Department for Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Department of Neurophysiology, Centre of Biomedicine and Medical Technology Mannheim, Medical Faculty Mannheim, Ruprecht Karls-University Heidelberg, Mannheim, Germany.
Pain. 2019 Nov;160(11):2487-2496. doi: 10.1097/j.pain.0000000000001641.
This study aimed to investigate whether the differences in pain perception between patients with borderline personality disorder (BPD) and healthy subjects (HCs) can be explained by differences in the glutamate/GABA ratio in the posterior insula. In total, 29 BPD patients and 31 HCs were included in the statistical analysis. Mechanical pain sensitivity was experimentally assessed with pinprick stimuli between 32 and 512 mN on a numeric rating scale. The metabolites were measured in the right posterior insula using the MEshcher-GArwood Point-RESolved Spectroscopy sequence for single-voxel magnetic resonance spectroscopy (1H-MRS). The 256- and the 512-mN pinprick stimuli were perceived as significantly less painful by the BPD patient group compared with HCs. No differences were found between groups for the glutamate/GABA ratios. A positive correlation between the glutamate/GABA ratio and the pain intensity ratings to 256- and 512-mN pinpricks could be found in the combined and in the HC group. In the BPD patient group, the correlations between the glutamate/GABA ratio and the pain intensity ratings to 256- and 512-mN pinpricks did not reach significance. In conclusion, the study showed that individual differences in pain perception may in part be explained by the individual glutamate/GABA ratio in the posterior insula. However, this possible mechanism does not explain the differences in pain perception between BPD patients and HCs.
本研究旨在探究边缘型人格障碍（BPD）患者与健康对照组（HCs）之间的疼痛感知差异是否可以用后岛叶谷氨酸/γ-氨基丁酸（GABA）比值的差异来解释。共有 29 名 BPD 患者和 31 名 HCs 纳入统计分析。使用数值评定量表在 32 至 512 mN 之间的针刺痛觉对机械疼痛敏感性进行实验评估。使用单磁共振波谱（1H-MRS）的 MEshcher-GArwood 点分辨波谱序列在后岛叶右部测量代谢物。与 HCs 相比，BPD 患者组对 256 和 512 mN 的针刺痛觉的感知明显较轻。两组之间的谷氨酸/GABA 比值无差异。在合并组和 HCs 组中，谷氨酸/GABA 比值与 256 和 512 mN 针刺痛觉的疼痛强度评分之间存在正相关。在 BPD 患者组中，谷氨酸/GABA 比值与 256 和 512 mN 针刺痛觉的疼痛强度评分之间的相关性未达到显著性。总之，该研究表明，疼痛感知的个体差异部分可以用后岛叶的个体谷氨酸/GABA 比值来解释。然而，这种可能的机制并不能解释 BPD 患者与 HCs 之间的疼痛感知差异。
