Generalized sensory sensitivity is associated with comorbid pain symptoms: a replication study in women with dysmenorrhea.
Generalized sensory sensitivity is associated with comorbid pain symptoms: a replication study in women with dysmenorrhea.
复制标题
全身感觉敏感性与共病疼痛症状相关：一项针对痛经女性的重复研究。
DOI：
10.1097/j.pain.0000000000002676
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发表时间：
2023
期刊：
影响因子：
7.4
通讯作者：
Tu,FrankF
中科院分区：
文献类型：
--
作者：
Schrepf,Andrew;Hellman,KevinM;Bohnert,AmyM;Williams,DavidA;Tu,FrankF
痛经的特点是转变为慢性疼痛的几率很高。在之前的一项使用结构方程模型的研究中，我们证明了与伤害性疼痛这一新兴概念相关的几个症状领域可以使用两个症状组来描述：广义感觉敏感性（GSS；由广泛的疼痛、拦截敏感性和环境敏感性组成）和空间（由不清爽的睡眠、疼痛、情感障碍、认知问题和能量减少组成）。在这里，我们进行了二次横断面分析，检查了一组未诊断为慢性疼痛的痛经患者的相同症状组。我们的目的是确定相同的症状模式是否明显，以及它们是否与共病疼痛的存在和严重程度相关。参与者为 201 名患有痛经的女性。我们在该队列中复制了假设的双因素结构（比较拟合指数 5 0.971，均方根误差近似 50.055；90% CI：0.000-0.097）。在包括 SPACE、患者年龄和 BMI 在内的多变量模型中，广义感觉敏感性与膀胱、肠道和整体疼痛的严重程度相关（所有 b.0.32，所有 P，0.05）。睡眠、疼痛、情感障碍、认知问题和精力下降与使用非甾体抗炎药期间的经痛相关，而 GSS 与不使用非甾体抗炎药时的经痛相关（均为 0.05）。这种症状的双因素模型似乎在一群有患慢性疼痛风险的女性中是可复制和有效的。这些症状组有望成为未来疼痛慢性化的潜在标志，并可能表明患者需要更早或更积极的干预。
Dysmenorrhea is characterized by high rates of transition to chronic pain. In a previous study using structural equation modeling, we demonstrated that several symptom domains associated with the emerging concept of nociplastic pain can be described using 2 symptom groups: generalized sensory sensitivity (GSS; composed of widespread pain, interceptive sensitivity, and environmental sensitivity) and SPACE (composed of unrefreshing sleep, pain, affective disturbances, cognitive issues, and reduced energy). Here, we perform a secondary cross-sectional analysis examining the same symptoms groups in a cohort of patients with dysmenorrhea without a diagnosis of chronic pain. Our purpose is to determine if the same symptom patterns are apparent and if they are associated with the presence and severity of comorbid pain. Participants were 201 women with dysmenorrhea. We replicated the hypothesized 2-factor structure in this cohort (comparative fit index 5 0.971 and root mean square error of approximation 50.055; 90% CI: 0.000-0.097). Generalized sensory sensitivity was associated with the severity of bladder, bowel, and overall pain in multivariable models including SPACE, patient age, and BMI (all b. 0.32, all P, 0.05). Sleep, pain, affective disturbances, cognitive issues, and reduced energy were associated with menstrual pain during nonsteroidal anti-inflammatory drug use, whereas GSS was associated with the same in the absence of nonsteroidal anti-inflammatory drug use (bothP, 0.05). This 2-factor model of symptoms seems to be replicable and valid in a cohort of women at risk for developing chronic pain conditions. These symptom groups are promising potential markers of future pain chronification and may point to patients in need of earlier or more aggressive intervention.