Fallon Nicholas, Li Xiaoyun, Chiu Yee, Nurmikko Turo, Stancak Andrej
Department Psychological Sciences, Institute of Psychology, Health, and Society, University of Liverpool, Liverpool, United Kingdom.
Department Psychological Sciences, Institute of Psychology, Health, and Society, University of Liverpool, Liverpool, United Kingdom.
J Pain. 2015 Aug;16(8):717-26. doi: 10.1016/j.jpain.2015.04.008. Epub 2015 May 12.
Fibromyalgia syndrome (FMS) is characterized by widespread chronic pain, fatigue, sleep disorders, and cognitive-emotional disturbance. Patients with FMS exhibit increased sensitivity to experimental pain and pain-related cues, as well as deficits in emotional regulation. The present study investigated the spatiotemporal patterns of brain activations for observed pain in 19 patients with FMS and 18 age-matched, healthy control individuals using event-related potential analysis. Patients with FMS attributed greater pain and unpleasantness to pain pictures, relative to healthy control participants. An augmented late positive potential (LPP) component (>500 milliseconds) was found in patients viewing both pain and nonpain pictures, and this amplitude difference in the LPP covaried with perceived unpleasantness of pictures. Mid-latency potentials (250-450 milliseconds) demonstrated similar amplitude increases of positive potentials in the FMS patient group. By contrast, the short-latency positive potential (140 milliseconds) was reduced in patients with FMS relative to healthy control participants. Results suggest amplitude increases to mid- to long-latency cortical activations in patients with FMS, which are known to reflect emotional control and motivational salience of stimuli.
Patients with FMS demonstrate increased activations associated with pain and nonpain pictures. The findings suggest that even innocuous, everyday visual stimuli with somatic connotations may challenge the emotional state of patients with FMS. Our study points toward the importance of cognitive-emotional therapeutic approaches for the treatment of FMS.
纤维肌痛综合征（FMS）的特征为广泛的慢性疼痛、疲劳、睡眠障碍以及认知-情绪紊乱。FMS患者对实验性疼痛和疼痛相关线索表现出更高的敏感性，同时在情绪调节方面存在缺陷。本研究使用事件相关电位分析，调查了19名FMS患者和18名年龄匹配的健康对照个体在观察疼痛时大脑激活的时空模式。与健康对照参与者相比，FMS患者将更大的疼痛和不适感归因于疼痛图片。在观看疼痛和非疼痛图片的患者中均发现晚期正电位（LPP）成分（>500毫秒）增强，并且LPP中的这种幅度差异与图片的感知不适感相关。中潜伏期电位（250 - 450毫秒）在FMS患者组中显示出正电位幅度有类似增加。相比之下，FMS患者的短潜伏期正电位（140毫秒）相对于健康对照参与者有所降低。结果表明，FMS患者中至长潜伏期皮质激活的幅度增加，已知这反映了刺激的情绪控制和动机显著性。
FMS患者在与疼痛和非疼痛图片相关的激活方面表现增加。研究结果表明，即使是具有躯体内涵的无害日常视觉刺激也可能挑战FMS患者的情绪状态。我们的研究指出了认知-情绪治疗方法对FMS治疗的重要性。
