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酒精使用障碍中的中枢敏化:疼痛、成瘾与健康相关生活质量的关联

Central sensitization in alcohol use disorder: correlates of pain, addiction and health-related quality of life.

作者信息

Hall O Trent, Entrup Parker, King Anthony, Vilensky Michael, Bryan Craig J, Teater Julie, Niedermier Julie, Kaplan Chelsea M, Turner Jessica A, Gorka Stephanie, Harte Steven E, Williams David A, Clauw Daniel J

机构信息

Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center, Columbus, OH, USA.

Department of Anesthesiology, Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor, MI, USA.

出版信息

J Addict Dis. 2025 Jan-Mar;43(1):32-43. doi: 10.1080/10550887.2023.2237396. Epub 2023 Jul 22.

Abstract

BACKGROUND

Central sensitization is an important mechanism underlying many chronic pain conditions. Chronic pain and alcohol use disorder (AUD) are highly comorbid. Despite great scientific interest in brain mechanisms linking chronic pain and AUD, progress has been impeded by difficulty assessing central sensitization in AUD.

OBJECTIVE

The present study is the first to employ a validated surrogate measure to describe central sensitization in a clinical sample with AUD.

METHODS

Participants with AUD ( = 99) were recruited from an academic addiction treatment center. A well-established surrogate measure of central sensitization, The American College of Rheumatology Fibromyalgia Survey Criteria (ACRFMS) was administered. Participants also responded to questions about quality of life (RAND-36), and AUD. Descriptive analyses and Spearman's rho correlations were performed.

RESULTS

Chronic pain and evidence of central sensitization were prevalent. Greater central sensitization was associated with worse health-related quality of life. Participants higher in central sensitization expressed greater endorsement of pain as a reason for AUD onset, maintenance, escalation, treatment delay, and relapse.

CONCLUSION

The present study bolsters prior assertions that AUD and chronic pain might compound one another progressive sensitization of shared brain circuitry. These results may inform future mechanistic research and precision AUD treatment.

摘要

背景

中枢敏化是许多慢性疼痛病症的重要潜在机制。慢性疼痛与酒精使用障碍(AUD)高度共病。尽管人们对连接慢性疼痛和AUD的脑机制有着浓厚的科学兴趣,但由于难以评估AUD中的中枢敏化,进展受到了阻碍。

目的

本研究首次采用经过验证的替代指标来描述患有AUD的临床样本中的中枢敏化。

方法

从一个学术性成瘾治疗中心招募了患有AUD的参与者(n = 99)。采用了一种成熟的中枢敏化替代指标,即美国风湿病学会纤维肌痛调查标准(ACRFMS)。参与者还回答了有关生活质量(RAND - 36)和AUD的问题。进行了描述性分析和斯皮尔曼等级相关分析。

结果

慢性疼痛和中枢敏化的证据很普遍。更高程度的中枢敏化与更差的健康相关生活质量相关。中枢敏化程度较高的参与者更倾向于将疼痛作为AUD发作、维持、加重、治疗延迟和复发的原因。

结论

本研究支持了先前的论断,即AUD和慢性疼痛可能会相互加剧——共享脑回路的渐进性敏化。这些结果可能为未来的机制研究和精准AUD治疗提供参考。

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