naa a22 c 4500 1988388694 DE-627 20261105072331.0 cr uuu---uuuuu 261105s2026 xx |||||o 00| ||eng c 10.1002/ejp.70287 doi (DE-627)1988388694 (DE-599)KXP1988388694 DE-627 ger DE-627 rda eng Lin, Yi-Wun 1996- VerfasserIn (DE-588)1423875532 (DE-627)1988390907 aut Conditioned pain modulation inter-site variability study effect sizes and test-retest reliability of two models Yi-Wun Lin, Hannah Schmidt, Niko Möller-Grell, Walter Magerl, Li-Ling Hope Pan, Shuu-Jiun Wang, Li-Wei Chou, Rolf-Detlef Treede May 2026 Diagramme 14 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Erstmals veröffentlicht: 4. Mai 2026 Gesehen am 05.11.2026 Background Conditioned pain modulation (CPM) is a set of psychophysical paradigms that is increasingly used clinically to evaluate descending pain modulation pathways. Impairment is common in chronic pain, suggesting CPM may serve as a mechanistic indicator. However, the lack of protocol standardization and reference data prevents clinical use in individual patients. Methods We compared two CPM protocols with different conditioning stimulus intensities, test stimulus types, and interaction timing. We assessed CPM effect size, test-retest reliability and sensitivity to detect loss of descending inhibition. Results Conditioning with 0°C water led to stronger inhibition of pressure pain threshold (PPT) than conditioning with 7°C water (Cohen's d = 0.52), when tested immediately after conditioning. When tested during conditioning, effects of 7°C water immersion on heat pain sensitivity had similar magnitude (D = 0.53) and test-retest reliability (ICC = 0.77) as those on PPT (D = 0.54, ICC = 0.73). For all outcomes assessed, 95% confidence intervals (CI) of CPM effect included some facilitation instead of inhibition. The maximum degree of facilitation compatible with normal CPM (upper cutoff of CI) indicates potential sensitivity to detect individual abnormality. This was most favourable for PPT assessed after conditioning with 0°C water (decrease by more than 75 kPa or 14% of baseline PPT). Conclusions In conclusion, testing during conditioning stimulation yields medium to large effect sizes and good test-retest reliability. PPT testing immediately after ice water immersion has the narrowest 95% CI and hence offers the potential to generalize CPM assessments beyond group-level differences and compare inhibition among individuals in clinical practice. Significance Statement Indicating the main aspects where this work adds significantly to existing knowledge in the field, and if appropriate to clinical practice. Simultaneous CPM protocols exhibit large effect sizes but are confounded by divided attention. We recommend a sequential protocol and provide model reference data for abnormal facilitation. conditioned pain modulation heat pain sensitivity pressure pain threshold reference data test-retest reliability Schmidt, Hannah 1993- VerfasserIn (DE-588)1373186224 (DE-627)1932511954 aut Möller-Grell, Niko 1996- VerfasserIn (DE-588)1383819432 (DE-627)1945081171 aut Magerl, Walter VerfasserIn (DE-588)1028214235 (DE-627)730453138 (DE-576)37571247X aut Pan, Li-Ling Hope VerfasserIn aut Wang, Shuu-Jiun VerfasserIn aut Chou, Li-Wei VerfasserIn aut Treede, Rolf-Detlef 1956- VerfasserIn (DE-588)109865960 (DE-627)606699856 (DE-576)309492459 aut Enthalten in European journal of pain Malden, Mass. [u.a.] : Wiley-Blackwell, 1997 30(2026), 5 vom: Mai, Artikel-ID e70287, Seite 1-14 Online-Ressource (DE-627)320420485 (DE-600)2002493-9 (DE-576)267761791 1532-2149 nnas volume:30 year:2026 number:5 month:05 elocationid:e70287 pages:1-14 extent:14 https://doi.org/10.1002/ejp.70287 Verlag Resolving-System kostenfrei Volltext 0 https://onlinelibrary.wiley.com/doi/abs/10.1002/ejp.70287 Verlag kostenfrei Volltext 0 AR 000 xxxxxcx a22 zn 4500 001 5062268311 003 DE-627 004 1988388694 005 20261105101804 008 261105||||||||||||||||ger||||||| 040 DE-16-250 DE-627 DE-16-250 689 s hd2026 689 s 1410508463 wissenschaftlicher Artikel (Zeitschrift) 689 s per_8 689 s s_14 689 p 198839094X Lin, Yi-Wun 689 k 1416822720 Extern 689 s 1410501914 Verfasser 689 s pos_1 689 p 1932511946 Schmidt, Hannah 689 k 1693597993 Mannheim Center for Translational Neuroscience (MCTN) 689 k 1416467254 Medizinische Fakultät Mannheim 689 s 1410501914 Verfasser 689 s pos_2 689 p 1945081198 Möller-Grell, Niko 689 k 1416467254 Medizinische Fakultät Mannheim 689 k 1416466967 Medizinische Fakultät Heidelberg 689 s 1410501914 Verfasser 689 s pos_3 689 p 1445712970 Magerl, Walter 689 k 1693597993 Mannheim Center for Translational Neuroscience (MCTN) 689 s 1410501914 Verfasser 689 s pos_4 689 p 1445312557 Treede, Rolf-Detlef 689 k 1416467254 Medizinische Fakultät Mannheim 689 s 1410501914 Verfasser 689 s pos_8 852 DE-16-250 852 1 00 938 fl 938 11 939 2026-11-05 l01