Vagal tone, pain sensitivity and exercise-induced hypoalgesia: The effect of physical activity level

IF 3.5 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2024-04-12 DOI:10.1002/ejp.2275

Ela Michaeli Izak, Einat Kodesh, Irit Weissman-Fogel

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Abstract

Background

Vagal activity has analgesic effects that are attributed to exercise-induced hypoalgesia (EIH). High vagal tone and low pain sensitivity are reported in individuals who routinely exercise yet, their association is unclear. Furthermore, it is unknown if the heightened vagal tone following high physical activity predicts and intensifies EIH.

Methods

Fifty-one healthy participants (27 low–moderately physically active; 27 females) underwent a resting-state electrocardiogram followed by heart rate variability analysis. Pain measurements, including pressure (PPT) and heat (HPT) pain thresholds, ratings of tonic heat pain (THP) and conditioned pain modulation (CPM) paradigm, were conducted pre- and post-exercise on a cycle ergometer.

Results

The highly active group demonstrated higher vagal tone compared to the low–moderately active (root mean square of successive differences between R–R intervals: 63.96.92 vs. 34.78 ms, p = 0.018; percentage of successive R–R intervals that exceed 50 ms: 24.41 vs. 11.52%, p = 0.012). Based on repeated-measure ANOVA, the highly active group showed higher PPT at pre-exercise, compared to the low–moderately active group (382 kPa vs. 327 kPa; p = 0.007). Post-exercise, both groups demonstrated EIH, increased HPT (p = 0.013) and decreased THP ratings (p < 0.001). Linear regression revealed that only in the low–moderately active group, higher vagal tone was associated with more efficient pre-exercise CPM and a greater reduction in THP ratings post-exercise (p ≤ 0.01).

Conclusions

Highly active individuals demonstrate greater vagal tone and lower pain sensitivity but no greater EIH. Vagal tone moderates pain inhibition efficiency and EIH only in low–moderately active individuals. These findings suggest that physical activity level moderates the vagal–pain association via the endogenous analgesia system.

Significance

Highly physically active individuals exhibit greater vagal tone and reduced sensitivity to experimental pain, yet they do not benefit more from exercise-induced hypoalgesia (EIH) compared to low–moderately active individuals. Moreover, low–moderately active individuals with greater vagal tone exhibited more efficient endogenous pain inhibition and greater EIH, suggestive of the moderation effect of physical activity level on vagal–pain associations.

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迷走神经张力、疼痛敏感性和运动诱发的低痛感：体育锻炼水平的影响

背景迷走神经活动具有镇痛作用，这归因于运动诱发的低痛感（EIH）。据报道，经常锻炼的人迷走神经张力高，疼痛敏感性低，但两者之间的关系尚不清楚。方法51 名健康参与者（27 名低度-中度运动活跃者；27 名女性）接受了静息状态心电图检查，随后进行了心率变异性分析。疼痛测量包括压力（PPT）和热痛（HPT）阈值、强直性热痛（THP）评分和条件性疼痛调节（CPM）范式，在自行车测力计上进行运动前后的测量。结果与中低度活跃组相比，高度活跃组的迷走神经张力更高（R-R 间期连续差值的均方根：63.96.92 vs. 34.78 ms，p = 0.018；连续 R-R 间期超过 50 ms 的百分比：24.41 vs. 11.52%，p = 0.012）。根据重复测量方差分析，与中低度活跃组相比，高度活跃组在运动前的 PPT 值更高（382 kPa vs. 327 kPa；p = 0.007）。运动后，两组均表现出 EIH、HPT 增加（p = 0.013）和 THP 评分降低（p < 0.001）。线性回归显示，只有在中低度活跃组中，迷走神经张力越高，运动前 CPM 的效率越高，运动后 THP 评分的降低幅度越大（p ≤ 0.01）。迷走神经张力只对中低运动量人群的疼痛抑制效率和EIH有调节作用。这些研究结果表明，体力活动水平通过内源性镇痛系统调节迷走神经与疼痛的关联。重要意义体力活动量大的人迷走神经张力更高，对实验性疼痛的敏感性更低，但与体力活动量中等偏低的人相比，他们并没有从运动诱导的低镇痛（EIH）中获益更多。此外，低中等运动量的人迷走神经张力较高，表现出更有效的内源性疼痛抑制和更大的 EIH，这表明运动水平对迷走神经-疼痛关联有调节作用。

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.