Sansom Institute for Health Research, University of South Australia, Adelaide SA 5001, Australia.
Rheumatology (Oxford). 2013 Aug;52(8):1509-19. doi: 10.1093/rheumatology/ket139. Epub 2013 May 9.
To determine whether tactile acuity is disrupted in people with knee OA and to determine whether tactile acuity, a clinical signature of primary sensory cortex representation, is related to motor imagery performance (MIP; evaluates working body schema) and pain.
Experiment 1: two-point discrimination (TPD) threshold at the knee was compared between 20 participants with painful knee OA, 20 participants with arm pain and 20 healthy controls. Experiment 2: TPD threshold, MIP (left/right judgements of body parts) and usual pain were assessed in 20 people with painful knee OA, 17 people with back pain and 38 healthy controls (20 knee TPD; 18 back TPD).
People with painful knee OA had larger TPD thresholds than those with arm pain and healthy controls (P < 0.05). TPD and MIP were not related in people with knee OA (P = 0.88) but were related in people with back pain and in healthy controls (P < 0.001). Pain did not relate to TPD threshold or to MIP (P > 0.15 for all).
In painful knee OA, tactile acuity at the knee is decreased, implying disrupted representation of the knee in primary sensory cortex. That TPD and MIP were unrelated in knee OA, but related in back pain, suggests that the relationship between them may vary between chronic pain conditions. That pain was not related to TPD threshold nor MIP suggests against the idea that disrupted cortical representations contribute to the pain of either condition.
确定膝骨关节炎患者的触觉敏锐度是否受损,并确定触觉敏锐度(初级感觉皮层代表性的临床特征)是否与运动意象表现(MIP;评估工作体图)和疼痛相关。
实验 1:在 20 名膝部疼痛的骨关节炎患者、20 名臂部疼痛的患者和 20 名健康对照者之间比较膝部两点辨别阈(TPD)。实验 2:在 20 名膝部疼痛的骨关节炎患者、17 名腰痛患者和 38 名健康对照者(20 名膝部 TPD;18 名背部 TPD)中评估 TPD 阈值、MIP(身体部位的左右判断)和通常疼痛。
膝部疼痛的骨关节炎患者的 TPD 阈值大于臂部疼痛的患者和健康对照者(P < 0.05)。膝部骨关节炎患者的 TPD 和 MIP 之间无相关性(P = 0.88),但腰痛患者和健康对照者之间有相关性(P < 0.001)。疼痛与 TPD 阈值或 MIP 均无相关性(P > 0.15)。
在膝部疼痛的骨关节炎患者中,膝部的触觉敏锐度降低,表明初级感觉皮层中膝部的代表受损。在膝部骨关节炎中,TPD 和 MIP 之间无相关性,而在腰痛中则有相关性,这表明它们之间的关系可能因慢性疼痛状况而异。疼痛与 TPD 阈值和 MIP 均无相关性,这表明皮质代表受损的想法并不能解释这两种情况的疼痛。