Emotional modulation of pain and spinal nociception in persons with major depressive disorder (MDD).
Emotional modulation of pain and spinal nociception in persons with major depressive disorder (MDD).
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DOI：
10.1016/j.pain.2013.08.009
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发表时间：
2013-12
期刊：
影响因子：
7.4
通讯作者：
Rhudy JL
中科院分区：
文献类型：
--
作者：
Terry EL;DelVentura JL;Bartley EJ;Vincent AL;Rhudy JL
重度抑郁症（MDD）与慢性疼痛的风险有关，但导致MDD和疼痛关系的机制尚不清楚。为了检查是否中断的情绪调节疼痛可能有助于，本研究评估了情绪处理和情绪调节的疼痛健康对照组和未服药的人与MDD（14 MDD，14对照）。带有攻击性的图片（色情、中性、残缺）分为四个部分。两块评估生理情绪反应（快乐/唤醒评级，皱眉肌肌电图，惊吓调制，皮肤电导）在没有疼痛和两块评估疼痛的情绪调制和伤害性屈曲反射（NFR，脊髓伤害的生理措施）引起的阈上电刺激。结果表明，图片一般引起预期的情绪反应;色情图片引起的快乐，主观唤醒，和较小的惊吓幅度，而残害图片引起的不满，皱眉肌肌电图激活，和主观/生理唤醒。然而，情感处理被部分破坏，在MDD证明了一个迟钝的快感反应色情和未能根据效价线性趋势调制惊吓。此外，在对照组中观察到疼痛的情绪调节，但没有MDD，即使在NFR阈值或NFR的情绪调节方面没有组间差异。总之，这些结果表明，与情感处理和情感调制疼痛相关的脊髓上过程可能在MDD中被破坏，但调节脊髓伤害性感受的脑脊髓过程是完整的。因此，疼痛缺陷的情绪调节可能是MDD未来疼痛风险的表型标志物。
Major depressive disorder (MDD) is associated with risk for chronic pain, but the mechanisms contributing to the MDD and pain relationship are unclear. To examine whether disrupted emotional modulation of pain might contribute, this study assessed emotional processing and emotional modulation of pain in healthy controls and unmedicated persons with MDD (14 MDD, 14 controls). Emotionally-charged pictures (erotica, neutral, mutilation) were presented in four blocks. Two blocks assessed physiological-emotional reactions (pleasure/arousal ratings, corrugator EMG, startle modulation, skin conductance) in the absence of pain and two blocks assessed emotional modulation of pain and the nociceptive flexion reflex (NFR, a physiological measure of spinal nociception) evoked by suprathreshold electric stimulations. Results indicated pictures generally evoked the intended emotional responses; erotic pictures elicited pleasure, subjective arousal, and smaller startle magnitudes, whereas mutilation pictures elicited displeasure, corrugator EMG activation, and subjective/physiological arousal. However, emotional processing was partially disrupted in MDD as evidenced by a blunted pleasure response to erotica and a failure to modulate startle according to a valence linear trend. Furthermore, emotional modulation of pain was observed in controls, but not MDD, even though there were no group differences in NFR threshold or emotional modulation of NFR. Together, these results suggest supraspinal processes associated with emotion processing and emotional modulation of pain may be disrupted in MDD, but brain-to-spinal cord processes that modulate spinal nociception are intact. Thus, emotional modulation of pain deficits may be a phenotypic marker for future pain risk in MDD.
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