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Early sympathetic neural responses during a cold pressor test linked to pain perception

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Abstract

Purpose

There is considerable interindividual variability in the perception of pain. Given that pain management is a major public health problem, gaining insight into the underlying physiology of these perceptual differences is important. We tested the hypothesis that when interindividual variability in initial muscle sympathetic nerve activity (MSNA) responses to a cold pressor test (CPT) is identified, the divergent responses will be linked to differences in pain perception in healthy young men and women.

Methods

In the supine position, blood pressure (BP) and MSNA were measured at baseline and during a 2-min CPT. Immediately following the CPT, pain was rated (range 0–10).

Results

Two groups were established: positive responders (Pos, n = 12) and negative responders (Neg, n = 12) based on the initial (first 30 s) MSNA response profiles (Pos: 12 ± 9, Neg: −3 ± 3 bursts/min, P < 0.0001). MSNA response profiles throughout the CPT were different between groups (P < 0.0001). Peak MSNA increases were different (Pos: 27 ± 11, Neg: 9 ± 5 bursts/min, P < 0.0001) and corresponded with initial MSNA responses (R2 = 0.6881, P < 0.0001). Blood pressure responses were also different throughout the CPT (P < 0.0001). Most importantly, the perception of pain induced by the CPT was different between the two groups (Pos: 8 ± 1, Neg: 4 ± 1, P < 0.0001).

Conclusions

The results indicate that in healthy young men and women, there are divergent initial sympathetic neural responses to a given painful stimulus that are linked to the magnitude of pain perception. These findings highlight the distinctive sympathetic patterns that may contribute to the considerable interindividual variability in the perception of pain.

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Acknowledgements

We are grateful to the study volunteers for their participation. This study was supported, in part, by an AHA Grant-In-Aid (13GRNT16990064), the Harry S. Moss Heart Trust, and Department of Defense—US Army grant (W81XWH1820012). JPM was supported by a British Heart Foundation Travel Fellowship.

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Authors and Affiliations

  1. UT Southwestern Medical Center, Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Suites 435, Dallas, TX, 75231, USA

    Mu Huang, Jeung-Ki Yoo, Abigail S. L. Stickford, Jonathan P. Moore, Joseph M. Hendrix, Craig G. Crandall & Qi Fu

  2. Department of Health Care Sciences, University of Texas Southwestern Medical Center, Dallas, USA

    Mu Huang

  3. Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, USA

    Jeung-Ki Yoo, Craig G. Crandall & Qi Fu

  4. Department of Health and Exercise Science, Appalachian State University, Boone, USA

    Abigail S. L. Stickford

  5. School of Sport, Health and Exercise Sciences, Bangor University, Bangor, UK

    Jonathan P. Moore

  6. Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, USA

    Joseph M. Hendrix

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  1. Mu Huang
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Correspondence to Qi Fu.

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Huang, M., Yoo, JK., Stickford, A.S.L. et al. Early sympathetic neural responses during a cold pressor test linked to pain perception. Clin Auton Res 31, 215–224 (2021). https://doi.org/10.1007/s10286-019-00635-7

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  • DOI: https://doi.org/10.1007/s10286-019-00635-7

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