TY - JOUR
T1 - The Effect of High Versus Low Cognitive Load on the Development of Nociceptive Hypersensitivity
T2 - The Roles of Sympathetic Arousal, Sex, and Pain-Related Fear
AU - Meyers, Elke
AU - Vlaeyen, Johan W. S.
AU - van den Broeke, Emanuel N.
AU - von Leupoldt, Andreas
AU - Palmer, Andrew J.
AU - Torta, Diana M.
N1 - Funding Information:
We preregistered this study on the Open Science Framework (doi: 10.17605/OSF.IO/XT789 ). This study was supported by a KU Leuven Starting Grant to Diana M. Torta (STG/19/025), an infrastructure grant from the Research Foundation Flanders (FWO) and the Research Fund KU Leuven, Belgium (I011320N; AKUL/19/06) to Andreas von Leupoldt, Johannes W. Vlaeyen, and Diana M. Torta, and a grant from the Faculty of Psychology and Educational Sciences, KU Leuven to Elke Meyers (PSG‐D9079). Emanuel van den Broeke is supported by the Fonds de Recherche Clinique (FRC), St Luc‐UC Louvain, and by the Queen Elisabeth Medical Foundation for Neurosciences. Johan W. S. Vlaeyen, Andreas von Leupoldt, and Diana M. Torta are supported by the Asthenes long‐term Methusalem grant (METH/15/011) from the Flemish Government (Belgium).
Publisher Copyright:
© 2023 European Pain Federation - EFIC ®.
PY - 2023/7
Y1 - 2023/7
N2 - Background: According to limited-capacity theories of attention, less attentional resources remain available when engaging in a high- versus a low-demanding cognitive task. This may reduce the perceived intensity and the evoked cortical responses of concomitant nociceptive stimuli. Whether and how the competition for limited attentional resources between a cognitive task and pain impacts the development of long-lasting hypersensitivity is unclear. Methods: Eighty-four healthy participants were randomized into a low or high cognitive load group. Low-frequency electrical stimulation (LFS) of the skin was used to induce secondary hypersensitivity. We hypothesized that performing the high-load task during LFS would reduce the development of hypersensitivity. We examined whether painfulness, nonpain-related sympathetic arousal, or sex related to hypersensitivity, by assessing intensity and unpleasantness of mechanical pinprick stimulation. During task execution, we recorded steady-state evoked potentials evoked by LFS and skin conductance level for sympathetic arousal. Afterwards, participants reported task difficulty and LFS-related fear. For the primary outcomes, we used mixed analysis of variances. Results: The results confirmed the difference in cognitive load. Although LFS successfully induced hypersensitivity, the high-load task did not reduce its development. Next, the steady-state evoked potentials did not differ between groups. Hypersensitivity correlated positively with pain-related fear and negatively with skin conductance level before LFS, despite the lack of group differences in skin conductance level. We did not find any sex differences in hypersensitivity. Conclusions: These results do not confirm that high cognitive load or sex modulate hypersensitivity, but show associations with pain-related fear and non-pain-related sympathetic arousal. Significance: Previous research has mainly focused on cognitive load effects on the perception of acute painful stimuli. Yet this study extends our understanding by investigating cognitive load effects on the development of long-lasting secondary hypersensitivity, a common aspect in numerous persistent pain conditions. As cognitive tasks are presented during a painful procedure inducing secondary hypersensitivity, we test the long-lasting effects of cognitive load. Additionally, we used psychophysiological measurements to explored potential underlying mechanisms involving limited attentional resources and sympathetic arousal.
AB - Background: According to limited-capacity theories of attention, less attentional resources remain available when engaging in a high- versus a low-demanding cognitive task. This may reduce the perceived intensity and the evoked cortical responses of concomitant nociceptive stimuli. Whether and how the competition for limited attentional resources between a cognitive task and pain impacts the development of long-lasting hypersensitivity is unclear. Methods: Eighty-four healthy participants were randomized into a low or high cognitive load group. Low-frequency electrical stimulation (LFS) of the skin was used to induce secondary hypersensitivity. We hypothesized that performing the high-load task during LFS would reduce the development of hypersensitivity. We examined whether painfulness, nonpain-related sympathetic arousal, or sex related to hypersensitivity, by assessing intensity and unpleasantness of mechanical pinprick stimulation. During task execution, we recorded steady-state evoked potentials evoked by LFS and skin conductance level for sympathetic arousal. Afterwards, participants reported task difficulty and LFS-related fear. For the primary outcomes, we used mixed analysis of variances. Results: The results confirmed the difference in cognitive load. Although LFS successfully induced hypersensitivity, the high-load task did not reduce its development. Next, the steady-state evoked potentials did not differ between groups. Hypersensitivity correlated positively with pain-related fear and negatively with skin conductance level before LFS, despite the lack of group differences in skin conductance level. We did not find any sex differences in hypersensitivity. Conclusions: These results do not confirm that high cognitive load or sex modulate hypersensitivity, but show associations with pain-related fear and non-pain-related sympathetic arousal. Significance: Previous research has mainly focused on cognitive load effects on the perception of acute painful stimuli. Yet this study extends our understanding by investigating cognitive load effects on the development of long-lasting secondary hypersensitivity, a common aspect in numerous persistent pain conditions. As cognitive tasks are presented during a painful procedure inducing secondary hypersensitivity, we test the long-lasting effects of cognitive load. Additionally, we used psychophysiological measurements to explored potential underlying mechanisms involving limited attentional resources and sympathetic arousal.
U2 - 10.1002/ejp.2098
DO - 10.1002/ejp.2098
M3 - Article
C2 - 36807466
SN - 1090-3801
VL - 27
SP - 682
EP - 698
JO - European Journal of Pain
JF - European Journal of Pain
IS - 6
ER -