Dissociation between pain and the nociceptive blink reflex during psychological arousal.

OBJECTIVE: To investigate the effect of psychological arousal on pain ratings and the R2 component of the electrically evoked blink reflex to a 'pure' noiciceptive stimulus. METHODS: Pain ratings and R2 to a noiciceptive stimulus (pulse width 0.3ms, 2mA, delivered from a concentric electrode attached to the supraorbital region of the forehead) were investigated in 16 healthy participants before and during a serial subtraction task, and in 16 control participants who sat quietly during nociceptive stimulation. RESULTS: Pain ratings decreased whereas R2 amplitude increased during the serial subtraction task. CONCLUSIONS: Supra-spinal rather than spinal mechanisms inhibited pain perception during psychological arousal. Moreover, psychological arousal facilitated the R2 component of the blink reflex to a nociception-specific stimulus. SIGNIFICANCE: Supra-spinal influences need to be considered during clinical evaluation of the trigeminal nociceptive blink reflex.