薄荷醇对不同程度幻肢痛的上肢截肢者冷感觉过敏和类风激痛的影响。

The effects of menthol on cold allodynia and wind-up-like pain in upper limb amputees with different levels of phantom limb pain.

机构信息

Department of Psychology, Aarhus University, Aarhus, Denmark; Danish Pain Research Center, Aarhus University Hospital, Aarhus, Denmark.

出版信息

Neurosci Lett. 2013 Feb 8;534:52-7. doi: 10.1016/j.neulet.2012.11.005. Epub 2012 Dec 21.

Abstract

The mechanisms underlying phantom limb pain are not fully known, but hypersensitivity appears to be a central element. Menthol has previously been suggested as a model for hypersensitivity, but it has not yet been investigated if different levels of neuropathic pain may influence the effects of menthol or if topical application of menthol may act as a model for hypersensitivity in patients with phantom limb pain. In the present study, menthol (l-menthol 40%) was applied to the affected and non-affected sides in 24 upper-limb amputees with different levels of phantom limb pain to test if menthol could induce cold allodynia and exacerbate wind-up-like pain. The average level of phantom limb pain was significantly related to cold allodynia (P=0.044). Prior to application of menthol, the level of phantom limb pain was significantly related to the level of wind-up-like pain following both brush (P=0.040) and pinprick (P=0.033) stimulation. After application of menthol, the level of phantom limb pain was only related to wind-up-like pain following brush (P=0.011) but not pinprick stimulation (P=0.233). This study indicates that menthol does influence hypersensitivity in phantom limb pain patients, and it is the first study to show that menthol may exacerbate wind-up-like pain in this group of neuropathic pain patients. The findings suggest that menthol may act as a model for studying sensitization in phantom limb patients.

摘要

幻肢痛的发病机制尚不完全清楚,但超敏反应似乎是一个核心要素。薄荷醇以前曾被认为是超敏反应的模型,但尚未研究不同程度的神经病理性疼痛是否会影响薄荷醇的作用,或者薄荷醇的局部应用是否可以作为幻肢痛患者超敏反应的模型。在本研究中,24 名上肢截肢患者的患侧和非患侧应用了不同浓度的薄荷醇(l-薄荷醇 40%),以测试薄荷醇是否能引起冷感觉过敏,并加重类似痉挛样的疼痛。幻肢痛的平均水平与冷感觉过敏显著相关(P=0.044)。在应用薄荷醇之前,幻肢痛的程度与刷(P=0.040)和针刺(P=0.033)刺激后类似痉挛样疼痛的程度显著相关。应用薄荷醇后,幻肢痛的程度仅与刷刺激后的类似痉挛样疼痛相关(P=0.011),而与针刺刺激无关(P=0.233)。本研究表明,薄荷醇确实会影响幻肢痛患者的超敏反应,这也是首次表明薄荷醇可能会加重这组神经病理性疼痛患者的类似痉挛样疼痛。这些发现表明,薄荷醇可能作为研究幻肢痛患者敏化作用的模型。

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