SynthesisEuropean journal of pain (London, England)2025
Recommendations for the Neurophysiological Assessment of Conditioned Pain Modulation: A Systematic Review of Nociceptive Blink Reflex and Nociceptive Withdrawal Reflex Protocols.
Synthesis in European journal of pain (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled 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.
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.
Who cites it
3 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pharmacological Influences on the R2 Blink Reflex Response in Healthy Participants: A Systematic Review.The European journal of neuroscience · 2026Pooled it
- Recommendations for the Neurophysiological Assessment of Conditioned Pain Modulation: A Systematic Review of Nociceptive Blink Reflex and Nociceptive Withdrawal Reflex Protocols.European journal of pain (London, England) · 2025Pooled it
- Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectiveThe nociceptive blink reflex (NBR) and nociceptive withdrawal reflex (NWR) are increasingly used as neurophysiological test stimuli to assess conditioned pain modulation (CPM). However, methodological inconsistencies limit reproducibility and cross-study comparison. This systematic review aimed to evaluate experimental protocols and outcome measures used in CPM studies employing NBR or NWR, and to propose recommendations for standardisation. DATABASES AND DATA TREATMENT: Following PRISMA guidelines, a systematic search of PubMed, Cochrane and Ovid databases was conducted. Studies were included if they assessed CPM in healthy adults using NBR or NWR. Data were extracted on stimulation parameters, electrode configuration, participant positioning, data acquisition, signal processing and CPM protocols. Sixteen studies met inclusion criteria (6 NBR, 10 NWR).
resultsAcross studies, stimulation protocols varied in frequency, pulse duration and threshold calibration. Electrode placements and participant positioning were often inconsistently reported. Data acquisition methods differed in sampling rates and filtering, and analysis windows were not always defined. CPM protocols included cold pressor, heat and electrocutaneous stimulation. Outcome measures included both amplitude- and threshold-based metrics.
conclusionsThis review highlights significant methodological heterogeneity in reflex-based CPM research in healthy participants. Standardisation of stimulation parameters, recording techniques, and CPM protocols is needed to enhance comparability and reproducibility across studies. To address this, we provide structured recommendations, based on GRADE classifications, for standardising protocols related to experimental setup, data acquisition and CPM outcome measures for both the NBR and NWR. SIGNIFICANCE STATEMENT: Reflex-based conditioned pain modulation demonstrates methodological inconsistencies, highlighting the need for standardised protocols. With standardised protocols recommended in this review, future efforts should focus on enhancing its reliability, reproducibility and clinical applicability.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.