Subconscious manipulation of pain expectation can modulate cortical nociceptive processing. As perceived pain inhibition was enhanced but flexion reflex size unchanged following the intervention, we suggest that the intervention gave rise to an inhibition of ascending nociceptive information at a supraspinal level resulting in reduced pain perception without influencing spinal level processing of nociceptive input. The finding that conditioned pain modulation can be enhanced is of relevance to clinical pain populations who commonly show impaired inhibition.
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