Headache and Pain Clinic, IRCCS Mediterranean Neurological Institute Neuromed, Pozzilli, Italy.
Clin Neurophysiol. 2012 Aug;123(8):1624-30. doi: 10.1016/j.clinph.2012.01.012. Epub 2012 Feb 17.
Our study is aimed to evaluate the spinal cord pain processing in Huntington's disease (HD) by testing both the temporal summation threshold (TST) of the nociceptive withdrawal reflex (NWR) and the functional activity of the diffuse noxious inhibitory control (DNIC) as form of supraspinal control of pain.
We enrolled 19 HD patients and 17 healthy controls. We measured threshold (Th), Area, TST and related psychophysical pain sensations of the NWR, at baseline and during and after activation of the DNIC by means of cold pressor test (CPT) as heterotopic noxious conditioning stimulation.
In HD patients we found a significantly higher Th and TST as well as a lower Area when compared to controls. During the CPT, a significant inhibition of reflex and psychophysical pain responses were found in both HD patients and controls when compared to baseline, without differences between the groups in CPT results.
Our study demonstrated an abnormal spinal cord pain processing in HD patients. Abnormalities in pain processing are not apparently linked to a dysfunctional DNIC inhibitory projection system in HD patients.
Our findings support the hypothesis that the striatum could play a role in pain modulation and that its atrophy could affect pain processing without change the DNIC efficiency.
本研究旨在通过测试伤害性撤退反射（NWR）的时间总和阈值（TST）和弥散性伤害性抑制控制（DNIC）的功能活动，评估亨廷顿病（HD）中的脊髓疼痛处理。
我们招募了 19 名 HD 患者和 17 名健康对照者。我们测量了 NWR 的阈值（Th）、面积、TST 和相关的痛觉感受，在基线时以及在冷加压测试（CPT）激活 DNIC 期间和之后进行，CPT 作为异源性伤害性条件刺激。
与对照组相比，HD 患者的 Th 和 TST 显著升高，而面积显著降低。与基线相比，在 CPT 期间，HD 患者和对照组的反射和痛觉反应均受到显著抑制，两组之间 CPT 结果无差异。
我们的研究表明 HD 患者的脊髓疼痛处理异常。疼痛处理异常与 HD 患者的 DNIC 抑制投射系统功能障碍无关。
我们的发现支持纹状体可能在疼痛调节中发挥作用的假说，其萎缩可能影响疼痛处理而不改变 DNIC 的效率。
