Pain
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The interaction between intensity of nociceptive stimuli and cognitive load in a concomitant task is still a challenging and complex topic. Here, we investigated the interaction between top-down factors (i.e., perceptual load), induced by a visual task, and bottom-up factors (i.e., intensity of nociceptive stimuli that implicitly modifies saliency of input). Using a new experimental paradigm, in which perceptual load is varied while laser heat stimuli of different intensities are processed; we show a significant interaction between intensity of nociceptive stimuli and perceptual load on both pain ratings and task performance. ⋯ However, under this condition, task performance was impaired, regardless of interindividual differences in motivation and pain catastrophizing. Thus, we showed that pain ratings can be reduced by increasing the load of attentional resources at the perceptual level of a non-pain-related task. Nevertheless, the disruptive effect of highly intensive nociceptive stimuli on the performance of the perceptual task was evident only under high load.
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Drug-resistant chronic cluster headache (CH) is an unremitting illness with excruciatingly severe headaches that occur several times daily. Starting in 2000, a total of 19 patients with long-lasting chronic CH, with multiple daily attacks unresponsive to all known prophylactics, received stimulation of the posterior inferior hypothalamic area ipsilateral to the pain as treatment. We report long-term follow-up (median 8.7 years, range 6-12 years) in 17 patients. ⋯ This exceptionally long follow-up shows that hypothalamic stimulation for intractable chronic CH produces long-lasting improvement in many patients. Previous experience was limited to a median of 16 months. Important new findings are as follows: stimulation is well tolerated for many years after implantation; after several years during which stimulation was necessary for relief, a persistent almost pain-free condition can be maintained when stimulation is off, suggesting that hypothalamic stimulation can change disease course; tolerance can occur after marked long-lasting improvement; and bilateral chronic CH seems to predict poor response to hypothalamic stimulation.
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Comparative Study
Ethnic differences in physical pain sensitivity: role of acculturation.
Although research suggests that Asian Americans are more reactive to physical pain than European Americans, some evidence suggests that the observed differences in ethnicity may actually reflect Asian Americans' differing levels of acculturation. Two studies were conducted to test this hypothesis. ⋯ Study 2 further controlled for ethnicity and replicated this pattern in finding heightened pain reactions among mainland Chinese students in Hong Kong relative to Hong Kong Chinese students. These findings suggest a role for acculturation in accounting for ethnic differences in physical pain sensitivity.