MULTIMETHOD ASSESSMENT OF EXPERIMENTAL AND CLINICAL PAIN IN PATIENTS WITH FIBROMYALGIA
MULTIMETHOD ASSESSMENT OF EXPERIMENTAL AND CLINICAL PAIN IN PATIENTS WITH FIBROMYALGIA
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DOI：
10.1016/0304-3959(94)90046-9
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发表时间：
1994-10-01
期刊：
影响因子：
7.4
通讯作者：
MCCAIN, GA
中科院分区：
文献类型：
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作者：
LAUTENBACHER, S;ROLLMAN, GB;MCCAIN, GA
在26名纤维肌痛女性患者和相同数量的年龄匹配的健康女性中，评估了对疼痛和非疼痛刺激的反应性实验测量以及典型和当前临床疼痛的测量。通过测痛仪测定的患者压痛阈值在压痛点（肱二头肌）和非压痛控制点（前臂内侧）均低于对照组。使用接触式热电极测量的热痛阈值也是如此。与此相反，皮肤电刺激的痛阈值下降，只有在招标点。非疼痛刺激（温暖，寒冷和电刺激）的检测阈值似乎在纤维肌痛患者中受影响较小，只有寒冷的检测阈值在两个部位都较低。压痛点比控制点对机械压力更敏感。对其他被测试的模式发现了相反的情况。尽管3种实验痛阈均表现为全身性或部位特异性疼痛高反应模式，但方法间相关性并不很高。虽然实验疼痛阈值和患者的临床疼痛的各种措施（局部疼痛评级，麦吉尔疼痛问卷）之间的相关性普遍较低，有显着的负相关性之间的压力疼痛阈值在两个网站和局部疼痛评级评估的疼痛水平。我们的结论是，一种疼痛高反应性的模式，广义的整个网站的伤害性刺激和整个物理性质的压力，与纤维肌痛。高反应性的模式似乎涉及外周因素（例如，肌肉伤害感受器的敏化）和中枢伤害感受器（例如，过度警觉或缺乏伤害性抑制）。
Experimental measures of responsiveness to painful and non-painful stimuli as well as measures of typical and present clinical pain were assessed in 26 female patients with fibromyalgia and in an equal number of age-matched healthy women. Pressure pain thresholds, determined by means of a dolorimeter, were lower in the patients compared to the control subjects both at a tender point (trapezius) and at a non-tender control point (inner forearm). The same was true for the heat pain thresholds, measured using a contact thermode. In contrast, the pain thresholds for electrocutaneous stimuli were decreased only at the tender point. The detection thresholds for non-painful stimuli (warmth, cold and electrical stimuli) seemed to be less affected in the fibromyalgia patients, with only the detection threshold for cold being lower at both sites. Tender points were more sensitive than control points for mechanical pressure. The reverse was found for the other modalities which were tested. Although the 3 experimental pain thresholds showed patterns of either generalized or site-specific pain hyperresponsiveness, the between-methods correlations were not very high. While the correlations between the experimental pain thresholds and the various measures of clinical pain (Localized Pain Rating, McGill Pain Questionnaire) in the patients were generally low, there were significant negative correlations between pressure pain thresholds at the two sites and the level of present pain assessed by the Localized Pain Rating. We conclude that a pattern of pain hyperresponsiveness, generalized across the site of noxious stimulation and across the physical nature of the stressor, is associated with fibromyalgia. The pattern of hyperresponsiveness appears to involve both peripheral factors (e.g., sensitization of muscle nociceptors) and central ones (e.g., hypervigilance or a lack of nociceptive inhibition).