Evidence map›Paper›PMID 40700127›Full record

ReviewNeuroSci2025

Do Pain and Autonomic Regulation Share a Common Central Compensatory Pathway? A Meta-Analysis of HRV Metrics in Pain Trials.

Marianna Daibes, Bassel Almarie, Maria Fernanda Andrade, Giovanna de Paula Vidigal, Nadine Aranis, Anna Gianlorenco, Carlos Bandeira de Mello Monteiro, Prateek Grover, David Sparrow, Felipe Fregni

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in NeuroSci, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Article
  2. Observational
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Marianna DaibesNeuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA 02138, USA.
Bassel AlmarieNeuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA 02138, USA.
Maria Fernanda AndradeNeuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA 02138, USA.ORCID 0009-0009-6093-241X
Giovanna de Paula VidigalNeuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA 02138, USA.
Nadine AranisNeuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA 02138, USA.ORCID 0000-0001-5416-0139
Anna GianlorencoNeuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA 02138, USA.ORCID 0000-0002-7334-3835
Carlos Bandeira de Mello MonteiroDepartment of Physical Therapy, Speech and Occupational Therapy, Faculty of Medicine, University of São Paulo (USP), Sao Paulo 05508-220, Brazil.
Prateek GroverLimb Loss, Difference, and Preservation Rehabilitation Center for Research, Education, and Service (LimbRehabCaRES), Penn State College of Medicine, Hershey, PA 17033, USA.ORCID 0000-0003-1367-8438
David SparrowDepartment of Medicine, Boston University Chobanian and Avedisian School of Medicine, and VA Normative Aging Study, Veterans Affairs Boston Healthcare System, Boston, MA 02118, USA.
Felipe FregniNeuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA 02138, USA.ORCID 0000-0002-1703-7526

Funding

NIH HHS 1R01HD082302-01A1
6 · The paper itself

Abstract

backgroundChronic pain is closely associated with dysregulation of the autonomic nervous system, often reflected by reduced heart rate variability (HRV). While observational studies have demonstrated this association, the extent to which pain interventions modulate HRV and the impact of individual factors on HRV changes remain unclear.

objectiveTo evaluate the impact of pain interventions on HRV parameters through meta-analysis of randomized controlled trials (RCTs), and to examine whether intervention type and individual factors such as body mass index (BMI) moderate HRV responses.

methodsWe conducted a systematic review of 23 RCTs and a meta-analysis of 21 RCTs (1262 subjects) involving patients with acute and chronic pain. HRV outcomes were extracted pre- and post-intervention. Both between-group (active vs. sham/control) and one-group (pre-post within active group) analyses were performed for time-domain indices-standard deviation of normal-to-normal intervals (SDNN), root mean square of successive differences (RMSSD), and percentage of successive normal-to-normal intervals > 50 ms (pNN50)-and frequency-domain indices-high-frequency (HF) and low-frequency (LF) components. Meta-regressions tested moderators including BMI, age, and pain phenotype. The protocol was registered in PROSPERO (CRD42023448264).

resultsTwenty-three RCTs involving 1262 participants with a wide range of pain conditions were included. Meta-analysis of time-domain HRV parameters showed a trend toward improvement: SDNN (g = 0.435,

Indexed as

autonomic nervous systemchronic painheart rate variabilitysystemic inflammation

Identifiers

PMID40700127
PMCPMC12285944

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.