Temporal summation to thermal stimuli is elevated in women with overactive bladder syndrome
Temporal summation to thermal stimuli is elevated in women with overactive bladder syndrome
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DOI：
10.1002/nau.23059
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发表时间：
2017-04-01
影响因子：
2
通讯作者：
Bruehl, Stephen
中科院分区：
文献类型：
--
作者：
Reynolds, William Stuart;Brown, Elizabeth Timbrook;Bruehl, Stephen
本研究旨在初步评估脊髓介导的传入神经亢进（即中枢致敏）是否可能导致女性膀胱过度活跃综合征（OAB）的表现，其指标是引起热痛刺激的时间累积升高。方法我们招募20名成年OAB女性，她们计划接受OAB的介入治疗，包括肉毒杆菌毒素注射或骶骨神经调节，以及23名没有OAB症状的健康对照者，进行皮肤热痛时间累积的定量感觉测试。主要的研究结果是时间总和的程度，这反映在在49摄氏度目标温度下的10个刺激序列的正斜率的大小上。采用线性回归和协方差分析比较各研究组间时间累加的程度。结果OAB女性的时间累加试验的标准化斜率显著高于对照组（=3.43,95%可信区间=0.6-6.2，P=0.017）。全OAB组和对照组的标准化时间和斜率的调整平均SE分别为3.0 +/- 0.5（95%可信区间=2.0,4.1）和1.7 +/- 0.5（95%可信区间=0.7,2.7）。结论：在这项初步研究中，我们证明，与没有OAB症状的女性相比，原发性和继发性OAB难治性女性表现出更大的皮肤颞叶热累积。这表明，以时间总和为指标的中枢敏感化可能是导致某些女性OAB的潜在因素。Neurourol。生物工程学报。36:1108-1112,2017。(c) 2016 Wiley Periodicals, Inc.；
IntroductionThis study sought to provide a preliminary assessment of whether spinally mediated afferent hyperactivity (i.e., central sensitization) might contribute to manifestations of overactive bladder syndrome (OAB) in women as indexed by elevated temporal summation of evoked heat pain stimuli.MethodsWe recruited 20 adult women with OAB who were planning to undergo interventional therapy for OAB with either onabotulinumtoxinA injection or sacral neuromodulation and 23 healthy controls without OAB symptoms to undergo quantitative sensory testing with cutaneous thermal pain temporal summation. The primary study outcome was the degree of temporal summation, as reflected in the magnitude of positive slope of the line fitted to the series of 10 stimuli at the 49 degrees C target temperatures. Linear regression and analysis of covariance were utilized to compare the degree of temporal summation between study groups.ResultsThe standardized slope of temporal summation trials for women with OAB was significantly higher than for controls (=3.43, 95% confidence interval=0.6-6.2, P=0.017). The adjusted means SE of the standardized temporal summation slopes for the full OAB and control groups were 3.0 +/- 0.5 (95% confidence interval=2.0, 4.1) and 1.7 +/- 0.5 (95% confidence interval=0.7, 2.7), respectively.ConclusionIn this preliminary study, we demonstrated that women with OAB refractory to primary and secondary therapies exhibited greater thermal cutaneous temporal summation than women without OAB symptoms. This suggests that central sensitization, indexed by temporal summation, may be an underlying factor contributing to OAB in some women. Neurourol. Urodynam. 36:1108-1112, 2017. (c) 2016 Wiley Periodicals, Inc.