Geisser Michael E, Glass Jennifer M, Rajcevska Ljubinka D, Clauw Daniel J, Williams David A, Kileny Paul R, Gracely Richard H
Chronic Pain and Fatigue Research Center, Department of Internal Medicine, Division of Rheumatology, University of Michigan, Ann Arbor, Michigan 48108, USA.
J Pain. 2008 May;9(5):417-22. doi: 10.1016/j.jpain.2007.12.006. Epub 2008 Feb 15.
Fibromyalgia (FM) is characterized by widespread tenderness. Studies have also reported that persons with FM are sensitive to other stimuli, such as auditory tones. We hypothesized that subjects with FM would display greater sensitivity to both pressure and auditory tones and report greater sensitivity to sounds encountered in daily activities. FM subjects (n = 30) and healthy control subjects (n = 28) were administered auditory tones and pressure using the same psychophysical methods to deliver the stimuli and a common way of scaling responses. Subjects were also administered a self-report questionnaire regarding sensitivity to everyday sounds. Participants with FM displayed significantly greater sensitivity to all levels of auditory stimulation (Ps < .05). The magnitude of difference between FM patients' lowered auditory sensitivity (relative to control subjects) was similar to that seen with pressure, and pressure and auditory ratings were significantly correlated in both control subjects and subjects with FM. FM patients also were more sensitive to everyday sounds (t = 8.65, P < .001). These findings support that FM is associated with a global central nervous system augmentation in sensory processing. Further research is needed to examine the neural substrates associated with this abnormality and its role in the etiology and maintenance of FM.
Muscle tenderness is the hallmark of FM, but the findings of this study and others suggest that persons with FM display sensitivity to a number of sensory stimuli. These findings suggest that FM is associated with a global central nervous system augmentation of sensory information. These findings may also help to explain why persons with FM display a number of comorbid physical symptoms other than pain.
纤维肌痛（FM）的特征是广泛压痛。研究还报告称，FM患者对其他刺激也敏感，如听觉音调。我们假设FM患者对压力和听觉音调都表现出更高的敏感性，并报告在日常活动中对声音更敏感。使用相同的心理物理学方法对FM患者（n = 30）和健康对照者（n = 28）施加听觉音调和压力以传递刺激，并采用一种常见的反应评分方式。还让受试者填写一份关于对日常声音敏感性的自我报告问卷。FM患者对所有水平的听觉刺激都表现出显著更高的敏感性（P <.05）。FM患者降低的听觉敏感性（相对于对照者）与压力方面的差异幅度相似，并且在对照者和FM患者中，压力和听觉评分都显著相关。FM患者对日常声音也更敏感（t = 8.65，P <.001）。这些发现支持FM与感觉处理中的整体中枢神经系统增强有关。需要进一步研究来检查与这种异常相关的神经基质及其在FM病因和维持中的作用。
肌肉压痛是FM的标志，但本研究及其他研究结果表明，FM患者对多种感觉刺激敏感。这些发现表明FM与感觉信息的整体中枢神经系统增强有关。这些发现也可能有助于解释为什么FM患者除疼痛外还表现出许多共病的身体症状。
