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脱水状态下人脑对疼痛刺激的激活强于再水合状态。

Dehydration enhances pain-evoked activation in the human brain compared with rehydration.

机构信息

From the *Department of Anesthesiology, Gunma University Graduate School of Medicine, Maebashi; †Department of Nursing, Faculty of Health and Welfare, Kawasaki University of Medical Welfare, Kurashiki; and ‡Department of Anesthesiology, Saiseikai-Hita Hospital, Hita, Japan.

出版信息

Anesth Analg. 2014 Jun;118(6):1317-25. doi: 10.1213/ANE.0b013e3182a9b028.

Abstract

BACKGROUND

Negative effects of dehydration on the human brain and cognitive function have been reported. In this study, we examined the effects of dehydration on pain thresholds and cortical activations in response to pain, compared with rehydration with an oral rehydration solution (ORS) by functional magnetic resonance imaging.

METHODS

Five healthy adult men were subjected to dehydration and rehydration on 2 different days. The condition on the first day was randomly assigned to each subject. They completed a 40-minute exercise protocol using a walking machine after 12 hours of fasting under both conditions. For rehydration, the subjects consumed up to 3000 mL ORS starting from the night before the test day. After exercise, a painful stimulus (cold pressor test) was applied to the subjects' medial forearm in a magnetic resonance imaging scanning gantry, and pain-evoked brain activation was analyzed.

RESULTS

On the rehydration day, each of the subjects consumed an average of 2040 mL (range; 1800-2500 mL) ORS. Physiological data revealed that subjects when dehydrated lost more weight from exercise than subjects when rehydrated had a larger heart rate increase, a higher tympanic temperature, and a higher urine osmolality. Subjective data revealed that the subjects reported significantly stronger thirst while dehydrated than while rehydrated with ORS, although the levels of hunger and anxiety and mood did not significantly differ between conditions. The cold pressor test robustly activated the pain-related neural network, notably the anterior cingulate cortex, insula, and thalamus. Such activations in the dehydrated subjects were greater than those in the rehydrated subjects in terms of peak and cluster, accompanied by a decrease in pain threshold (P = 0.001).

CONCLUSION

Our findings suggest that dehydration brings about increased brain activity related to painful stimuli together with enhanced thirst, whereas rehydration with ORS alleviates thirst and decreases brain activity related to painful stimuli.

摘要

背景

已有研究报道,脱水对人脑和认知功能会产生负面影响。在这项研究中,我们通过功能性磁共振成像,对比口服补液盐(ORS)再水化,研究了脱水对疼痛阈值和疼痛反应皮质激活的影响。

方法

5 名健康成年男性在 2 天内分别接受脱水和再水化处理。每位受试者的第 1 天条件随机分配。在两种条件下,他们均禁食 12 小时后,使用跑步机完成 40 分钟的运动方案。再水化时,受试者从前一天晚上开始,最多摄入 3000 毫升 ORS。运动后,在磁共振成像扫描架内对受试者的内前臂施加疼痛刺激(冷加压试验),并分析疼痛诱发的大脑激活。

结果

在再水化日,每位受试者平均摄入 2040 毫升(范围 1800-2500 毫升)ORS。生理数据显示,与再水化相比,脱水时受试者在运动中损失的体重更多,且脱水时的心率增加更大、鼓膜温度更高、尿液渗透压更高。主观数据显示,与再水化时相比,受试者在脱水时明显更口渴,尽管饥饿感、焦虑和情绪水平在两种情况下并无显著差异。冷加压试验强烈激活了与疼痛相关的神经网络,尤其是前扣带皮层、岛叶和丘脑。与再水化相比,脱水时受试者的这些区域的激活峰值和簇都更大,疼痛阈值降低(P = 0.001)。

结论

我们的研究结果表明,脱水会引起与疼痛刺激相关的大脑活动增加和口渴加剧,而 ORS 再水化可缓解口渴并降低与疼痛刺激相关的大脑活动。

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