Sugimine S, Saito S, Araki T, Yamamoto K, Obata H
Department of Anesthesiology, Gunma University Graduate School of Medicine, Maebashi, Japan.
Department of Clinical Pharmacology, Gunma University Graduate School of Medicine, Maebashi, Japan.
Eur J Pain. 2017 Jul;21(6):997-1006. doi: 10.1002/ejp.1007. Epub 2017 Feb 7.
Conditioned pain modulation (CPM) is widely used to measure endogenous analgesia, and a recent study indicated that drugs that act on endogenous analgesia are more effective in individuals with lower CPM. Recent animal studies have indicated that pregabalin activates endogenous analgesia by stimulating the descending pain inhibitory system. The present study examined whether the analgesic effect of pregabalin is greater in individuals with lower original endogenous analgesia using CPM.
Fifty-nine healthy subjects were randomly assigned to either a pregabalin group or a placebo group, and 50 of them completed the study. CPM was measured before and after pregabalin or placebo administration. The correlation of initial CPM to change in CPM was compared between the pregabalin and placebo groups.
Initial CPM was significantly correlated with the change in CPM in the pregabalin group (r = -0.73, p < 0.0001) but not in the placebo group (p = 0.56) (difference in correlation coefficients between groups; p = 0.004). Furthermore, the initial CPM significantly affected the change in CPM in the pregabalin group but not in the placebo group (pregabalin group: adj R = 0.51, p < 0.001, y = -0.54x + 2.98; placebo group: p = 0.56, significant difference in regression slopes; p = 0.015). These results indicate that pregabalin has a higher endogenous analgesic effect in individuals with lower original endogenous analgesia.
The analgesic effect of pregabalin depends on the original endogenous analgesia status. Its effect on conditioned pain modulation (CPM) was stronger for subjects with lower original endogenous analgesia, suggesting that the mechanism of pregabalin involves the improvement of endogenous analgesia.
条件性疼痛调制（CPM）被广泛用于测量内源性镇痛，最近一项研究表明，作用于内源性镇痛的药物在CPM较低的个体中更有效。最近的动物研究表明，普瑞巴林通过刺激下行性疼痛抑制系统来激活内源性镇痛。本研究使用CPM检验了普瑞巴林在初始内源性镇痛较低的个体中镇痛效果是否更强。
59名健康受试者被随机分为普瑞巴林组或安慰剂组，其中50人完成了研究。在给予普瑞巴林或安慰剂之前和之后测量CPM。比较普瑞巴林组和安慰剂组初始CPM与CPM变化之间的相关性。
在普瑞巴林组中，初始CPM与CPM的变化显著相关（r = -0.73，p < 0.0001），而在安慰剂组中则无相关性（p = 0.56）（组间相关系数差异；p = 0.004）。此外，初始CPM显著影响普瑞巴林组中CPM的变化，但不影响安慰剂组（普瑞巴林组：调整后R = 0.51，p < 0.001，y = -0.54x + 2.98；安慰剂组：p = 0.56，回归斜率有显著差异；p = 0.015）。这些结果表明，普瑞巴林在初始内源性镇痛较低的个体中具有更高的内源性镇痛效果。
普瑞巴林的镇痛效果取决于初始内源性镇痛状态。对于初始内源性镇痛较低的受试者，其对条件性疼痛调制（CPM）的作用更强，这表明普瑞巴林的作用机制涉及内源性镇痛的改善。
