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高频刺激诱导中枢痛觉通路敏化后,定量感觉测试评估躯体感觉功能的可靠性。

Reliability of quantitative sensory testing in the assessment of somatosensory function after high-frequency stimulation-induced sensitisation of central nociceptive pathways.

机构信息

Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.

Pain Research, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom.

出版信息

Pain. 2024 Apr 1;165(4):941-950. doi: 10.1097/j.pain.0000000000003093. Epub 2023 Oct 25.

DOI:10.1097/j.pain.0000000000003093
PMID:37878469
Abstract

The high frequency stimulation (HFS) model can be used alongside quantitative sensory testing (QST) to assess the sensitisation of central nociceptive pathways. However, the validity and between-session reliability of using QST z -score profiles to measure changes in mechanical and thermal afferent pathways in the HFS model are poorly understood. In this study, 32 healthy participants underwent QST before and after HFS (5× 100 Hz trains; 10× electrical detection threshold) in the same heterotopic skin area across 2 repeated sessions. The only mechanical QST z -score profiles that demonstrated a consistent gain of function across repeated test sessions were mechanical pain threshold (MPT) and mechanical pain sensitivity (MPS), which were associated with moderate and good reliability, respectively. There was no relationship between HFS intensity and MPT and MPS z -score profiles. There was no change in low intensity, but a consistent facilitation of high-intensity pin prick stimuli in the mechanical stimulus response function across repeated test sessions. There was no change in cold pain threshold (CPT) and heat pain threshold (HPT) z -score profiles across session 1 and 2, which were associated with moderate and good reliability, respectively. There were inconsistent changes in the sensitivity to innocuous thermal QST parameters, with cool detection threshold (CDT), warm detection threshold (WDT), and thermal sensory limen (TSL) all producing poor reliability. These data suggest that HFS-induced changes in MPS z -score profiles is a reliable way to assess experimentally induced central sensitisation and associated secondary mechanical hyperalgesia in healthy participants.

摘要

高频刺激(HFS)模型可与定量感觉测试(QST)一起用于评估中枢伤害感受途径的敏化。然而,使用 QST z 分数谱来测量 HFS 模型中机械和热传入途径变化的有效性和组间可靠性知之甚少。在这项研究中,32 名健康参与者在同异位皮肤区域的 2 个重复疗程中,在 HFS(5×100Hz 刺激;10×电检测阈值)前后进行 QST。只有机械 QST z 分数谱显示出一致的功能增益,即机械痛阈(MPT)和机械痛敏(MPS),它们具有中等和良好的可靠性。HFS 强度与 MPT 和 MPS z 分数谱之间没有关系。在机械刺激反应功能中,低强度没有变化,但高强度刺痛刺激有一致的易化作用,跨越重复测试疗程。1 期和 2 期的冷痛阈(CPT)和热痛阈(HPT)z 分数谱没有变化,它们分别具有中等和良好的可靠性。无害热 QST 参数的敏感性变化不一致,冷觉阈(CDT)、温觉阈(WDT)和热感觉阈(TSL)的可靠性均较差。这些数据表明,MPS z 分数谱的 HFS 诱导变化是评估健康参与者中实验诱导的中枢敏化和相关继发性机械性痛觉过敏的可靠方法。

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