Temporal summation of pain from mechanical stimulation of muscle tissue in normal controls and subjects with fibromyalgia syndrome
Temporal summation of pain from mechanical stimulation of muscle tissue in normal controls and subjects with fibromyalgia syndrome
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DOI：
10.1016/s0304-3959(02)00344-5
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发表时间：
2003-03-01
期刊：
影响因子：
7.4
通讯作者：
Vierck, CJ
中科院分区：
文献类型：
--
作者：
Staud, R;Cannon, RC;Vierck, CJ
被诊断患有纤维肌痛综合征（FMS）的个体报告慢性疼痛，这种疼痛经常因体力活动而恶化，并通过休息而改善。肌肉和肌腱结构的触诊表明，深部组织中的伤害感受器在FMS中异常敏感，但需要肌肉的受控机械刺激的方法来更好地表征深部组织的敏感性。因此，力控制的机械刺激施加到前臂的屈趾肌肌肉在一系列的短暂接触（15个刺激，每个1秒的持续时间，在3或5秒的刺激间隔）。重复刺激用于确定正常受试者是否会发生深部肌肉疼痛的时间总和，以及FMS受试者是否会增强。正常对照组（NC）观察到中度深度疼痛的时间总和，FMS受试者的时间总和被大大夸大。FMS受试者的时间总和发生在大幅降低的力和较低的刺激频率。此外，疼痛的后感幅度更大，FMS受试者的持续时间更长。这些观察结果补充了先前的证明，即FMS受试者的皮肤热刺激引起的疼痛和后感的时间总和适度增强。从肌肉伤害感受器的异常输入似乎是FMS中产生中枢致敏的基础，该中枢致敏概括为从皮肤伤害感受器的输入。(C)2002年国际疼痛研究协会。由Elsevier Science B.V.出版，版权所有。
Individuals diagnosed with fibromyalgia syndrome (FMS) report chronic pain that is frequently worsened by physical activity and improved by rest. Palpation of muscle and tendinous structures suggests that nociceptors in deep tissues are abnormally sensitive in FMS, but methods of controlled mechanical stimulation of muscles are needed to better characterize the sensitivity of deep tissues. Accordingly, force-controlled mechanical stimulation was applied to the flexor digitorum muscle of the forearm in a series of brief contacts (15 stimuli, each of 1 s duration, at 3 or 5 s interstimulus intervals). Repetitive stimulation was utilized to determine whether temporal summation of deep muscular pain would occur for normal subjects and would be enhanced for FMS subjects. Moderate temporal summation of deep pain was observed for normal controls (NC), and temporal summation was greatly exaggerated for FMS subjects. Temporal summation for FMS subjects occurred at substantially lower forces and at a lower frequency of stimulation. Furthermore, painful after-sensations were greater in amplitude and more prolonged for FMS subjects. These observations complement a previous demonstration that temporal summation of pain and after-sensations elicited by thermal stimulation of the skin are moderately enhanced for FMS subjects. Abnormal input from muscle nociceptors appears to underlie production of central sensitization in FMS that generalizes to input from cutaneous nociceptors. (C) 2002 International Association for the Study of Pain. Published by Elsevier Science B.V. All rights reserved.