University Department of Anaesthesiology and Pain Therapy, Bern University Hospital, Inselspital, Bern, Switzerland Division of Clinical Epidemiology and Biostatistics, Institute of Social and Preventive Medicine, University of Bern, Switzerland, and Clinical Trial Unit (CTU) Bern, Bern University Hospital, Inselspital, Bern, Switzerland DeFiMS, School of Oriental and African Studies (SOAS), University of London, London, United Kingdom, and DEI, University of Rome Tor Vergata, Rome, Italy Center for Sensory-Motor Interaction, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
Pain. 2011 May;152(5):1146-1155. doi: 10.1016/j.pain.2011.01.047. Epub 2011 Mar 10.
During the last decade, a multi-modal approach has been established in human experimental pain research for assessing pain thresholds and responses to various experimental pain modalities. Studies have concluded that differences in responses to pain stimuli are mainly related to variation between individuals rather than variation in response to different stimulus modalities. In a factor analysis of 272 consecutive volunteers (137 men and 135 women) who underwent tests with different experimental pain modalities, it was determined whether responses to different pain modalities represent distinct individual uncorrelated dimensions of pain perception. Volunteers underwent single painful electrical stimulation, repeated painful electrical stimulation (temporal summation), test for reflex receptive field, pressure pain stimulation, heat pain stimulation, cold pain stimulation, and a cold pressor test (ice water test). Five distinct factors were found representing responses to 5 distinct experimental pain modalities: pressure, heat, cold, electrical stimulation, and reflex-receptive fields. Each of the factors explained approximately 8% to 35% of the observed variance, and the 5 factors cumulatively explained 94% of the variance. The correlation between the 5 factors was near null (median ρ=0.00, range -0.03 to 0.05), with 95% confidence intervals for pairwise correlations between 2 factors excluding any relevant correlation. Results were almost similar for analyses stratified according to gender and age. Responses to different experimental pain modalities represent different specific dimensions and should be assessed in combination in future pharmacological and clinical studies to represent the complexity of nociception and pain experience.
在过去的十年中，人类实验性疼痛研究中已经建立了一种多模态方法，用于评估各种实验性疼痛模式的疼痛阈值和反应。研究得出的结论是，对疼痛刺激的反应差异主要与个体之间的差异有关，而不是与不同刺激模式的反应差异有关。在对 272 名连续志愿者（137 名男性和 135 名女性）进行不同实验性疼痛模式测试的因子分析中，确定了对不同疼痛模式的反应是否代表疼痛感知的不同个体不相关维度。志愿者接受了单次疼痛电刺激、重复疼痛电刺激（时间总和）、反射感受野测试、压痛刺激、热痛刺激、冷痛刺激和冷加压试验（冰水试验）。发现了 5 个不同的因素，代表了对 5 种不同的实验性疼痛模式的反应：压力、热、冷、电刺激和反射感受野。每个因素解释了大约 8%到 35%的观察到的方差，这 5 个因素累积解释了 94%的方差。这 5 个因素之间的相关性接近零（中位数ρ=0.00，范围-0.03 到 0.05），2 个因素之间的置信区间为 95%，排除了任何相关的相关性。按照性别和年龄分层进行分析的结果几乎相似。对不同实验性疼痛模式的反应代表不同的特定维度，在未来的药理学和临床研究中，应结合评估这些维度，以代表伤害感受和疼痛体验的复杂性。
