Biological and psychological predictors of visceral pain sensitivity in healthy premenopausal women
Biological and psychological predictors of visceral pain sensitivity in healthy premenopausal women
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DOI：
10.1002/j.1532-2149.2013.00397.x
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发表时间：
2014-04-01
影响因子：
3.6
通讯作者：
Elsenbruch, S.
中科院分区：
文献类型：
--
作者：
Lacourt, T. E.;Houtveen, J. H.;Elsenbruch, S.
背景与疼痛感知相关的因素仍然不完全清楚，特别是在内脏痛领域。因此，目前的研究旨在探讨可能的心理和生物学预测内脏疼痛敏感性在健康subjects.MethodsIn一个样本的59名健康绝经前女性受试者的激素避孕药，胃肠道（GI）症状的措施，在日常生活中，特质和状态焦虑，抑郁，血清皮质醇浓度和血清白细胞介素-6（IL-6）水平，随后评估直肠扩张疼痛敏感性测量（即，直肠扩张感觉阈值，疼痛阈值和疼痛等级离散直肠扩张刺激）。结果回归分析表明，更多的GI症状在日常生活中预测较低的疼痛阈值。较高水平的状态焦虑预示着较低的疼痛阈值。较高的皮质醇浓度预示着较低的疼痛等级。IL-6与胃肠道症状呈正相关，但在多元回归分析中，疼痛阈值是一个非显着的预测因子。与躯体疼痛研究结果一致，状态焦虑而不是特质焦虑被发现可以预测内脏疼痛敏感性。我们发现血清皮质醇作为疼痛敏感性的阳性预测因子，这一发现可能与皮质醇的免疫抑制作用有关。我们发现IL-6在胃肠道症状中的作用对于了解患者的胃肠道症状是有希望的，需要进一步调查。
BackgroundFactors that are associated with pain perception remain incompletely understood, especially in the visceral pain field. Therefore, the current study aimed to investigate possible psychological and biological predictors of visceral pain sensitivity in healthy subjects.MethodsIn a sample of 59 healthy premenopausal female subjects on hormonal contraceptives, measures of gastrointestinal (GI) symptoms in daily life, trait and state anxiety, depression, serum cortisol concentrations and serum levels of interleukin-6 (IL-6) were obtained, followed by assessment of rectal distension pain sensitivity measures (i.e., rectal distension sensory threshold, pain threshold and pain ratings for discrete rectal distension stimuli).ResultsRegression analyses showed that more GI symptoms in daily life predicted a lower pain threshold. Higher levels of state anxiety predicted a lower pain threshold. Higher cortisol concentrations predicted lower pain ratings. IL-6 was positively related to GI symptoms but was a non-significant predictor of pain threshold in the multiple regression analysis.ConclusionsSimilar to findings in patients with functional GI symptoms, we showed that subclinical GI symptoms predict visceral pain sensitivity. In line with somatic pain findings, state but not trait anxiety was found to predict visceral pain sensitivity. Our finding on serum cortisol as positive predictor of pain sensitivity might be interpreted in light of immunosuppressive effects of cortisol. Our finding on the role of IL-6 in GI symptoms is promising for understanding GI complaints in patients and needs further investigation.