Carrillo-de-la-Peña M T, Triñanes Y, González-Villar A, Gómez-Perretta C, García-Larrea L
Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Spain.
Eur J Pain. 2015 Apr;19(4):576-84. doi: 10.1002/ejp.627. Epub 2014 Nov 28.
It has been suggested that fibromyalgia (FM) patients show increased sensory processing of nociceptive and non-nociceptive stimuli and also reduced habituation. Although this pattern of increased reactivity has been established for the somatosensory modality, its generalization to other sensory modalities remains controversial.
Auditory evoked potentials were obtained using a paired-stimuli paradigm from a sample of 52 FM female patients and 55 healthy women matched for age and socio-economic status. Sensory gating of the P50 component, as indicated by P50 suppression rates to the second identical stimuli, was analysed in relation to clinical indices of FM, including algometry of tender points and a number of self-reported questionnaires.
Sensory gating mechanisms in FM patients proved to be normal, robust and as efficient as those recorded in control subjects. There was no correlation between P50 suppression rates and indices of clinical or experimental (threshold or tolerance) pain. In addition, P50 sensory gating was not related to the other main symptoms of FM, including fatigue, sleep dysfunction or co-morbid depression, nor to hypersensitivity to noise or headache.
The results indicate that FM patients do not present significant deficits in early sensory gating when processing auditory stimuli, and therefore challenge the 'generalized hypersensitivity' hypothesis of FM.
有人提出,纤维肌痛(FM)患者对伤害性和非伤害性刺激的感觉处理增强,且习惯化减弱。尽管这种反应性增强的模式已在躯体感觉模态中得到证实,但其是否能推广到其他感觉模态仍存在争议。
采用配对刺激范式,从52名FM女性患者和55名年龄及社会经济地位相匹配的健康女性样本中获取听觉诱发电位。根据对第二个相同刺激的P50抑制率来分析P50成分的感觉门控,并与FM的临床指标相关联,包括压痛点的痛觉测量和一些自我报告问卷。
事实证明,FM患者的感觉门控机制正常、稳固,与对照组受试者所记录的机制一样有效。P50抑制率与临床或实验性(阈值或耐受性)疼痛指标之间无相关性。此外,P50感觉门控与FM的其他主要症状无关,包括疲劳、睡眠功能障碍或共病性抑郁,也与对噪音或头痛的超敏反应无关。
结果表明,FM患者在处理听觉刺激时,早期感觉门控不存在显著缺陷,因此对FM的“全身性超敏反应”假说提出了挑战。