School of Physiotherapy, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia Department of Physiotherapy, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia Department of Neurosurgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia Pain Medicine Unit, Fremantle Hospital and Health Service, Fremantle, Western Australia, Australia School of Surgery, University of Western Australia, Perth, Western Australia, Australia.
Pain. 2012 Dec;153(12):2403-2414. doi: 10.1016/j.pain.2012.08.007. Epub 2012 Sep 11.
The aim of this study was to establish the somatosensory profiles of patients with cervical radiculopathy and patients with nonspecific neck-arm pain associated with heightened nerve mechanosensitivity (NSNAP). Sensory profiles were compared to healthy control (HC) subjects and a positive control group comprising patients with fibromyalgia (FM). Quantitative sensory testing (QST) of thermal and mechanical detection and pain thresholds, pain sensitivity and responsiveness to repetitive noxious mechanical stimulation was performed in the maximal pain area, the corresponding dermatome and foot of 23 patients with painful C6 or C7 cervical radiculopathy, 8 patients with NSNAP in a C6/7 dermatomal pain distribution, 31 HC and 22 patients with FM. For both neck-arm pain groups, all QST parameters were within the 95% confidence interval of HC data. Patients with cervical radiculopathy were characterised by localised loss of function (thermal, mechanical, vibration detection P<.009) in the maximal pain area and dermatome (thermal detection, vibration detection, pressure pain sensitivity P<.04), consistent with peripheral neuronal damage. Both neck-arm pain groups demonstrated increased cold sensitivity in their maximal pain area (P<.03) and the foot (P<.009), and this was also the dominant sensory characteristic in patients with NSNAP. Both neck-arm pain groups differed from patients with FM, the latter characterised by a widespread gain of function in most nociceptive parameters (thermal, pressure, mechanical pain sensitivity P<.027). Despite commonalities in pain characteristics between the 2 neck-arm pain groups, distinct sensory profiles were demonstrated for each group.
本研究旨在建立颈神经根病患者和伴有神经机械敏感性增高的非特异性颈臂痛（NSNAP）患者的体感特征。将体感特征与健康对照组（HC）和包括纤维肌痛（FM）患者的阳性对照组进行比较。对 23 例颈 C6 或 C7 根性病变疼痛患者、8 例 C6/7 皮节疼痛分布的 NSNAP 患者、31 例 HC 和 22 例 FM 患者的最大疼痛区域、相应皮节和足部进行热和机械探测及痛阈、痛敏和重复有害机械刺激的反应的定量感觉测试（QST）。对于这两个颈臂痛组，所有 QST 参数均在 HC 数据的 95%置信区间内。颈神经根病患者在最大疼痛区域和皮节（热探测、振动探测、压力痛敏 P<.04）表现为局部功能丧失（热、机械、振动探测 P<.009），这与周围神经元损伤一致。两个颈臂痛组在最大疼痛区域（P<.03）和足部（P<.009）均表现出冷敏增加，而这也是 NSNAP 患者的主要感觉特征。两个颈臂痛组与 FM 患者不同，后者在大多数伤害性参数（热、压力、机械痛敏 P<.027）中表现出广泛的功能增益。尽管这两个颈臂痛组的疼痛特征存在共同之处，但每个组都表现出不同的感觉特征。
