Widespread hyperalgesia in irritable bowel syndrome is dynamically maintained by tonic visceral impulse input and placebo/nocebo factors: evidence from human psychophysics, animal models, and neuroimaging.
Widespread hyperalgesia in irritable bowel syndrome is dynamically maintained by tonic visceral impulse input and placebo/nocebo factors: evidence from human psychophysics, animal models, and neuroimaging.
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肠易激综合征中广泛的痛觉过敏是通过强直内脏冲动输入和安慰剂/反安慰剂因素动态维持的：来自人类心理物理学、动物模型和神经影像学的证据。
DOI：
10.1016/j.neuroimage.2009.04.028
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发表时间：
2009-09
期刊：
影响因子：
5.7
通讯作者：
Robinson ME
中科院分区：
文献类型：
--
作者：
Price DD;Craggs JG;Zhou Q;Verne GN;Perlstein WM;Robinson ME
肠易激综合征（IBS）是一种高度流行的胃肠道疾病，通常伴有内脏和躯体痛觉过敏（结肠直肠和躯体刺激引起的疼痛增强）。这两种类型的痛觉过敏的神经机制已经分析了IBS患者的神经影像学研究和动物模拟研究的“IBS样”大鼠迟发性直肠和躯体超敏反应。这些研究的结果表明，与内脏和广泛的继发性皮肤痛觉过敏相关的疼痛是由来自非炎症结肠和/或直肠的强直性脉冲输入和脑-脊髓促进作用动态维持的。与正常对照受试者相比，IBS患者的内脏和躯体疼痛增强伴随着疼痛相关的大脑活动增强;安慰剂可以使他们的痛觉过敏和增强的大脑活动正常化。IBS中的疼痛可能至少部分地由来自结肠/直肠的外周脉冲输入维持，这一点得到以下结果的支持：局部直肠-结肠麻醉使IBS患者的内脏和躯体痛觉过敏正常化，并使“IBS样”大鼠的内脏和躯体超敏性正常化。然而，这些形式的痛觉过敏也可以通过安慰剂和反安慰剂因素（例如，分别为救济或痛苦的期望）。我们的工作假设是，安慰剂/反安慰剂因子和增强的传入处理之间发生协同作用，以增强，维持或减少IBS的痛觉过敏。这种解释性模型可能与其他持续性疼痛状况有关。
Irritable bowel syndrome (IBS) is a highly prevalent gastrointestinal disorder that is often accompanied by both visceral and somatic hyperalgesia (enhanced pain from colorectal and somatic stimuli). Neural mechanisms of both types of hyperalgesia have been analyzed by neuroimaging studies of IBS patients and animal analog studies of “IBS-like” rats with delayed rectal and somatic hypersensitivity. Results from these studies suggest that pains associated with both visceral and widespread secondary cutaneous hyperalgesia are dynamically maintained by tonic impulse input from the non-inflamed colon and/or rectum and by brain-to-spinal cord facilitation. Enhanced visceral and somatic pains are accompanied by enhanced pain-related brain activity in IBS patients as compared to normal control subjects; placebos can normalize both their hyperalgesia and enhanced brain activity. That pain in IBS which is likely to be at least partly maintained by peripheral impulse input from the colon/rectum is supported by results showing that local rectal–colonic anesthesia normalizes visceral and somatic hyperalgesia in IBS patients and visceral and somatic hypersensitivity in “IBS-like” rats. Yet these forms of hyperalgesia are also highly modifiable by placebo and nocebo factors (e.g., expectations of relief or distress, respectively). Our working hypothesis is that synergistic interactions occur between placebo/nocebo factors and enhanced afferent processing so as to enhance, maintain, or reduce hyperalgesia in IBS. This explanatory model may be relevant to other persistent pain conditions.
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影响因子：
7.4
作者：
King CD;Wong F;Currie T;Mauderli AP;Fillingim RB;Riley JL 3rd
通讯作者：
Riley JL 3rd
影响因子：
7.4
作者：
Craggs JG;Price DD;Perlstein WM;Verne NG;Robinson ME
通讯作者：
Robinson ME
影响因子：
2.9
作者：
Lin, C;Al-Chaer, ED
通讯作者：
Al-Chaer, ED
影响因子：
3.1
作者：
Gupta, V;Sheffield, D;Verne, GN
通讯作者：
Verne, GN
影响因子：
4
作者：
Devor, M
通讯作者：
Devor, M