Jensen-Dahm Christina, Madsen Caspar Skau, Waldemar Gunhild, Ballegaard Martin, Hejl Anne-Mette, Johnsen Birger, Jensen Troels Staehelin
*Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark;
Danish Pain Research Centre, Department of Neurology, Aarhus University Hospital, Denmark;
Pain Med. 2016 Apr;17(4):675-84. doi: 10.1093/pm/pnv012. Epub 2015 Dec 14.
Clinical studies have found that patients with Alzheimer's disease report pain of less intensity and with a lower affective response, which has been thought to be due to altered pain processing. The authors wished to examine the cerebral processing of non-painful and painful stimuli using somatosensory evoked potentials and contact heat evoked potentials in patients with Alzheimer's disease and in healthy elderly controls.
Case-control study
Twenty outpatients with mild-moderate Alzheimer's disease and in 17 age- and gender-matched healthy controls were included
Contact heat evoked potentials and somatosensory evoked potentials were recorded in all subjects. Furthermore, warmth detection threshold and heat pain threshold were assessed. Patients and controls also rated quality and intensity of the stimuli.
The authors found no difference on contact heat evoked potential amplitude (P = 0.59) or latency of N2 or P2 wave (P = 0.62 and P = 0.75, respectively) between patients and controls. In addition, there was no difference in regard to pain intensity scores or pain quality. The patients and controls had similar warmth detection threshold and heat pain threshold. Somatosensory evoked potentials, amplitude, and latency were within normal range and similar for the two groups.
The findings suggest that the processing of non-painful and painful stimuli is preserved in patients with mild to moderate Alzheimer's disease.
临床研究发现，阿尔茨海默病患者报告的疼痛强度较低，情感反应也较弱，这被认为是由于疼痛处理过程改变所致。作者希望利用体感诱发电位和接触热诱发电位，研究阿尔茨海默病患者和健康老年对照者对非疼痛和疼痛刺激的大脑处理过程。
病例对照研究
纳入20例轻度至中度阿尔茨海默病门诊患者和17名年龄及性别匹配的健康对照者。
记录所有研究对象的接触热诱发电位和体感诱发电位。此外，评估热觉检测阈值和热痛阈值。患者和对照者还对刺激的质量和强度进行评分。
作者发现，患者和对照者在接触热诱发电位幅度（P = 0.59）或N2波或P2波潜伏期（分别为P = 0.62和P = 0.75）方面没有差异。此外，在疼痛强度评分或疼痛质量方面也没有差异。患者和对照者的热觉检测阈值和热痛阈值相似。两组的体感诱发电位、幅度和潜伏期均在正常范围内且相似。
研究结果表明，轻度至中度阿尔茨海默病患者对非疼痛和疼痛刺激的处理功能保存完好。
