Stress-induced hyperalgesia instead of analgesia in patients with chronic musculoskeletal pain

被引：0

作者：

Loeffler, Martin ^{[1
,2
,3
]}

Schneider, Pia ^{[1
]}

Schuh-Hofer, Sigrid ^{[4
]}

Kamping, Sandra ^{[1
,6
]}

Usai, Katrin ^{[1
]}

Treede, Rolf-Detlef ^{[4
]}

Nees, Frauke ^{[1
,5
]}

Flor, Herta ^{[1
]}

机构：

[1] Heidelberg Univ, Inst Cognit & Clin Neurosci, Cent Inst Mental Hlth, Med Fac Mannheim, Sq J5, D-68159 Mannheim, Germany

[2] Univ Zurich, Balgrist Univ Hosp, Dept Chiropract Med, Integrat Spinal Res Grp, Zurich, Switzerland

[3] Univ Zurich, Zurich, Switzerland

[4] Heidelberg Univ, Med Fac Mannheim, Chair Neurophysiol, Mannheim Ctr Translat Neurosci, Heidelberg, Germany

[5] Univ Kiel, Univ Med Ctr Schleswig Holstein, Inst Med Psychol & Med Sociol, Kiel, Germany

[6] Tabea Hosp, Outpatient Clin Chron Pain, Hamburg, Germany

来源：

NEUROBIOLOGY OF PAIN | 2023年 / 13卷

关键词：

Stress -induced analgesia; Stress -induced hyperalgesia; Musculoskeletal pain; Pain modulation; Cognitive stressor;

D O I：

暂无

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Many individuals with chronic musculoskeletal pain (CMP) show impairments in their pain-modulatory capacity. Although stress plays an important role in chronic pain, it is not known if stress-induced analgesia (SIA) is affected in patients with CMP. We investigated SIA in 22 patients with CMP and 18 pain-free participants. Pain thresholds, pain tolerance and suprathreshold pain ratings were examined before and after a cognitive stressor that typically induces pain reduction (SIA). Whereas the controls displayed a significant increase in pain threshold in response to the stressor, the patients with CMP showed no analgesia. In addition, increased pain intensity ratings after the stressor indicated hyperalgesia (SIH) in the patients with CMP compared to controls. An exploratory analysis showed no significant association of SIA or SIH with spatial pain extent. We did not observe significant changes in pain tolerance or pain unpleasantness ratings after the stressor in patients with CMP or controls. Our data suggest that altered stress-induced pain modulation is an important mechanism involved in CMP. Future studies need to clarify the psychobiological mechanisms of these stress-induced alterations in pain processing and determine the role of contributing factors such as early childhood trauma, catastrophizing, comorbidity with mental disorders and genetic predisposition.

引用

页数：11