Touch Perception Altered by Chronic Pain and by Opioid Blockade
Touch Perception Altered by Chronic Pain and by Opioid Blockade
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DOI：
10.1523/eneuro.0138-15.2016
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发表时间：
2016-01-01
期刊：
影响因子：
3.4
通讯作者：
Bushnell, M. Catherine
中科院分区：
文献类型：
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作者：
Case, Laura K.;Ceko, Marta;Bushnell, M. Catherine
触摸在人类社会行为和社会沟通中起着重要作用，其奖励性质已被认为涉及阿片类药物。阿片类药物的封锁导致猴子增加恳求和接受梳理，这表明触摸的高度享受。我们试图研究内源性阿片类物质在健康成人和纤维肌痛患者感知情感触摸中的作用，纤维肌痛是一种慢性疼痛疾病，涉及阿片受体可用性降低。触摸的愉悦感与C触觉纤维的激活有关，C触觉纤维对缓慢轻柔的触摸反应最大，并与愉悦感的评级相关。我们管理纳洛酮的患者和健康对照组直接观察的后果类似阿片类药物的封锁对感知的愉悦和强度的触摸。我们发现，在基线慢性疼痛患者表现出迟钝的区别慢，快刷牙的强度和愉快，这表明减少C-触觉触摸处理。此外，我们发现阿片类药物阻滞对健康受试者和疼痛患者的触觉感知有不同的影响。在健康个体中，阿片类药物阻滞显示出触摸愉悦度评分增加的趋势，而在慢性疼痛患者中，它显着降低了触摸强度的评分。此外，在健康个体中，纳洛酮诱导的触摸愉悦度增加与纳洛酮诱导的缓慢触摸偏好降低相关，表明阿片类药物水平可能对C-触觉纤维输入的处理产生影响。这些发现表明内源性阿片类物质在触觉处理中的作用，并为慢性疼痛患者阿片类物质功能的改变提供了进一步的证据。
Touch plays a significant role in human social behavior and social communication, and its rewarding nature has been suggested to involve opioids. Opioid blockade in monkeys leads to increased solicitation and receipt of grooming, suggesting heightened enjoyment of touch. We sought to study the role of endogenous opioids in perception of affective touch in healthy adults and in patients with fibromyalgia, a chronic pain condition shown to involve reduced opioid receptor availability. The pleasantness of touch has been linked to the activation of C-tactile fibers, which respond maximally to slow gentle touch and correlate with ratings of pleasantness. We administered naloxone to patients and healthy controls to directly observe the consequences of similar to -opioid blockade on the perceived pleasantness and intensity of touch. We found that at baseline chronic pain patients showed a blunted distinction between slow and fast brushing for both intensity and pleasantness, suggesting reduced C-tactile touch processing. In addition, we found a differential effect of opioid blockade on touch perception in healthy subjects and pain patients. In healthy individuals, opioid blockade showed a trend toward increased ratings of touch pleasantness, while in chronic pain patients it significantly decreased ratings of touch intensity. Further, in healthy individuals, naloxone-induced increase in touch pleasantness was associated with naloxone-induced decreased preference for slow touch, suggesting a possible effect of opioid levels on processing of C-tactile fiber input. These findings suggest a role for endogenous opioids in touch processing, and provide further evidence for altered opioid functioning in chronic pain patients.