Lautenbacher Stefan, Kunz Miriam
Physiological Psychology, University of Bamberg, Markusplatz 3, 96047 Bamberg. Germany.
Department of General Practice, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
Curr Alzheimer Res. 2017;14(5):501-505. doi: 10.2174/1567205013666160603010455.
The analysis of the facial expression of pain promises to be one of the most sensitive tools for the detection of pain in patients with moderate to severe forms of dementia, who can no longer self-report pain. Fine-grain analysis using the Facial Action Coding System (FACS) is possible in research but not feasible for clinical use at the moment because it is too time and effort consuming. Studies using the FACS showed either enhanced facial responses or no alterations of facial activity during pain in patients with cognitive impairment. Pain assessment in the clinical context relies strongly on the use of observational scales when self-report has become invalid. All of the established scales include items describing facial responses to pain. Despite this agreement, the content of these face items is very different, ranging from anatomically-based descriptions to inference of internal states. Recent studies let the anatomical orientation appear more promising. Automated video systems for the detection of pain in patients with dementia may lead to ground-breaking improvements of pain care in the future.
对疼痛面部表情的分析有望成为检测中重度痴呆患者疼痛的最敏感工具之一，这些患者已无法自我报告疼痛。使用面部动作编码系统（FACS）进行细粒度分析在研究中是可行的，但目前在临床应用中不可行，因为它太耗费时间和精力。使用FACS的研究表明，认知障碍患者在疼痛期间面部反应增强或面部活动无变化。当自我报告无效时，临床环境中的疼痛评估强烈依赖于观察量表的使用。所有已建立的量表都包括描述面部对疼痛反应的项目。尽管有此共识，但这些面部项目的内容差异很大，从基于解剖学的描述到内部状态的推断。最近的研究使解剖学取向显得更有前景。用于检测痴呆患者疼痛的自动视频系统可能会在未来带来疼痛护理的突破性改进。
