Papers on Pain by Pedro Montoya
Affective facial expressions are potent social cues that can induce relevant physiological change... more Affective facial expressions are potent social cues that can induce relevant physiological changes, as well as behavioral dispositions in the observer. Previous studies have revealed that angry faces induced significant reductions in body sway as compared with neutral and happy faces, reflecting an avoidance behavioral tendency as freezing. The expression of pain is usually considered an unpleasant stimulus, but also a relevant cue for delivering effective care and social support. Nevertheless, there are few data about behavioral dispositions elicited by the observation of pain expressions in others. The aim of the present research was to evaluate approach-avoidance tendencies by using video recordings of postural body sway when participants were standing and observing facial expressions of pain, happy and neutral. We hypothesized that although pain faces would be rated as more unpleasant than the other faces, they would provoke significant changes in postural body sway as compared to neutral facial expressions. Forty healthy female volunteers (mean age 25) participated in the study. Amplitude of forward movements and backward movements in the anterior-posterior and medial-lateral axes were obtained. Statistical analyses revealed that pain faces were the most unpleasant stimuli, and that both happy and pain faces were more arousing than neutral ones. Happy and pain faces also elicited greater amplitude of body sway in the anterior-posterior axes as compared with neutral faces. In addition, significant positive correlations were found between body sway elicited by pain faces and pleasantness and empathic ratings, suggesting that changes in postural body sway elicited by pain faces might be associated with approach and cooperative behavioral responses.
Risky decision-making seems to be markedly disrupted in patients with chronic pain, probably due ... more Risky decision-making seems to be markedly disrupted in patients with chronic pain, probably due to the high cost that impose pain and negative mood on executive control functions. Patients' behavioral performance on decision-making tasks such as the Iowa Gambling Task (IGT) is characterized by selecting cards more frequently from disadvantageous than from advantageous decks, and by switching often between competing responses in comparison with healthy controls (HCs). In the present study, we developed a simple heuristic model to simulate individuals' choice behavior by varying the level of decision randomness and the importance given to gains and losses. The findings revealed that the model was able to differentiate the behavioral performance of patients with chronic pain and HCs at the group, as well as at the individual level. The best fit of the model in patients with chronic pain was yielded when decisions were not based on previous choices and when gains were considered more relevant than losses. By contrast, the best account of the available data in HCs was obtained when decisions were based on previous experiences and losses loomed larger than gains. In conclusion, our model seems to provide useful information to measure each individual participant extensively, and to deal with the data on a participant-by-participant basis.
Facial expression provides information for an accurate estimation of others' pain.
Background: Although cerebral palsy (CP) is usually defined as a group of permanent motor disorde... more Background: Although cerebral palsy (CP) is usually defined as a group of permanent motor disorders due to non-progressive disturbances in the developing fetal or infant brain, recent research has shown that CP individuals are also characterized by altered somatosensory perception, increased pain and abnormal activation of cortical somatosensory areas. The present study was aimed to examine hemispheric differences on somatosensory brain processing in individuals with bilateral CP and lateralized motor impairments compared with healthy controls. Nine CP individuals with left-dominant motor impairments (LMI) (age range 5-28 yrs), nine CP individuals with right-dominant motor impairments (RMI) (age range 7-29 yrs), and 12 healthy controls (age range 5-30 yrs) participated in the study. Proprioception, touch and pain thresholds, as well as somatosensory evoked potentials (SEP) elicited by tactile stimulation of right and left lips and thumbs were compared. Results: Pain sensitivity was higher, and lip stimulation elicited greater beta power and more symmetrical SEP amplitudes in individuals with CP than in healthy controls. In addition, although there was no significant differences between individuals with RMI and LMI on pain or touch sensitivity, lip and thumb stimulation elicited smaller beta power and more symmetrical SEP amplitudes in individuals with LMI than with RMI.
Background: Children and adolescents with cerebral palsy suffer from higher levels of pain than t... more Background: Children and adolescents with cerebral palsy suffer from higher levels of pain than their peers without disability. The aim of this study was to explore the impact of pain on health-related quality of life and motor function in individuals with cerebral palsy as reported by health professionals. Methods: Cross-sectional study carried out in Associations for Care of Individuals with Cerebral Palsy and Related Disabilities (ASPACE) in Balearic Islands and Castile Leon (Spain). Thirty-five physiotherapists rated pain, health-related quality of life and motor function in 91 children and adolescents with cerebral palsy [8-19y]. A semi-structured interview was used to collect demographic and clinical data according with the Study of Participation of Children with Cerebral Palsy Living in Europe (SPARCLE). Results: Physiotherapists reported that 51% of individuals with cerebral palsy suffered from pain. Physiotherapists also perceived that pain in individuals with cerebral palsy was responsible for reductions of psychological but not physical domains of health-related quality of life. According with physiotherapists' estimations, motor impairment scores were not correlated with pain scores in individuals with cerebral palsy, but they were significantly associated with physical and autonomy domains of health-related quality of life. Conclusions: These findings highlighted the importance of assessing and providing interventions for pain relief in persons with cerebral palsy even at an early age.
Event-related potentials to visually displayed pseudowords were registered from 13 individuals. I... more Event-related potentials to visually displayed pseudowords were registered from 13 individuals. In a dil'lcrcnlial conditioning paradigm, half of the pscudoword.s had previously been paired with a painlul electric shock (shock words) and the other halt had been presented without shock (nonshock words). Participants were asked to decide if the words had been presented during the conditioning phase or not. Larger NKK) amplitudes and a more negativegoing slow wave 4(X)-8(X) ms after word presentation were found for shock as compared with nonshock words. This effect was stronger over the left than over the right hemisphere. This lelt-latcralizx-d tiegativiiy might reflect the activation of a cell assembly representing the memory of the learned word-shock contingency. I urthertnore, the increased NlOO amplitude elicited by shock as compared with nonshock words may be interpreted as an increased attentive facilitation for aversive pain-related information as a consequence of conditioning.
The observation and descriptions of animal's behavior and emotions from the New World began short... more The observation and descriptions of animal's behavior and emotions from the New World began shortly after the arrival of Spaniards in America. The discovery of the Indian natives and completely unknown species in Europe sparked a great interest in pioneers like Álvarez Chanca, Fernández de Oviedo, Cieza de León, Sahagún, Francisco Hernández, Acosta, Cobo or much later by Azara. In our opinion, these studies provided the basis for the study of animal behavior and emotions in the New and the Old World and allowed a new understanding of the Natural History and the relationship between structure and function. It is likely that these findings were crucial for the work of Charles Darwin three Centuries later. Moreover, it is suggested that the future development of Comparative Psychology based on Darwin and Romanes work, based its roots in the work and observations of these early pioneers.
Papers on Stress by Pedro Montoya
Book chapters by Pedro Montoya
Recent research has emphasized the possibility that pain and tenderness in fibromyalgia (FM) migh... more Recent research has emphasized the possibility that pain and tenderness in fibromyalgia (FM) might be linked to altered neurobiological and cognitive mechanisms during the processing of somatosensory information. This review discusses empirical data indicating that FM patients are mainly characterized by generalized significant abnormalities of central nociceptive and cognitive processing. This is clinically manifested by a widespread hyperalgesia and allodynia which is reflected by reduced pain thresholds upon painful thermal and mechanical stimulation of tender points as well as non-painful body sites. Numerous studies also point to the importance of psychological factors which might influence the perpetuation of chronic FM. Research highlights the importance of psychological distress involving stressful traumatic life events with high prevalence rates in FM patients. Other psychological variables such as anxiety, depression, negative and positive affect, catastrophizing and hypervigilance has been also discussed as predisposing psychological factors which might alter pain perception. The role of social support in modulating pain perception and brain correlates of somatosensory brain processing is also discussed. Although the evidence is not conclusive, it seems that the social factors as the presence of significant others may significantly modulate pain sensitivity in FM. Finally, neuroimaging research has further revealed significant changes in brain activity during the cognitive processing of somatosensory information. Taken together, all these findings may suggest that FM Pedro Montoya and Wolfgang Larbig 130 represents a complex clinical entity with multifacetic etiology, which is maintained not only by peripheral and psychological, but also by central hyperexcitabilty.
Papers by Pedro Montoya
International Journal of Environmental Research and Public Health
Pain and abnormal somatosensory processing are important associated conditions in children and ad... more Pain and abnormal somatosensory processing are important associated conditions in children and adolescents with cerebral palsy (CP). Perceived social support is highly relevant for pain perception and coping. Aim: The aim of the present study was to assess the influence of social support on pain sensitivity in children and adolescents with cerebral palsy and healthy peers. Design: Cross-sectional study. Methods: Pressure pain thresholds were assessed in 42 children and adolescents with CP and 190 healthy peers during three different conditions: alone, with their mother and with a stranger. Results: Children with CP reported lower pain sensitivity when they were with their mother than being alone or with a stranger, whereas healthy peers did not experience different pain sensitivity related to the social condition. Sex or clinical characteristics did not affect the relationship between pain perception and social support. Conclusion: The present study shows how children with CP are hi...
Children
Many individuals with cerebral palsy (CP) suffer from pain and must develop pain-coping strategie... more Many individuals with cerebral palsy (CP) suffer from pain and must develop pain-coping strategies, although the factors determining them are unknown. This observational study aims at exploring the association between different pain-coping strategies and factors such as age, sex, pain, health status, sleep or motor and cognitive function in individuals with cerebral palsy (CP) and typically developing peers (TD). Main caregivers of 94 individuals with CP (age range = 6–69 years, mean age = 17.78 (10.05)) and the closest relative of 145 individuals with TD (age range = 6–51 years, mean age = 19.13 (12.87)) completed questionnaires on the previous topics (Parent Report of the PEDsQL Pediatric Coping Inventory, the Health Utility Index HUI-3, Epworth Sleepiness Score and the Pittsburgh Sleep Quality Index). Pain presence, duration, intensity, location and ratings of current and worst pain in the last week in an 11-point numerical rating scale were assessed in an interview. Global healt...
Frontiers in Neurology
Fibromyalgia is a chronic pain disease with few effective therapeutic options. We evaluated the e... more Fibromyalgia is a chronic pain disease with few effective therapeutic options. We evaluated the efficacy of a 12-weeks therapy program that involves the use of whole body vibration in patients with fibromyalgia. The experimental group (N = 20 patients) participated in a neuromuscular training with a rotational whole body vibration platform for 12 weeks. The control group (N = 20 patients) received no physiotherapy treatment. The following variables were assessed before, after and 3 months after the therapy program: Fibromyalgia impact questionnaire, pain intensity, quality of life, sensitivity measurements (pressure pain thresholds, vibration thresholds), motor function tasks (Berg scale, 6-min walk test, isometric back muscle strength), and static and dynamic balance. We found improvements in the indexes of functional disability, static equilibrium and vibration sensitivity and a reduction of pain sensitivity. Our results showed that the intervention group improved almost all param...
Journal of Clinical Medicine
To compare differences in postural balance, pain and depression in patients with chronic and acut... more To compare differences in postural balance, pain and depression in patients with chronic and acute low back pain, twenty patients with chronic and twenty patients with acute low back pain from the Edward Francis Small Hospital (Banjul, Gambia), as well as 20 age-matched healthy controls participated in the study. A modified Romberg test was used to assess postural balance during one minute with closed eyes. Body sway in the anteroposterior and mediolateral axes was video-recorded during test performance and further analyzed with an open source software for movement analyses (CvMob). Pain sensitivity was assessed by means of pressure pain thresholds and depression by a self-report questionnaire (PHQ-9). As results, patients with chronic low back pain displayed higher body sway in the anteroposterior and mediolateral axes, as well as faster body sway than patients with acute low back pain and healthy controls. Nevertheless, group differences disappeared when depression was introduced ...
Children, 2021
Cerebral palsy (CP) is an impacting chronic condition. Concomitant comorbidities such as pain and... more Cerebral palsy (CP) is an impacting chronic condition. Concomitant comorbidities such as pain and speech inability may further affect parents’ perception of the pathology impact in the family quality of life and the provided care. The objective of this cross-sectional descriptive correlational study was to compare parental reports on family impact and healthcare satisfaction in children with CP with and without chronic pain and with and without speech ability. Parents of 59 children with CP (age range = 4–18 years) completed several questions about pain and speech ability and two modules of the Pediatric Quality of Life Measurement Model: The PedsQLTM 2.0 Family Impact Module and the PedsQLTM Healthcare Satisfaction Generic Module. Our findings revealed that children’s pain slightly impacted family physical health, social health and worry. In children without pain, speech inability increased the perceived health impact. Parents’ healthcare satisfaction was barely affected by pain or...
Healthcare, 2021
Fibromyalgia (FM) and chronic low back pain (CLBP) have shared pathophysiology and have a conside... more Fibromyalgia (FM) and chronic low back pain (CLBP) have shared pathophysiology and have a considerable impact on patients’ daily activities and quality of life. The main objective of this study was to compare pain impact, somatosensory sensitivity, motor functionality, and balance among 60 patients with FM, 60 patients with CLBP, and 60 pain-free controls aged between 30 and 65 years. It is essential to know the possible differences existing in symptomatology of two of the major chronic pain processes that most affect the population, such as FM and CLBP. The fact of establishing possible differences in sensory thresholds, motor function, and proprioceptive measures among patients with FM and CLBP could bring us closer to a greater knowledge of the chronic pain process. Through an observational study, a comparison was made between the three groups (FM, CLBP, and pain-free controls) evaluating functional performance, postural balance, kinematic gait parameters, strength, depression, f...
International Journal of Environmental Research and Public Health, 2021
Whole body vibration has been proven to improve the health status of patients with fibromyalgia, ... more Whole body vibration has been proven to improve the health status of patients with fibromyalgia, providing an activation of the neuromuscular spindles, which are responsible for muscle contraction. The present study aimed to compare the effectiveness of two types of whole body vibrating platforms (vertical and rotational) during a 12-week training program. Sixty fibromyalgia patients (90% were women) were randomly assigned to one of the following groups: group A (n = 20), who performed the vibration training with a vertical platform; group B (n = 20), who did rotational platform training; or a control group C (n = 20), who did not do any training. Sensitivity measures (pressure pain and vibration thresholds), quality of life (Quality of Life Index), motor function tasks (Berg Scale, six-minute walking test, isometric back muscle strength), and static and dynamic balance (Romberg test and gait analysis) were assessed before, immediately after, and three months after the therapy progr...
NeuroRehabilitation, 2018
BACKGROUND: Children with cerebral palsy (CP) perform less physical activity than their typically... more BACKGROUND: Children with cerebral palsy (CP) perform less physical activity than their typically developing peers (TDP). Pain, important comorbidity in children with CP, restrains levels of physical activity. OBJECTIVE: This study aims at exploring the influence of chronic pain in physical activity of children with CP and TDP. METHODS: 24-hour heart rate was registered in four groups of children: children with CP and TDP, with and without chronic pain. Heart rate based indexes of physical activity (MET percentages, energy expenditure) were computed. A self-reported diary of activities rated activities pain and fatigue intensity. RESULTS: Children with CP and chronic pain reported more painful activities and higher pain than their TDP with chronic pain. Moreover, children with CP and chronic pain presented higher time and periods of light activity and less sedentary activity than their TDP with chronic pain. No differences were found between CP and TDP without chronic pain. CONCLUSION: Children with CP regulate physical activity differently than TD children in the presence of chronic pain. The maintenance of light levels of physical activity in children with CP may suggest efficient pain coping strategies and perseverance in participation. These findings encourage the implementation of programs to improve fitness in this population.
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Papers on Pain by Pedro Montoya
Papers on Stress by Pedro Montoya
Book chapters by Pedro Montoya
Papers by Pedro Montoya