Characterization of a novel model of tonic heat pain stimulation in healthy volunteers

The vast majority of the experimental pain studies have used acute, phasic heat stimuli to investigate the neurobiological mechanisms of pain. However, the validity of these models for understanding clinical forms of pain is questionable. We here describe the characteristics of a model of prolonged tonic heat pain stimulation and compared the responses on this test with other measures of pain. In 58 normal volunteers, we applied a 7-min lasting contact heat stimulation of 47 degrees C to the upper leg while participants constantly rated their pain. Average pain rating during the 7-min period was 6.2+/-0.4, females scoring higher than men (7.4+/-0.5 vs. 5.2+/-0.5; p<0.005). Pain ratings showed a steady increase during the first half of the stimulation period after which they stabilized. A strong interindividual variability was observed in the time profiles of the pain ratings over the course of the 7-min stimulation period. The model showed a good test-retest reproducibility. Tonic heat pain ratings only correlated moderately with the pain threshold while stronger correlations were observed with pain tolerance and ratings of suprathreshold phasic heat pain. We conclude that the tonic heat model is a suitable model that can be applied without excessive discomfort in the majority of subjects and offers a valuable addition to the armamentarium of experimental pain models. The model can be particularly suitable for brain imaging receptor binding studies which require long stimulation periods.