Lautenbacher S, Kunz M, Mylius V, Scharmann S, Hemmeter U, Schepelmann K
Physiologische Psychologie, Otto-Friedrich-Universität Bamberg, Markusplatz 3, 96045 Bamberg, Deutschland.
Schmerz. 2007 Nov;21(6):529-38. doi: 10.1007/s00482-007-0545-4.
It is well known that patients with dementia complain less about pain and receive fewer analgesics than other patients. The question arises of whether disorders associated with dementia change the processing of pain.
A total of 20 patients with dementia and 40 patients with mild cognitive impairment (MCI) as well as 40 healthy control subjects were investigated for their subjective (category scale), facial (FACS) and motor (R-III reflex) pain responses to mechanical and electrical stimuli.
Patients with dementia did not rate the intensity of the stimuli differently; however, they were less frequently capable of providing ratings. At equal levels of stimulus intensity, demented patients showed stronger facial responses. The R-III reflex thresholds were lowered in demented patients. MCI patients appeared only slightly changed.
Our findings suggest that the processing of acute noxious stimuli is intensified in patients with dementia. Against the background of a reduced prescription of analgesics, an under-treatment of pain in patients with dementia might be the consequence.
众所周知，与其他患者相比，痴呆症患者对疼痛的抱怨较少，接受的镇痛药也较少。由此产生一个问题，即与痴呆症相关的疾病是否会改变疼痛处理过程。
对20名痴呆症患者、40名轻度认知障碍（MCI）患者以及40名健康对照者进行了调查，观察他们对机械和电刺激的主观（分类量表）、面部（面部动作编码系统）和运动（R-III反射）疼痛反应。
痴呆症患者对刺激强度的评分没有差异；然而，他们给出评分的频率较低。在相同刺激强度水平下，痴呆症患者表现出更强的面部反应。痴呆症患者的R-III反射阈值降低。MCI患者仅有轻微变化。
我们的研究结果表明，痴呆症患者对急性伤害性刺激的处理有所增强。在镇痛药处方减少的背景下，痴呆症患者的疼痛治疗不足可能是其后果。
