Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany Max Planck Institute for Human and Cognitive Brain Sciences, Department of Social Neuroscience, Leipzig, Germany.
Pain. 2013 Sep;154(9):1846-1855. doi: 10.1016/j.pain.2013.06.003. Epub 2013 Jun 7.
This study aimed to investigate the modulating effects of emotional context on pain perception in 16 patients with fibromyalgia syndrome (FMS) and 16 healthy control (HC) subjects. An infrared laser was used to apply individually adapted painful stimuli to the dorsum of the left hand. The emotional background of the painful stimuli was modulated by concurrent presentations of negative, neutral, and positive picture stimuli selected from the International Affective Picture System. As control conditions, painful stimuli and the pictures were also presented by themselves. During each of the 5 laser-picture trials, subjects received 10 painful stimuli and were asked to rate the average intensity and unpleasantness of the experienced pain. Functional magnetic resonance images were obtained, using a T2(∗) sensitive echo planar sequence. HC subjects showed a linear increase in pain intensity and unpleasantness ratings when painful stimuli were presented during positive, neutral, and negative pictures. In contrast, FMS patients showed a quadratic trend for pain intensity ratings indicating a lack of pain reduction by the positive pictures. In addition, the FMS patients showed less activation in secondary somatosensory cortex, insula, orbitofrontal cortex, and anterior cingulate cortex during the positive picture pain trials. Our results suggest that fibromyalgia patients are less efficient in modulating pain by positive affect and may benefit less from appetitive events than healthy control subjects.
本研究旨在探讨情绪背景对 16 名纤维肌痛综合征（FMS）患者和 16 名健康对照（HC）受试者疼痛感知的调节作用。采用红外激光对手背进行个体适应的疼痛刺激。疼痛刺激的情绪背景通过同时呈现选自国际情感图片系统的负性、中性和正性图片刺激来调节。作为对照条件，疼痛刺激和图片也单独呈现。在 5 次激光图片试验中的每一次中，受试者接受 10 次疼痛刺激，并被要求对所经历的疼痛的平均强度和不愉快程度进行评分。使用 T2（∗）敏感的回波平面序列获得功能磁共振图像。HC 受试者在呈现正性、中性和负性图片时，疼痛强度和不愉快评分呈线性增加。相比之下，FMS 患者的疼痛强度评分呈二次趋势，表明正性图片不能减轻疼痛。此外，在正性图片疼痛试验中，FMS 患者的次级体感皮层、脑岛、眶额皮层和前扣带皮层的激活程度较低。我们的研究结果表明，纤维肌痛患者通过积极情绪调节疼痛的效率较低，并且可能不如健康对照受试者从正性事件中获益。
