Augière Tania, Desjardins Audrey, Paquette Raynard Emmanuelle, Brun Clémentine, Pinard Anne Marie, Simoneau Martin, Mercier Catherine
Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, QC, Canada.
Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, QC, Canada.
Front Pain Res (Lausanne). 2021 Dec 24;2:740897. doi: 10.3389/fpain.2021.740897. eCollection 2021.
Fibromyalgia is a chronic pain syndrome characterized by sensorimotor deficits and distortions of body representation, that could both be caused by alterations in sensory processing. Several studies suggest a hypersensitivity to various sensory stimulations in fibromyalgia but results on detection of both noxious and non-noxious tactile stimulation, which are particularly relevant for body representation and motor control, remain conflicting. Therefore, the aim of this study is to systematically review and quantify the detection thresholds to noxious and non-noxious tactile stimuli in individuals with fibromyalgia compared to pain-free controls. A systematic review and a meta-analysis were performed in the MEDLINE, EMBASE, CINAHL, Cochrane, PsycInfo and Web of Science databases using keywords related to fibromyalgia, tactile pain detection threshold, tactile detection threshold and quantitative sensory testing. Nineteen studies were included in the review, with 12 in the meta-analysis. Despite the heterogeneity of the results, the data from both the review and from the meta-analysis suggest a trend toward hyperalgesia and no difference of sensitivity to non-noxious tactile stimuli in participants with fibromyalgia compared to healthy controls. This contradicts the hypothesis of a general increase in responsiveness of the central nervous system to noxious and non-noxious stimulations in fibromyalgia. This study shows no alteration of the sensitivity to non-noxious tactile stimulation in fibromyalgia, suggesting that an altered unimodal processing is not sufficient to explain symptoms such as sensorimotor impairments and body representation distortions. Future research should investigate whether alterations in multisensory integration could contribute to these symptoms.
纤维肌痛是一种慢性疼痛综合征，其特征为感觉运动功能缺陷和身体表征扭曲，这两者都可能由感觉处理的改变引起。多项研究表明，纤维肌痛患者对各种感觉刺激存在超敏反应，但关于有害和无害触觉刺激检测的结果，而这两者对身体表征和运动控制尤为重要，仍然相互矛盾。因此，本研究的目的是系统回顾并量化纤维肌痛患者与无疼痛对照组相比，对有害和无害触觉刺激的检测阈值。使用与纤维肌痛、触觉疼痛检测阈值、触觉检测阈值和定量感觉测试相关的关键词，在MEDLINE、EMBASE、CINAHL、Cochrane、PsycInfo和科学网数据库中进行了系统回顾和荟萃分析。该回顾纳入了19项研究，荟萃分析纳入了12项研究。尽管结果存在异质性，但回顾和荟萃分析的数据均表明，与健康对照组相比，纤维肌痛患者存在痛觉过敏趋势，且对无害触觉刺激的敏感性无差异。这与纤维肌痛患者中枢神经系统对有害和无害刺激反应普遍增加的假设相矛盾。本研究表明，纤维肌痛患者对无害触觉刺激的敏感性没有改变，这表明单峰处理的改变不足以解释感觉运动障碍和身体表征扭曲等症状。未来的研究应调查多感觉整合的改变是否可能导致这些症状。
