Clinically feasible TENS-pressure-cuff paradigm for conditioned pain modulation

Abstract

Conditioned pain modulation (CPM) assesses the attenuation of pain when a concurrent noxious stimulus is applied and is linked to prognosis in pain syndromes. Clinical implementation remains constrained by response variability and equipment requirements. The objective of this study was to assess the feasibility, variability, and reliability of a novel, user-friendly transcutaneous electrical nerve stimulation (TENS)-pressure-cuff CPM paradigm and compare it to a conventional algometry-pressure-cuff paradigm. A TENS-pressure-cuff paradigm is a suitable approach for assessing CPM. Its variability and inter-session reliability are comparable to a conventional algometry-pressure-cuff paradigm, while exhibiting higher inter-rater reliability and sensitivity to detect inhibitory CPM responses. Further research should evaluate the utility of this paradigm in pathological populations.