African Americans show alterations in endogenous pain regulatory mechanisms and reduced pain tolerance to experimental pain procedures
African Americans show alterations in endogenous pain regulatory mechanisms and reduced pain tolerance to experimental pain procedures
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DOI：
10.1097/01.psy.0000188466.14546.68
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发表时间：
2005-11-01
影响因子：
3.3
通讯作者：
Girdler, SS
中科院分区：
文献类型：
--
作者：
Mechlin, MB;Maixner, W;Girdler, SS
目的：研究疼痛敏感性的种族差异以及疼痛耐受性与血压和神经内分泌因素的关系。方法：51名非裔美国人(24名男性，27名女性)和55名其他种族的人(主要是高加索人；26名男性，29名女性)接受了两次止血带缺血、热和冷加压试验的疼痛敏感性测试，一次是在精神应激之后，一次是在休息对照之后。测定静息和应激诱导的血压(BP)、血浆去甲肾上腺素(NE)和皮质醇。结果：在所有三种疼痛测试中，非裔美国人在休息和压力后的疼痛耐受性都低于高加索人/其他人。只有非非洲裔美国人组显示出预期的BP和疼痛敏感度之间的相反关系。非裔美国人在休息和应激时皮质醇浓度较低，对应激反应的NE和收缩压反应迟钝。只有在高加索人/其他人中，才能看到更高的应激诱导的血压、皮质醇和NE水平与更强的疼痛耐受性之间的关系。结论：结果表明，非裔美国人的内源性疼痛调节机制发生了改变，包括BP、皮质醇和NE。这种失调可能会导致他们经历更高的临床疼痛症状。据推测，非裔美国人中更大的慢性压力可能是疼痛调节变化的一个促成因素。
Objectives: To examine ethnic differences in pain sensitivity and relationship of pain tolerance to blood pressure and neuroendocrine factors. Methods: Fifty-one African Americans (24 men, 27 women) and 55 people from other ethnic groups (primarily Caucasian; 26 men, 29 women) were tested twice for pain sensitivity to tourniquet ischemia, thermal heat, and cold pressor tests, once following mental stress and once following rest control. Resting and stress-induced blood pressure (BP), plasma norepinephrine (NE), and cortisol were assessed. Results: In response to all three pain tests, African Americans had lower pain tolerance relative to Caucasian/Others after both rest and stress. Only the non-African American group showed the expected inverse relationship between BP and pain sensitivity. African Americans had lower cortisol concentrations at rest and stress and showed blunted NE and systolic BP responses to stress. Only in Caucasians/Others was the relationship seen between higher stress-induced BP, cortisol, and NE levels and greater pain tolerance. Conclusions: The results suggest that there are alterations in endogenous pain regulatory mechanisms involving BP, cortisol, and NE in African Americans. Such dysregulation may contribute to the greater rate of clinical pain symptoms they experience. It is hypothesized that greater chronic stress in African Americans may be a contributing factor to the alterations in pain regulation.