Personalized pain medicine: the clinical value of psychophysical assessment of pain modulation profile.
Experimental pain stimuli can be used to simulate patients' pain experience. We review recent developments in psychophysical pain testing, focusing on the application of the dynamic tests-conditioned pain modulation (CPM) and temporal summation (TS). Typically, patients with clinical pain of various types express either less efficient CPM or enhanced TS, or both. These tests can be used in prediction of incidence of acquiring pain and of its intensity, as well as in assisting the correct choice of analgesic agents for individual patients. This can help to shorten the commonly occurring long and frustrating process of adjusting analgesic agents to the individual patients. We propose that evaluating pain modulation can serve as a step forward in individualizing pain medicine.
Department of Neurology, Rambam Medical Center, and Clinical Neurophysiology Lab, Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
Yelena
Y
Granovsky
David
D
Yarnitsky
Conditioned pain modulation; individualized medicine; pain; psychophysics; temporal summation