title: Conditioned pain modulation evoked by different intensities of mechanical stimuli applied to the craniofacial region in healthy men and women.
abstract: OBJECTIVE
  To investigate systematically whether conditioned pain modulation (CPM) evoked by tonic mechanical stimuli applied to the craniofacial region is intensity-, assessment site-, and gender-dependent.
  
  
  METHODS
  Twenty healthy men and 20 women participated in four sessions. Tonic painful mechanical stimulation was applied to pericranial muscles by a mechanical headband pressure device. The pressures applied to four probes were adjusted via pain feedback from a 0 to 10 electronic visual analog scale (VAS) to generate different pain levels (VAS0, VAS1, VAS3, or VAS5) for 10 minutes. Pressure pain thresholds (PPTs) and pressure pain tolerance thresholds (PPTols) were assessed from right masseter muscle and left forearm by pressure algometry before, during, immediately after, 10 minutes after, and 20 minutes after the conditioning stimulus (CS). Data were analyzed with multilevel ANOVAs.
  
  
  RESULTS
  PPT values normalized to baseline recordings were not dependent on gender or assessment site, but dependent on intensity (P < .001) and time (P < .001). The most painful CS (VAS5) was associated with the highest PPT increases (32.6% ± 3.3%, mean value for the two assessment sites and two genders) during CS compared to all other intensities of CS (P < .001). PPTol values normalized to baseline recordings were also not dependent on gender or assessment site, but dependent on intensity (P < .001) and time (P < .001). The most painful CS (VAS5) was associated with higher PPTol increases (11.2% ± 2.8%, mean value for the two assessment sites and two genders) during CS (P < .001).
  
  
  CONCLUSIONS
  CPM evoked by mechanical stimulation of the craniofacial region is intensity-dependent but not assessment site- or gender-dependent.
authors.affiliation: Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Oono
authors.forename: Kelun
authors.initials: K
authors.lastname: Wang
authors.forename: Peter
authors.initials: P
authors.lastname: Svensson
authors.forename: Lars
authors.initials: L
authors.lastname: Arendt-Nielsen
mesh_terms: D000293:Adolescent; D000328:Adult; D003213:Conditioning, Psychological / Q000502:physiology*; D005157:Facial Pain / Q000503:physiopathology*; D056228:Feedback, Sensory / Q000502:physiology; D005260:Female; D005542:Forearm / Q000503:physiopathology; D005624:Frontal Bone; D006801:Humans; D008297:Male; D008406:Masseter Muscle / Q000503:physiopathology; D018482:Muscle, Skeletal / Q000503:physiopathology; D009777:Occipital Bone; D010146:Pain / Q000503:physiopathology*; D010147:Pain Measurement; D017288:Pain Threshold / Q000502:physiology*; D010812:Physical Stimulation; D011312:Pressure; D013997:Time Factors; D055815:Young Adult