Supra-threshold scaling, temporal summation, and after-sensation: relationships to each other and anxiety/fear

Michael E Robinson¹, Joel E Bialosky², Mark D Bishop², Donald D Price³, Steven Z George²

¹Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA; ²Department of Physical Therapy, University of Florida, Gainesville, FL, USA; ³Dentistry and Neurosciences, University of Florida,  Gainesville, FL, USA

Abstract: This study investigated the relationship of thermal pain testing from three types of quantitative sensory testing (ie, supra-threshold stimulus response scaling, temporal summation, and after-sensation) at three anatomical sites (ie, upper extremity, lower extremity, and trunk). Pain ratings from these procedures were also compared with common psychological measures previously shown to be related to experimental pain responses and consistent with fear-avoidance models of pain. Results indicated that supra-threshold stimulus response scaling, temporal summation, and after-sensation, were significantly related to each other. The site of stimulation was also an important factor, with the trunk site showing the highest sensitivity in all three quantitative sensory testing procedures. Supra-threshold response measures were highly related to measures of fear of pain and anxiety sensitivity for all stimulation sites. For temporal summation and after-sensation, only the trunk site was significantly related to anxiety sensitivity, and fear of pain, respectively. Results suggest the importance of considering site of stimulation when designing and comparing studies. Furthermore, psychological influence on quantitative sensory testing is also of importance when designing and comparing studies. Although there was some variation by site of stimulation, fear of pain and anxiety sensitivity had consistent influences on pain ratings.

Keywords: experimental pain, temporal summation, after-sensation, fear/avoidance, anxiety