According to the neurocognitive model of attention to pain, when the attentional resources invested in a task unrelated to pain are high, limited cognitive resources can be directed toward the pain. This is supported by experimental studies showing that diverting people's attention away from acute pain leads to experiencing less pain. Theoretical work has suggested that this phenomenon may present a top-down modulatory mechanism for persistent pain as well. However, conclusive empirical evidence is lacking. To fill this gap, we used a preregistered, double-blind, between-subject study design to investigate whether performing a tailored, demanding, and engaging working memory task unrelated to pain (difficult) vs a task that requires less mental effort to be performed (easy), could lead to lower development of secondary hypersensitivity-a hallmark of central sensitization. Eighty-five healthy volunteers, randomly assigned to one of the 2 conditions, performed a visual task with a different cognitive load (difficult vs easy), while secondary hypersensitivity was induced on their nondominant forearm using high-frequency stimulation. To assess the development of secondary hypersensitivity, sensitivity to mechanical stimuli was measured 3 times: T0, for baseline and 20 (T1) and 40 (T2) minutes after the procedure. We did not observe any significant difference in the development of secondary hypersensitivity between the 2 groups, neither in terms of the intensity of mechanical sensitivity nor its spatial extent. Our results suggest that a top-down modulation through attention might not be sufficient to affect pain sensitization and the development of secondary hypersensitivity.

中文翻译：

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自上而下的注意力不会调节继中枢敏化后的机械超敏反应：实验分析的见解。

根据疼痛注意力的神经认知模型，当投入与疼痛无关的任务的注意力资源较高时，有限的认知资源可以被引导到疼痛上。实验研究证明，将人们的注意力从急性疼痛上转移开可以减轻疼痛。理论工作表明，这种现象也可能为持续性疼痛提供一种自上而下的调节机制。然而，缺乏确凿的经验证据。为了填补这一空白，我们使用了预先注册的双盲受试者间研究设计来调查是否执行与疼痛无关（困难）的定制的、要求较高且引人入胜的工作记忆任务与需要较少脑力工作的任务（简单），可能会导致继发性超敏反应的发展降低——继发性超敏反应是中枢敏化的标志。 85 名健康志愿者被随机分配到两种条件之一，执行具有不同认知负荷（困难与简单）的视觉任务，同时使用高频刺激在他们的非优势前臂上诱发继发性超敏反应。为了评估继发性超敏反应的发展，测量了 3 次对机械刺激的敏感性：T0（基线）以及手术后 20（T1）和 40（T2）分钟。我们没有观察到两组之间继发性超敏反应的发生有任何显着差异，无论是机械敏感性的强度还是其空间范围。我们的结果表明，通过注意力进行自上而下的调节可能不足以影响疼痛敏化和继发性超敏反应的发展。