Associations Between Catastrophizing and Endogenous Pain-Inhibitory Processes: Sex Differences
Associations Between Catastrophizing and Endogenous Pain-Inhibitory Processes: Sex Differences
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DOI：
10.1016/j.jpain.2008.08.012
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发表时间：
2009-02-01
期刊：
影响因子：
4
通讯作者：
Edwards, Robert R.
中科院分区：
文献类型：
--
作者：
Goodin, Burel R.;McGuire, Lynanne;Edwards, Robert R.
疼痛灾难化是疼痛结果最可靠的预测因素之一，内源性疼痛抑制系统的破坏是一种潜在的机制，可能解释了报告更高疼痛灾难化的个体疼痛增加。疼痛灾难化可能会通过复杂的解剖回路将皮质对疼痛的反应与调节疼痛的过程联系起来，对内源性疼痛抑制的测量——弥漫性有害抑制控制（DNIC）产生负面影响。本研究在35名健康的年轻人中调查了DNIC是否介导了灾难化和疼痛之间的关系，并检查了性别的调节作用，以确定男性和女性之间的关联程度或方向是否不同。DNIC在冷压任务前和任务中使用前臂压力疼痛阈值进行评估。使用偏差校正的自适应置信区间，结果显示DNIC的降低是更大的疼痛相关灾难和更严重的疼痛评分之间关系的显著部分中介。参与者的性别调节了这些关联；对于男性和女性来说，更高的灾难化预测更低的DNIC，然而，灾难化对疼痛评分的影响仅部分由DNIC介导。这些发现进一步支持疼痛灾难化在疼痛结果调节中的主要作用。观点：这些发现支持这样的假设，即疼痛灾难化程度较高的个体报告的疼痛加剧可能与内源性疼痛调节的中断有关，通过评估DNIC进行操作。减少疼痛灾难化的干预措施是否会通过对DNIC的影响来影响疼痛结局，这还需要进一步的研究。(c) 2009年由美国疼痛协会发布
Pain catastrophizing is among the most robust predictors of pain outcomes, and a disruption in endogenous pain-inhibitory systems is 1 potential mechanism that may account for increased pain among individuals who report higher pain catastrophizing. Pain catastrophizing may negatively influence diffuse noxious inhibitory controls (DNIC) a measure of endogenous pain inhibition, through complex anatomical circuitry linking cortical responses to pain with processes that modulate pain. The current study examined whether DNIC mediated the relationship between catastrophizing and pain among 35 healthy young adults and examined the moderating effects of sex to determine whether the magnitude or direction of associations differed among men and women. DNIC was assessed using pressure pain thresholds on the forearm before and during a cold pressor task. Using bias-corrected bootstrapped confidence intervals, results showed that diminished DNIC was a significant partial mediator of the relation between greater pain-related catastrophizing and more severe pain ratings. Participant sex moderated these associations; higher catastrophizing predicted lower DNIC for men and women, however, the effect of catastrophizing on pain ratings was partially mediated by DNIC for women only. These findings further support the primary role of pain catastrophizing in modulation of pain outcomes.Perspective: These findings support the hypothesis that the heightened pain reported by individuals higher in pain catastrophizing may be related to a disruption in the endogenous modulation of pain, operationalized by assessing DNIC. Whether interventions that reduce pain catastrophizing affect pain outcomes via effects on DNIC is in need of investigation. (c) 2009 by the American Pain Society