Gentles Avonae, Goodwin Emma, Bedaiwy Yomna, Marshall Nisha, Yong Paul J
Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC V6H 3N1, Canada.
BC Women's Center for Pelvic Pain and Endometriosis, Vancouver, BC V6H 3N1, Canada.
J Clin Med. 2024 Dec 10;13(24):7521. doi: 10.3390/jcm13247521.
Endometriosis is an inflammatory chronic condition associated with nociceptive, neuropathic, and nociplastic pain. Central sensitization (CS) is the primary nociplastic pain mechanism. However, there are currently no standardized methods for detecting CS or nociplastic pain. This review aims to identify available tools for characterizing CS/nociplastic pain in endometriosis-related chronic pelvic pain. Following the PRISMA-P protocol, MEDLINE, Embase, Scopus, and PsychINFO databases were searched on 23 April 2024, for the terms "endometriosis", "central sensitization", "nociplastic pain", "widespread pain", and "assessment tools". Publications were selected if they mentioned tool(s) for detecting nociplastic pain or CS in endometriosis patients. Information was extracted on study demographics, assessment types, and the tools used for detection. Of the 379 citations retrieved, 30 papers met the inclusion criteria. When working to identify CS and nociplastic pain, fourteen studies exclusively used patient-reported questionnaires, six used quantitative sensory testing (QST), two used clinical assessments, and eight used multiple approaches combining patient-reported questionnaires and clinical assessment. This review illustrates the diversity of tools currently used to identify CS and nociplastic pain in endometriosis patients. Further research is needed to evaluate their validity and to standardize methods in order to improve the accuracy of nociplastic pain identification and guide treatment.
子宫内膜异位症是一种与伤害性疼痛、神经病理性疼痛和神经可塑性疼痛相关的慢性炎症性疾病。中枢敏化（CS）是主要的神经可塑性疼痛机制。然而，目前尚无检测CS或神经可塑性疼痛的标准化方法。本综述旨在确定用于表征子宫内膜异位症相关慢性盆腔疼痛中CS/神经可塑性疼痛的现有工具。按照PRISMA-P协议，于2024年4月23日在MEDLINE、Embase、Scopus和PsychINFO数据库中检索了“子宫内膜异位症”“中枢敏化”“神经可塑性疼痛”“广泛性疼痛”和“评估工具”等术语。如果出版物提及用于检测子宫内膜异位症患者神经可塑性疼痛或CS的工具，则将其选中。提取了关于研究人口统计学、评估类型和用于检测的工具的信息。在检索到的379篇文献中，有30篇符合纳入标准。在致力于识别CS和神经可塑性疼痛时，14项研究仅使用了患者报告问卷，6项使用了定量感觉测试（QST），2项使用了临床评估，8项使用了将患者报告问卷和临床评估相结合的多种方法。本综述说明了目前用于识别子宫内膜异位症患者CS和神经可塑性疼痛的工具的多样性。需要进一步研究以评估其有效性并规范方法，以提高神经可塑性疼痛识别的准确性并指导治疗。
