Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark Section of Anesthesiology and Clinical Physiology, Department of Oral Restitution, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan Section of Clinical Oral Physiology, Department of Dentistry, Aarhus University, Aarhus, Denmark Department of Oral & Maxillofacial Surgery, Aalborg Hospital, Aalborg, Denmark Center of Functionally Integrative Neuroscience (CFIN), MindLab, Aarhus University Hospital, Aarhus, Denmark.
Pain. 2013 Dec;154(12):2684-2690. doi: 10.1016/j.pain.2013.07.049. Epub 2013 Aug 1.
The aim of the study was to systematically investigate the effect of craniofacially evoked conditioned pain modulation on somatosensory function using a quantitative sensory testing (QST) protocol applied to the trigeminal area in healthy humans. Pressure pain evoked by a mechanical compressive device was applied as conditioning stimulus (CS) in the craniofacial region, with a pain intensity of 5 on a visual analogue scale (VAS: 0-10 cm) (painful session) or with VAS score of 0 (control session). A full QST battery of 13 parameters was performed as test stimuli on the dominant-side cheek. The individual QST data from 11 men and 12 women were transformed into z scores, and the QST data and z scores were tested using analyses of variance. Analyses of variance of pressure pain threshold (PPT) data (log-transformed values and z scores) indicated significant session (P ≤ .003) and time (P < .001) effects with a session-time interaction (P < .001), but no main effect of sex (P ≥ .053, effect size ≥ .166). The session-time interaction showed that the PPTs in the painful session were associated with significantly higher log-transformed PPT values and significantly lower z scores compared with the control session at the time point during CS (hypoalgesia) (P < .001). No other QST parameters were significantly modulated by the CS. Sex differences were not detected in this study; a larger sample size may be needed to further explore this possibility. However, the findings indicate that when extensive QST protocols are applied, PPT may be the most sensitive measure to detect endogenous pain inhibitory mechanisms.
本研究旨在通过应用于健康人类三叉神经区域的定量感觉测试（QST）方案，系统研究颅面诱发条件性疼痛调制对感觉功能的影响。使用机械压缩装置产生的压力疼痛作为刺激（CS）施加于颅面区域，疼痛强度为视觉模拟量表（VAS）的 5 分（疼痛组）或 VAS 评分为 0（对照组）。在优势侧脸颊上进行了 13 个参数的完整 QST 电池测试。11 名男性和 12 名女性的个体 QST 数据转换为 z 分数，并使用方差分析测试 QST 数据和 z 分数。压力疼痛阈值（PPT）数据（对数转换值和 z 分数）的方差分析表明，有显著的组间（P≤.003）和时间（P<.001）效应，且存在组间-时间交互作用（P<.001），但性别无主要效应（P≥.053，效应量≥.166）。组间-时间交互作用表明，在 CS 期间（痛觉过敏），疼痛组的 PPT 与对照组相比，对数转换后的 PPT 值显著升高，z 分数显著降低（P<.001）。CS 未显著调节其他 QST 参数。本研究未发现性别差异；可能需要更大的样本量来进一步探索这种可能性。然而，研究结果表明，当应用广泛的 QST 方案时，PPT 可能是检测内源性疼痛抑制机制最敏感的测量指标。
