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慢性非特异性颈部疼痛中的感觉和交感神经紊乱。

Sensory and sympathetic disorders in chronic non-specific neck pain.

作者信息

Zaproudina Nina, Ming Zhiyong, Närhi Matti

出版信息

Funct Neurol. 2015 Jul-Sep;30(3):165-71. doi: 10.11138/fneur/2015.30.3.165.

Abstract

The signs of sympathetic and sensory nerve-related disorders are not widely investigated in chronic nonspecific neck pain (NNP) patients. Thus, we performed skin temperature (Tsk), evaporation and touch threshold (TT) measurements to reveal possible dysfunctions at the fingertips of NNP patients (n=60) compared with healthy controls (n=11). Neck pain intensity was the main modifier of Tsk, and age the main modifier of TT in a multivariate model. On comparisons of the subgroups of NNP patients with unilateral (n=26) and bilateral (n=34) symptoms and controls, TT differed and Tsk tended to differ, the unilateral pain patients being found to demonstrate higher TT values on both sides. Interrelations between the measured parameters were found in the controls, but not in the patients. The NNP patients exhibited signs of functional impairment of innervation reflected in changes in tactile sensitivity and vasoactive sympathetic function. These changes may be based on both central and peripheral mechanisms, which possibly differ in patients with unilateral and bilateral symptoms.

摘要

在慢性非特异性颈部疼痛(NNP)患者中,交感神经和感觉神经相关紊乱的体征尚未得到广泛研究。因此,我们进行了皮肤温度(Tsk)、蒸发和触觉阈值(TT)测量,以揭示NNP患者(n = 60)与健康对照者(n = 11)指尖可能存在的功能障碍。在多变量模型中,颈部疼痛强度是Tsk的主要调节因素,年龄是TT的主要调节因素。在比较有单侧(n = 26)和双侧(n = 34)症状的NNP患者亚组与对照组时,TT存在差异,Tsk也有差异倾向,发现单侧疼痛患者两侧的TT值更高。在对照组中发现了测量参数之间的相互关系,但在患者中未发现。NNP患者表现出神经支配功能受损的体征,这反映在触觉敏感性和血管活性交感神经功能的变化上。这些变化可能基于中枢和外周机制,单侧和双侧症状患者的机制可能有所不同。

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