Psychophysiological responses to visceral and somatic pain in functional chest pain identify clinically relevant pain clusters

Background Despite chronic pain being a feature of functional chest pain (FCP) its experience is variable. The factors responsible for this variability remain unresolved. We aimed to address these knowledge gaps, hypothesizing that the psychophysiological profiles of FCP patients will be distinct from healthy subjects. Methods 20 Rome III defined FCP patients (nine males, mean age 38.7 years, range 28–59 years) and 20 healthy age‐, sex‐, and ethnicity‐matched controls (nine males, mean 38.2 years, range 24–49) had anxiety, depression, and personality traits measured. Subjects had sympathetic and parasympathetic nervous system parameters measured at baseline and continuously thereafter. Subjects received standardized somatic (nail bed pressure) and visceral (esophageal balloon distension) stimuli to pain tolerance. Venous blood was sampled for cortisol at baseline, post somatic pain and post visceral pain. Key Results Patients had higher neuroticism, state and trait anxiety, and depression scores but lower extroversion scores vs controls (all p