通过定量感觉测试和自述症状探讨急性非特异性颈部疼痛患者的体感觉功能

IF 2.6 3区 医学 Q2 ANESTHESIOLOGY
Jente Bontinck, Marjolein Chys, Iris Coppieters, Mira Meeus, Barbara Cagnie
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引用次数: 1

摘要

目的:躯体感觉功能的适应是几种慢性疼痛的特征,包括非特异性颈部疼痛(NNP)。中枢性致敏(CS)的早期症状会导致颈部扭伤和腰痛后的疼痛慢性化和治疗反应不良。尽管有这种明确的关联,急性NNP患者CS的患病率,以及相应的,这种关联的潜在影响,仍然不清楚。因此,本研究旨在探讨在NNP急性期是否会发生体感觉功能的改变。方法:本横断面研究比较了35例急性NNP患者和27例无痛个体。所有参与者都完成了标准化问卷和广泛的多模式定量感官测试方案。对60名患有慢性鞭扭伤相关疾病的患者进行了二次比较,其中CS已得到证实。结果:与无痛组相比,边远区压痛阈值(PPTs)、热检测和痛阈值无明显变化。然而,急性NNP患者表现出较低的颈椎PPTs和条理性疼痛调节,较高的颞叶总和、中枢致敏指数评分和疼痛强度。与慢性鞭扭伤相关疾病组相比,PPTs在任何部位都没有差异,但中枢致敏指数得分较低。讨论:体感觉功能的改变在急性NNP中已经发生。局部机械性痛觉过敏表现为外周致敏,而疼痛促进增强、条理性疼痛调节受损和CS自我报告的症状表明,早在NNP阶段,疼痛加工就已经适应了。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Exploration of Somatosensory Function of Patients With Acute Nonspecific Neck Pain, Through Quantitative Sensory Testing and Self-reported Symptoms.

Objectives: Adaptations in somatosensory function characterize several chronic pain conditions, including nonspecific neck pain (NNP). Early signs of central sensitization (CS) contribute to pain chronification and poor treatment responses after conditions such as whiplash injury and low back pain. Despite this well-established association, the prevalence of CS in patients with acute NNP, and accordingly, the potential impact of this association, is still unclear. Therefore, this study aimed to investigate whether changes in somatosensory function occur during the acute phase of NNP.

Methods: This cross-sectional study compared 35 patients with acute NNP with 27 pain-free individuals. All participants completed standardized questionnaires and an extensive multimodal Quantitative Sensory Testing protocol. A secondary comparison was made with 60 patients, with chronic whiplash-associated disorders, a population wherein CS is well-established.

Results: Compared with pain-free individuals, pressure pain thresholds (PPTs) in remote areas and thermal detection and pain thresholds were unaltered. However, patients with acute NNP showed lower cervical PPTs and conditioned pain modulation, higher temporal summation, Central Sensitization Index scores, and pain intensity. Compared with the group with chronic whiplash-associated disorders, PPTs did not differ at any location, yet the Central Sensitization Index scores were lower.

Discussion: Changes in somatosensory function occur already in acute NNP. Local mechanical hyperalgesia demonstrated peripheral sensitization, while enhanced pain facilitation, impaired conditioned pain modulation, and self-reported symptoms of CS suggest adaptations in pain processing already early in the stage of NNP.

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来源期刊
Clinical Journal of Pain
Clinical Journal of Pain 医学-临床神经学
CiteScore
5.40
自引率
3.40%
发文量
118
审稿时长
4-8 weeks
期刊介绍: ​​​The Clinical Journal of Pain explores all aspects of pain and its effective treatment, bringing readers the insights of leading anesthesiologists, surgeons, internists, neurologists, orthopedists, psychiatrists and psychologists, clinical pharmacologists, and rehabilitation medicine specialists. This peer-reviewed journal presents timely and thought-provoking articles on clinical dilemmas in pain management; valuable diagnostic procedures; promising new pharmacological, surgical, and other therapeutic modalities; psychosocial dimensions of pain; and ethical issues of concern to all medical professionals. The journal also publishes Special Topic issues on subjects of particular relevance to the practice of pain medicine.
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