Borg Céline, Chouchou Florian, Dayot-Gorlero Jenny, Zimmerman Perrine, Maudoux Delphine, Laurent Bernard, Michael George A
Neurology/Neuropsychology CMRR Unit, Hospital Nord, Saint-Priest-en-Jarez, France.
Department of Psychology, University of Lyon, Lyon, France.
J Pain Res. 2018 Apr 19;11:823-835. doi: 10.2147/JPR.S152012. eCollection 2018.
This study investigated interoception in fibromyalgia (FM), a disorder characterized by chronic pain accompanied by mood deregulation. Based on observations on the relationship between somatosensory processing and pain in FM and considering the affective symptoms of this disorder, we tested in FM three dimensions of interoception: interoceptive accuracy (IA), interoceptive awareness (IAW) and interoceptive sensibility (IS).
Twenty-one female FM patients (M = 50.3) and 21 female matched controls (M = 46.3) completed a heartbeat tracking task as an assessment of IA, rated confidence in their responses as a measure of IAW and completed the Multidimensional Assessment of Interoceptive Awareness as a measure of IS. Furthermore, they completed self-report scales that, according to a principal component analysis, targeted anxiety, emotional consciousness and pain-related affect and reactions.
Multiple regression analyses showed that increased pain-related affect and reactions decrease IA in FM. When the results of each group were examined separately, such effect was found only in FM patients. On its turn, IS was predicted by emotional consciousness and pain-related affect and reactions, but these effects did not differ between FM and controls. Finally, none of the variables we used predicted IAW.
Pain-related affect and reactions in FM patients can reduce their interoceptive ability. Our results help to better understand the integration between bodily signals and emotional processing in chronic pain.
本研究调查了纤维肌痛(FM)患者的内感受,这是一种以慢性疼痛伴情绪失调为特征的疾病。基于对FM患者体感加工与疼痛之间关系的观察,并考虑到该疾病的情感症状,我们在FM患者中测试了内感受的三个维度:内感受准确性(IA)、内感受意识(IAW)和内感受敏感性(IS)。
21名女性FM患者(M = 50.3)和21名匹配的女性对照者(M = 46.3)完成了一项心跳追踪任务以评估IA,对其反应的信心评分作为IAW的测量指标,并完成了内感受意识多维评估作为IS的测量指标。此外,她们还完成了自我报告量表,根据主成分分析,这些量表针对焦虑、情绪意识以及与疼痛相关的情感和反应。
多元回归分析表明,在FM患者中,与疼痛相关的情感和反应增加会降低IA。当分别检查每组结果时,这种效应仅在FM患者中发现。反过来,IS由情绪意识以及与疼痛相关的情感和反应预测,但这些效应在FM患者和对照组之间没有差异。最后,我们使用的变量均未预测IAW。
FM患者中与疼痛相关的情感和反应会降低他们的内感受能力。我们的结果有助于更好地理解慢性疼痛中身体信号与情绪加工之间的整合。