Vagally mediated heart rate variability is a predictor for the occurrence of the thermal grill-induced pain illusion

Aim: Unpleasantness and negative affect accompany the sensory experience of pain. Both components of pain are heavily influenced by cognitive and emotional processes. In this framework, alterations in baroreceptor reactivity and concomitant changes in cardiac rhythm and blood pressure related to these processes contribute to the modulation of pain sensitivity. Furthermore, self-regulatory capacity has been shown to play a major role in the regulation of cognitive, affective, and behavioural reactions to adverse contexts. These regulatory mechanisms include adjustment of cardiovascular activity and heavily depend on prefrontal cortical processing. Vagally mediated heart rate variability (HRV) at rest is an indicator of the prefrontally modulated vagal activation and has been used as a psychophysiological marker for self-regulatory capacity.
The present study investigated the predictive value of the trait self-regulation in the triggering of the thermal grill-induced pain illusion (TGI). We hypothesized inter-individual differences in paradoxical pain perception to be predicted by self-regulatory capacity in a way that participants displaying lower levels of self-regulation should be more likely to perceive the painful grill illusion than subjects with relatively higher self-regulation ability.
Methods: A total of 54 healthy participants were recruited among university students and staff. A custom-built, water-bath driven thermal grill device, with interlaced cold and warm glass tubes, was used for the induction of the TGI. A pre-set temperature combination of 15°C and 41°C was applied to the palm of the dominant hand with stimulus durations of 1 min. Subsequent control conditions consisted in the interlaced combination of a baseline temperature of 32°C with one of the stimulus temperatures mentioned above. The procedure was repeated three times. The volunteers used numerical rating scales ranging from 0-100 to rate sensory and affective pain perceptions in intervals of 15 seconds. Vagally mediated HRV at rest was assessed prior to the thermal stimulation protocols.
Results: Time-domain components of HRV used as graded indicators of parasympathetic activity and of the extent of self-regulation significantly predicted the possibility of an occurrence of pain and unpleasantness sensations in response to thermal grill stimulation (p <.05). Participants characterized in this way were more likely to express paradoxical pain than subjects not displaying similar levels of HRV.
Conclusion: The present results support previous findings indicating an impact of several psychological traits on the individual disposition to paradoxical pain perceptions. Self-regulation ability, operationalized as vagally mediated heart rate variability, can partially explain the probability of perceived pain in response to non-noxious thermal grill stimulation.