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Human Experimental Pain Models
Author Bios
Learning Objectives
Clinical Significance and Phenomenology
Complex Diseases: Need to Simplify
Model Requirements
Brief and Sustained Experimental Pain
Currently selected section: Choice of the Pain Stimulus
A Model Design for Pain Experimentation
Experiential Adjustment
Choice of Stimulation Site
Stimulation Site for a Study of TMJD
Experimental Design
Model Validation: Level 1
Model Validation: Level 2
Model Validation: Level 3
Model Validation: An Example
Cross-Validation with Other Model Systems
Model Systems as Tools
Sample Size Estimation
Potential Difficulties
Conclusion

 

Chapter 21: Human Experimental Pain Models: Choice of the Pain Stimulus
        

Any model of pain for human application should be safe and reliable. The pain challenge should also be applied to deep tissue, such as muscle, because, in contrast to superficial pain, deep pain is poorly localized and frequently associated with pronounced autonomic responses (Cervero, 1988; Gebhardt and Ness, 1991).

Deep pain in tissue such as muscle has been induced in humans by experimental techniques such as fatiguing concentric and eccentric muscles, ischemia, and electrical stimulation. Pain has also been induced in deep tissue by injection of algesic substances that are suitable for human use. Although heat has been applied directly to deep tissue in experimental animals, thermal stimulation is unlikely to gain acceptance in the study of deep somatic pain in humans because of tissue damage. Visceral pain conditions have been modeled by systems using mechanical distention or electrical stimulation.

Since pain sensitivity and ability to suppress pain vary widely between individuals, a stimulus of a given magnitude is likely to result in significant response differences between subjects. This variation may need to be taken into account in the design of the model conditions and interpretation of results. With this background in mind, differences in model conditions need to be understood within the context of the question that the investigator aims to study.

Table 6.1: Stimulus and Subject Response
Stimulus Type Pain Stimulation Resulting Pain Experience
SingleBrief or InitialInter-individual differences in pain intensity
Repeated Constant magnitudeProlongedInter-individual differences in pain intensity and time course of pain
Continuous Experientially-adjusted SustainedSimilar intensity and time course of perceived pain among subjects

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