{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T13:43:36Z","timestamp":1791639816627,"version":"4.3.4"},"reference-count":60,"publisher":"Wiley","issue":"24","license":[{"start":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T00:00:00Z","timestamp":1728432000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Physiology"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec><jats:title>Abstract<\/jats:title><jats:p>The autonomic nervous system (ANS) and pain exhibit a reciprocal relationship, where acute pain triggers ANS responses, whereas resting ANS activity can influence pain perception. Nociceptive signalling can also be altered by \u2018top\u2010down\u2019 processes occurring in the brain, brainstem and spinal cord, known as \u2018descending modulation\u2019. By employing the conditioned pain modulation (CPM) paradigm, we previously revealed a connection between reduced low\u2010frequency heart rate variability and CPM. Individuals with chronic pain often experience both ANS dysregulation and impaired CPM. Baroreceptors, which contribute to blood pressure and heart rate variability regulation, may play a significant role in this relationship, although their involvement in pain perception and their functioning in chronic pain have not been sufficiently explored. In the present study, we combined artificial \u2018baroreceptor stimulation\u2019 in both pressure pain and CPM paradigms, seeking to explore the role of baroreceptors in pain perception and descending modulation. In total, 22 individuals with chronic low back pain (CLBP) and 29 individuals with no\u2010pain (NP) took part in the present study. We identified a differential modulation of baroreceptor stimulation on pressure pain between the groups of NP and CLBP participants. Specifically, NP participants perceived less pain in response to baroreflex activation, whereas CLBP participants exhibited increased pain sensitivity. CPM scores were associated with baseline measures of baroreflex sensitivity in both CLBP and NP participants. Our data support the importance of the baroreflex in chronic pain and a possible mechanism of dysregulation involving the interaction between the ANS and descending pain modulation.\n<jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/tjp16353-gra-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec><jats:sec><jats:title>Key points<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Baroreflex stimulation has different effects on pressure pain in participants with chronic pain compared to matched individuals with no\u2010pain.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Baroreceptor activation decreases pain in participants with no\u2010pain but increases pain perception in participants with chronic pain.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Baroreflex sensitivity is associated with conditioned pain modulation in both groups of chronic pain and no\u2010pain participants.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>The reactivity of the baroreflex during autonomic stress demonstrated a positive correlation with Pain Trait scores in participants with chronic back pain.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec>","DOI":"10.1113\/jp286375","type":"journal-article","created":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T18:08:16Z","timestamp":1728497296000},"page":"6941-6957","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Investigating the effects of artificial baroreflex stimulation on pain perception: A comparative study in no\u2010pain and chronic low back pain individuals"],"prefix":"10.1113","volume":"602","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-9074-7025","authenticated-orcid":false,"given":"Alessandra","family":"Venezia","sequence":"first","affiliation":[{"name":"Department of Neuroimaging, Institute of Psychology, Psychiatry &amp; Neuroscience King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harriet","family":"Fawsitt\u2010Jones","sequence":"additional","affiliation":[{"name":"Department of Neuroimaging, Institute of Psychology, Psychiatry &amp; Neuroscience King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Hohenschurz\u2010Schmidt","sequence":"additional","affiliation":[{"name":"Department of Surgery &amp; Cancer Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Mancini","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Endocrine\u2010Metabolic Diseases and Aging Italian National Institute of Health  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9359-3057","authenticated-orcid":false,"given":"Matthew","family":"Howard","sequence":"additional","affiliation":[{"name":"Department of Neuroimaging, Institute of Psychology, Psychiatry &amp; Neuroscience King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Makovac","sequence":"additional","affiliation":[{"name":"Department of Neuroimaging, Institute of Psychology, Psychiatry &amp; Neuroscience King's College London  London UK"},{"name":"Department of Life Sciences, Division of Psychology Brunel University London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,9]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.22013"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S33559"},{"key":"e_1_2_5_4_1","doi-asserted-by":"crossref","unstructured":"Bolanos M. Nazeran H. &Haltiwanger E.(2006).Comparison of heart rate variability signal features derived from electrocardiography and photoplethysmography in NO\u2010PAINindividuals. 2006 International Conference of the IEEE Engineering in Medicine and Biology Society","DOI":"10.1109\/IEMBS.2006.260607"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1207\/s15327558ijbm0501_5"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-006-1070-3"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2013.04.027"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2007.11.011"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpsycho.2022.03.001"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.2012.232314"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/PR9.0000000000000735"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2011.06.008"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpain.2008.02.007"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpsycho.2007.03.012"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/1469-8986.00076"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00540-012-1363-0"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1207\/s15327558ijbm0103_3"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1113\/expphysiol.2012.066191"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-8760(98)00024-5"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.21315"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2010.09.028"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1152\/jn.00998.2014"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2020.117178"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2019.12.010"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000689"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/536859"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1542-474X.2008.00219.x"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpregu.00709.2002"},{"key":"e_1_2_5_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(81)90333-X"},{"key":"e_1_2_5_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejp.1633"},{"key":"e_1_2_5_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cortex.2017.07.002"},{"key":"e_1_2_5_32_1","doi-asserted-by":"publisher","DOI":"10.1038\/npp.2015.10"},{"key":"e_1_2_5_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000002427"},{"key":"e_1_2_5_34_1","doi-asserted-by":"publisher","DOI":"10.1113\/JP282013"},{"key":"e_1_2_5_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000000778"},{"key":"e_1_2_5_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpain.2010.10.001"},{"key":"e_1_2_5_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/SPC.0000000000000126"},{"key":"e_1_2_5_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2018.01.010"},{"key":"e_1_2_5_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/PR9.0000000000001032"},{"key":"e_1_2_5_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2013.01.780"},{"key":"e_1_2_5_41_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00221-014-3997-7"},{"key":"e_1_2_5_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejp.533"},{"key":"e_1_2_5_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-8760(97)00058-5"},{"key":"e_1_2_5_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2010.05.013"},{"key":"e_1_2_5_45_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-010-0098-y"},{"key":"e_1_2_5_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8986.1994.tb01051.x"},{"key":"e_1_2_5_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmn.2019.08.001"},{"key":"e_1_2_5_48_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0241154"},{"key":"e_1_2_5_49_1","doi-asserted-by":"publisher","DOI":"10.1111\/psyp.12027"},{"key":"e_1_2_5_50_1","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.2003.059444"},{"key":"e_1_2_5_51_1","doi-asserted-by":"publisher","DOI":"10.1111\/jch.12145"},{"key":"e_1_2_5_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2012.03.119"},{"key":"e_1_2_5_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2023.08.002"},{"key":"e_1_2_5_54_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12471-012-0346-y"},{"key":"e_1_2_5_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmpb.2013.07.024"},{"key":"e_1_2_5_56_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000360"},{"key":"e_1_2_5_57_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001384"},{"key":"e_1_2_5_58_1","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pny305"},{"key":"e_1_2_5_59_1","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.23199"},{"key":"e_1_2_5_60_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2015.08.060"},{"key":"e_1_2_5_61_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2020.00330"}],"container-title":["The Journal of Physiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/physoc.onlinelibrary.wiley.com\/doi\/pdf\/10.1113\/JP286375","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T05:36:53Z","timestamp":1739252213000},"score":1,"resource":{"primary":{"URL":"https:\/\/physoc.onlinelibrary.wiley.com\/doi\/10.1113\/JP286375"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,9]]},"references-count":60,"journal-issue":{"issue":"24","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1113\/JP286375"],"URL":"https:\/\/doi.org\/10.1113\/jp286375","archive":["Portico"],"relation":{},"ISSN":["0022-3751","1469-7793"],"issn-type":[{"value":"0022-3751","type":"print"},{"value":"1469-7793","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,9]]},"assertion":[{"value":"2024-02-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}