Characteristics of sensitization associated with chronic pain conditions.
Characteristics of sensitization associated with chronic pain conditions.
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DOI：
10.1097/ajp.0b013e318287aac7
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发表时间：
2014-02
期刊：
影响因子：
--
通讯作者：
Riley JL 3rd
中科院分区：
文献类型：
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作者：
Vierck CJ;Wong F;King CD;Mauderli AP;Schmidt S;Riley JL 3rd
描述和了解慢性疼痛患者痛觉过敏的致敏种类和特点。将热刺激传递到无痛受试者和患有肠易激综合征（IBS）、颞下颌关节疼痛障碍（TMD）和纤维肌痛综合征（FMS）的个体的面部、前臂和小腿。在30秒时发生预热的热电极的三次第二接触。以先升后降的顺序间隔（0.7°C步长）。在上升系列的热疼痛评级在每个网站诊断为慢性疼痛的个人更大。测试时的强烈疼痛进一步提高了所有部位的评分，但轻度或中度临床疼痛没有这种影响。所有受试者的热疼痛在手臂和腿部刺激的下降系列期间比在上升系列期间更大。无痛、FMS和TMD受试者在下行系列期间的超敏反应相当，但FMS受试者手臂或腿部刺激的持续时间增加。IBS和TMD受试者的广泛致敏并不依赖于通常用于解释与慢性疼痛相关的广泛痛觉过敏的空间和时间总和机制。在刺激手臂或腿而不是面部的下行序列期间增加的敏感性表明对脊髓的伤害性输入敏感化的倾向。FMS患者异常延长的致敏反应揭示了涉及深部躯体组织的广泛慢性疼痛的独特影响。
To describe and understand varieties and characteristics of sensitization contributing to hyperalgesia for patients with chronic pain conditions. Thermal stimulation was delivered to the face, forearm and calf of pain-free subjects and individuals with irritable bowel syndrome (IBS), temporomandibular pain disorder (TMD) and fibromyalgia syndrome (FMS). Three second contacts of a preheated thermode occurred at 30 sec. intervals in ascending and then descending series (0.7°C steps). Thermal pain ratings during ascending series were greater at each site for individuals diagnosed with chronic pain. Strong pain at the time of testing further enhanced the ratings at all sites, but mild or moderate clinical pain did not have this effect. Thermal pain for all subjects was greater during descending series than during ascending series of arm and leg stimulation. The hypersensitivity during descending series was comparable for pain-free, FMS and TMD subjects but was increased in duration for arm or leg stimulation of FMS subjects. The widespread sensitization for IBS and TMD subjects does not rely on mechanisms of spatial and temporal summation often invoked to explain widespread hyperalgesia associated with chronic pain. Increased sensitivity during descending series during stimulation of an arm or leg but not the face indicates a propensity for sensitization of nociceptive input to the spinal cord. Abnormally prolonged sensitization for FMS patients reveals a unique influence of widespread chronic pain referred to deep somatic tissues.