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Reduction of conditioned pain modulation in humans by naltrexone: an exploratory study of the effects of pain catastrophizing

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Abstract

The current study tested the hypothesis that conditioned pain modulation is mediated by the release of endogenous opioids with a placebo-controlled (sugar pill) study of naltrexone (50 mg) in 33 healthy volunteers over two counter-balanced sessions. Pain modulation consisted of rating of heat pain (palm) during concurrent cold water immersion (foot). Compared to baseline heat pain ratings, concurrent foot immersion lowered pain intensity ratings, which suggests an inhibitory effect, was reduced with naltrexone, suggesting at least partial dependence of inhibition on endogenous opioids. An exploratory analysis revealed that individual differences in catastrophizing moderated the effects of naltrexone; endogenous opioid blockade abolished modulation in subjects lower in catastrophizing while modulation was unaffected by naltrexone among high catastrophizers. The results suggest a role of endogenous opioids in endogenous analgesia, but hint that multiple systems might contribute to conditioned pain modulation, and that these systems might be differentially activated as a function of individual differences in responses to pain.

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References

  • al’Absi, M., Wittmers, L. E., Ellestad, D., Nordehn, G., Kim, S. W., Kirschbaum, C., et al. (2004). Sex differences in pain and hypothalamic-pituitary-adrenocortical responses to opioid blockade. Psychosomatic Medicine, 66, 198–206.

    Article  PubMed  Google Scholar 

  • Bandura, A., O’Leary, A., Taylor, C. B., Gauthier, J., & Gossard, D. (1987). Perceived self-efficacy and pain control: Opioid and nonopioid mechanisms. Journal of Personality and Social Psychology, 53, 563–571.

    Article  PubMed  CAS  Google Scholar 

  • Bartley, E. J., & Rhudy, J. L. (2008). The influence of pain catastrophizing on experimentally induced emotion and emotional modulation of nociception. J Pain, 9, 388–396.

    Article  PubMed  Google Scholar 

  • Basbaum, A. I., & Fields, H. L. (1984). Endogenous pain control systems: Brainstem spinal pathways and endorphin circuitry. Annual Review of Neuroscience, 7, 309–338.

    Article  PubMed  CAS  Google Scholar 

  • Bouhassira, D., Bing, Z., & Lebars, D. (1993). Studies of brain structures involved in diffuse noxious inhibitory controls in the rat—the rostral ventromedial medulla. Journal of Physiology-London, 463, 667–687.

    CAS  Google Scholar 

  • Bruehl, S., Burns, J. W., Chung, O. Y., Magid, E., Chont, M., Gilliam, W., et al. (2010). Hypoalgesia associated with elevated resting blood pressure: Evidence for endogenous opioid involvement. Journal of Behavioral Medicine, 33, 168–176.

    Article  PubMed  Google Scholar 

  • Bruehl, S., Chung, O. Y., Ward, P., Johnson, B., & McCubbin, J. A. (2002). The relationship between resting blood pressure and acute pain sensitivity in healthy normotensives and chronic back pain sufferers: The effects of opioid blockade. Pain, 100, 191–201.

    Article  PubMed  CAS  Google Scholar 

  • Burns, J. W., Bruehl, S., Chung, O. Y., Magid, E., Chont, M., Goodlad, J. K., et al. (2009). Endogenous opioids may buffer effects of anger arousal on sensitivity to subsequent pain. Pain, 146, 276–282.

    Article  PubMed  CAS  Google Scholar 

  • Campbell, C. M., & Edwards, R. R. (2009). Mind-body interactions in pain: The neurophysiology of anxious and catastrophic pain-related thoughts. Translational Research, 153, 97–101.

    Article  PubMed  Google Scholar 

  • Campbell, C. M., Kronfli, T., Buenaver, L. F., Smith, M. T., Berna, C., Haythornthwaite, J. A., et al. (2010a). Situational versus dispositional measurement of catastrophizing: Associations with pain responses in multiple samples. The Journal of Pain, 11, 443 e442–453 e442.

  • Campbell, C. M., Witmer, K., Simango, M., Carteret, A., Loggia, M. L., Campbell, J. N., et al. (2010b). Catastrophizing delays the analgesic effect of distraction. Pain, 149, 202–207.

    Article  PubMed  Google Scholar 

  • Cano, A., Leonard, M. T., & Franz, A. (2005). The significant other version of the Pain Catastrophizing Scale (PCS-S): Preliminary validation. Pain, 119, 26–37.

    Article  PubMed  Google Scholar 

  • Casale, G., Pecorini, M., Cuzzoni, G., & de Nicola, P. (1985). Beta-endorphin and cold pressor test in the aged. Gerontology, 31, 101–105.

    Article  PubMed  CAS  Google Scholar 

  • Chitour, D., Dickenson, A. H., & Lebars, D. (1982). Pharmacological evidence for the involvement of serotonergic mechanisms in diffuse noxious inhibitory controls (DNIC). Brain Research, 236, 329–337.

    Article  PubMed  CAS  Google Scholar 

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: L. Erlbaum Associates.

    Google Scholar 

  • Crabtree, B. L. (1984). Review of naltrexone, a long-acting opiate antagonist. Clin Pharm, 3, 273–280.

    PubMed  CAS  Google Scholar 

  • Edwards, R. R. (2005). Individual differences in endogenous pain modulation as a risk factor for chronic pain. Neurology, 65, 437–443.

    Article  PubMed  Google Scholar 

  • Edwards, R. R., Campbell, C. M., & Fillingim, R. B. (2005). Catastrophizing and experimental pain sensitivity: Only in vivo reports of catastrophic cognitions correlate with pain responses. The Journal of Pain, 6, 338–339.

    Article  PubMed  Google Scholar 

  • Edwards, R. R., Fillingim, R. B., & Ness, T. J. (2003). Age-related differences in endogenous pain modulation: A comparison of diffuse noxious inhibitory controls in healthy older and younger adults. Pain, 101, 155–165.

    Article  PubMed  Google Scholar 

  • Edwards, R. R., Kronfli, T., Haythornthwaite, J. A., Smith, M. T., McGuire, L., & Page, G. G. (2008). Association of catastrophizing with interleukin-6 responses to acute pain. Pain, 140, 135–144.

    Article  PubMed  CAS  Google Scholar 

  • Edwards, R. R., Ness, T. J., & Fillingim, R. B. (2004). Endogenous opioids, blood pressure, and diffuse noxious inhibitory controls: A preliminary study. Perceptual and Motor Skills, 99, 679–687.

    PubMed  Google Scholar 

  • Edwards, R. R., Smith, M. T., Stonerock, G., & Haythornthwaite, J. A. (2006). Pain-related catastrophizing in healthy women is associated with greater temporal summation of and reduced habituation to thermal pain. Clinical Journal of Pain, 22, 730–737.

    Article  PubMed  Google Scholar 

  • France, C. R., al’Absi, M., Ring, C., France, J. L., Harju, A., & Wittmers, L. E. (2007). Nociceptive flexion reflex and pain rating responses during endogenous opiate blockade with naltrexone in healthy young adults. Biological Psychology, 75, 95–100.

    Article  PubMed  Google Scholar 

  • Frid, M., Singer, G., & Rana, C. (1979). Interactions between personal expectations and naloxone: Effects on tolerance to ischemic pain. Psychopharmacology (Berlin), 65, 225–231.

    Article  CAS  Google Scholar 

  • Gjerstad, J., Tjolsen, A., Svendsen, F., & Hole, K. (2000). Inhibition of spinal nociceptive responses after intramuscular injection of capsaicin involves activation of noradrenergic and opioid systems. Brain Research, 859, 132–136.

    Article  PubMed  CAS  Google Scholar 

  • Goffaux, P., de Souza, J. B., Potvin, S., & Marchand, S. (2009). Pain relief through expectation supersedes descending inhibitory deficits in fibromyalgia patients. Pain, 145, 18–23.

    Article  PubMed  Google Scholar 

  • Goffaux, P., Redmond, W. J., Rainville, P., & Marchand, S. (2007). Descending analgesia—when the spine echoes what the brain expects. Pain, 130, 137–143.

    Article  PubMed  Google Scholar 

  • Gonzalez, J. P., & Brogden, R. N. (1988). Naltrexone. A review of its pharmacodynamic and pharmacokinetic properties and therapeutic efficacy in the management of opioid dependence. Drugs, 35, 192–213.

    Article  PubMed  CAS  Google Scholar 

  • Goodin, B. R., McGuire, L. M., Stapleton, L. M., Quinn, N. B., Fabian, L. A., Haythornthwaite, J. A., et al. (2009). Pain catastrophizing mediates the relationship between self-reported strenuous exercise involvement and pain ratings: Moderating role of anxiety sensitivity. Psychosomatic Medicine, 71, 1018–1025.

    Article  PubMed  Google Scholar 

  • Gracely, R. H., Geisser, M. E., Giesecke, T., Grant, M. A., Petzke, F., Williams, D. A., et al. (2004). Pain catastrophizing and neural responses to pain among persons with fibromyalgia. Brain, 127, 835–843.

    Article  PubMed  CAS  Google Scholar 

  • Granot, M., Granovsky, Y., Sprecher, E., Nir, R. R., & Yarnitsky, D. (2006). Contact heat-evoked temporal summation: Tonic versus repetitive-phasic stimulation. Pain, 122, 295–305.

    Article  PubMed  Google Scholar 

  • Granot, M., Weissman-Fogel, I., Crispel, Y., Pud, D., Granovsky, Y., Sprecher, E., et al. (2008). Determinants of endogenous analgesia magnitude in a diffuse noxious inhibitory control (DNIC) paradigm: Do conditioning stimulus painfulness, gender and personality variables matter? Pain, 136, 142–149.

    Article  PubMed  Google Scholar 

  • Heymen, S., Maixner, W., Whitehead, W. E., Klatzkin, R. R., Mechlin, B., & Light, K. C. (2010). Central processing of noxious somatic stimuli in patients with irritable bowel syndrome compared with healthy controls. Clinical Journal of Pain, 26, 104–109.

    Article  PubMed  Google Scholar 

  • Jiang, J. B., Hanson, R. N., Portoghese, P. S., & Takemori, A. E. (1977). Stereochemical studies on medicinal agents. 23. Synthesis and biological evaluation of 6-amino derivatives of naloxone and naltrexone. Journal of Medicinal Chemistry, 20, 1100–1102.

    Article  PubMed  CAS  Google Scholar 

  • Kelly, S. J., & Franklin, K. B. (1987). Role of peripheral and central opioid activity in analgesia induced by restraint stress. Life Sciences, 41, 789–794.

    Article  PubMed  CAS  Google Scholar 

  • King, C. D., Devine, D. P., Vierck, C. J., Mauderli, A., & Yezierski, R. P. (2007). Opioid modulation of reflex versus operant responses following stress in the rat. Neuroscience, 147, 174–182.

    Article  PubMed  CAS  Google Scholar 

  • King, C. D., Wong, F., Currie, T., Mauderli, A. P., Fillingim, R. B., & Riley, J. L., I. I. I. (2009). Deficiency in endogenous modulation of prolonged heat pain in patients with irritable bowel syndrome and temporomandibular disorder. Pain, 143, 172–178.

    Article  PubMed  Google Scholar 

  • Kotlyar, M., al’Absi, M., Brauer, L. H., Grant, J. E., Fong, E., & Kim, S. W. (2008). Naltrexone effect on physiological and subjective response to a cold pressor task. Biological Psychology, 77, 233–236.

    Article  PubMed  Google Scholar 

  • Kraus, E., Besson, J. M., & Lebars, D. (1982). Behavioral model for diffuse noxious inhibitory controls (DNIC)—potentation by 5-hydroxytryptophan. Brain Research, 231, 461–465.

    Article  PubMed  CAS  Google Scholar 

  • Kraus, E., Le Bars, D., & Besson, J. M. (1981). Behavioral confirmation of “diffuse noxious inhibitory controls” (DNIC) and evidence for a role of endogenous opiates. Brain Research, 206, 495–499.

    Article  PubMed  CAS  Google Scholar 

  • Lautenbacher, S., Prager, M., & Rollman, G. B. (2007). Pain additivity, diffuse noxious inhibitory controls, and attention: A functional measurement analysis. Somatosensory and Motor Research, 24, 189–201.

    Article  PubMed  Google Scholar 

  • Le Bars, D., Chitour, D., Kraus, E., Dickenson, A. H., & Besson, J. M. (1981). Effect of naloxone upon diffuse noxious inhibitory controls (DNIC) in the rat. Brain Research, 204, 387–402.

    Article  PubMed  Google Scholar 

  • Lee, M. C., Wagner, H. N., Jr, Tanada, S., Frost, J. J., Bice, A. N., & Dannals, R. F. (1988). Duration of occupancy of opiate receptors by naltrexone. Journal of Nuclear Medicine, 29, 1207–1211.

    PubMed  CAS  Google Scholar 

  • Maixner, W., Fillingim, R., Booker, D., & Sigurdsson, A. (1995). Sensitivity of patients with painful temporomandibular disorders to experimentally evoked pain. Pain, 63, 341–351.

    Article  PubMed  CAS  Google Scholar 

  • Meyer, M. C., Straughn, A. B., Lo, M. W., Schary, W. L., & Whitney, C. C. (1984). Bioequivalence, dose-proportionality, and pharmacokinetics of naltrexone after oral administration. Journal of Clinical Psychiatry, 45, 15–19.

    PubMed  CAS  Google Scholar 

  • Millan, M. J. (2002). Descending control of pain. Progress in Neurobiology, 66, 355–474.

    Article  PubMed  CAS  Google Scholar 

  • Moont, R., Pud, D., Sprecher, E., Sharvit, G., & Yarnitsky, D. (2010). ‘Pain inhibits pain’ mechanisms: Is pain modulation simply due to distraction? Pain, 150, 113–120.

    Article  PubMed  Google Scholar 

  • Naert, A. L., Kehlet, H., & Kupers, R. (2008). Characterization of a novel model of tonic heat pain stimulation in healthy volunteers. Pain, 138, 163–171.

    Article  PubMed  Google Scholar 

  • Pert, C. B., Pasternak, G., & Snyder, S. H. (1973). Opiate agonists and antagonists discriminated by receptor binding in brain. Science, 182, 1359–1361.

    Article  PubMed  CAS  Google Scholar 

  • Pertovaara, A., Kemppainen, P., Johansson, G., & Karonen, S. L. (1982). Ischemic pain non-segmentally produces a predominant reduction of pain and thermal sensitivity in man—a selective role for endogenous opioids. Brain Research, 251, 83–92.

    Article  PubMed  CAS  Google Scholar 

  • Peters, M. L., Schmidt, A. J., Van den Hout, M. A., Koopmans, R., & Sluijter, M. E. (1992). Chronic back pain, acute postoperative pain and the activation of diffuse noxious inhibitory controls (DNIC). Pain, 50, 177–187.

    Article  PubMed  CAS  Google Scholar 

  • Picavet, H. S., Vlaeyen, J. W., & Schouten, J. S. (2002). Pain catastrophizing and kinesiophobia: Predictors of chronic low back pain. American Journal of Epidemiology, 156, 1028–1034.

    Article  PubMed  Google Scholar 

  • Piche, M., Arsenault, M., & Rainville, P. (2009). Cerebral and cerebrospinal processes underlying counterirritation analgesia. Journal of Neuroscience, 29, 14236–14246.

    Article  PubMed  CAS  Google Scholar 

  • Pielsticker, A., Haag, G., Zaudig, M., & Lautenbacher, S. (2005). Impairment of pain inhibition in chronic tension-type headache. Pain, 118, 215–223.

    Article  PubMed  Google Scholar 

  • Popescu, A., LeResche, L., Truelove, E. L., & Drangsholt, M. T. (2010). Gender differences in pain modulation by diffuse noxious inhibitory controls: A systematic review. Pain, 150, 309–318.

    Article  PubMed  Google Scholar 

  • Porter, S. J., Somogyi, A. A., & White, J. M. (2002). In vivo and in vitro potency studies of 6beta-naltrexol, the major human metabolite of naltrexone. Addiction Biology, 7, 219–225.

    Article  PubMed  CAS  Google Scholar 

  • Price, D. D., & McHaffie, J. G. (1988). Effects of heterotopic conditioning stimuli on first and second pain: A psychophysical evaluation in humans. Pain, 34, 245–252.

    Article  PubMed  CAS  Google Scholar 

  • Pruessner, J. C., Kirschbaum, C., Meinlschmid, G., & Hellhammer, D. H. (2003). Two formulas for computation of the area under the curve represent measures of total hormone concentration versus time-dependent change. Psychoneuroendocrinology, 28, 916–931.

    Article  PubMed  CAS  Google Scholar 

  • Pud, D., Granovsky, Y., & Yarnitsky, D. (2009). The methodology of experimentally induced diffuse noxious inhibitory control (DNIC)-like effect in humans. Pain, 144, 16–19.

    Article  PubMed  Google Scholar 

  • Quiton, R. L., & Greenspan, J. D. (2008). Across- and within-session variability of ratings of painful contact heat stimuli. Pain, 137, 245–256.

    Article  PubMed  Google Scholar 

  • Riley, J. L., Hastie, B. A., Glover, T. L., Fillingim, R. B., Staud, R., & Campbell, C. M. (2010a). Cognitive-affective and somatic side effects of morphine and pentazocine: Side-effect profiles in healthy adults. Pain Medicine, 11, 195–206.

    Article  PubMed  Google Scholar 

  • Riley, J., King, C., Wong, F., Fillingim, R. B., & Mauderli, A. P. (2010b). Lack of endogenous modulation and reduced decay of prolonged heat pain in older adults. Pain, 150, 153–160.

    Article  PubMed  Google Scholar 

  • Ring, C., France, C. R., al’Absi, M., Beesley, L., Edwards, L., McIntyre, D., et al. (2007). Effects of opioid blockade with naltrexone and distraction on cold and ischemic pain in hypertension. Journal of Behavioral Medicine, 30, 59–68.

    Article  PubMed  Google Scholar 

  • Rosa, C., Ghione, S., Mezzasalma, L., Pellegrini, M., Basile Fasolo, C., Giaconi, S., et al. (1988). Relationship between pain sensitivity, cardiovascular reactivity to cold pressor test and indexes of activity of the adrenergic and opioid system. Clin Exp Hypertens A, 10, 383–390.

    Article  PubMed  Google Scholar 

  • Song, G. H., Venkatraman, V., Ho, K. Y., Chee, M. W., Yeoh, K. G., & Wilder-Smith, C. H. (2006). Cortical effects of anticipation and endogenous modulation of visceral pain assessed by functional brain MRI in irritable bowel syndrome patients and healthy controls. Pain, 126, 79–90.

    Article  PubMed  Google Scholar 

  • Sprenger, C., Bingel, U., & Buchel, C. (2011). Treating pain with pain: Supraspinal mechanisms of endogenous analgesia elicited by heterotopic noxious conditioning stimulation. Pain, 152, 428–439.

    Article  PubMed  Google Scholar 

  • Staud, R., Robinson, M. E., Vierck, C. J., Jr., & Price, D. D. (2003). Diffuse noxious inhibitory controls (DNIC) attenuate temporal summation of second pain in normal males but not in normal females or fibromyalgia patients. Pain, 101, 167–174.

    Article  PubMed  Google Scholar 

  • Sullivan, M. J., Bishop, S. R., & Pivik, J. (1995). The pain catastrophizing scale: Development and validation. Psychological Assessment, 7, 524–532.

    Article  Google Scholar 

  • Suzuki, K., Maekawa, K., Minakuchi, H., Yatani, H., Clark, G. T., Matsuka, Y., et al. (2007). Responses of the hypothalamic-pituitary-adrenal axis and pain threshold changes in the orofacial region upon cold pressor stimulation in normal volunteers. Archives of Oral Biology, 52, 797–802.

    Article  PubMed  CAS  Google Scholar 

  • Takemori, A. E., & Portoghese, P. S. (1984). Comparative antagonism by naltrexone and naloxone of mu, kappa, and delta agonists. European Journal of Pharmacology, 104, 101–104.

    Article  PubMed  CAS  Google Scholar 

  • Tepperman, F. S., Hirst, M., & Smith, P. (1983). Brain and serum levels of naloxone following peripheral administration. Life Sciences, 33, 1091–1096.

    Article  PubMed  CAS  Google Scholar 

  • Tousignant-Laflamme, Y., Page, S., Goffaux, P., & Marchand, S. (2008). An experimental model to measure excitatory and inhibitory pain mechanisms in humans. Brain Research, 1230, 73–79.

    Article  PubMed  CAS  Google Scholar 

  • Tricklebank, M. D., Hutson, P. H., & Curzon, G. (1984). Analgesia induced by brief or more prolonged stress differs in its dependency on naloxone, 5-hydroxytryptamine and previous testing of analgesia. Neuropharmacology, 23, 417–421.

    Article  PubMed  CAS  Google Scholar 

  • van Wijk, G., & Veldhuijzen, D. S. (2010). Perspective on diffuse noxious inhibitory controls as a model of endogenous pain modulation in clinical pain syndromes. J Pain, 11, 408–419.

    Article  PubMed  Google Scholar 

  • Verebey, K. (1981). The clinical pharmacology of naltrexone: Pharmacology and pharmacodynamics. NIDA Research Monograph, 28, 147–158.

    PubMed  CAS  Google Scholar 

  • Villanueva, L. (2009). Diffuse noxious inhibitory control (DNIC) as a tool for exploring dysfunction of endogenous pain modulatory systems. Pain, 143, 161–162.

    Article  PubMed  Google Scholar 

  • Walsh, S. L., Sullivan, J. T., Preston, K. L., Garner, J. E., & Bigelow, G. E. (1996). Effects of naltrexone on response to intravenous cocaine, hydromorphone and their combination in humans. Journal of Pharmacology and Experimental Therapeutics, 279, 524–538.

    PubMed  CAS  Google Scholar 

  • Washington, L. L., Gibson, S. J., & Helme, R. D. (2000). Age-related differences in the endogenous analgesic response to repeated cold water immersion in human volunteers. Pain, 89, 89–96.

    Article  PubMed  CAS  Google Scholar 

  • Weissman-Fogel, I., Sprecher, E., & Pud, D. (2008). Effects of catastrophizing on pain perception and pain modulation. Experimental Brain Research, 186, 79–85.

    Article  Google Scholar 

  • Wen, Y.-R., Wang, C.-C., Yeh, G.-C., Hsu, S.-F., Huang, Y.-J., Li, Y.-L., et al. (2010). DNIC-mediated analgesia produced by a supramaximal electrical or a high-dose formalin conditioning stimulus: Roles of opioid and alpha2-adrenergic receptors. Journal of Biomedical Science, 17, 19.

    Article  PubMed  Google Scholar 

  • Wilder-Smith, C. H., Schindler, D., Lovblad, K., Redmond, S. M., & Nirkko, A. (2004). Brain functional magnetic resonance imaging of rectal pain and activation of endogenous inhibitory mechanisms in irritable bowel syndrome patient subgroups and healthy controls. Gut, 53, 1595–1601.

    Article  PubMed  CAS  Google Scholar 

  • Wilder-Smith, C. H., Song, G., Yeoh, K. G., & Ho, K. Y. (2009). Activating endogenous visceral pain modulation: A comparison of heterotopic stimulation methods in healthy controls. European Journal of Pain, 13, 836–842.

    Article  PubMed  Google Scholar 

  • Willer, J. C., Le Bars, D., & De Broucker, T. (1990). Diffuse noxious inhibitory controls in man: Involvement of an opioidergic link. European Journal of Pharmacology, 182, 347–355.

    Article  PubMed  CAS  Google Scholar 

  • Willer, J. C., Roby, A., & Le Bars, D. (1984). Psychophysical and electrophysiological approaches to the pain-relieving effects of heterotopic nociceptive stimuli. Brain, 107, 1095–1112.

    Article  PubMed  Google Scholar 

  • Wong, F., Vierck, C. J., Riley, J. L., King, C., & Mauderli, A. P. (2010). A new thermal stimulation method for human psychophysical studies: Pain intensity clamping. Journal of Neuroscience Methods, 188, 83–88.

    Article  PubMed  Google Scholar 

  • Yarnitsky, D., Arendt-Nielsen, L., Bouhassira, D., Edwards, R. R., Fillingim, R. B., Granot, M., et al. (2010). Recommendations on terminology and practice of psychophysical DNIC testing. European Journal of Pain, 14, 339.

    Article  PubMed  Google Scholar 

  • Zimmerman, D. M., & Leander, J. D. (1990). Opioid antagonists: Structure activity relationships. NIDA Research Monograph, 96, 50–60.

    PubMed  CAS  Google Scholar 

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Acknowledgments

This research was supported by a University of Florida College of Dentistry (UFCD) Student Summer Research Fellowship, UFCD Seed Grant (Riley), NIH-NIDCR grant T32 DE007200 (King), UF CTSI UL1TR000064/KL2TR000065 (King), American Pain Society Future Leaders in Pain Research Grant Program (King), AG033906-06S1 (Fillingim), and the UF Comprehensive Center for Pain Research (CCPR). The authors of this study have no conflict of interests. This material was also supported by the North Florida/South Georgia Veterans Health System, Gainesville, FL, USA.

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  1. Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, 1329 SW 16th St, Suite 5180, PO Box 103628, Gainesville, FL, 32610-3628, USA

    Christopher D. King, Burel Goodin, Lindsay L. Kindler, Joseph L. Riley III & Roger B. Fillingim

  2. Department of Oral and Maxillary Surgery, College of Dentistry, University of Florida, Gainesville, FL, USA

    Robert M. Caudle

  3. Department of Anesthesiology, Brigham and Women’s Hospital and Harvard Medical School, Chestnut Hill, MA, USA

    Robert R. Edwards

  4. Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, FL, USA

    Nikolaus Gravenstein

  5. North Florida/South Georgia Veterans Health System, Gainesville, FL, USA

    Roger B. Fillingim

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King, C.D., Goodin, B., Kindler, L.L. et al. Reduction of conditioned pain modulation in humans by naltrexone: an exploratory study of the effects of pain catastrophizing. J Behav Med 36, 315–327 (2013). https://doi.org/10.1007/s10865-012-9424-2

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