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诱导性阴道前庭疼痛女性的弥散性伤害性抑制控制功能。

Diffuse noxious inhibitory control function in women with provoked vestibulodynia.

机构信息

Departments of Psychology, Queen's University, Kingston General Hospital, Kingston, ON, Canada.

出版信息

Clin J Pain. 2012 Oct;28(8):667-74. doi: 10.1097/AJP.0b013e318243ede4.

Abstract

OBJECTIVES

The objective of the study was to assess diffuse noxious inhibitory control (DNIC) function in women with provoked vestibulodynia (PVD) compared with healthy controls through the use of 2 different methodologies. Furthermore, the study aimed to assess whether pain characteristics correlate with DNIC in women with PVD.

METHODS

Twenty-three healthy control women and 23 women diagnosed with PVD by the study gynecologist participated in the study. To assess DNIC, heat pain tolerance, determined through an ascending method of limits and temporal summation of thermal pain were used as test stimuli and a cold water bath was used as the conditioning stimulus. Participants reported on pain characteristics as potential correlates with DNIC function.

RESULTS

No significant group differences were found in the number of DNIC responders per group when using heat pain tolerance or temporal summation procedures to examine DNIC. The magnitude of the DNIC response was examined for the overall groups and for positive DNIC responders only. When all participants were included in the analyses with the heat pain tolerance procedure, women with PVD displayed a higher magnitude of DNIC responding. Correlations between pain variables and DNIC responding and magnitude were nonsignificant.

DISCUSSION

Results support previous findings of intact DNIC function in women with PVD, using both an ascending method of limits and a temporal summation paradigm. Pain-related variables were not correlated with DNIC function in women with PVD, perhaps this unexpected finding is due to the possibility that central processes other than DNIC, such as descending facilitation, provoke or maintain this chronic pain condition.

摘要

目的

本研究旨在通过使用 2 种不同的方法,评估伴有激发性外阴痛(PVD)的女性与健康对照组之间的弥散性伤害性抑制控制(DNIC)功能。此外,本研究旨在评估 PVD 女性的疼痛特征与 DNIC 是否相关。

方法

本研究纳入了 23 名健康对照组女性和 23 名经研究妇科医生诊断为 PVD 的女性。为了评估 DNIC,使用热痛耐量(通过递增极限法确定)和热痛的时间总和作为测试刺激,冷水浴作为条件刺激。参与者报告了潜在与 DNIC 功能相关的疼痛特征。

结果

当使用热痛耐量或时间总和程序来检查 DNIC 时,两组中 DNIC 反应者的数量没有显著差异。还对总体组和阳性 DNIC 反应者的 DNIC 反应幅度进行了检查。当将所有参与者纳入热痛耐量程序的分析中时,患有 PVD 的女性表现出更高的 DNIC 反应幅度。疼痛变量与 DNIC 反应和幅度之间的相关性无统计学意义。

讨论

结果支持了先前关于 PVD 女性 DNIC 功能完整的发现,使用了递增极限法和时间总和范式。疼痛相关变量与 PVD 女性的 DNIC 功能不相关,这种出乎意料的发现可能是由于除了 DNIC 之外的其他中枢过程,例如下行促进,引发或维持这种慢性疼痛状态。

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