Department of Neurology, University Hospital, LMU Munich, Munich, Germany.
Graduate School of Systemic Neurosciences, LMU Munich, Planegg-Martinsried, Germany.
Pain. 2018 Jul;159(7):1359-1365. doi: 10.1097/j.pain.0000000000001219.
Individual differences in sensitivity to pain are large and have clinical and scientific importance. Although heavily influenced by situational factors, they also relate to genetic factors and psychological traits, and are reflected by differences in functional activation in pain-related brain regions. Here, we used voxel-based morphometry to investigate if individual pain sensitivity is related to local gray matter volumes. Pain sensitivity was determined using (1) index finger pressure pain thresholds (PPTs) and (2) pain intensity ratings of imagined painful situations as assessed by the Pain Sensitivity Questionnaire (PSQ) in 501 population-based subjects participating in the BiDirect Study. Pain Sensitivity Questionnaire scores were positively associated with gray matter in 2 symmetrical clusters, with a focus on the parahippocampal gyrus, extending to the hippocampus, fusiform gyrus, BA19, putamen, and insula (P < 0.05 corrected), but the effect was small (R = 0.045-0.039). No negative associations with the PSQ and no associations with the PPT reached significance. Parahippocampal activation during pain and altered parahippocampal gray matter in chronic pain have been reported, which would be consistent with positive associations with PSQ scores. Alternatively, associations of PSQ scores with the parahippocampal and fusiform gray matter could relate to the visual imagination of painful situations required by the PSQ, not to pain sensitivity itself. Regarding PPTs, the present data obtained in a large sample strongly suggest an absence of associations of this parameter with gray matter volume. In conclusion, the present results argue against a strong association between pain sensitivity and local gray matter volumes.
个体对疼痛的敏感性存在很大差异，具有临床和科学意义。尽管这种差异受到情境因素的强烈影响，但它也与遗传因素和心理特征有关，并且反映在与疼痛相关的大脑区域的功能激活差异上。在这里，我们使用基于体素的形态测量法来研究个体疼痛敏感性是否与局部灰质体积有关。在参加 BiDirect 研究的 501 名基于人群的受试者中，使用（1）食指压痛阈值（PPT）和（2）想象中的疼痛情况的疼痛强度评分（通过疼痛敏感性问卷（PSQ）评估）来确定疼痛敏感性。PSQ 评分与 2 个对称簇中的灰质呈正相关，焦点位于海马旁回，延伸到海马体、梭状回、BA19、壳核和岛叶（校正后 P < 0.05），但效果很小（R = 0.045-0.039）。PSQ 与 PPT 之间没有负相关，也没有与 PSQ 相关的关联达到显著水平。已经报道了疼痛期间海马旁回的激活和慢性疼痛中海马旁回灰质的改变，这与 PSQ 评分的正相关是一致的。或者，PSQ 评分与海马旁回和梭状回灰质的关联可能与 PSQ 所需的疼痛情况的视觉想象有关，而与疼痛敏感性本身无关。关于 PPT，本研究在大样本中获得的数据强烈表明，该参数与灰质体积之间不存在关联。总之，本研究结果表明，疼痛敏感性与局部灰质体积之间没有很强的关联。
