User-independent assessment of conditioning pain modulation by cuff pressure algometry
User-independent assessment of conditioning pain modulation by cuff pressure algometry
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DOI：
10.1002/ejp.958
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发表时间：
2017-03-01
影响因子：
3.6
通讯作者：
Arendt-Nielsen, L.
中科院分区：
文献类型：
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作者：
Graven-Nielsen, T.;Izumi, M.;Arendt-Nielsen, L.
背景：条件性疼痛调制(CPM)的使用受到重复性差和缺乏独立于用户的范例的阻碍。方法：在20名受试者中，在不同的袖带条件(10、30、60kPA/60 S；30、60kPA/10 S)前和同时进行的对侧小腿疼痛测试刺激下，观察袖带刺激对手臂持续模式的影响。作为测试刺激，另一个袖带充气(1kpa/S)，直到受试者检测到疼痛耐受阈值，在此期间提取疼痛检测阈值和10 cm视觉模拟评分(PVAS6)上疼痛强度为6 cm的压力。作为比较，压力痛阈值(PPTs)作为测试刺激被记录在依赖于用户的手持压力痛觉计量仪中。此外，还评估了调节(疼痛强度标准化)和对侧测试刺激(腿-臂、腿-腿、臂-大腿)的袖带位置的组合。结果：在所有实验方案中，PDT、PVAS6和PTT在条件反射过程中均较基础状态下增加(p<；0.05)。PVAS6、PTT和PPT的CPM效应(即条件反射减去基线)随着条件化强度的增加而增加(p<；0.05)。CPM效应在条件反射持续时间或条件反射/测试刺激位置的变化中没有显著差异。在两次训练中，在腿部/大腿接受60 S条件反射后，评估PVAS6和PTT的CPM效果的类内相关系数最高(0.47-0.73)，PPT的类内相关系数为0.04-0.6。结论：用户独立的袖带计算法用于CPM评估是可靠的，对于痛阈值上的刺激比用户依赖的技术更好。意义：一种用户独立的CPM技术，条件反应由一个袖带刺激控制，测试刺激由另一个袖带刺激提供。本研究表明袖带痛觉计量法用于CPM评估是可靠的。
Background: The use of conditioning pain modulation (CPM) is hampered by poor reproducibility and lack of user-independent paradigms. This study refined the CPM paradigm by applying user-independent cuff algometry.Methods: In 20 subjects, the CPM effect of conditioning with cuff stimulation on the arm was investigated by pain test stimuli on the contralateral leg before and in parallel with different cuff conditionings (10, 30, 60 kPa/60 s; 30, 60 kPa/10 s). As test stimulus, another cuff was inflated (1 kPa/s) until the subjects detected the pain tolerance threshold (PTT) during which the pain detection threshold (PDT) and the pressure at a pain intensity of 6 cm on a 10-cm visual analogue scale (PVAS6) were extracted. For comparison, pressure pain thresholds (PPTs) as test stimuli were recorded by the user-dependent handheld pressure algometry. Combinations of cuff locations for conditioning (pain intensity standardized) and contralateral test stimuli were additionally evaluated (leg-arm, leg-leg, arm-thigh). The test-retest reliability in two sessions 1 month apart was assessed in five CPM protocols.Results: In all protocols, the PDT, PVAS6 and PTT increased during conditioning compared with baseline (p < 0.05). The CPM effect (i.e. conditioning minus baseline) for PVAS6, PTT and PPT increased for increasing conditioning intensities (p < 0.05). The CPM effects were not significantly different for changes in conditioning durations or conditioning/test stimulus locations. In two sessions, the CPM effects for PVAS6 and PTT assessed after 60 s of conditioning on the leg/thigh showed the highest intra-class correlations (0.47-0.73), where they were 0.04-0.6 for PPTs.Conclusions: The user-independent cuff algometry is reliable for CPM assessment and for supra-pain threshold test stimuli better than the user-dependent technology.Significance: A user-independent CPM technique where the conditioning is controlled by one cuff stimulation, and the test-stimulus is provided by another cuff stimulation. This study shows that cuff algometry is reliable for CPM assessment.