A Subgroup of Chronic Low Back Pain Patients With Central Sensitization
A Subgroup of Chronic Low Back Pain Patients With Central Sensitization
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DOI：
10.1097/ajp.0000000000000755
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发表时间：
2019-11-01
影响因子：
2.9
通讯作者：
Sharma, Neena K.
中科院分区：
文献类型：
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作者：
Aoyagi, Kosaku;He, Jianghua;Sharma, Neena K.
背景：我们对慢性腰痛（CLBP）中枢敏化（CS）的了解有限。 2011 年纤维肌痛标准和严重程度量表（2011 年 FM 调查）已被用来确定 FM 阳性作为 CS 的替代。 CS 的主要特征包括广泛的痛觉过敏和下行抑制通路功能障碍，可以通过压力痛阈 (PPT) 和条件性疼痛调节 (CPM) 测试来识别。该研究的目的是检查 FM 阳性 CLBP 亚组与 FM 阴性 CLBP 患者相比的神经生理学特征和心理社会症状。方法：共有 46 名 CLBP 参与者和 22 名无痛对照者完成了 2011 年 FM 调查、PPT 和 CPM 测试以及心理社会问卷的结果测量。分析了 FM 阳性和 FM 阴性 CLBP 参与者在这些指标上的差异和相关性。结果：2011 年 FM 调查确定 22 名 (48%) CLBP 参与者为 FM 阳性。 FM 阳性 CLBP 参与者表现出较低的缩略图 (P=0.011) 和下背部 (P=0.003) PPT 值、较低的缩略图 CPM 值 (P=0.002) 以及更严重的灾难性疼痛、焦虑和抑郁症状 (P
Background: Our knowledge of central sensitization (CS) in chronic low back pain (CLBP) is limited. 2011 fibromyalgia criteria and severity scales (2011 FM survey) have been used to determine FM positive as a surrogate of CS. The major features of CS including widespread hyperalgesia and dysfunction of the descending inhibitory pathways can be identified by pressure pain threshold (PPT) and conditioned pain modulation (CPM) tests. The purpose of the study was to examine neurophysiological characteristics and psychosocial symptoms in a subgroup of FM-positive CLBP compared with FM-negative CLBP patients. Methods: A total of 46 participants with CLBP and 22 pain-free controls completed outcome measures of the 2011 FM survey, PPT and CPM tests, and psychosocial questionnaires. Differences between FM-positive and FM-negative CLBP participants on these measures and correlations were analyzed. Results: The 2011 FM survey identified 22 (48%) participants with CLBP as FM positive. FM-positive CLBP participants showed lower PPT values of the thumbnail (P=0.011) and lower back (P=0.003), lower CPM values of the thumbnail (P=0.002), and more severe pain catastrophizing, anxiety, and depression symptoms (P