Aftersensations and Lingering Pain After Examination in Patients with Fibromyalgia Syndrome.
Aftersensations and Lingering Pain After Examination in Patients with Fibromyalgia Syndrome.
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DOI：
10.1093/pm/pnac089
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发表时间：
2022-12-01
期刊：
影响因子：
3.1
通讯作者：
Marshall, Andrew
中科院分区：
文献类型：
--
作者：
Berwick, Richard J.;Andersson, David A.;Goebel, Andreas;Marshall, Andrew
关键词：
纤维肌痛综合征（FMS）是一种慢性广泛性疼痛，伴有外周和中枢混合性疼痛。患者对一系列刺激表现出超敏反应。患者的钝性压力疼痛阈值通常会降低，有时（约15%）轻轻的刷牙会引起异常性疼痛。然而，据我们所知，这些刺激后的后感还没有报道。我们研究了FMS中钝压和“愉快的触摸”的感知。患者首先接受采访，并完成标准的心理测量问卷。然后，我们测量了他们对钝压的敏感性和对愉快触觉的感知，包括后感;患者随访5天，以评估钝压引起的持续疼痛。我们在英国疼痛管理中心招募了51名FMS患者和16名无痛健康对照（HC）。44例患者完成了后感方案。大多数患者在施加比HC报告疼痛的压力水平更低的机械压力后报告疼痛; FMS患者的手臂和腿部阈值中位数分别为167 kPa和233 kPa。84%（31/37）的患者在测试后1天报告了压力施加部位的持续疼痛，49%（18/37）在5天时仍然感觉到疼痛。在FMS组中，刷牙后的后感很常见，77%（34/44）的FMS患者和25%（4/16）的HC患者报告了这一情况; 34%（15/44）的患者（但无HC）认为这些后感不舒服。对于经历过后感的FMS患者，笔触愉悦度评分降低，皮肤通常是疼痛的重要部位。钝性压力评估后的疼痛通常持续数天。刺激后的后感觉是一种以前未报道的FMS现象。它们与触觉快感缺乏有关，可能是一个临床上不同的亚组。
Fibromyalgia syndrome (FMS) is a chronic widespread pain condition with mixed peripheral and central contributions. Patients display hypersensitivities to a spectrum of stimuli. Patients’ blunt pressure pain thresholds are typically reduced, and sometimes (∼15%) gentle brushstroke induces allodynia. However, aftersensations after these stimuli have not, to our knowledge, been reported. We examined the perception of blunt pressure and “pleasant touch” in FMS. Patients were first interviewed and completed standard psychometric questionnaires. We then measured their sensitivity to blunt pressure and perception of pleasant touch, including aftersensations; patients were followed up for 5 days to evaluate lingering pain from blunt pressure. We recruited 51 patients with FMS and 16 pain-free healthy controls (HCs) at a UK Pain Management Centre. Forty-four patients completed the aftersensation protocol. Most patients reported pain after the application of less mechanical pressure than the level of pressure at which HCs reported pain; median arm and leg thresholds for the patients with FMS were 167 kPa and 233 kPa, respectively. Eighty-four percent (31/37) of patients reported ongoing pain at the site of pressure application 1 day after testing, and 49% (18/37) still perceived pain at 5 days. Aftersensations after brushstroke were common in the FMS group, reported by 77% (34/44) of patients with FMS vs 25% (4/16) of HCs; 34% (15/44) of patients, but no HCs, perceived these aftersensations as uncomfortable. For patients with FMS who experienced aftersensations, brushstroke pleasantness ratings were reduced, and the skin was often an important site of pain. Pain after blunt pressure assessment typically lingers for several days. Aftersensations after brushstroke stimulation are a previously unreported FMS phenomenon. They are associated with tactile anhedonia and might identify a clinically distinct subgroup.
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DOI：
10.1016/j.amjmed.2009.09.006
发表时间：
2009-12-01
期刊：
The American journal of medicine
影响因子：
--
作者：
Clauw, Daniel J
通讯作者：
Clauw, Daniel J
影响因子：
3.5
作者：
Herdman, M.;Gudex, C.;Lloyd, A.;Janssen, M. F.;Kind, P.;Parkin, D.;Bonsel, G.;Badia, X.
通讯作者：
Badia, X.
影响因子：
3.4
作者：
Case, Laura K.;Ceko, Marta;Bushnell, M. Catherine
通讯作者：
Bushnell, M. Catherine
影响因子：
7.6
作者：
Fraley, RC;Waller, NG;Brennan, KA
通讯作者：
Brennan, KA
影响因子：
3.3
作者：
Boehme, Rebecca;van Ettinger-Veenstra, Helene;Nagi, Saad S.
通讯作者：
Nagi, Saad S.