The influence of expectations and attention on conditioned pain modulation: A systematic review and meta-analysis

IF 13.7 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical Psychology Review Pub Date : 2024-11-05 DOI:10.1016/j.cpr.2024.102517

Amber Billens , Sophie Van Oosterwijck , Evy Dhondt , Mira Meeus , Indra De Greef , Stefaan Van Damme , Jessica Van Oosterwijck

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引用次数: 0

Abstract

Conditioned pain modulation (CPM) is a psychophysical experimental measure of endogenous pain inhibition in humans. Within this paradigm, one noxious stimulus, the conditioning stimulus (CS), reduces the pain perception from another heterotopic noxious stimulus, the test stimulus (TS). Cognitive processes are known to influence pain perception and might impact the underlying mechanisms of CPM. This systematic review and meta-analysis synthesizes the existing scientific literature addressing the influence of cognitive factors, namely, expectations and attention on CPM. Four electronic databases were searched to identify relevant literature. Risk of bias and quality of evidence were assessed according to two modified Newcastle-Ottawa Scales and the GRADE approach, respectively. Twenty-four articles were included. Qualitative analysis showed more efficient CPM when pain relief is expected, and an association between intrinsic attention to pain and reduced CPM. Although the evidence is not unanimous, meta-analyses showed that CPM is more efficient when attention is directed towards the CS versus the TS, and is not influenced by distraction. In conclusion, while CPM seems robust to attentional distraction, expectations and attentional focus appear to influence CPM. However, the evidence is limited and conflicting and warrants further study in order to prevent cognitive confounding and enhance mechanistic understanding.

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预期和注意力对条件性疼痛调节的影响：系统回顾与荟萃分析。

条件性疼痛调节（CPM）是对人类内源性疼痛抑制的一种心理物理实验测量方法。在这一范例中，一种有害刺激--条件刺激（CS）--会降低来自另一种异位有害刺激--测试刺激（TS）的痛觉。众所周知，认知过程会影响痛觉，并可能影响 CPM 的基本机制。本系统综述和荟萃分析综合了现有的科学文献，探讨了认知因素（即期望和注意力）对 CPM 的影响。我们检索了四个电子数据库以确定相关文献。分别根据两个修订的纽卡斯尔-渥太华量表和 GRADE 方法评估了偏倚风险和证据质量。共纳入 24 篇文章。定性分析显示，当疼痛有望缓解时，CPM 的效率更高，而对疼痛的内在关注与减少 CPM 之间存在关联。尽管证据并不一致，但荟萃分析表明，当注意力指向 CS 而不是 TS 时，CPM 的效率更高，且不受注意力分散的影响。总之，虽然 CPM 似乎不受注意力分散的影响，但期望和注意力集中似乎会影响 CPM。然而，这些证据是有限和相互矛盾的，因此需要进一步研究，以防止认知混淆并加深对机理的理解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Psychology Review PSYCHOLOGY, CLINICAL-

CiteScore

23.10

自引率

1.60%

发文量

期刊介绍： Clinical Psychology Review serves as a platform for substantial reviews addressing pertinent topics in clinical psychology. Encompassing a spectrum of issues, from psychopathology to behavior therapy, cognition to cognitive therapies, behavioral medicine to community mental health, assessment, and child development, the journal seeks cutting-edge papers that significantly contribute to advancing the science and/or practice of clinical psychology. While maintaining a primary focus on topics directly related to clinical psychology, the journal occasionally features reviews on psychophysiology, learning therapy, experimental psychopathology, and social psychology, provided they demonstrate a clear connection to research or practice in clinical psychology. Integrative literature reviews and summaries of innovative ongoing clinical research programs find a place within its pages. However, reports on individual research studies and theoretical treatises or clinical guides lacking an empirical base are deemed inappropriate for publication.