Hyperexcitable C nociceptors in fibromyalgia
Hyperexcitable C nociceptors in fibromyalgia
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DOI：
10.1002/ana.24065
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发表时间：
2014-02-01
影响因子：
11.2
通讯作者：
Bostock, Hugh
中科院分区：
文献类型：
--
作者：
Serra, Jordi;Collado, Antonio;Bostock, Hugh
目的验证纤维肌痛患者外周C伤害感受器功能异常的假说，以及C伤害感受器功能异常可能导致纤维肌痛患者报告的症状。方法采用微神经造影记录30例符合纤维肌痛标准的女性患者的C -痛觉感受器，并与17例女性小纤维神经病患者和9例女性对照进行比较。结果我们在纤维肌痛组获得了186个C痛觉感受器的稳定记录，在小纤维神经病组获得了114个，在对照组获得了66个。纤维肌痛患者的机械敏感痛觉感受器表现正常，而76.6%的纤维肌痛患者的沉默痛觉感受器表现异常。在纤维肌痛症中，31%的沉默伤害感受器检测到自发活动，在小纤维神经病中检测到34%，在对照组中检测到2.2%。在纤维肌痛患者中，有24.2%的沉默伤害感受器对机械刺激敏感，在小纤维神经病患者中有22.7%，在对照组中有3.7%。首次0.25Hz刺激时传导速度异常高减慢在纤维肌痛症中更为常见。我们首次表明，大多数纤维肌痛患者有异常的C伤害感受器。许多沉默的伤害感受器表现出与小纤维神经病变相似的高兴奋性，但高度活动依赖性传导速度减慢在纤维肌痛患者中更为常见，这可能是一个显著特征。我们推断异常外周C伤害感受器持续活动和机械敏感性增加可能导致纤维肌痛患者的疼痛和压痛。神经网络学报，2014；75:196 - 208
ObjectiveTo test the hypothesis that peripheral C nociceptor function may be abnormal in fibromyalgia and that C nociceptor dysfunction may contribute to the symptoms reported by these patients.MethodsMicroneurography was used to record C nociceptors of 30 female patients meeting criteria for fibromyalgia and compared with recordings from 17 female patients with small-fiber neuropathy and 9 female controls.ResultsWe obtained stable recordings of 186 C nociceptors in the fibromyalgia group, 114 from small-fiber neuropathy patients, and 66 from controls. The mechanosensitive nociceptors in the fibromyalgia patients behaved normally, but the silent nociceptors in 76.6% of fibromyalgia patients exhibited abnormalities. Spontaneous activity was detected in 31% of silent nociceptors in fibromyalgia, 34% in small-fiber neuropathy, and 2.2% in controls. Sensitization to mechanical stimulation was found in 24.2% of silent nociceptors in fibromyalgia, 22.7% in small-fiber neuropathy, and 3.7% in controls. Abnormally high slowing of conduction velocity when first stimulated at 0.25Hz was more common in fibromyalgia.InterpretationWe show for the first time that the majority of fibromyalgia patients have abnormal C nociceptors. Many silent nociceptors exhibit hyperexcitability resembling that in small-fiber neuropathy, but high activity-dependent slowing of conduction velocity is more common in fibromyalgia patients, and may constitute a distinguishing feature. We infer that abnormal peripheral C nociceptor ongoing activity and increased mechanical sensitivity could contribute to the pain and tenderness suffered by patients with fibromyalgia. ANN NEUROL 2014;75:196-208