Psychosocial, Functional, and Emotional Correlates of Long-Term Opioid Use in Patients with Chronic Back Pain: A Cross-Sectional Case-Control Study.
Psychosocial, Functional, and Emotional Correlates of Long-Term Opioid Use in Patients with Chronic Back Pain: A Cross-Sectional Case-Control Study.
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慢性背痛患者长期使用阿片类药物的心理、功能和情绪相关性：一项横断面病例对照研究。
DOI：
10.1007/s40122-021-00257-w
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发表时间：
2021-06
期刊：
影响因子：
4
通讯作者：
Baliki MN
中科院分区：
文献类型：
--
作者：
Wakaizumi K;Vigotsky AD;Jabakhanji R;Abdallah M;Barroso J;Schnitzer TJ;Apkarian AV;Baliki MN
鸦片剂的流行造成了严重的医疗和社会后果。阿片类药物通常用于慢性疼痛患者，是阿片类药物流行的主要原因。长期使用阿片类药物的不良反应主要在依赖/成瘾性疾病中进行了研究，但未在慢性疼痛中进行研究。在这里，我们研究了长期使用阿片类药物的医源性影响，心理学和脑形态学在匹配的慢性疼痛患者中使用和不使用阿片类药物（病例对照设计）。我们比较了使用或不使用阿片类药物治疗疼痛的慢性背痛（CBP）患者的社会心理、功能和心理指标，从而控制疼痛对这些结果的影响。此外，我们研究了与长期阿片类药物使用相关的脑形态学差异。我们招募了58名CBP患者，其中29名长期使用阿片类药物，29名未使用阿片类药物，并且在年龄，性别，疼痛强度和疼痛持续时间方面匹配。问卷用于评估疼痛质量、疼痛心理、消极和积极情绪、身体、认知、感觉和运动功能、生活质量和人格特征。阿片类药物治疗的CBP患者表现出更多的负性情绪、更差的身体功能和更多的疼痛干扰（p < 0.001），而认知和运动功能以及人格特质没有统计学差异。使用结构脑成像数据的基于体素的形态测定法确定了阿片类药物患者背侧副扣带回皮质灰质密度降低（家族误差校正p < 0.05），这与负面情绪相关（p = 0.03）。最后，海马子区域的体积分析确定了阿片类药物患者的左前下托体积较低（p < 0.001）。长期使用阿片类药物治疗慢性疼痛与不良的负面情绪和残疾有关，以及特定大脑区域的灰质体积减少。在线版本包含补充材料，可通过10.1007/s40122-021-00257-w获得。
The opiate epidemic has severe medical and social consequences. Opioids are commonly prescribed in patients with chronic pain, and are a main contributor to the opiate epidemic. The adverse effects of long-term opioid usage have been studied primarily in dependence/addiction disorders, but not in chronic pain. Here, we examine the added iatrogenic effects, psychology, and brain morphology of long-term opioid use in matched patients with chronic pain with and without opioid use (case–controlled design). We compared psychosocial, functional, and psychological measures between patients with chronic back pain (CBP) who were managing their pain with or without opioids, thereby controlling for the effect of pain on these outcomes. In addition, we investigated brain morphological differences associated with long-term opioid usage. We recruited 58 patients with CBP, 29 of them on long-term opioids and 29 who did not use opioids, and who were matched in terms of age, sex, pain intensity, and pain duration. Questionnaires were used to assess pain quality, pain psychology, negative and positive emotions, physical, cognitive, sensory, and motor functions, quality of life, and personality traits. Patients with CBP on opioids displayed more negative emotion, poorer physical function, and more pain interference (p < 0.001), whereas there were no statistical differences in cognitive and motor functions and personality traits. Voxel-based morphometry using structural brain imaging data identified decreased gray matter density of the dorsal paracingulate cortex (family-wise error-corrected p < 0.05) in patients with opioids, which was associated with negative emotion (p = 0.03). Finally, a volumetric analysis of hippocampal subfields identified lower volume of the left presubiculum in patients on opioids (p < 0.001). Long-term opioid use in chronic pain is associated with adverse negative emotion and disabilities, as well as decreased gray matter volumes of specific brain regions. The online version contains supplementary material available at 10.1007/s40122-021-00257-w.
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影响因子：
7.4
作者：
Butler, Stephen F.;Budman, Simon H.;Jamison, Robert N.
通讯作者：
Jamison, Robert N.
影响因子：
9.9
作者：
Dalton, Pamela;Doty, Richard L.;Slotkin, Jerry
通讯作者：
Slotkin, Jerry
影响因子：
9.9
作者：
Cook, Karon F.;Dunn, Winnie;Gershon, Richard C.
通讯作者：
Gershon, Richard C.
DOI：
10.1016/j.pnpbp.2011.09.014
发表时间：
2012-01-10
影响因子：
5.6
作者：
Du, Ming-Ying;Wu, Qi-Zhu;Gong, Qi-Yong
通讯作者：
Gong, Qi-Yong
CDC规定慢性疼痛的阿片类药物的指南 - 美国，2016年。
DOI：
10.1001/jama.2016.1464
发表时间：
2016-04-19
期刊：
JAMA
影响因子：
--
作者：
Dowell D;Haegerich TM;Chou R
通讯作者：
Chou R