Department of Medicine, Ohio State University, Columbus, OH, USA College of Dentistry, University of Florida, Gainesville, FL, USA North Florida/South Georgia Veteran Health System, USA Research Service, Cincinnati VAMC, Cincinnati, OH, USA Institute of Behavioral Medicine Research, Columbus, OH, USA.
Pain. 2010 Mar;148(3):454-461. doi: 10.1016/j.pain.2009.12.005. Epub 2010 Jan 13.
Previous investigations of somatic hypersensitivity in IBS patients have typically involved only a single stimulus modality, and little information exists regarding whether patterns of somatic pain perception vary across stimulus modalities within a group of patients with IBS. Therefore, the current study was designed to characterize differences in perceptual responses to a battery of noxious somatic stimuli in IBS patients compared to controls. A total of 78 diarrhea-predominant and 57 controls participated in the study. We evaluated pain threshold and tolerance and sensory and affective ratings of contact thermal, mechanical pressure, ischemic stimuli, and cold pressor stimuli. In addition to assessing perceptual responses, we also evaluated differences in neuroendocrine and cardiovascular responses to these experimental somatic pain stimuli. A subset of IBS patients demonstrated the presence of somatic hypersensitivity to thermal, ischemic, and cold pressor nociceptive stimuli. The somatic hypersensitivity in IBS patients was somatotopically organized in that the lower extremities that share viscerosomatic convergence with the colon demonstrate the greatest hypersensitivity. There were also changes in ACTH, cortisol, and systolic blood pressure in response to the ischemic pain testing in IBS patients when compared to controls. The results of this study suggest that a more widespread alteration in central pain processing in a subset of IBS patients may be present as they display hypersensitivity to heat, ischemic, and cold pressor stimuli.
先前对 IBS 患者躯体感觉过敏的研究通常只涉及单一刺激模式,对于 IBS 患者群体中,不同刺激模式下躯体疼痛感知模式是否存在差异,相关信息较少。因此,本研究旨在描述 IBS 患者与对照组相比,对一系列有害躯体刺激的感知反应差异。共有 78 例腹泻为主型和 57 例对照者参与了该研究。我们评估了疼痛阈值和耐痛阈,以及对接触热、机械压力、缺血性刺激和冷加压刺激的感觉和情感评分。除了评估感知反应外,我们还评估了这些实验性躯体疼痛刺激对神经内分泌和心血管反应的差异。一部分 IBS 患者对热、缺血和冷加压伤害性刺激表现出躯体感觉过敏。IBS 患者的躯体感觉过敏在躯体上是有组织的,与结肠有内脏躯体汇聚的下肢表现出最大的过敏。与对照组相比,IBS 患者在进行缺血性疼痛测试时,ACTH、皮质醇和收缩压也发生了变化。本研究结果表明,一部分 IBS 患者可能存在更广泛的中枢性疼痛处理改变,因为他们对热、缺血和冷加压刺激表现出过敏。
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