Malejko Kathrin, Huss André, Schönfeldt-Lecuona Carlos, Braun Maren, Graf Heiko
Department of Psychiatry and Psychotherapy III, University of Ulm, 89075 Ulm, Germany.
Department of Neurology, University of Ulm, 89081 Ulm, Germany.
Brain Sci. 2020 Nov 24;10(12):905. doi: 10.3390/brainsci10120905.
Various studies suggested alterations in pain perception in psychiatric disorders, such as borderline personality disorder (BPD) and major depression (MD). We previously investigated affective components of pain perception in BPD compared to healthy controls (HC) by increasing aversive stimulus intensities using repetitive peripheral magnetic stimulation (rPMS) and observed alterations in emotional rather than somatosensory components in BPD. However, conclusions on disorder specific alterations in these components of pain perception are often limited due to comorbid depression and medication in BPD. Here, we compared 10 patients with BPD and comorbid MD, 12 patients with MD without BPD, and 12 HC. We applied unpleasant somatosensory stimuli with increasing intensities by rPMS and assessed pain threshold (PT), cutaneous sensation, emotional valence, and arousal by a Self-Assessments Manikins scale. PTs in BPD were significantly higher compared to HC. The somatosensory discrimination of stimulus intensities did not differ between groups. Though elevated rPMS intensities led to increased subjective aversion and arousal in MD and HC, these emotional responses among intensity levels remained unchanged in BPD. Our data give further evidence for disorder-specific alterations in emotional components of pain perception in BPD with an absent emotional modulation among varying aversive intensity levels.
多项研究表明，精神疾病如边缘型人格障碍（BPD）和重度抑郁症（MD）患者的疼痛感知存在改变。我们之前通过重复外周磁刺激（rPMS）增加厌恶刺激强度，比较了BPD患者与健康对照者（HC）疼痛感知的情感成分，观察到BPD患者在情感而非躯体感觉成分上存在改变。然而，由于BPD患者存在共病抑郁和药物治疗，关于这些疼痛感知成分中特定疾病改变的结论往往受到限制。在此，我们比较了10例BPD合并MD患者、12例无BPD的MD患者和12例HC。我们通过rPMS施加强度不断增加的不愉快躯体感觉刺激，并通过自我评估人体模型量表评估疼痛阈值（PT）、皮肤感觉、情感效价和唤醒水平。与HC相比，BPD患者的PT显著更高。各组之间对刺激强度的躯体感觉辨别没有差异。尽管增加rPMS强度会导致MD患者和HC患者的主观厌恶和唤醒增加，但在BPD患者中，不同强度水平之间的这些情感反应保持不变。我们的数据进一步证明了BPD患者疼痛感知情感成分存在特定疾病改变，且在不同厌恶强度水平下情感调节缺失。
