Perception of noxious and innocuous heat stimulation among healthy women and women with fibromyalgia: association with mood, somatic focus, and catastrophizing
Perception of noxious and innocuous heat stimulation among healthy women and women with fibromyalgia: association with mood, somatic focus, and catastrophizing
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DOI：
10.1016/s0304-3959(02)00417-7
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发表时间：
2003-04-01
期刊：
影响因子：
7.4
通讯作者：
Crofford, LJ
中科院分区：
文献类型：
--
作者：
Geisser, ME;Casey, KL;Crofford, LJ
最近的研究表明，纤维肌痛患者对不同类型的疼痛刺激表现出异常的加工，这表明这种疾病的特征是中枢疼痛处理缺陷，而不仅仅限于肌肉疼痛。在本研究中，对20名纤维肌痛妇女和20名正常健康妇女的压力、疼痛刺激和对有害和无害强度的接触热的反应进行了比较。根据美国风湿病学会的标准，患有纤维肌痛的女性在18个压痛点显示出显著较低的压痛阈值，在五个对照部位也表现出较低的压痛阈值。当刺激左前臂掌侧表面时，患有纤维肌痛的女性的热痛阈值和耐受性显著降低。在考察强度和对持续刺激的不适感的视觉模拟评分时，对这些评分进行的多变量方差分析表明，刺激水平和组的主效应显著。对每个温度下的个体差异分析显示，在有害和无害温度下，两组之间的疼痛强度和不适程度存在显著差异。多元回归分析表明，在整个样本中，更大的疼痛灾害化和纤维肌痛的诊断与痛阈值和耐受性的降低有关，而抑郁症状的自我报告与阈值和耐受性的增加有关。躯体症状的自我报告与这些措施无关。这些发现表明，纤维肌痛患者对压力和热刺激的感知发生了变化，即使是在无害的水平上也是如此。他们还表明，对疼痛的灾难性想法可能在这一人群中疼痛感知的增加中发挥作用。(C)2002年国际疼痛研究协会。爱思唯尔科学公司出版。版权所有。
Recent studies have demonstrated that persons with fibromyalgia display abnormal processing of different types of painful stimulation, suggesting the disorder is characterized by a central pain-processing deficit not limited specifically to muscle pain. In the present study, 20 women with fibromyalgia and 20 normal, healthy women were compared on measures of pressure pain stimulation and response to contact thermal heat at both noxious and innocuous intensities. Women with fibromyalgia displayed significantly lower pressure pain thresholds at 18 tender point locations as defined by the American College of Rheumatology criteria, as well as lower pressure pain thresholds at five control sites. Women with fibromyalgia had significantly lower heat pain thresholds and tolerances when stimulated on the volar surface of the left forearm. When examining visual analog ratings of intensity and unpleasantness to constant stimuli, a multivariate analysis of variance performed on these ratings indicated that there were significant main effects of level of stimulation and group. Individual analysis of variances at each temperature revealed significant differences between the groups in pain intensity and unpleasantness ratings at both noxious and innocuous temperatures. Multiple regression analyses indicated that greater pain catastrophizing and diagnosis of fibromyalgia were associated with decreased pain thresholds and tolerances in the entire sample, whereas, self-report of depressive symptoms was associated with increased thresholds and tolerances. Self-report of somatic symptoms was not associated with these measures. These findings indicate that persons with fibromyalgia display altered perception of both pressure and thermal stimulation, even at innocuous levels. They also suggest that catastrophic thoughts about pain may play a role in increased pain perception in this population. (C) 2002 International Association for the Study of Pain. Published by Elsevier Science B.V. All rights reserved.