An endogenous pain control system is altered in subjects with interstitial cystitis.
An endogenous pain control system is altered in subjects with interstitial cystitis.
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DOI：
10.1016/j.juro.2013.08.024
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发表时间：
2014-02
期刊：
影响因子：
--
通讯作者：
Fillingim RB
中科院分区：
文献类型：
--
作者：
Ness TJ;Lloyd LK;Fillingim RB
多项研究表明，在健康受试者中，施加到身体某一部位的疼痛刺激会抑制身体其他部位的疼痛感，这种现象称为条件性疼痛调节（CPM）。 CPM 与内源性疼痛控制系统的存在有关。研究表明，许多（但并非所有）慢性疼痛疾病都存在与 CPM 相关的抑制缺陷。本研究旨在确定间质性膀胱炎/膀胱疼痛综合征 (IC/BPS) 受试者的 CPM 是否发生改变。使用定量皮肤热、前臂缺血和冰水浸泡测试对患有和未诊断出 IC/BPS 的女性受试者进行心理物理学研究。通过量化将手浸入冰水中（条件刺激）对施加到对侧下肢的皮肤热痛（测试刺激）的阈值和耐受性的影响来评估 CPM。对于皮肤热阈值和耐受性测量，IC/BPS 受试者的 CPM 反应与健康对照受试者的 CPM 反应存在统计学差异。健康对照受试者表现出统计上显着的热痛耐受性增加，而诊断为 IC/BPS 的受试者表现出统计上显着的热痛耐受性下降。通常用 CPM 观察到的内源性疼痛抑制系统在 IC/BPS 受试者中发生了改变。这表明 IC/BPS 与其他几种慢性疼痛疾病（如纤维肌痛和肠易激综合征）相似，并表明内源性疼痛抑制系统的缺陷可能是此类慢性疼痛疾病的一个原因。
Multiple studies have demonstrated that in healthy subjects painful stimuli applied to one part of the body inhibit pain sensation in other parts of the body, a phenomenon referred to as conditioned pain modulation (CPM). CPM is related to the presence of endogenous pain control systems. Studies have demonstrated deficits in CPM-associated inhibition in many, but not all chronic pain disorders. The present study sought to determine whether CPM was altered in subjects with Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS). Female subjects with and without the diagnosis of IC/BPS were studied psychophysically using quantitative cutaneous thermal, forearm ischemia and ice water immersion tests. CPM was assessed by quantifying the effects of immersion of the hand in ice water (conditioning stimulus) on threshold and tolerance of cutaneous heat pain (test stimulus) applied to the contralateral lower extremity. CPM responses of the subjects with IC/BPS were statistically different from those of healthy control subjects for both cutaneous thermal threshold and tolerance measures. Healthy control subjects demonstrated statistically significant increases in their thermal pain tolerances whereas subjects with the diagnosis of IC/BPS demonstrated statistically significant reductions in their thermal pain tolerances. An endogenous pain inhibitory system normally observed with CPM was altered in subjects with IC/BPS. This identifies IC/BPS as similar to several other chronic pain disorders such as fibromyalgia and irritable bowel syndrome and suggests that a deficit in endogenous pain inhibitory systems may be a contributor to such chronic pain disorders.