Psychophysic-psychological dichotomy in very early acute mTBI pain: A prospective study

Pora Kuperman, Yelena Granovsky, Michal Granot, Hany Bahouth, Shiri Fadel, Gila Hyams, Hen Ben Lulu, Osnat Aspis, Rabia Salame, Julia Begal, David Hochstein, Shahar Grunner, Liat Honigman, Maya Reshef, Elliot Sprecher, Noam Bosak, Michele Sterling, David Yarnitsky

Research output: Contribution to journalArticlepeer-review


OBJECTIVE: To characterize the pain-related somatosensory and psychological presentation of very early acute patients with a mild traumatic brain injury (mTBI). METHODS: Patients with an mTBI participated in a prospective observational study undergoing clinical, psychophysic, and psychological assessment within 72 hours after the accident. Healthy controls underwent similar protocol. RESULTS: One hundred acute patients with an mTBI (age 36 ± 12.5 [SD] years, range 19-67 years, 42 women) and 80 healthy controls (age 43 ± 14.3 years, range 24-74 years, 40 women) participated. Patients with an mTBI demonstrated a pronociceptive psychophysic response in most tests such as less efficient pressure-pain threshold-conditioned pain modulation (0.19 ±0.19±.09 vs. 0.91±.10 kg, p < 0.001) and lower temperature needed to elicit a Pain50 response (44.72 ± 0.26°C vs 46.41 ± 0.30°C, p < 0.001). Their psychophysic findings correlated with clinical pain measures, e.g., Pain50 temperature and mean head (r = -0.21, p = 0.045) and neck (r = -0.26, p = 0.011) pain. The pain-catastrophizing magnification subscale was the only psychological variable to show a difference from the controls, while no significant correlations were found between any psychological measures and the clinical or psychophysic pain measures. CONCLUSIONS: There appears to be a dichotomy between somatosensory and psychological findings in the very early acute post-mTBI stage; while the first is altered and is associated with the clinical picture, the second is unchanged. In the context of the ongoing debate on the pathophysiologic nature of the post-mTBI syndrome, our findings support its "physical" basis, free of mental influence, at least in the short time window after the injury.

Original languageEnglish
Pages (from-to)e931-e938
Issue number10
StatePublished - 4 Sep 2018

Bibliographical note

Publisher Copyright:
© 2018 American Academy of Neurology.

ASJC Scopus subject areas

  • Clinical Neurology


Dive into the research topics of 'Psychophysic-psychological dichotomy in very early acute mTBI pain: A prospective study'. Together they form a unique fingerprint.

Cite this