Robayo Linda E, Govind Varan, Vastano Roberta, Felix Elizabeth R, Fleming Loriann, Cherup Nicholas P, Widerström-Noga Eva
Neuroscience Graduate Program, University of Miami Miller School of Medicine, Miami, FL, United States.
Christine E. Lynn Rehabilitation Center, Miami Project to Cure Paralysis at UHealth/Jackson Memorial, Miami, FL, United States.
Front Pain Res (Lausanne). 2022 Aug 19;3:947562. doi: 10.3389/fpain.2022.947562. eCollection 2022.
More than 50% of individuals develop chronic pain following traumatic brain injury (TBI). Research suggests that a significant portion of post-TBI chronic pain conditions is neuropathic in nature, yet the relationship between neuropathic pain, psychological distress, and somatosensory function following TBI is not fully understood. This study evaluated neuropathic pain symptoms, psychological and somatosensory function, and psychosocial factors in individuals with TBI (TBI, = 38). A two-step cluster analysis was used to identify phenotypes based on the Neuropathic Pain Symptom Inventory and Beck's Anxiety Inventory scores. Phenotypes were then compared on pain characteristics, psychological and somatosensory function, and psychosocial factors. Our analyses resulted in two different neuropathic pain phenotypes: (1) Moderate neuropathic pain severity and anxiety scores (MNP-AS, = 11); and (2) mild or no neuropathic pain symptoms and anxiety scores (LNP-AS, = 27). Furthermore, the MNP-AS group exhibited greater depression, PTSD, pain severity, and affective distress scores than the LNP-AS group. In addition, thermal somatosensory function (difference between thermal pain and perception thresholds) was significantly lower in the MNP-AS compared to the LNP-AS group. Our findings suggest that neuropathic pain symptoms are relatively common after TBI and are not only associated with greater psychosocial distress but also with abnormal function of central pain processing pathways.
超过50%的个体在创伤性脑损伤(TBI)后会出现慢性疼痛。研究表明,TBI后相当一部分慢性疼痛状况本质上是神经性的,但TBI后神经性疼痛、心理困扰和躯体感觉功能之间的关系尚未完全明确。本研究评估了TBI患者(n = 38)的神经性疼痛症状、心理和躯体感觉功能以及社会心理因素。基于神经性疼痛症状量表和贝克焦虑量表得分,采用两步聚类分析来识别表型。然后比较各表型在疼痛特征、心理和躯体感觉功能以及社会心理因素方面的差异。我们的分析得出了两种不同的神经性疼痛表型:(1)中度神经性疼痛严重程度和焦虑得分(MNP - AS,n = 11);(2)轻度或无神经性疼痛症状和焦虑得分(LNP - AS,n = 27)。此外,MNP - AS组在抑郁、创伤后应激障碍、疼痛严重程度和情感困扰得分方面均高于LNP - AS组。另外,与LNP - AS组相比,MNP - AS组的热躯体感觉功能(热痛与感觉阈值之间的差异)显著更低。我们的研究结果表明,神经性疼痛症状在TBI后相对常见,不仅与更大的社会心理困扰有关,还与中枢性疼痛处理通路的功能异常有关。