Waller Robert, Smith Anne J, O'Sullivan Peter B, Slater Helen, Sterling Michele, Straker Leon M
School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia.
RECOVER Injury Research Centre, NHMRC Centre of Research Excellence in Road Traffic Injury, The University of Queensland, Herston, Australia.
Pain. 2020 Jan;161(1):220-229. doi: 10.1097/j.pain.0000000000001704.
Early life stress (ELS) can significantly influence biological pathways associated with nociception, increasing vulnerability to future heightened pain sensitivity and subsequent risk of pain events. However, very little human research has investigated the association of ELS, measured across multiple domains, with future pain sensitivity. Data from Gen1 and Gen2 of the Raine Study were used to assess the association between a wide range of early life stressors, including antenatally, and pressure and cold pain sensitivity at young adulthood. Participants were classified into 2 groups according to their cold pain sensitivity. In addition, the interaction between ELS, pain sensitivity, and pain experience (based on Örebro Musculoskeletal Pain Questionnaire) at age 22 years was examined. Analysis was performed using both a complete case and multiple imputation approach, adjusting for contemporaneous 22-year correlates, with comparable results in each model. More problematic behaviour at age 2 years was associated with less pressure pain sensitivity at 22 years (13.7 kPa, 95% CI: 1.0-27.0, P = 0.037), with no interaction between problematic behaviour and pain experience at 22 years. For those reporting a moderate/high pain experience at 22 years, poor family functioning increased the odds ratio for high cold pain sensitivity (3.0, 95% CI: 1.6-5.6), but for those reporting no/low pain experience, it did not (OR:1.2, 95% CI: 0.8-1.8). This study provides the most comprehensive investigation of the relationship between ELS and pressure and cold pain sensitivity in young adults supporting early life as a critical period of development influencing future nociceptive processing.
早年生活应激（ELS）可显著影响与伤害感受相关的生物学途径，增加未来对疼痛敏感性升高及后续疼痛事件风险的易感性。然而，很少有人类研究调查跨多个领域测量的ELS与未来疼痛敏感性之间的关联。使用雷恩研究第一代和第二代的数据评估一系列早期生活应激源（包括产前应激源）与青年期压力和冷痛敏感性之间的关联。根据冷痛敏感性将参与者分为两组。此外，还研究了22岁时ELS、疼痛敏感性和疼痛体验（基于厄勒布鲁肌肉骨骼疼痛问卷）之间的相互作用。采用完整病例法和多重填补法进行分析，并对22岁时的同期相关因素进行校正，每个模型的结果相当。2岁时更多的问题行为与22岁时较低的压力疼痛敏感性相关（13.7千帕，95%置信区间：1.0 - 27.0，P = 0.037），22岁时问题行为与疼痛体验之间无相互作用。对于那些在22岁时报告有中度/高度疼痛体验的人，家庭功能不良会增加高冷痛敏感性的比值比（3.0，95%置信区间：1.6 - 5.6），但对于那些报告无/低疼痛体验的人则不会（比值比：1.2，95%置信区间：0.8 - 1.8）。本研究对ELS与青年期压力和冷痛敏感性之间的关系进行了最全面的调查，支持早年生活是影响未来伤害性处理的关键发育时期。
