Experimental Psychiatry Laboratory, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico.
J Psychiatr Res. 2012 Jan;46(1):128-34. doi: 10.1016/j.jpsychires.2011.09.008. Epub 2011 Sep 28.
Diminished pain sensitivity in schizophrenia has been reported in clinical studies. While the role of antipsychotic medications as a cause of the decrease in pain perception has been questioned, little is known about neural pain processing in treated schizophrenia patients. The aim of this pilot study was to examine the blood oxygen level-dependent (BOLD) changes induced by an experimental pain tolerance (endure) hot stimuli vs. non-painful stimuli in clinically stable patients with schizophrenia and in healthy controls. Twelve patients with schizophrenia, treated with risperidone and considered clinically stable, and 13 gender- and age-matched healthy controls were studied using painful and non-painful thermal stimuli in a periodic block design. BOLD changes were assessed using high field, 3 T functional Magnetic Resonance Imaging (fMRI). Pain tolerance in stable patients was not statistically different than healthy controls. Interestingly, patients showed higher activation in the primary somatosensory cortex (S1) and superior prefrontal cortex, and less activation in the posterior cingulate cortex and brainstem than controls. Our pilot study indicates that pain tolerance is similar in clinically stable patients and controls, although the neural processing of pain is not normalized with antipsychotic treatment.
在临床研究中已经报道了精神分裂症患者的疼痛敏感性降低。虽然抗精神病药物作为降低疼痛感知的原因的作用受到质疑，但对于接受治疗的精神分裂症患者的神经疼痛处理知之甚少。本初步研究旨在检查在接受利培酮治疗且被认为临床稳定的精神分裂症患者和健康对照者中，由实验性疼痛耐受（忍受）热刺激与非疼痛刺激引起的血氧水平依赖（BOLD）变化。使用周期性块设计，使用高磁场、3T 功能磁共振成像（fMRI）对 12 名接受利培酮治疗且被认为临床稳定的精神分裂症患者和 13 名性别和年龄匹配的健康对照者进行了疼痛和非疼痛热刺激的研究。疼痛耐受在稳定的患者中与健康对照组在统计学上没有差异。有趣的是，与对照组相比，患者在初级体感皮层（S1）和额上回表现出更高的激活，在后扣带回和脑干表现出更低的激活。我们的初步研究表明，在临床稳定的患者和对照组中，疼痛耐受是相似的，尽管抗精神病药物治疗并未使疼痛的神经处理正常化。
