DOI: 10.1097/j.pain.0000000000004080 ISSN: 0304-3959

Temporal contrast enhancement in auditory and nociceptive processing

Jakob Poehlmann, Tibor M. Szikszay, Luisa Luebke, Waclaw M. Adamczyk, Kerstin Luedtke, Malte Wöstmann

Abstract

Temporal contrast enhancement (TCE), also termed offset analgesia, describes a temporal filtering mechanism, whereby a small decrease in stimulus intensity produces a disproportionately large reduction in perceived pain. Although TCE is considered a robust marker of endogenous pain modulation, its underlying mechanisms remain unresolved. It is unclear whether TCE reflects a nociceptive-specific modulatory process or a supramodal temporal filtering mechanism that generalizes to nonpainful but aversive sensory stimulation. In this study, healthy and pain-free participants were enrolled in 2 experiments: a behavioral study (n = 33) or a neurophysiological study (n = 29). Continuous pain ratings, electroencephalography (EEG), and pupillometry data were collected. A conventional TCE paradigm was applied using either noxious heat delivered via a thermal contact stimulator or unpleasant auditory stimulation delivered through over-ear headphones. Both noxious heat and unpleasant sounds induced behavioral TCE effects ( P < 0.01), indicating a supramodal mechanism with modality-specific temporal dynamics, which was further supported by the absence of a significant correlation of TCE effects across modalities ( P > 0.05). In the second experiment, noxious heat—but not unpleasant sound—resulted in decreased power of neural alpha oscillations (∼10 Hz, P < 0.05) and increased pupil size ( P < 0.05), potentially indicating bottom-up modulation of the autonomic nervous system and a release of neural inhibition, respectively. However, subjectively experienced TCE effects were not reflected in neurophysiological correlates. These findings are consistent with the view of TCE as a supramodal temporal filtering mechanism characterized by modality-specific temporal dynamics, for which no corresponding signatures are found in EEG or pupillometry.

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