酒精戒断患者的体感特征分析:神经性疼痛和感觉丧失是否代表一个问题?

IF 3.9 3区 医学 Q1 CLINICAL NEUROLOGY
Aurore Fernandez, Guillaume Graf, Aurélie Lasserre, Jean-Bernard Daeppen, Paul Chu Sin Chung, Chantal Berna, Marc R. Suter
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引用次数: 0

摘要

众所周知,长期大量饮酒可引起神经系统并发症,如周围神经病变。在病理生理学方面,很少有腓肠神经和皮肤活检研究表明,小纤维可能选择性地易发生酒精相关周围神经病变的变性。在这种病理中,疼痛很少得到适当的评估。本研究旨在评估疼痛强度,潜在的神经病变特征以及小神经和大神经敏感纤维的功能。方法在本观察性研究中,连续招募27例因酒精戒断住院的成年患者和13名健康对照者。根据德国神经性疼痛研究网络的标准化方案,所有参与者都进行了定量感觉测试(QST),进行了神经学检查,并填写了评估酒精消耗和依赖、疼痛特征和心理合并症的标准化问卷。结果近一半(13/27)的患者报告疼痛。然而,疼痛强度较弱,导致对日常生活的干扰较低,其特征不支持神经性成分。小神经纤维的功能损伤经常被描述,52%的患者观察到热感觉减退。在过去2年中,高饮酒量的患者显示出更大的小纤维功能损害。患者报告疼痛,但考虑到非长度依赖性分布和缺乏神经性疼痛特征,疼痛不太可能由周围神经病变引起。AUD的慢性疼痛值得更好地评估和管理,因为它代表了改善长期临床结果的机会,可能参与复发预防。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Somatosensory profiling of patients undergoing alcohol withdrawal: Do neuropathic pain and sensory loss represent a problem?

Somatosensory profiling of patients undergoing alcohol withdrawal: Do neuropathic pain and sensory loss represent a problem?

Introduction

Chronic heavy alcohol use is known to cause neurological complications such as peripheral neuropathy. Concerning the pathophysiology, few sural nerve and skin biopsy studies showed that small fibers might be selectively vulnerable to degeneration in alcohol-related peripheral neuropathy. Pain has rarely been properly evaluated in this pathology. The present study aims at assessing pain intensity, potential neuropathic characteristics as well as the functionality of both small and large nerve sensitive fibers.

Methods

In this observational study, 27 consecutive adult patients, hospitalized for alcohol withdrawal and 13 healthy controls were recruited. All the participants underwent a quantitative sensory testing (QST) according to the standardized protocol of the German Research Network Neuropathic Pain, a neurological examination and filled standardized questionnaires assessing alcohol consumption and dependence as well as pain characteristics and psychological comorbidities.

Results

Nearly half of the patients (13/27) reported pain. Yet, pain intensity was weak, leading to a low interference with daily life, and its characteristics did not support a neuropathic component. A functional impairment of small nerve fibers was frequently described, with thermal hypoesthesia observed in 52% of patients. Patients with a higher alcohol consumption over the last 2 years showed a greater impairment of small fiber function.

Discussion

Patients report pain but it is however unlikely to be caused by peripheral neuropathy given the non-length-dependent distribution and the absence of neuropathic pain features. Chronic pain in AUD deserves to be better evaluated and managed as it represents an opportunity to improve long-term clinical outcomes, potentially participating to relapse prevention.

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来源期刊
CiteScore
6.10
自引率
7.90%
发文量
45
审稿时长
>12 weeks
期刊介绍: The Journal of the Peripheral Nervous System is the official journal of the Peripheral Nerve Society. Founded in 1996, it is the scientific journal of choice for clinicians, clinical scientists and basic neuroscientists interested in all aspects of biology and clinical research of peripheral nervous system disorders. The Journal of the Peripheral Nervous System is a peer-reviewed journal that publishes high quality articles on cell and molecular biology, genomics, neuropathic pain, clinical research, trials, and unique case reports on inherited and acquired peripheral neuropathies. Original articles are organized according to the topic in one of four specific areas: Mechanisms of Disease, Genetics, Clinical Research, and Clinical Trials. The journal also publishes regular review papers on hot topics and Special Issues on basic, clinical, or assembled research in the field of peripheral nervous system disorders. Authors interested in contributing a review-type article or a Special Issue should contact the Editorial Office to discuss the scope of the proposed article with the Editor-in-Chief.
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