Psychophysics of phasic and tonic heat pain stimuli by quantitative sensory testing in healthy subjects
Psychophysics of phasic and tonic heat pain stimuli by quantitative sensory testing in healthy subjects
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DOI：
10.1016/s1090-3801(02)00087-3
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发表时间：
2003-01-01
影响因子：
3.6
通讯作者：
Yarnitsky, D
中科院分区：
文献类型：
--
作者：
Granot, M;Sprecher, E;Yarnitsky, D
在疼痛研究中越来越多地使用定量感觉测试，提出了描述健康受试者对有害刺激的心理物理反应的各个方面的需求。本研究旨在解决使用热痛刺激的几个问题：（a）短期重复相性刺激的疼痛评分是否一致？ (b) 暴露于强直性热痛刺激是否会导致敏化并改变后续阶段性刺激的分数？ (c) 阶段性热痛和强直性热痛的疼痛评分是否相关？为了解决这些问题，我们在一个小时内对 70 名健康志愿者的前臂进行了一系列 47 摄氏度的四阶段热痛刺激。通过视觉模拟量表（VAS）对每次刺激进行疼痛评分。在 50 名受试者中，在第一阶段和第二阶段刺激之间给予 47.5 摄氏度、持续 70 秒的强直性热痛。沿着该强直刺激在四个点处获得疼痛评分。重复测量方差分析和敏感的事后分析表明，虽然第二次几乎立即进行的试验中疼痛感觉有所减轻，但随后的疼痛感觉 VAS 评分与第一次试验没有差异（分别为#1：35.2 +/- 19.2；#2：31.4 +/- 20.2；#3：33.0 +/- 21.6；和#4：33.2 +/- 20.1），阶段性测试。平均强直性疼痛评分为 53.7 +/- 23.1。与那些没有接受强直性疼痛刺激的受试者相比，强直性疼痛刺激的施用不会导致随后的阶段性疼痛刺激的VAS评分不同。强直性疼痛和阶段性疼痛呈正相关（例如，对于第一阶段性刺激，r = 0.45，p < 0.001）。然而，在感知到的疼痛水平（无论是针对阶段性刺激还是针对强直性刺激）与强直性疼痛期间存在或不存在时间总和之间没有发现任何关系。结论：(i) 基线后 30' 和 60' 时的阶段性疼痛评分评估是一致的； (ii) 强直性热痛，尽管 VAS 评分相对较高，但不会引起后续阶段性刺激评分的变化； (iii) 阶段性疼痛评分和强直性疼痛评分彼此相关。因此，疼痛感知的正常模式是稳定的，不会因单次强直性疼痛刺激而改变。 (C) 2002 年国际疼痛研究协会欧洲分会联合会。由爱思唯尔科学有限公司出版。保留所有权利。
The increased use of quantitative sensory testing in the study of pain raises the need to characterize various aspects of psychophysical response to noxious stimulation in healthy subjects. The present study aims to address several issues regal-ding the use of heat pain stimuli: (a) Are pain scores for short-term repeated phasic stimuli consistent? (b) Does an exposure to tonic heat pain stimulus cause sensitization and change the scores for subsequent phasic stimuli? and (c) Are pain scores for phasic and tonic heat pain correlated? To address these questions, a series of four phasic heat pain stimuli of 47degreesC were given to the forearms of 70 healthy volunteers, over the course of an hour. Pain scores by Visual Analog Scale (VAS) were obtained for each stimulus. In 50 subjects, a tonic heat pain of 70 s duration at 47.5 degreesC was given between the first and second phasic stimuli. Pain scores were obtained at four points along this tonic stimulus. Repeated measures ANOVA and a sensitive post hoc analysis indicated that, while the pain perception was reduced on the second, nearly immediate trial, subsequent VAS scores of pain perception were not different from the first (#1: 35.2 +/- 19.2; #2: 31.4 +/- 20.2, #3: 33.0 +/- 21.6; and #4: 33.2 +/- 20.1, respectively), with strong correlation among the phasic tests. The average tonic pain score was 53.7 +/- 23.1. Administration of tonic pain stimuli did not result in different VAS scores of subsequent phasic pain stimuli, compared to those subjects who did not receive tonic pain stimuli. Tonic and phasic pain were positively correlated (e.g., r = 0.45, p < 0.001 for the first phasic stimuli). However, no relation was found between the level of perceived pain, either for phasic or for tonic stimuli, and presence or absence of temporal summation during the tonic pain. In conclusion: (i) phasic pain scores assessments at 30' and 60' after baseline is consistent; (ii) tonic heat pain, despite relatively high VAS scores, does not cause a change in the scoring of subsequent phasic stimuli; and (iii) phasic and tonic pain scores correlate with each other. Thus, the normal pattern of pain perception is stable and not altered by single tonic pain stimulation. (C) 2002 European Federation of Chapters of the International Association for the Study of Pain. Published by Elsevier Science Ltd. All rights reserved.