改良生物反馈(条件化生物反馈)通过增加伤害性屈肌反射阈值和减少疼痛的时间总和来促进镇痛:一项对照试验。

Modified Biofeedback (Conditioned Biofeedback) Promotes Antinociception by Increasing the Nociceptive Flexion Reflex Threshold and Reducing Temporal Summation of Pain: A Controlled Trial.

机构信息

Department of Psychology, The University of Tulsa, Tulsa, Oklahoma.

Department of Psychology, The University of Tulsa, Tulsa, Oklahoma.

出版信息

J Pain. 2020 May-Jun;21(5-6):663-676. doi: 10.1016/j.jpain.2019.10.006. Epub 2019 Nov 1.

Abstract

This study examined whether a modified version of biofeedback (ie, Conditioned Biofeedback) that incorporated placebo analgesia-like manipulations could promote antinociception in healthy, pain-free participants. During Conditioned Biofeedback (n = 28), sympathetic arousal level was displayed visually and participants were asked to reduce it while they received painful electric stimulations that were surreptitiously controlled by their arousal level. Thus, electric pain decreased as arousal decreased to associate successful arousal-reduction/relaxation with pain relief, and to promote expectations for future pain relief. A Biofeedback Only group (n = 24) controlled for the general effects of biofeedback/relaxation. A Biofeedback+Shock group (n = 21) controlled for the effects of practicing biofeedback during painful shocks. Nociceptive flexion reflex (NFR) threshold and temporal summation of pain (TS-pain) were used to assess changes in spinal nociception and pain facilitation, respectively. Results indicated all groups showed pre- to postbiofeedback increases in NFR threshold, but only the Conditioned Biofeedback group showed pre- to postbiofeedback reductions in TS-pain. Moreover, Conditioned Biofeedback resulted in a persistent (prebiofeedback) increase in NFR threshold across sessions, whereas Biofeedback Only resulted in a persistent (prebiofeedback) decrease in TS-pain. In sum, Conditioned Biofeedback may promote antinociception in healthy participants thus reducing risk for chronic pain. The study was registered prospectively on ClinicalTrials.gov (TU1560). PERSPECTIVE: A modified version of biofeedback that employs placebo analgesia manipulations was successful in increasing descending inhibition and reducing pain facilitation in healthy volunteers. As a result, it may be an effective means of reducing risk of future chronic pain onset by promoting an antinociceptive pain profile.

摘要

这项研究旨在检验一种改良的生物反馈形式(即条件化生物反馈),该形式纳入了类似安慰剂镇痛的操作,是否能促进健康无痛参与者的镇痛。在条件化生物反馈(n=28)中,交感神经唤醒水平通过视觉呈现,参与者被要求在接受隐秘地由其唤醒水平控制的疼痛电刺激时降低唤醒水平。因此,随着唤醒水平降低,电刺激疼痛减轻,这将成功的唤醒降低/放松与疼痛缓解相关联,并促进对未来疼痛缓解的预期。生物反馈仅组(n=24)控制了生物反馈/放松的一般效果。生物反馈+电击组(n=21)控制了在电击疼痛期间练习生物反馈的效果。伤害性屈肌反射(NFR)阈值和疼痛的时间总和(TS-pain)分别用于评估脊髓伤害感受和疼痛易化的变化。结果表明,所有组在生物反馈前到后都显示出 NFR 阈值增加,但只有条件化生物反馈组显示出生物反馈前到后 TS-pain 减少。此外,条件化生物反馈导致 NFR 阈值在整个疗程中持续(生物反馈前)增加,而生物反馈仅导致 TS-pain 持续(生物反馈前)减少。总之,条件化生物反馈可能会促进健康参与者的镇痛,从而降低慢性疼痛的风险。该研究在 ClinicalTrials.gov(TU1560)上进行了前瞻性注册。观点:一种改良的生物反馈形式,采用安慰剂镇痛操作,成功地增加了下行抑制作用,减少了健康志愿者的疼痛易化。因此,它可能是通过促进一种镇痛疼痛模式来有效降低未来慢性疼痛发病风险的一种手段。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索