Comparison of experimental and acute clinical pain responses in humans as pain phenotypes

被引:64
|
作者
Kim, H [1 ]
Neubert, JK [1 ]
Rowan, JS [1 ]
Brahim, JS [1 ]
Iadarola, MJ [1 ]
Dionne, RA [1 ]
机构
[1] NIDCR, Pain & Neurosensory Mechanisms Branch, NIH, Bethesda, MD 20892 USA
来源
JOURNAL OF PAIN | 2004年 / 5卷 / 07期
基金
美国国家卫生研究院;
关键词
pain; phenotype; thermal testing; cold pressor; clinical inflammatory pain;
D O I
10.1016/j.jpain.2004.06.003
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
This study evaluates the sensitivity of normal subjects (N = 617; 369 women, 248 men) to experimentally induced pain including thermal stimuli and the cold pressor test to delineate individual response patterns and pain phenotypes. A subset of subjects (n = 157; 99 women and 58 men) also underwent standardized oral surgery, and the responses to clinically induced acute inflammatory pain were evaluated. A wide range of pain responses was found in both the experimental and clinical situations. The latency for withdrawal in the cold pressor test exhibited a dichotomous distribution of short and long times. Women exhibited higher responses to cold (P < .001) and thermal stimuli (P < .05) than men. Ethnicity affected pain responses to thermal stimuli ranging from 43degreesC to 47degreesC (P < .05) and cold stimuli (P < .001). However, neither gender nor ethnicity affected pain responses to clinically induced acute inflammatory stimuli. Cross-modality comparisons of responses within experimental pain showed strong correlations (P < .01) but weaker relationships with clinical inflammatory pain. These data suggest that the background factors and characteristics of experimental pain responses differ from those of clinical pain; therefore, experimental pain ratings alone are not sufficient to predict responses to clinically induced acute pain. Perspective: The findings of the present study suggest that investigations of pain phenotypes should take into consideration the subjects' gender and ethnicity and the pain-inducing stimuli. The predictive value of experimental pain for clinically induced pain is weak and not reliable. (C) 2004 by the American Pain Society.
引用
收藏
页码:377 / 384
页数:8
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