceptor activation) reduced pain ratings, cortical disfacilitation (from Pz, as revealed by N150) and lower SCR were found as compared to pressure (baroreceptor deactivation). Moreover, brain evoked potentials (N150 and P260) reflecting cortical inhibition were found under condition of baroreceptor stimulation during unpleasant slides, but not during pleasant or neutral ones: this result was found in the high blood pressure subjects only. Data showed also a valence effect on pain ratings: pain was evaluated to be higher during unpleasant slides, than neutral and pleasant ones. Results are discussed in the light of "baroreceptor reward" hypothesis, which proposes a learning mechanism for the development of essential hypertension.
 ...
PMID:Baroreceptor cortical effects, emotions and pain. 779 Feb 90

Prior studies have noted a pain relieving effect of baroreceptor stimulation and of higher tonic blood pressure in animals and humans. The present study used a new technique for the controlled, noninvasive stimulation of human carotid baroreceptors (PRES). PRES baroreceptor manipulation was delivered to both normotensive subjects (n = 11) and medication-free labile hypertensive subjects (n = 10) during both thermal and mechanical pain. Consistent with prior research, hypertensives had a higher threshold for thermal pain than did normotensives. PRES baroreceptor manipulation had no significant effect on thermal pain threshold for either group. For the mechanical pain model, the opposite results were obtained; group pain thresholds did not differ, but there was a significant PRES baroreceptor stimulation effect of increasing pain threshold for both groups. Results are discussed in terms of specific features of the stimuli, dampening of pain in hypertensives, and adaptation to pain.
 ...
PMID:Effects of PRES baroreceptor stimulation on thermal and mechanical pain threshold in borderline hypertensives and normotensives. 797 2

Baroreceptor activity has been implicated in the modulation of pain. Sensory detection thresholds and pain ratings were measured in a group of 28 men during carotid baroreceptor manipulation with the PRES (phase-related external suction) neck suction technique. Brief, cardiac phase-related electrical impulses were delivered intracutaneously to the finger. The results indicate that minimum baroreceptor activity was associated with more severe pain, but had no effect on sensory detection threshold. The results are discussed in terms of the learned model of hypertension.
 ...
PMID:Baroreceptor stimulation: pain perception and sensory thresholds. 800 87

Nineteen chronic low back pain patients (aged 19-63) and 17 controls (aged 20-41) received electrical pain stimuli during manipulation of their carotid baroreceptors. The non-invasive mechanical manipulation of baroreceptors, using the PRES technique (Phase Related External Suction), simulates the end-effects of phasic blood pressure changes. This technique was developed to assess pain responses induced by changes in blood pressure without the typical shortcomings of pharmacological manipulation or lack of a control condition. During maximum baroreceptor activity, there was an unexpected increase in the amplitude of the somatosensory evoked potentials (SEPs) elicited by the electrical pain stimuli condition (N150-P260 peak-to-peak). In most other studies the opposite effect was found, with decreased pain responses during maximum baroreceptor activity. The chronic pain group reported greater pain during highest baroreceptor activation than did the controls. In addition, the chronic pain group showed lower diastolic blood pressure. To determine whether pain and baroreceptor responses observed in the chronic pain group depended on lower blood pressure levels, a second experiment with a non-clinical sample was performed. Results showed that lower tonic blood pressures are associated with greater baroreceptor activity amplifying pain, while higher blood pressure is associated with pain dampening during high baroreceptor activity. Data suggested that the differences in pain responses found in low back pain patients were associated with their lower tonic blood pressure levels. It is proposed that in general, lower blood pressures may be associated with greater pain during baroreceptor activation.
 ...
PMID:Somatotosensory evoked potentials during baroreceptor stimulation in chronic low back pain patients and normal controls. 910 44

The influence of baroreceptor modulation on pain perception has been extensively studied in normal and hypertensive subjects, but not in hypotensive subjects. The present experiment was performed to verify the following hypotheses: 1. Hypotensive subjects exhibit an increased pain response following baroreceptor activation compared to normals; 2. unlike the hypotensives, normal subjects, with normal baroreceptor reflexes, would learn to choose more often the baroreceptor activation condition compared to the opposite condition, during painful stimulation; 3. sensory and pain thresholds are correlated with blood pressure. The subjects (39 men), divided according to low and normal blood-pressure groups, participated in an experiment in which electrically-induced pain ratings and pain-evoked potentials were measured. Baroreceptor manipulation was performed by means of the PRES procedure. Whereas hypotensive subjects did not perceive any pain difference between the two baroreceptor conditions, activation and inhibition, normotensive men were able to perceive the baroreceptor activation condition as less painful. Similarly to subjective ratings, pain-evoked potentials of the low blood-pressure group showed a reversed trend compared to normals: larger somatosensory evoked potentials (N150-P260) to the baroreceptor activation condition and the opposite to the baroreceptor deactivation condition. Furthermore, results showed a negative correlation between diastolic blood pressure and sensory perception threshold, and a positive correlation between systolic pressure and pain threshold. Contrary to expectations, the rate of choice of baroreceptor conditions during painful stimulation did not show, in either group, any preference for baroreceptor activation.
 ...
PMID:The influence of low blood pressure and baroreceptor activity on pain responses. 925 85

Placement of C1 lateral mass screws may be facilitated by intentional C2 root sacrifice. Functional outcomes and morbidity following intentional sacrifice of the C2 root have not been reported in the literature. The objective is to find out if intentional C2 nerve root sacrifice affects functional outcomes and operative morbidity in patients undergoing posterior cervical fusion with C1 lateral mass screws. The study is a case report. Twenty-two consecutive elderly patients (10 males, 12 females with an average age of 77 years) with C1-2 instability were treated with posterior cervical fusion using C1 lateral mass screw placement. Five patients had preservation of the bilateral C2 nerve roots (PRES group) and 18 patients had intentional sacrifice of the bilateral C2 nerve root (SAC group). Operative times, blood loss, hospital length of stay, and complications were recorded for each patient. Functional outcomes, pain, and satisfaction scores were compared between the two groups at the time of ultimate follow-up. Average follow-up time was 19.3 months (range 6-66). The SAC group demonstrated significantly decreased operative time (109.4 vs. 187 min) and a trend towards decreased blood loss (344 vs. 1,030 mL). At ultimate follow-up both groups experienced similar mild disability with no significant difference in NDI scores, analog pain, and satisfaction scores. No patient had C2 root dysesthesia, swallowing, or speech difficulty. In this small case series, intentional sacrifice of the bilateral C2 nerve root ganglion resulted in less operative time and decreased blood loss in elderly patents undergoing C1-2 posterior fusion with the Harms technique. Functional outcome, pain and satisfaction scores were not adversely affected when this technique was used in elderly patients.
 ...
PMID:C1 lateral mass screw placement with intentional sacrifice of the C2 ganglion: functional outcomes and morbidity in elderly patients. 2049 37