Fibromyalgia pain and its modulation by hypnotic and non-hypnotic suggestion: An fMRI analysis
Fibromyalgia pain and its modulation by hypnotic and non-hypnotic suggestion: An fMRI analysis
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DOI：
10.1016/j.ejpain.2008.06.010
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发表时间：
2009-05-01
影响因子：
3.6
通讯作者：
Oakley, David A.
中科院分区：
文献类型：
--
作者：
Derbyshire, Stuart W. G.;Whalley, Matthew G.;Oakley, David A.
纤维肌痛等疼痛状况的神经心理状态仍然存在争议。纤维肌痛通常被归类为“心身”或“功能”障碍。依赖于纤维肌痛疼痛体验的主观改变的大脑结构的激活可以提供对潜在的神经心理过程的洞察。催眠诱导后的暗示可以很容易地调节疼痛的主观体验。目前还不清楚没有催眠的暗示是否同样有效。为了探讨这些和相关问题，在功能磁共振成像中使用催眠诱导后的建议和未催眠诱导的相同建议来增加和减少纤维肌痛的主观体验。这两种情况下的暗示都导致了报告的疼痛体验的显著变化，尽管患者声称对他们的疼痛有明显的控制，并报告在催眠时疼痛有更大的减轻。中脑、小脑、丘脑、中扣带回、初级和次级感觉、顶叶下部、脑岛和前额叶皮质的激活与催眠和非催眠暗示的疼痛变化相关。然而，当在小脑、前扣带回皮质、前岛和后岛以及顶叶下部皮质进行催眠诱导后，这些激活的幅度更大。因此，我们的结果提供了证据，证明在催眠诱导后暗示的效果更好。它们还表明，在纤维肌痛疼痛体验中，与疼痛“神经基质”广泛相关的区域网络直接参与。这些发现超越了一般关于疼痛的神经网络的建议，提供了直接证据，表明参与疼痛体验的区域积极参与了纤维肌痛疼痛的产生。(C)2008年欧洲国际疼痛研究协会分会联合会。爱思唯尔有限公司出版。保留所有权利。
The neuropsychological Status of pain conditions Such as fibromyalgia, commonly categorized as 'psychosomatic' or 'functional' disorders, remains controversial. Activation of brain structures dependent upon subjective alterations of fibromyalgia pain experience could provide an insight into the underlying neuropsychological processes. Suggestion following a hypnotic induction can readily modulate the subjective experience of pain. It is unclear whether suggestion Without hypnosis is equally effective. To explore these and related questions, suggestions following a hypnotic induction and the same suggestions without a hypnotic induction were used during functional magnetic resonance imaging to increase and decrease the subjective experience of fibromyalgia pain. Suggestion in both conditions resulted in significant changes in reported pain experience, although patients claimed significantly more control over their pain and reported greater pain reduction when hypnotised. Activation of the midbrain, cerebellum, thalamus, and midcingulate, primary and secondary sensory, inferior parietal, insula and prefrontal cortices Correlated with reported changes in pain with hypnotic and non-hypnotic Suggestion. These activations were of greater magnitude, however, when suggestions followed a hypnotic induction in the cerebellum, anterior midcingulate cortex, anterior and posterior insula and the inferior parietal cortex. Our results thus Provide evidence for the greater efficacy of suggestion following a hypnotic induction. They also indicate direct involvement of a network of areas widely associated with the pain 'neuromatrix' in fibromyalgia pain experience. These findings extend beyond the general proposal of a neural network for pain by providing direct evidence that regions involved in pain experience are actively involved in the generation of fibromyalgia pain. (C) 2008 European Federation of Chapters of the International Association for the Study of Pain. Published by Elsevier Ltd. All rights reserved.