Volume 9, Issue 1 (January & February 2018 2018)
BCN 2018, 9(1): 43-50 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Hayashi K, Ikemoto T, Ueno T, Arai Y P, Shimo K, Nishihara M, et al . Discordant Relationship Between Evaluation of Facial Expression and Subjective Pain Rating Due to the Low Pain Magnitude. BCN 2018; 9 (1) :43-50
URL: http://bcn.iums.ac.ir/article-1-882-en.html
URL: http://bcn.iums.ac.ir/article-1-882-en.html
Kazuhiro Hayashi * 
1, Tatsunori Ikemoto1 , Takefumi Ueno2 , Young-Chang Park Arai1 , Kazuhiro Shimo1 , Makoto Nishihara1 , Shigeyuki Suzuki3 , Takahiro Ushida1
1, Tatsunori Ikemoto1 , Takefumi Ueno2 , Young-Chang Park Arai1 , Kazuhiro Shimo1 , Makoto Nishihara1 , Shigeyuki Suzuki3 , Takahiro Ushida1
1- Multidisciplinary Pain Center, Aichi Medical University, Nagakute, Japan.
2- National Hospital Organization, Hizen Psychiatric Center, Kyushu, Japan.
3- Program in Physical and Occupational Therapy, Graduate School of Medicine, Nagoya University, Japan.
2- National Hospital Organization, Hizen Psychiatric Center, Kyushu, Japan.
3- Program in Physical and Occupational Therapy, Graduate School of Medicine, Nagoya University, Japan.
Abstract:
Introduction: Facial expression to pain is an important pain indicator; however, facial movements look unresponsive when perceiving mild pain. The present study investigates whether pain magnitude modulates the relationship between subjective pain rating and an observer’s evaluation of facial expression.
Methods: Twelve healthy volunteers were recruited to obtain 108 samples for pain rating with Visual Analogue Scale (VAS). Subjects underwent three different mechanical painful stimuli (monofilament forces of 100 g, 300 g, and 600 g) over three sessions and their facial expressions were videotaped throughout all sessions. Three observers independently evaluated facial expression of the subjects with a four-point categorical scale (no pain, mild pain, moderate pain, and severe pain). The correlations between subjective pain ratings and the evaluation of facial expression were analyzed in dichotomous group which was low pain ratings (VAS<30), or high pain rating (VAS≥30).
Results: Subjective pain ratings was significantly correlated with the evaluation of facial expression in high pain ratings, however no correlation was found between them in mild pain ratings. In mild pain ratings, most of the subjects (78%) were rated as no pain by observers, despite the fact that subjects reported pain.
Conclusion: The results suggest that the evaluation of facial expression of pain was difficult for the observer to detect pain severity when the subjects feel mild pain.
Type of Study: Original |
Subject:
Behavioral Neuroscience
Received: 2016/12/13 | Accepted: 2017/04/10 | Published: 2018/01/1
Received: 2016/12/13 | Accepted: 2017/04/10 | Published: 2018/01/1
References
1. Abbey, J., Piller, N., Bellis, A. D., Esterman, A., Parker, D., Giles, L., et al. (2004). The abbey pain scale: A 1-minute numerical indicator for people with end-stage dementia. International Journal of Palliative Nursing, 10(1), 6–13. doi: 10.12968/ijpn.2004.10.1.12013 [DOI:10.12968/ijpn.2004.10.1.12013]
2. Apkarian, A. V., Bushnell, M. C., Treede, R.-D., & Zubieta, J. K. (2005). Human brain mechanisms of pain perception and regulation in health and disease. European Journal of Pain, 9(4), 463. doi: 10.1016/j.ejpain.2004.11.001 [DOI:10.1016/j.ejpain.2004.11.001]
3. Apkarian, V. A., Hashmi, J. A., & Baliki, M. N. (2011). Pain and the brain: Specificity and plasticity of the brain in clinical chronic pain. Pain, 152(Supplement), S49–S64. doi: 10.1016/j.pain.2010.11.010 [DOI:10.1016/j.pain.2010.11.010]
4. Büchel, C., Bornhövd, K., Quante, M., Glauche, V., Bromm, B., & Weiller, C. (2002). Dissociable neural responses related to pain intensity, stimulus intensity, and stimulus awareness within the anterior cingulate cortex: A parametric single-trial laser functional magnetic resonance imaging study. Journal of Neuroscience, 22(3), 970-6. PMID: 11826125 [PMID]
5. Coghill, R. C., McHaffie, J. G., & Yen, Y. F. (2003). Neural correlates of interindividual differences in the subjective experience of pain. Proceedings of the National Academy of Sciences, 100(14), 8538–42. doi: 10.1073/pnas.1430684100 [DOI:10.1073/pnas.1430684100]
6. Collins, S. L., Moore, A. R., & McQuay, H. J. (1997). The visual analogue pain intensity scale: What is moderate pain in millimetres. Pain, 72(1), 95–7. doi: 10.1016/s0304-3959(97)00005-5 [DOI:10.1016/S0304-3959(97)00005-5]
7. Decety, J. (2009). Empathy, sympathy and the perception of pain. Pain, 145(3), 365–6. doi: 10.1016/j.pain.2009.08.006 [DOI:10.1016/j.pain.2009.08.006]
8. Derbyshire, S. W., Jones, A. K. ., Gyulai, F., Clark, S., Townsend, D., & Firestone, L. L. (1997). Pain processing during three levels of noxious stimulation produces differential patterns of central activity. Pain, 73(3), 431–45. doi: 10.1016/s0304-3959(97)00138-3 [DOI:10.1016/S0304-3959(97)00138-3]
9. Devinsky, O., Morrell, M. J., & Vogt, B. A. (1995). Contributions of anterior cingulate cortex to behaviour. Brain, 118(1), 279–306. doi: 10.1093/brain/118.1.279 [DOI:10.1093/brain/118.1.279]
10. Deyo, K. S., Prkachin, K. M., & Mercer, S. R. (2004). Development of sensitivity to facial expression of pain. Pain, 107(1), 16–21. doi: 10.1016/s0304-3959(03)00263-x [DOI:10.1016/S0304-3959(03)00263-X]
11. Fishbain, D. A., Goldberg, M., Rosomoff, R. S., & Rosomoff, H. L. (1991). More Munchausen with chronic pain. The Clinical Journal of Pain, 7(3), 237–44. doi: 10.1097/00002508-199109000-00012 [DOI:10.1097/00002508-199109000-00012]
12. Gerbershagen, H. J., Rothaug, J., Kalkman, C. J., & Meissner, W. (2011). Determination of moderate-to-severe postoperative pain on the numeric rating scale: A cut-off point analysis applying four different methods. British Journal of Anaesthesia, 107(4), 619–26. doi: 10.1093/bja/aer195 [DOI:10.1093/bja/aer195]
13. Goebel, R. (2012). BrainVoyager: Past, present, future. Neuro Image, 62(2), 748–56. doi: 10.1016/j.neuroimage.2012.01.083 [DOI:10.1016/j.neuroimage.2012.01.083]
14. Graven Nielsen, T., Mense, S., & Arendt Nielsen, L. (2004). Painful and non-painful pressure sensations from human skeletal muscle. Experimental Brain Research, 159(3), 273–83. doi: 10.1007/s00221-004-1937-7 [DOI:10.1007/s00221-004-1937-7]
15. Hadjistavropoulos, T., Chapelle, D. L., Hadjistavropoulos, H. D., Green, S., & Asmundson, G. J. G. (2002). Using facial expressions to assess musculoskeletal pain in older persons. European Journal of Pain, 6(3), 179–87. doi: 10.1053/eujp.2001.0327 [DOI:10.1053/eujp.2001.0327]
16. Hayashi, K., Ikemoto, T., Ueno, T., Arai, Y. C. P., Shimo, K., Nishihara, M., et al. (2015). Regional differences of repeatability on visual analogue scale with experimental mechanical pain stimuli. Neuroscience Letters, 585, 67–71. doi: 10.1016/j.neulet.2014.11.032 [DOI:10.1016/j.neulet.2014.11.032]
17. Hayashi, K., Ikemoto, T., Ueno, T., Arai, Y. C. P., Shimo, K., Nishihara, M., et al. (2016). Higher pain rating results in lower variability of somatosensory cortex activation by painful mechanical stimuli: An fMRI study. Clinical Neurophysiology, 127(4), 1923–8. doi: 10.1016/j.clinph.2016.01.008 [DOI:10.1016/j.clinph.2016.01.008]
18. Herr, K., Coyne, P. J., Key, T., Manworren, R., McCaffery, M., Merkel, S., et al. (2006). Pain assessment in the nonverbal patient: Position statement with clinical practice recommendations. Pain Management Nursing, 7(2), 44–52. doi: 10.1016/j.pmn.2006.02.003 [DOI:10.1016/j.pmn.2006.02.003]
19. Hofbauer, R. K., Rainville, P., Duncan, G. H., & Bushnell, M. C. (2001). Cortical representation of the sensory dimension of pain. Journal of Neurophysiology, 86(1), 402–11. doi: 10.1152/jn.2001.86.1.402 [DOI:10.1152/jn.2001.86.1.402]
20. Jackson, P. L., Meltzoff, A. N., & Decety, J. (2005). How do we perceive the pain of others? A window into the neural processes involved in empathy. NeuroImage, 24(3), 771–9. doi: 10.1016/j.neuroimage.2004.09.006 [DOI:10.1016/j.neuroimage.2004.09.006]
21. Kemp, J., Despres, O., & Dufour, A. (2012). Unreliability of the visual analog scale in experimental pain assessment: A sensitivity and evoked potentials study. Pain Physician, 15(5), E693-9. PMID: 22996863 [PMID]
22. Kundel, H. L., & Polansky, M. (2003). Measurement of observer agreement. Radiology, 228(2), 303–8. doi: 10.1148/radiol.2282011860 [DOI:10.1148/radiol.2282011860]
23. Kunz, M., Chatelle, C., Lautenbacher, S., & Rainville, P. (2008). The relation between catastrophizing and facial responsiveness to pain. Pain, 140(1), 127–34. doi: 10.1016/j.pain.2008.07.019 [DOI:10.1016/j.pain.2008.07.019]
24. Kunz, M., Chen, J. I., Lautenbacher, S., Vachon-Presseau, E., & Rainville, P. (2011). Cerebral regulation of facial expressions of pain. Journal of Neuroscience, 31(24), 8730–8. doi: 10.1523/jneurosci.0217-11.2011 [DOI:10.1523/JNEUROSCI.0217-11.2011]
25. Kunz, M., Gruber, A., & Lautenbacher, S. (2006). Sex differences in facial encoding of pain. The Journal of Pain, 7(12), 915–28. doi: 10.1016/j.jpain.2006.04.012 [DOI:10.1016/j.jpain.2006.04.012]
26. Kunz, M., Mylius, V., Schepelmann, K., & Lautenbacher, S. (2004). On the relationship between self-report and facial expression of pain. The Journal of Pain, 5(7), 368–76. doi: 10.1016/j.jpain.2004.06.002 [DOI:10.1016/j.jpain.2004.06.002]
27. Kunz, M., Mylius, V., Schepelmann, K., & Lautenbacher, S. (2008). Impact of age on the facial expression of pain. Journal of Psychosomatic Research, 64(3), 311–8. doi: 10.1016/j.jpsychores.2007.09.010 [DOI:10.1016/j.jpsychores.2007.09.010]
28. Kwan, C. L., Crawley, A. P., Mikulis, D. J., & Davis, K. D. (2000). An fMRI study of the anterior cingulate cortex and surrounding medial wall activations evoked by noxious cutaneous heat and cold stimuli. Pain, 85(3), 359-74. PMID: 10781909 [DOI:10.1016/S0304-3959(99)00287-0]
29. LeResche, L., & Dworkin, S. F. (1984). Facial expression accompanying pain. Social Science & Medicine, 19(12), 1325–30. doi: 10.1016/0277-9536(84)90020-0 [DOI:10.1016/0277-9536(84)90020-0]
30. Littman, G. S., Walker, B. R., & Schneider, B. E. (1985). Reassessment of verbal and visual analog ratings in analgesic studies. Clinical Pharmacology and Therapeutics, 38(1), 16–23. doi: 10.1038/clpt.1985.127 [DOI:10.1038/clpt.1985.127]
31. Lord, B. (2009). Paramedic assessment of pain in the cognitively impaired adult patient. BMC Emergency Medicine, 9(1). doi: 10.1186/1471-227x-9-20 [DOI:10.1186/1471-227X-9-20]
32. Lucey, P., Cohn, J. F., Prkachin, K. M., Solomon, P. E., Chew, S., & Matthews, I. (2012). Painful monitoring: Automatic pain monitoring using the UNBC-McMaster shoulder pain expression archive database. Image and Vision Computing, 30(3), 197–205. doi: 10.1016/j.imavis.2011.12.003 [DOI:10.1016/j.imavis.2011.12.003]
33. Merskey, H. (1979). Pain terms: A list with definitions and notes on usage. Recommended by the IASP Subcommittee on Taxonomy. Pain, 6, 249-52. PMID: 460932
34. Mogil, J. S. (2015). Social modulation of and by pain in humans and rodents. Pain, 156, S35–S41. doi: 10.1097/01.j.pain.0000460341.62094.77 [DOI:10.1097/01.j.pain.0000460341.62094.77]
35. Moisset, X., & Bouhassira, D. (2007). Brain imaging of neuropathic pain. NeuroImage, 37, S80–8. doi: 10.1016/j.neuroimage.2007.03.054 [DOI:10.1016/j.neuroimage.2007.03.054]
36. Moore, R. A., Straube, S., & Aldington, D. (2013). Pain measures and cut-offs - "no worse than mild pain" as a simple, universal outcome. Anaesthesia, 68(4), 400–12. doi: 10.1111/anae.12148 [DOI:10.1111/anae.12148]
37. Nasu, T., Taguchi, T., & Mizumura, K. (2010). Persistent deep mechanical hyperalgesia induced by repeated cold stress in rats. European Journal of Pain, 14(3), 236–44. doi: 10.1016/j.ejpain.2009.05.009 [DOI:10.1016/j.ejpain.2009.05.009]
38. Prkachin, K. M. (1992). The consistency of facial expressions of pain: a comparison across modalities. Pain, 51(3), 297–306. doi: 10.1016/0304-3959(92)90213-u [DOI:10.1016/0304-3959(92)90213-U]
39. Puntillo, K. A., Miaskowski, C., Kehrle, K., Stannard, D., Gleeson, S., & Nye, P. (1997). Relationship between behavioral and physiological indicators of pain, critical care patients' self-reports of pain, and opioid administration. Critical Care Medicine, 25(7), 1159-66. doi: 10.1097/00003246-199707000-00017 [DOI:10.1097/00003246-199707000-00017]
40. Quiton, R. L., & Greenspan, J. D. (2008). Across- and within-session variability of ratings of painful contact heat stimuli. Pain, 137(2), 245–56. doi: 10.1016/j.pain.2007.08.034 [DOI:10.1016/j.pain.2007.08.034]
41. Robinson, M. E., Staud, R., & Price, D. D. (2013). Pain measurement and brain activity: Will neuroimages replace pain ratings. The Journal of Pain, 14(4), 323–7. doi: 10.1016/j.jpain.2012.05.007 [DOI:10.1016/j.jpain.2012.05.007]
42. Rohling, M. L., Binder, L. M., & Langhinrichsen-Rohling, J. (1995). Money matters: A meta-analytic review of the association between financial compensation and the experience and treatment of chronic pain. Health Psychology, 14(6), 537–47. doi: 10.1037/0278-6133.14.6.537 [DOI:10.1037/0278-6133.14.6.537]
43. Shrout, P. E. (1998). Measurement reliability and agreement in psychiatry. Statistical Methods in Medical Research, 7(3), 301–17. doi: 10.1177/096228029800700306 [DOI:10.1177/096228029800700306]
44. Singer, T. (2004). Empathy for pain involves the affective but not sensory components of pain. Science, 303(5661), 1157–62. doi: 10.1126/science.1093535 [DOI:10.1126/science.1093535]
45. Takahashi, K., Taguchi, T., Itoh, K., Okada, K., Kawakita, K., & Mizumura, K. (2005). Influence of surface anesthesia on the pressure pain threshold measured with different-sized probes. Somatosensory & Motor Research, 22(4), 299–305. doi: 10.1080/08990220500420475 [DOI:10.1080/08990220500420475]
46. Takai, Y., Yamamoto Mitani, N., Chiba, Y., Nishikawa, Y., Hayashi, K., & Sugai, Y. (2010). Abbey pain scale: Development and validation of the Japanese version. Geriatrics & gerontology international, 10(2), 145-53. doi: 10.1111/j.1447-0594.2009.00568.x. [DOI:10.1111/j.1447-0594.2009.00568.x]
47. Treede, R. D., Kenshalo, D. R., Gracely, R. H., & Jones, A. K. . (1999). The cortical representation of pain. Pain, 79(2), 105–11. doi: 10.1016/s0304-3959(98)00184-5 [DOI:10.1016/S0304-3959(98)00184-5]
48. Vlaeyen, J. W. S., Hanssen, M., Goubert, L., Vervoort, T., Peters, M., van Breukelen, G., et al. (2009). Threat of pain influences social context effects on verbal pain report and facial expression. Behaviour Research and Therapy, 47(9), 774–82. doi: 10.1016/j.brat.2009.05.008 [DOI:10.1016/j.brat.2009.05.008]
49. Wallenstein, S., Heidrich d, G., Kaiko, R., & Houde, R. (1980). Clinical evaluation of mild analgesics: the measurement of clinical pain. British Journal of Clinical Pharmacology, 10(S2), 319S–27. doi: 10.1111/j.1365-2125.1980.tb01816.x [DOI:10.1111/j.1365-2125.1980.tb01816.x]
50. Williams, A. C. de C. (2002). Facial expression of pain: An evolutionary account. Behavioral and Brain Sciences, 25(4):439-55. doi: 10.1017/s0140525x02000080 [DOI:10.1017/S0140525X02000080]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Copyright © The Author(s);
This is an open access article distributed under the terms of the Creative Commons Attribution License (CC-By-NC), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Contact Information
