Do you get what you expect? Studying the effect of expectations on high-frequency electrical stimulation-induced pain and pinprick hypersensitivity.

Abstract

This study investigated whether expecting more pain increases high-frequency electrical stimulation (HFS)-induced pain and pinprick hypersensitivity. Fifty healthy volunteers were randomly allocated to either a control group (N=25) or a nocebo group (N=25). Participants in both groups received a patch containing water on the right forearm. The nocebo group was told that the patch contained capsaicin that sensitized their skin, while the control group was told that the patch contained water that had no effect on skin sensitivity. Before and after patch attachment, single electrical stimuli were delivered to the area of the patch to measure the perceived intensity to these stimuli. After patch removal, and after the participant rated expected pain and fear for HFS, HFS was delivered to the same skin site. To assess changes in pinprick sensitivity, pinprick stimuli were delivered before and after HFS. The nocebo group rated the perceived intensity for the single electrical stimulus after removal of the patch as more intense compared to the control group, indicating that our manipulation worked. Yet, this effect did not transfer to expected pain for HFS, nor did it affect pain intensity ratings during HFS. HFS increased pinprick sensitivity but no group differences were found. Because of the lack of differences in expected pain and pain intensity ratings for HFS between groups, no firm conclusions can be drawn regarding their effect on pinprick hypersensitivity. Nevertheless, exploratory analyses showed a significant and moderate correlation between the expected pain for HFS and the actual pain intensity reported during HFS