• Masataka Umeda and Akiko Okifuji.
• Department of Kinesiology, University of Texas at San Antonio, San Antonio, Texas, USA.
• Eur J Pain. 2022 Sep 1; 26 (8): 1811-1820.

BackgroundBaseline heart rate variability (HRV) that reflects parasympathetic nervous system (PNS) activity may serve as an objective, physiological index of pain assessment, but more research is warranted to examine the link between HRV and laboratory pain responses. This study examined whether baseline HRV would predict pain responses to subsequent cold pressor test (CPT) in healthy adults.MethodsOne hundred twenty-three participants completed resting HRV assessment and CPT consisting of immersing their right hand into a cold-water bath for a maximum of 2 min. Pain threshold and pain rating were assessed during CPT. Completion status of CPT, defined as completing CPT or terminating CPT before 2 min, was recorded as an additional laboratory pain measure. Pearson's correlation analysis was performed to examine the link between HRV and pain responses, whereas regression analysis was performed to test the prediction of pain responses via baseline HRV.ResultsHF-HRVlog , which reflects PNS activity, was significantly associated with the CPT completion status (r = 0.23, p = 0.01), but not significantly associated with pain threshold (r = 0.17, p = 0.06) or pain rating (r = -0.11, p = 0.24). HF- HRVlog was found to be a significant predictor of CPT completion status (B = 0.53, p = 0.013).ConclusionsBaseline HF- HRVlog may serve as an objective, physiological index to predict laboratory pain responses, and the completion status of laboratory pain tests, such as CPT, may be used as a laboratory pain measure to capture important individual differences in pain processing.SignificanceA better understanding of how psychophysiology relates to human pain is important. We examined the association of baseline heart rate variability (HRV) with pain response to subsequently-administered cold pressor test (CPT) in healthy adults. We found that HF-HRVlog , which reflects parasympathetic nervous system activity, predicted the completion status (completion or termination) of CPT. Baseline HF-HRVlog may serve as an objective, physiological index of pain and the completion status of CPT may help assess the important individual differences in pain processing.© 2022 European Pain Federation - EFIC ®.

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