Is descending analgesia dysfunctional in fibromyalgia and nonspecific low back pain?

下行镇痛在纤维肌痛和非特异性腰痛中是否功能障碍？

• 批准号: G0802156/1
• 负责人: Stuart Derbyshire
• 金额: $ 26.01万
• 依托单位: University of Birmingham
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2009
• 资助国家: 英国
• 起止时间: 2009 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=G0802156%2F1
• 关键词: descending; analgesia; dysfunctional; fibromyalgia; nonspecific

Normally patients seek help from doctors for their aches and pains and doctors diagnose diseases to explain them. Problems arise, however, when the doctor cannot find a disease to explain the aches and pains. The aches and pains alone then become the problem and the aches and pains alone define the disease. These types of aches and pains, that don?t have any known disease as a cause, are called ?functional?. There are many functional pains including fibromyalgia, where patients report feeling bruised all over, and several types of low back pain. These problems are common, accounting for roughly one out of every five visits to a family doctor. The problems are also very difficult to treat with around three out of four patients still suffering from the same aches and pains more than ten years after their first visit to a doctor. During that time the aches and pains reduce quality of life, often prevent or reduce the ability to work and may have other bad effects on health. There is a pressing need for improved understanding and treatment of these functional pains. The lack of any obvious disease in the body to account for the aches and pains has led to an increasing interest in how the brain might respond to pain in these patients. Modern brain scanners allow us to peer directly at the living, working brain and we have developed a series of procedures that allow us to change a person?s pain experience while they are scanned. One surprising finding is that a mild pain that follows a strong pain is not felt as painful. Recently we have discovered that this surprising fall in pain is due a small part of the brain becoming active and somehow blocking further pain experience. We want to know if this small part of the brain is working in the same way in patients with unexplained aches and pains. We suspect that it is not. If we are right, then our studies will provide a way to explain why some patients feel aches and pains even though their body is not injured and there are no signs of disease.

通常情况下，病人会向医生寻求疼痛的帮助，医生会诊断疾病来解释疼痛。然而，当医生找不到一种疾病来解释疼痛时，问题就出现了。只有疼痛和痛苦才成为问题，只有疼痛和痛苦才能定义疾病。这种疼痛，是不是？没有任何已知的疾病作为一个原因，被称为？功能？有许多功能性疼痛，包括纤维肌痛，患者报告感觉全身瘀伤，以及几种类型的腰痛。这些问题很常见，约占家庭医生就诊的五分之一。这些问题也很难治疗，大约四分之三的患者在第一次看医生后十多年仍然遭受同样的疼痛。在此期间，疼痛会降低生活质量，通常会阻止或降低工作能力，并可能对健康产生其他不良影响。迫切需要改善对这些功能性疼痛的理解和治疗。身体中缺乏任何明显的疾病来解释疼痛，这使得人们越来越感兴趣大脑如何对这些患者的疼痛做出反应。现代的大脑扫描仪让我们可以直接看到活着的、工作的大脑，我们已经开发了一系列程序，让我们可以改变一个人。的痛苦经历，而他们被扫描。一个令人惊讶的发现是，强烈疼痛之后的轻微疼痛并不感到疼痛。最近我们发现，这种令人惊讶的疼痛下降是由于大脑的一小部分变得活跃，并以某种方式阻止了进一步的疼痛体验。我们想知道这一小部分大脑是否以同样的方式工作在患有不明原因疼痛的患者身上。我们怀疑它不是。如果我们是正确的，那么我们的研究将提供一种方法来解释为什么有些患者即使身体没有受伤，也没有疾病的迹象，也会感到疼痛。