Congenital Blindness Results in Lower Thermal Pain Thresholds

Absence of vision from birth leads to a permanent state of pain hypersensitivity, reports PAIN®

Philadelphia, PA, November 1, 2013

An international team of scientists investigated whether congenitally blind subjects experience pain differently than sighted individuals. Their results, published in the current issue of PAIN®, reveal compelling evidence that congenitally blind individuals are hypersensitive to pain caused by thermal stimuli.

The findings are important because a key biological function of acute pain is to prevent bodily injury. Vision plays a critical role, as it allows a person to immediately detect and avoid potentially hazardous situations. Previous studies conducted in normal-sighted individuals had already demonstrated the link between vision and pain perception. The research team hypothesized that the absence of visual cues may therefore lead to heightened vigilance for painful stimuli.

Investigators recruited one group of 11 congenitally blind and 15 normal-sighted participants from Italy and a second group of 18 congenitally blind and 18 normal-sighted participants from Denmark. They conducted three experiments. The first compared pain thresholds and responses to suprathreshold pain (pain of sufficient intensity to produce a physiologic effect) stimuli among members of both groups. The second measured detection thresholds for warmth and cold perceptions. The third tested whether study results could be reproduced in an independent study population with culturally distinct ways of responding to pain.

Researchers used thermal probes on the medial forearm to measure thresholds of pain. The congenitally blind participants were allowed to touch the equipment beforehand and received verbal descriptions to reduce any anxiety. Sighted subjects were blindfolded during the actual testing. All subjects reported feelings of heat or cold pain through use of a response button. To assess suprathreshold pain, the researchers used a laser stimulation device. All participants completed a pain vigilance and awareness questionnaire, which allowed researchers to gather information on attitudes toward pain in daily life.

The study team found that compared with sighted subjects, congenitally blind subjects have lower heat pain thresholds, rate suprathreshold heat pain stimuli as more painful than the normal-sighted reported, and have increased sensitivity to cold pain stimuli.

In addition, interesting cultural differences emerged. "There is evidence that, compared to people from northern countries (e.g., Denmark), people in southern countries (e.g., Italy) are more emotionally expressive and responsive to pain," says lead investigator Ron Kupers, PhD, Director of the BRAINlab, Department of Neuroscience and Pharmacology, Faculty of Health and Medical Sciences—Panum Institute, University of Copenhagen, Denmark.

The results of the pain questionnaires further demonstrated that blind subjects are more attentive to external threat signals. Dr. Kupers concludes, "We have shown that the absence of vision from birth induces a hypersensitivity to painful stimuli, lending new support to a model of sensory integration of vision and pain processing."

In a commentary accompanying the article, Flavia Mancini, PhD, Institute of Cognitive Neuroscience, University College London, United Kingdom, says, "The novel finding of pain hypersensitivity in blindness has several important implications for both basic and clinical science. This study is noteworthy for research on multisensory interactions and plasticity, because it shows a strong link between vision and pain. The next step is to understand the nature of the interaction between visual loss and pain sensitivity. Which aspect of pain processing is involved in the interplay with vision, and what is its neural basis? The hope is that this work will open the door to pain investigations into the world of sensory loss, left unexplained for too long."

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Notes for editors
"Hypersensitivity to Pain in Congenital Blindness," by Hocine Slimani, MSc; Sabrina Danti, PhD; Emiliano Ricciardi, MD, PhD; Pietro Pietrini, MD, PhD; Maurice Ptito, PhD; Ron C. Kupers, PhD (DOI: http://dx.doi.org/10.1016/j.pain.2013.05.036).

"Focus on Pain in the Blind," by Flavia Mancini, PhD (DOI: http://dx.doi.org/10.1016/j.pain.2013.06.029)

They appear in PAIN, Volume 154, Issue 10 (October 2013) published by Elsevier.

Full text of the articles is available to credentialed journalists upon request. Contact Terry Materese at +1 215 239 3196 or painmedia@elsevier.com for copies. Journalists wishing to set up interviews with Ron Kupers may contact him directly at +45 249 596 24 or kupers@sund.ku.dk. Flavia Mancini may be contacted at f.mancini@ucl.ac.uk.

About PAIN®
PAIN®, the official journal of the International Association for the Study of Pain® (IASP®), publishes 12 issues per year of original research on the nature, mechanisms, and treatment of pain. This peer-reviewed journal provides a forum for the dissemination of research in the basic and clinical sciences of multidisciplinary interest and is cited in Current Contents and MEDLINE. It continues to be ranked No.1 out of the 29 journals in the Anesthesiology category, according to the 2012 Journal Citation Reports, published by Thomson Reuters. www.painjournalonline.com

About the International Association For The Study of Pain® (IASP®)
IASP® is the world's largest multidisciplinary organization focused specifically on pain research and treatment. It is the leading professional forum for science, practice, and education in the field of pain, bringing together scientists, clinicians, health-care providers, and policymakers to stimulate and support the study of pain and to translate that knowledge into improved pain relief worldwide. Founded in 1973, IASP has nearly 8,000 members from 133 countries and in 90 chapters. www.iasp-pain.org

About Elsevier

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Media contact
Terry Materese
(o) +1 215 239 3196
(m) +1 215 327 9934
painmedia@elsevier.com