Deep pain thresholds in the distal limbs of healthy human subjects
Deep pain thresholds in the distal limbs of healthy human subjects
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DOI：
10.1016/j.ejpain.2004.04.001
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发表时间：
2005-02-01
影响因子：
3.6
通讯作者：
Treede, RD
中科院分区：
文献类型：
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作者：
Rolke, R;Campbell, KA;Treede, RD
尽管其潜在的临床重要性，但远侧肢体的压痛阈值（PPT）尚未得到充分研究。因此，我们比较了上下肢远端甲床、骨赘和肌肉的PPT。我们调查了12名健康受试者使用三种手持设备：弹簧加载，模拟压力阈值计（PTM）与两个操作范围，和电子Algometer。用三个系列的递增刺激强度以约50 kPa/s的斜坡确定PPT。PPT在对数空间呈正态分布。不同组织的PPT差异显著（ANOVA，p < 0.001）：甲床的平均阈值和95%置信区间为615 kPa（266-1424 kPa），骨赘的平均阈值和95%置信区间为581 kPa（271-1245 kPa），肌肉的平均阈值和95%置信区间为520 kPa（246-1100 kPa）。除了肌肉外，足部的PPT高于手部（ANOVA，p < 0.01）。Algometer的PPT显著低于PTM（ANOVA，p < 0.01）;同样，当对肌肉进行测试时，这些差异最小。没有显著的左右差异（ANOVA，p = 0.33）。尽管受试者之间存在相当大的变异性，但受试者内的重现性很高（相关系数>0.90）。对于受试者内比较，阈值升高超过33-43%将是异常的（95%置信区间），而相对于绝对标准值，只有与组平均值的偏差至少为2倍才是异常的。远端肌肉的PPT与近端肢体和躯干肌肉的已发表值相当。这些研究结果表明，远端肌肉的压力疼痛测试可能是对深度疼痛敏感性的敏感测试，并且简单且较便宜的设备足以测试这种组织类型。个体内研究中心间比较将比绝对标准值更敏感。(C)2004年，国际疼痛研究协会欧洲分会联合会。由爱思唯尔有限公司出版。保留所有权利。
Pressure pain thresholds (PPTs) in distal limbs have been under-investigated despite their potential clinical importance. Therefore, we compared PPTs over nail bed, bony prominences, and muscle in distal parts of upper and lower limbs. We investigated 12 healthy subjects using three handheld devices: a spring-loaded, analogue pressure threshold meter (PTM) with two operating ranges, and an electronic Algometer. PPTs were determined with three series of ascending stimulus intensities with a ramp of about 50 kPa/s. PPTs were normally distributed in logarithmic space. PPTs over different tissues varied significantly (ANOVA, p < 0.001): mean thresholds and 95% confidence intervals were 615 kPa (266-1424 kPa) over the nail bed, 581 kPa (271-1245 kPa) over bony prominences, and 520 kPa (246-1100 kPa) over muscles. PPTs on the foot were higher than on the hand (ANOVA, p < 0.01), except over muscles. PPTs were significantly lower with the Algometer than with PTMs (ANOVA, p < 0.01); again these differences were least when testing over muscle. There was no significant right-left difference (ANOVA, p = 0.33). In spite of considerable variability across subjects, reproducibility within subjects was high (correlation coefficients >0.90). For within-subject comparisons, threshold elevations beyond 33-43% would be abnormal (95% confidence intervals), whereas only deviations from the group mean by at least a factor of two would be abnormal with respect to absolute normative values. PPTs over distal muscles were comparable to published values on proximal limb and trunk muscles. These findings suggest that pressure pain testing over distal muscles may be a sensitive test for deep pain sensitivity and that the simple and less expensive devices are sufficient for testing this tissue type. Intra-individual site-to-site comparisons will be more sensitive than absolute normative values. (C) 2004 European Federation of Chapters of the International Association for the Study of Pain. Published by Elsevier Ltd. All rights reserved.