European journal of pain : EJP
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This study reports a multivariate test of sex and race differences in experimental pain, and the degree to which these differences could be uniquely attributable to three levels of cognition: primary appraisals (threat, challenge), secondary appraisals (pain catastrophizing) and/or cognitive processes (mindful observing, non-reactivity). Both the predictive and mediator role of the cognitive variables was of interest. ⋯ The three levels of cognition investigated in this research represent changeable, important processes for potentially mitigating the impact of pain in vulnerable groups.
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Mechanisms underpinning ongoing symptoms in chronic whiplash associated-disorder (WAD) are not well understood. People with chronic WAD can exhibit sensory dysfunction consistent with small nerve fibre pathology, including thermal hypoaesthesia and hyperalgesia. This study investigated small fibre structure and function in chronic WAD. ⋯ Our study found decreased intraepidermal nerve fibre density, reduced dermal innervation, thermal hypoaesthesia and hypersensitivity in people with chronic WAD, suggestive of small fibre pathology. This observation of peripheral nervous system pathology in chronic whiplash provides novel insights on mechanisms underpinning symptoms and challenges commonly held beliefs regarding this condition.
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Clinical and experimental evidence advocates a structural and functional link between the vestibular and other sensory systems. For instance, visuo-vestibular and vestibular-somatosensory interactions have been widely reported. However, whether visual inputs carrying vestibular information can modulate pain is not yet clear. Recent evidence using natural vestibular stimulation or moving visual stimuli, points at an unspecific effect of distraction. ⋯ This study explored how the visualization of static environments in immersive virtual reality can lead to pain threshold modulation through the activation of the vestibular system. Immersion into rotated virtual environments led to the illusory sensation of body rotation, and this sensation was found to be related with a modulation of pain perception. Possible analgesic effects due to distraction could be ruled out. These results expand our current knowledge about how the visual, vestibular and somatosensory (pain) systems interact. These findings may influence future pain treatment strategies based on multisensory stimulation.