Agostinho Mariana, Canaipa Rita, Honigman Liat, Treister Roi
CIIS, Centre for Interdisciplinary Health Research, Institute of Health Sciences, Catholic University of Portugal, Lisbon, Portugal.
The Clinical Pain Innovation Lab, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
Front Neurosci. 2019 Aug 13;13:774. doi: 10.3389/fnins.2019.00774. eCollection 2019.
The subjective nature of pain assessment and its large variance negatively affect patient-health care provider communication and reduce the assay sensitivity of pain clinical trials. Given the lack of an objective gold standard measure, identifying the source (true or error) of the within-subject variability of pain reports is a challenge. By assessing the within-subjects variability of pain and taste reports, alongside with interoceptive measures, the current study is aimed to investigate if the ability to reliably report bodily sensations is a cross-modal characteristic.
This prospective study enrolled healthy volunteers from local universities. After consenting, subjects underwent the Focus Analgesia Selection Task (FAST), to assess within-subjects variability of pain reports in response to experimental noxious stimuli; a taste task, which similarly assesses within-subjects variability of tastes (salty and sweet) intensity reports; and the heartbeat perception task, an interoceptive task aimed to assess how accurate subjects are in monitoring and reporting their own heartbeat. In addition, all subjects completed the Multidimensional Assessment of Interoceptive Awareness (MAIA), the Perceived Stress Scale (PSS), and Hospital Anxiety and Depression Scale (HADS). Spearman's correlations were used to assess relations between all measures.
Sixty healthy volunteers were recruited. Variability of intensity reports of different modalities were independent of each other ( > 0.05 for all correlations). The only correlation found was within modality, between variability of intensity reports of salt and sweet tastes (Spearman's = 0.477, < 0.001). No correlations were found between any of the task results and questionnaire results.
Within-subjects variability of pain reports do not relate to variability of reports of other modalities or to interoceptive awareness. Further research is ongoing to investigate the clinical relevance of within-subjects' variability of pain reports.
疼痛评估的主观性及其较大的变异性对患者与医护人员之间的沟通产生负面影响，并降低了疼痛临床试验的检测灵敏度。鉴于缺乏客观的金标准测量方法，识别疼痛报告中个体内部变异性的来源（真实或误差）是一项挑战。通过评估疼痛和味觉报告的个体内部变异性以及内感受性测量，本研究旨在调查可靠报告身体感觉的能力是否为一种跨模态特征。
这项前瞻性研究招募了当地大学的健康志愿者。在获得同意后，受试者接受了聚焦镇痛选择任务（FAST），以评估对实验性有害刺激的疼痛报告的个体内部变异性；一项味觉任务，同样用于评估味觉（咸和甜）强度报告的个体内部变异性；以及心跳感知任务，这是一项内感受性任务，旨在评估受试者监测和报告自己心跳的准确性。此外，所有受试者完成了内感受性意识多维评估（MAIA）、感知压力量表（PSS）和医院焦虑抑郁量表（HADS）。使用斯皮尔曼相关性来评估所有测量之间的关系。
招募了60名健康志愿者。不同模态强度报告的变异性相互独立（所有相关性均>0.05）。唯一发现的相关性是在模态内，盐味和甜味强度报告的变异性之间（斯皮尔曼相关系数 = 0.477，P<0.001）。在任何任务结果与问卷结果之间均未发现相关性。
疼痛报告的个体内部变异性与其他模态报告的变异性或内感受性意识无关。正在进行进一步研究以调查疼痛报告个体内部变异性的临床相关性。
