Psychological mechanisms of offset analgesia: The effect of expectancy manipulation

Tibor M. Szikszay*, Waclaw M. Adamczyk, Janina Panskus, Lotte Heimes, Carolin David, Philip Gouverneur, Kerstin Luedtke

*Corresponding author for this work


A frequently used paradigm to quantify endogenous pain modulation is offset analgesia, which is defined as a disproportionate large reduction in pain following a small decrease in a heat stimulus. The aim of this study was to determine whether suggestion influences the magnitude of offset analgesia in healthy participants. A total of 97 participants were randomized into three groups (hypoalgesic group, hyperalgesic group, control group). All participants received four heat stimuli (two constant trials and two offset trials) to the ventral, non-dominant forearm while they were asked to rate their perceived pain using a computerized visual analogue scale. In addition, electrodermal activity was measured during each heat stimulus. Participants in both intervention groups were given a visual and verbal suggestion about the expected pain response in an hypoalgesic and hyperalgesic manner. The control group received no suggestion. In all groups, significant offset analgesia was provoked, indicated by reduced pain ratings (p < 0.001) and enhanced electrodermal activity level (p < 0.01). A significant group difference in the magnitude of offset analgesia was found between the three groups (F[2,94] = 4.81, p < 0.05). Participants in the hyperalgesic group perceived significantly more pain than the hypoalgesic group (p = 0.031) and the control group (p < 0.05). However, the electrodermal activity data did not replicate this trend (p > 0.05). The results of this study indicate that suggestion can be effective to reduce but not increase endogenous pain modulation quantified by offset analgesia in healthy participants.

Original languageEnglish
Article numbere0280579
JournalPLoS ONE
Issue number1 January
Publication statusPublished - 01.2023

Research Areas and Centers

  • Health Sciences

DFG Research Classification Scheme

  • 206-05 Experimental Models for Investigating Diseases of the Nervous System
  • 206-08 Cognitive and Systemic Human Neuroscience

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