Department of Psychiatry and Psychotherapy, University Hospital, Jena, Germany.
J Pain. 2010 Mar;11(3):287-90. doi: 10.1016/j.jpain.2009.07.012. Epub 2009 Nov 27.
Most previous studies indicated that patients suffering from major depressive disorder (MDD) showed a decreased sensitivity for external or skin surface pain, eg, for heat or electrical stimuli, as compared to healthy controls. Here, we investigated cold-pain thresholds in 20 unmedicated patients suffering from MDD and 20 matched controls. We applied the ascending method of limits which has previously been used for heat-pain assessment in patients with depression. Similar to previous results for heat-pain thresholds we found a decreased sensitivity for cold pain in patients with MDD as indicated by increased cold-pain thresholds. This difference was significant on the right arm, whereas only a trend was obtained on the left arm, thus suggesting a certain degree of lateralization, similar to that seen in heat-pain perception in patients suffering from MDD or adjustment disorder. The study confirms our previous results of a lower sensitivity for externally induced pain in patients with MDD. Moreover, it adds weight to the assumption of a lateralized perception of thermal pain in depression.
This investigation provides further evidence for reduced pain perception of externally applied stimuli in major depression. Thus, central-nervous correlates for this altered pain perception in major depression are worth examining in future studies in order to gain more insight into mechanisms of pain perception on the one hand, and pathology of depression on the other.
大多数先前的研究表明,与健康对照组相比,患有重度抑郁症(MDD)的患者对外界或皮肤表面疼痛(例如热或电刺激)的敏感性降低。在这里,我们调查了 20 名未接受药物治疗的 MDD 患者和 20 名匹配对照者的冷痛阈值。我们应用了先前用于评估抑郁症患者热痛的升序极限法。与热痛阈值的先前结果相似,我们发现 MDD 患者的冷痛敏感性降低,表现为冷痛阈值增加。这种差异在右臂上显著,而在左臂上仅呈现出一种趋势,因此表明存在一定程度的偏侧化,类似于 MDD 或适应障碍患者的热痛感知。该研究证实了我们先前关于 MDD 患者对外源性疼痛敏感性降低的结果。此外,它进一步支持了抑郁时热痛感知存在偏侧化的假设。
这项研究为重度抑郁症患者对外界刺激的疼痛感知降低提供了进一步证据。因此,在未来的研究中,值得检查中枢神经系统对这种改变的疼痛感知的相关性,以便一方面更深入地了解疼痛感知的机制,另一方面了解抑郁的病理学。