Abstract
Background and Objective: Heart rate variability (HRV) as an index of the autonomic nervous system appears to be related to reactivity to experimental pain stimuli. HRV could better explain the contributions of sympathetic and parasympathetic activity response to nociceptive stimulation. The aim of this study was to systematically review and synthesize the current evidence on HRV in relation to the experience of pain in experimental tasks. Databases and Data Treatment: Studies indexed in the PubMed, PsycINFO, MEDLINE, WebOfScience, and Scopus databases were reviewed for eligibility. Studies on the autonomic response (i.e., HRV) to experimentally induced pain in healthy adults were included. Different methods of pain induction were considered (e.g., thermal, pressure, and electrical). Data were synthesized considering the association between HRV and both pain induction and subjective measures of pain. Results: Seventy-one studies were included. The results underline significant change in both the sympathetic and parasympathetic autonomic nervous systems during the painful stimulation independent of the pain induction method. The autonomic reaction to pain could be affected by several factors, such as sex, age, body mass index, breathing patterns, the intensity of the stimulation, and the affective state. Moreover, an association between the autonomic nervous system and the subjective experience of pain was found. Higher parasympathetic activity was associated with better self-regulation capacities and, accordingly, a higher pain inhibition capacity. Conclusions: HRV appears to be a helpful marker to evaluate nociceptive response in experimentally induced pain. Future studies are also needed in clinical samples to understand better the interindividual changes of autonomic response due to pain stimuli.
Highlights
Pain is defined as an aversive sensory and emotional experience typically caused by actual or potential tissue injury [1,2]
The findings suggest that placebo analgesia, induced administering a placebo, can increase Heart rate variability (HRV) and induce pain relief [37,50], consistent with the Neurovisceral Integration Model [19,25]
We can conclude that HRV is a good measure of autonomic reactivity to nociceptive stimulation
Summary
Pain is defined as an aversive sensory and emotional experience typically caused by (or resembling that caused by) actual or potential tissue injury [1,2]. Pain can be defined as “somatic” when it involves the skin, subcutaneous tissues, bones, muscles, blood vessels, or connective tissues or “visceral” when it affects the internal organs or the linings of the body cavities [5]. The former can arise from thermal, mechanical, and chemical stimuli, while the latter results from distension or prolonged contraction of the smooth muscle wall of the structure [6]. Heart rate variability (HRV) as an index of the autonomic nervous system appears to be related to reactivity to experimental pain stimuli. Studies on the autonomic response (i.e., HRV) to experimentally induced pain in healthy adults were included. Future studies are needed in clinical samples to understand better the interindividual changes of autonomic response due to pain stimuli
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