Intensity dependence of auditory-evoked cortical potentials in fibromyalgia patients:: A test of the generalized hypervigilance hypothesis
Intensity dependence of auditory-evoked cortical potentials in fibromyalgia patients:: A test of the generalized hypervigilance hypothesis
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DOI：
10.1016/j.jpain.2006.01.452
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发表时间：
2006-07-01
期刊：
影响因子：
4
通讯作者：
Gomez-Perretta, C.
中科院分区：
文献类型：
--
作者：
Carrillo-de-la-Pena, M. T.;Vallet, M.;Gomez-Perretta, C.
最近的证据的基础上传入的刺激放大纤维肌痛（FM）患者，它已被提出，一个广义的过度警觉的疼痛和非疼痛的感觉可能是这种疾病的根源。到目前为止，对这个问题的研究还没有定论，可能是由于缺乏一致的操作定义的“广义的过度警觉”，并缺乏强大的客观措施的特点FM患者的感觉风格。在这项研究中，我们记录了27名女性FM患者和25名健康对照者的听觉诱发电位（AEPs）的强度增加（60，70，80，90和105 dB）的音调引起的。纤维肌痛患者的N1和P2潜伏期较短，AEP的强度依赖性较强。这两个结果表明，FM患者可能是高度警惕的感官刺激，特别是当非常响亮的音调使用。患者和对照受试者之间最值得注意的差异是在最高刺激强度下，更多的患者保持与90 dB音调相关的N1-P2振幅增加。较大的AEP振幅为105分贝的音调表明，缺陷的抑制系统，防止过度刺激可能是一个至关重要的因素，在FM的病理生理。由于AEP的较强响度依赖性与弱的神经递质传递有关，因此假设许多FM患者对有害和强烈听觉刺激的反应抑制不足可能是由于神经递质缺乏所致。对FM患者对强度增加的音调反应的听觉诱发电位的研究可能有助于阐明这种疾病的病理生理学，特别是关于抑制缺陷的作用，涉及神经元功能障碍，并可能是一个有用的工具，以指导FM患者的药物治疗。(C)2006年，美国疼痛协会。
On the basis of recent evidence concerning the amplification of incoming stimulation in fibromyalgia (FM) patients, it has been proposed that a generalized hypervigilance of painful and nonpainful sensations may be at the root of this disorder. So far, research into this issue has been inconclusive, possibly owing to the lack of agreement as to the operational definition of "generalized hypervigilance" and to the lack of robust objective measures characterizing the sensory style of FM patients. In this study, we recorded auditory-evoked potentials (AEPs) elicited by tones of increasing intensity (60, 70, 80, 90, and 105 dB) in 27 female FM patients and 25 healthy controls. Fibromyalgia patients presented shorter N1 and P2 latencies and a stronger intensity dependence of their AEPs. Both results suggest that FM patients may be hypervigilant to sensory stimuli, especially when very loud tones are used. The most noteworthy difference between patients and control subjects is at the highest stimulus intensity, for which far more patients maintained increased N1-P2 amplitudes in relation to the 90-dB tones. The larger AEP amplitudes to the 105-dB tones suggest that defects in an inhibitory system protecting against overstimulation may be a crucial factor in the pathophysiology of FM. Because a stronger loudness dependence of AEPs has been related to weak serotonergic transmission, it is hypothesized that for many FM patients deficient inhibition of the response to noxious and intense auditory stimuli may be due to a serotonergic deficit.Perspective: The study of auditory-evoked potentials in response to tones of increasing intensity in FM patients may help to clarify the pathophysiology of this disorder, especially regarding the role of inhibition deficits involving serotonergic dysfunction, and may be a useful tool to guide the pharmacologic treatment of FM patients. (C) 2006 by the American Pain Society.