慢性外周神经性疼痛中的过度紧张征兆

IF 3.5 2区 医学 Q1 ANESTHESIOLOGY
Malin Erika Carmland, Melissa Dall Kreutzfeldt, Peter Kolind Brask-Thomsen, Troels Staehelin Jensen, Flemming Winther Bach, Søren Hein Sindrup, Nanna Brix Finnerup
{"title":"慢性外周神经性疼痛中的过度紧张征兆","authors":"Malin Erika Carmland, Melissa Dall Kreutzfeldt, Peter Kolind Brask-Thomsen, Troels Staehelin Jensen, Flemming Winther Bach, Søren Hein Sindrup, Nanna Brix Finnerup","doi":"10.1002/ejp.4739","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Neuropathic pain is pain due to a disease or lesion of the somatosensory system, and can be either spontaneous, evoked or both. Hyperpathia is a type of evoked pain defined by IASP as 'a painful syndrome characterized by an abnormally painful reaction to a stimulus, especially a repetitive stimulus, as well as an increased threshold'. The literature is sparse, and definitions are unclear and inconsistent.</p><p><strong>Methods: </strong>The aim of this study was to examine for the presence of mechanical hyperpathia in a heterogeneous group of patients with peripheral neuropathic pain and correlate signs of hyperpathia with other sensory signs. Patients were examined with graded pinprick stimuli to obtain a stimulus-response curve and repetitive pinprick stimuli to assess increase in pain over time and aftersensations. Then, patients were grouped based on the likelihood of having mechanical hyperpathia with either a steep stimulus-response curve or a steep curve on the repetitive pinprick test and results were correlated to mechanical detection and pain thresholds and other outcomes from a full quantitative sensory testing.</p><p><strong>Results: </strong>We included 124 patients with documented peripheral neuropathic pain. Patients with a steep stimulus-response curve did not overlap with patients with a steep curve on the repetitive pinprick test and both groups more often had decreased rather than increased detection and pain thresholds.</p><p><strong>Conclusions: </strong>Our study questions the concept of hyperpathia and suggests that more studies are needed to identify which symptoms and signs group together and might form a syndrome.</p><p><strong>Significance statement: </strong>Hyperpathia is a syndrome of evoked pain. It is poorly defined and little is known about its clinical presentation. Since it is part of pain symptomatology it is important to have a clear definition and understand the pathophysiology behind. This study explored signs of hyperpathia in a heterogeneous group of patients with peripheral neuropathic pain. We used stimulus-response function and repetitive pinprick stimulation to group patients based on the IASP definition. More studies are needed to understand how symptoms and signs coincide.</p>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.5000,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Signs of hyperpathia in chronic peripheral neuropathic pain.\",\"authors\":\"Malin Erika Carmland, Melissa Dall Kreutzfeldt, Peter Kolind Brask-Thomsen, Troels Staehelin Jensen, Flemming Winther Bach, Søren Hein Sindrup, Nanna Brix Finnerup\",\"doi\":\"10.1002/ejp.4739\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Neuropathic pain is pain due to a disease or lesion of the somatosensory system, and can be either spontaneous, evoked or both. Hyperpathia is a type of evoked pain defined by IASP as 'a painful syndrome characterized by an abnormally painful reaction to a stimulus, especially a repetitive stimulus, as well as an increased threshold'. The literature is sparse, and definitions are unclear and inconsistent.</p><p><strong>Methods: </strong>The aim of this study was to examine for the presence of mechanical hyperpathia in a heterogeneous group of patients with peripheral neuropathic pain and correlate signs of hyperpathia with other sensory signs. Patients were examined with graded pinprick stimuli to obtain a stimulus-response curve and repetitive pinprick stimuli to assess increase in pain over time and aftersensations. Then, patients were grouped based on the likelihood of having mechanical hyperpathia with either a steep stimulus-response curve or a steep curve on the repetitive pinprick test and results were correlated to mechanical detection and pain thresholds and other outcomes from a full quantitative sensory testing.</p><p><strong>Results: </strong>We included 124 patients with documented peripheral neuropathic pain. Patients with a steep stimulus-response curve did not overlap with patients with a steep curve on the repetitive pinprick test and both groups more often had decreased rather than increased detection and pain thresholds.</p><p><strong>Conclusions: </strong>Our study questions the concept of hyperpathia and suggests that more studies are needed to identify which symptoms and signs group together and might form a syndrome.</p><p><strong>Significance statement: </strong>Hyperpathia is a syndrome of evoked pain. It is poorly defined and little is known about its clinical presentation. Since it is part of pain symptomatology it is important to have a clear definition and understand the pathophysiology behind. This study explored signs of hyperpathia in a heterogeneous group of patients with peripheral neuropathic pain. We used stimulus-response function and repetitive pinprick stimulation to group patients based on the IASP definition. More studies are needed to understand how symptoms and signs coincide.</p>\",\"PeriodicalId\":12021,\"journal\":{\"name\":\"European Journal of Pain\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2024-10-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Pain\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/ejp.4739\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Pain","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ejp.4739","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

背景:神经病理性疼痛是由于躯体感觉系统的疾病或病变引起的疼痛,可以是自发的,也可以是诱发的或两者兼有。超病理性疼痛是诱发性疼痛的一种类型,国际疼痛学会(IASP)将其定义为 "一种疼痛综合征,其特征是对刺激(尤其是重复性刺激)的异常疼痛反应以及阈值升高"。相关文献较少,定义不明确且不一致:本研究的目的是检查不同类型的周围神经痛患者是否存在机械性过度紧张,并将过度紧张的迹象与其他感觉迹象联系起来。对患者进行分级针刺刺激检查,以获得刺激-反应曲线,并进行重复针刺刺激检查,以评估疼痛随时间推移而增加的情况和后遗症状。然后,根据刺激-反应曲线陡峭或重复针刺试验曲线陡峭的机械性神经过敏的可能性对患者进行分组,并将结果与机械检测和疼痛阈值以及全面定量感觉测试的其他结果相关联:我们纳入了124名有外周神经病理性疼痛记录的患者。刺激-反应曲线陡峭的患者与重复针刺试验曲线陡峭的患者并不重叠,两组患者的检测和疼痛阈值通常都是降低而非升高:我们的研究对 "过度紧张症 "的概念提出了质疑,并建议需要进行更多的研究,以确定哪些症状和体征组合在一起可能会形成一种综合征:过度紧张症是一种诱发疼痛的综合征。其定义尚不明确,临床表现也鲜为人知。由于它是疼痛症状学的一部分,因此明确定义并了解其背后的病理生理学非常重要。本研究探讨了外周神经病理性疼痛异质性患者群体中的过度紧张迹象。我们使用刺激-反应功能和重复针刺刺激,根据 IASP 定义对患者进行分组。要了解症状和体征是如何重合的,还需要更多的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Signs of hyperpathia in chronic peripheral neuropathic pain.

Background: Neuropathic pain is pain due to a disease or lesion of the somatosensory system, and can be either spontaneous, evoked or both. Hyperpathia is a type of evoked pain defined by IASP as 'a painful syndrome characterized by an abnormally painful reaction to a stimulus, especially a repetitive stimulus, as well as an increased threshold'. The literature is sparse, and definitions are unclear and inconsistent.

Methods: The aim of this study was to examine for the presence of mechanical hyperpathia in a heterogeneous group of patients with peripheral neuropathic pain and correlate signs of hyperpathia with other sensory signs. Patients were examined with graded pinprick stimuli to obtain a stimulus-response curve and repetitive pinprick stimuli to assess increase in pain over time and aftersensations. Then, patients were grouped based on the likelihood of having mechanical hyperpathia with either a steep stimulus-response curve or a steep curve on the repetitive pinprick test and results were correlated to mechanical detection and pain thresholds and other outcomes from a full quantitative sensory testing.

Results: We included 124 patients with documented peripheral neuropathic pain. Patients with a steep stimulus-response curve did not overlap with patients with a steep curve on the repetitive pinprick test and both groups more often had decreased rather than increased detection and pain thresholds.

Conclusions: Our study questions the concept of hyperpathia and suggests that more studies are needed to identify which symptoms and signs group together and might form a syndrome.

Significance statement: Hyperpathia is a syndrome of evoked pain. It is poorly defined and little is known about its clinical presentation. Since it is part of pain symptomatology it is important to have a clear definition and understand the pathophysiology behind. This study explored signs of hyperpathia in a heterogeneous group of patients with peripheral neuropathic pain. We used stimulus-response function and repetitive pinprick stimulation to group patients based on the IASP definition. More studies are needed to understand how symptoms and signs coincide.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
European Journal of Pain
European Journal of Pain 医学-临床神经学
CiteScore
7.50
自引率
5.60%
发文量
163
审稿时长
4-8 weeks
期刊介绍: European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信