Jensen Mark P, Gianas Ann, Sherlin Leslie H, Howe Jon D
*Department of Rehabilitation Medicine, University of Washington §Department of Psychology, University of Washington, Seattle, WA †Department of Psychology, Northern Arizona University, Flagstaff ‡Nova Tech EEG, Mesa, AZ.
Clin J Pain. 2015 Oct;31(10):852-8. doi: 10.1097/AJP.0000000000000182.
Pain catastrophizing is thought to play a causal role in the development and maintenance of chronic pain and its negative impact on functioning. However, few studies have examined the factors that might contribute to the development and maintenance of catastrophizing. The Anterior Asymmetry and Emotion (AAE) model hypothesizes that more activity in left anterior brain regions is associated with a tendency to engage in approach responses (often, but not always, associated with positive valance), and that more right anterior activity is associated with a tendency to engage in more withdrawal responses (often associated with negative valance). Given the consistent associations found between catastrophizing and both (1) approach versus avoidance pain coping style; and (2) affective responses to pain, the AAE model would predict that more left (vs. right) anterior brain activity would prospectively predict future catastrophizing.
Anterior asymmetry measures computed using electroencephalogram data from 30 individuals with spinal cord injury were correlated with catastrophizing scores obtained 2 years after the electroencephalograph recording.
Consistent with the AAE model, anterior asymmetry scores reflecting greater left than right anterior activity were negatively associated with subsequent catastrophizing.
The study findings identify a biological factor that may be associated with greater vulnerability to pain-related catastrophizing. If replicated in future research, the findings suggest new possibilities for treating catastrophizing, which may then contribute to improved pain treatment outcomes.
疼痛灾难化被认为在慢性疼痛的发生和维持及其对功能的负面影响中起因果作用。然而，很少有研究探讨可能导致灾难化发生和维持的因素。前不对称与情绪（AAE）模型假设，左前脑区域更多的活动与参与趋近反应的倾向相关（通常，但并非总是与正性效价相关），而右前脑更多的活动与参与更多退缩反应的倾向相关（通常与负性效价相关）。鉴于在灾难化与（1）趋近与回避疼痛应对方式；以及（2）对疼痛的情感反应之间发现的一致关联，AAE模型预测，左（相对于右）前脑更多的活动将前瞻性地预测未来的灾难化。
使用30名脊髓损伤患者的脑电图数据计算出的前不对称测量值，与脑电图记录后2年获得的灾难化评分进行相关性分析。
与AAE模型一致，反映左前活动大于右前活动的前不对称评分与随后的灾难化呈负相关。
该研究结果确定了一个可能与疼痛相关灾难化易感性增加有关的生物学因素。如果在未来的研究中得到重复验证，这些结果为治疗灾难化提出了新的可能性，进而可能有助于改善疼痛治疗效果。
