Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.
Neurogastroenterol Motil. 2013 Dec;25(12):e791-802. doi: 10.1111/nmo.12207. Epub 2013 Aug 12.
Hypersensitivity to somatic or visceral pain has been reported in numerous clinical conditions such as fibromyalgia or the irritable bowel syndrome, and general hypersensitivity has been proposed to be the underlying mechanism. However, cross-modal relationships especially between somatic and visceral pain have rarely been investigated even in healthy volunteers. Furthermore, psychological influences on pain have rarely been characterized across modalities.
Sixty-one healthy participants underwent testing of perception and pain thresholds for cutaneous thermode heat and cold, as well as for rectal balloon distension. Psychological testing for anxiety, depression, and pain experience (including catastrophizing and coping) as well as cardiac interoception was performed. Measurement quality and the correlations between the different modalities were examined.
Significant correlations existed between the perception thresholds for cold/heat (τB = -0.28, p = 0.002) and cold/distension (τB = -0.21, p = 0.03) and for the pain thresholds for cold/heat (r = -0.61, p < 0.001) and heat/distension (r = 0.33, p = 0.01). No association was found between pain thresholds and anxiety, depression, psychological experience with and processing of pain, or cardiac interoception. Retest reliabilities for pain measurements were satisfying after short intertrial intervals (all intraclass correlation coefficients >0.8), but less so after longer intervals. The individuals contributing to the respective correlations differ between measurements.
CONCLUSIONS & INFERENCES: Moderate associations were found for pain thresholds across modalities. The strength of the associations and their stability over time warrants further investigation and might serve to increase the understanding of conditions affecting multiple pain modalities.
在许多临床情况下，如纤维肌痛或肠易激综合征，已经报道了对躯体或内脏疼痛的超敏反应，并且一般超敏反应被认为是潜在的机制。然而，即使在健康志愿者中，也很少研究跨模态的关系，特别是躯体和内脏疼痛之间的关系。此外，很少跨模态描述心理对疼痛的影响。
61 名健康参与者接受了皮肤热和冷 Thermode 热觉和冷觉阈值以及直肠球囊扩张的测试。对焦虑、抑郁和疼痛体验（包括灾难化和应对）以及心脏内脏知觉进行了心理测试。检查了测量质量和不同模态之间的相关性。
冷/热（τB = -0.28，p = 0.002）和冷/扩张（τB = -0.21，p = 0.03）的知觉阈值以及冷/热（r = -0.61，p < 0.001）和热/扩张（r = 0.33，p = 0.01）的疼痛阈值之间存在显著相关性。疼痛阈值与焦虑、抑郁、对疼痛的心理体验和处理或心脏内脏知觉之间没有关联。在短试验间隔（所有组内相关系数 >0.8）后，疼痛测量的重测信度令人满意，但在较长间隔后则不太满意。在不同的测量中，对各个相关性有贡献的个体不同。
跨模态发现疼痛阈值存在中度相关性。关联的强度及其随时间的稳定性值得进一步研究，可能有助于增加对影响多种疼痛模态的条件的理解。
