利用强直性热痛和冷压力测试范式探索无痛个体的时间和条件疼痛调节反应谱

IF 3.5 2区 医学 Q1 ANESTHESIOLOGY
M. Vincenot, G. Léonard, C. Cloutier-Langevin, M. Bordeleau, L. Gendron, F. Camirand Lemyre, S. Marchand
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引用次数: 0

摘要

背景:在许多慢性疼痛个体中,时间累积(TS)和条件疼痛调节(CPM)功能受损,尽管典型的TS和CPM反应尚不清楚。提供TS和CPM值的分位数分布可以帮助确定TS和CPM反应是否超出通常范围,从而为疼痛管理策略提供信息。本研究的目的是在一个大的、无痛的队列中提供这些机制的反应分布。方法对347例无痛患者进行评价。TS被解释为在持续热痛刺激下疼痛感知评分的变化。CPM是通过冷压试验(CPT)前后补性热痛刺激和机械性痛阈引起的疼痛知觉评分的差异来评估的。进行分位数回归以确定第5至第95百分位数,特别关注第75、90和95百分位数及其置信区间,同时考虑年龄和性别。结果分析显示,TS和CPM的反应范围特别大,从CPM的强抑制和TS的强叠加到中度甚至无效。值得注意的是,一些反应偏离了预期的模式,某些个体表现出高痛觉CPM效应,而其他个体表现出低痛觉TS反应。TS分布的最高百分位数受年龄和性别的影响,而CPM分数保持不变。本研究的结果提供了对TS和CPM可能的反应谱的概述,可能为将其纳入疼痛管理策略铺平道路。本研究考察了光谱,并提供了TS和CPM值的分布,以更好地确定可能构成这些机制缺陷的因素,并加强其临床解释。临床试验注册。gov识别码:NCT03376867
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Exploring the Spectrum of Temporal Summation and Conditioned Pain Modulation Responses in Pain-Free Individuals Using a Tonic Heat Pain and Cold Pressor Test Paradigms

Exploring the Spectrum of Temporal Summation and Conditioned Pain Modulation Responses in Pain-Free Individuals Using a Tonic Heat Pain and Cold Pressor Test Paradigms

Background

Temporal summation (TS) and conditioned pain modulation (CPM) are impaired in many chronic pain individuals, although typical TS and CPM responses remain unclear. Providing a quantile distribution of TS and CPM values could help determine whether TS and CPM responses fall outside the usual ranges, thereby informing pain management strategies. The objective of this study was to provide a response distribution for these mechanisms in a large, pain-free cohort.

Methods

Pain-free participants (n = 347) were evaluated. TS was interpreted as the change in pain perception scores during a constant heat pain stimulus. CPM was assessed by the difference in pain perception scores induced by a tonic heat pain stimulus and a mechanical pain threshold, before and after a cold pressor test (CPT). Quantile regression was performed to identify the 5th to 95th percentiles, with a specific focus on the 75th, 90th and 95th percentiles and their confidence intervals, while considering age and sex.

Results

Analyses revealed a particularly large range of TS and CPM responses, spanning from strong inhibition in CPM and strong summation in TS to moderate or even null effects. Notably, some responses deviated from the expected patterns, with certain individuals exhibiting hyperalgesic CPM effects and others displaying hypoalgesic TS responses. The highest percentiles of the TS distribution were influenced by age and gender, while CPM scores remained unchanged.

Conclusion

The results of this study provide an overview of the possible spectra of responses for TS and CPM, potentially paving the way for their incorporation into pain management strategies.

Significance Statement

This study examines the spectrum and provides a distribution for TS and CPM values to better identify what may constitute a deficit in these mechanisms and enhance their clinical interpretation.

Trial Registration

clinicaltrial.gov identifier: NCT03376867

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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.
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