Experimental Assessment of Affective Processing in Fibromyalgia
Experimental Assessment of Affective Processing in Fibromyalgia
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DOI：
10.1016/j.jpain.2009.04.008
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发表时间：
2009-11-01
期刊：
影响因子：
4
通讯作者：
Williams, Amy E.
中科院分区：
文献类型：
--
作者：
Bartley, Emily J.;Rhudy, Jamie L.;Williams, Amy E.
纤维肌痛综合征（FMS）是一种慢性疼痛疾病，与广泛的肌肉骨骼疼痛、压痛和疲劳有关。此外，相关研究表明，消极情绪（如抑郁、焦虑）和积极情绪缺失可能导致FMS症状。然而，有必要进行控制良好的实验研究，以确定FMS患者是否在情感加工方面存在问题。本研究在17名FMS患者和17名性别和年龄匹配的健康对照者中使用了一种经过验证的图片观看范式来唤起情绪反应。每个参与者都观看了令人愉悦的（色情）、中性的和令人不快的（与攻击有关的）图片，三分之二的图片会发出突然的白噪音，以引起震惊的眨眼。食欲和防御反应是通过对图片的主观反应（效价/愉悦和唤醒等级）和生理反应（波纹肌肌电图、心率、皮肤电导反应、惊吓反射调节）来评估的。结果表明，FMS与令人不快的、与威胁相关的图片有更大的防御激活（不愉快、主观唤醒、瓦楞纸肌电图）相关，但与情欲图片的食欲激活缺陷无关。虽然是初步的，但这些数据表明，FMS患者在情感处理方面存在缺陷，但这种失调可能仅限于防御激活。讨论了治疗和未来研究的意义。观点：纤维肌痛是一种与情感痛苦相关的衰弱性疾病。本研究的结果表明，FMS与非痛苦威胁相关刺激的防御激活增强有关，但与性欲刺激的食欲反应缺陷无关。这些发现对FMS的治疗和研究具有启示意义。(C) 2009年由美国疼痛学会出版
Fibromyalgia syndrome (FMS) is a chronic pain disorder associated with widespread musculoskeletal pain, tenderness, and fatigue. Additionally, correlational research suggests negative affect (eg, depression, anxiety) and deficits in positive affect may contribute to FMS symptomatology. However, well-controlled, experimental research is necessary to ascertain whether patients with FMS have problems in affective processing. The present study used a well-validated picture-viewing paradigm to evoke emotional responses in 17 patients with FMS and 17 sex- and age-matched healthy control participants. Each participant viewed pleasant (erotica), neutral, and unpleasant (attack related) pictures, and abrupt white noises were delivered during two-thirds of the pictures to evoke startle eyeblinks. Appetitive and defensive responding was assessed from subjective (valence/pleasure and arousal ratings) and physiological (corrugator EMG, heart rate, skin-conductance response, startle-reflex modulation) reactions to pictures. Results suggested FMS was associated with greater defensive activation (displeasure, subjective arousal, corrugator EMG) to the unpleasant, threat-related pictures, but not deficits in appetitive activation to erotic pictures. Although preliminary, these data suggest individuals with FMS have deficits in affective processing, but this dysregulation may be limited to defensive activation. Implications for treatment and future research are discussed.Perspective: Fibromyalgia is a debilitating disease associated with affective distress. Results from the present study suggest that FMS is associated with enhanced defensive activation to nonpainful threat-related stimuli, but not deficits in appetitive reactions to erotic stimuli. These findings have implications for the treatment and study of FMS. (C) 2009 by the American Pain Society