Lautenbacher S, Rollman G B, McCain G A
Departments of Psychology, University of Western Ontario, LondonCanada Departments of Medicine, University of Western Ontario, LondonCanada Department of Psychiatry, University of Marburg, MarburgGermany.
Pain. 1994 Oct;59(1):45-53. doi: 10.1016/0304-3959(94)90046-9.
Experimental measures of responsiveness to painful and non-painful stimuli as well as measures of typical and present clinical pain were assessed in 26 female patients with fibromyalgia and in an equal number of age-matched healthy women. Pressure pain thresholds, determined by means of a dolorimeter, were lower in the patients compared to the control subjects both at a tender point (trapezius) and at a non-tender control point (inner forearm). The same was true for the heat pain thresholds, measured using a contact thermode. In contrast, the pain thresholds for electrocutaneous stimuli were decreased only at the tender point. The detection thresholds for non-painful stimuli (warmth, cold and electrical stimuli) seemed to be less affected in the fibromyalgia patients, with only the detection threshold for cold being lower at both sites. Tender points were more sensitive than control points for mechanical pressure. The reverse was found for the other modalities which were tested. Although the 3 experimental pain thresholds showed patterns of either generalized or site-specific pain hyperresponsiveness, the between-methods correlations were not very high. While the correlations between the experimental pain thresholds and the various measures of clinical pain (Localized Pain Rating, McGill Pain Questionnaire) in the patients were generally low, there were significant negative correlations between pressure pain thresholds at the two sites and the level of present pain assessed by the Localized Pain Rating. We conclude that a pattern of pain hyperresponsiveness, generalized across the site of noxious stimulation and across the physical nature of the stressor, is associated with fibromyalgia.(ABSTRACT TRUNCATED AT 250 WORDS)
对26名患有纤维肌痛的女性患者以及同等数量年龄匹配的健康女性，评估了对疼痛和非疼痛刺激的反应性实验指标以及典型和当前临床疼痛指标。通过压痛计确定的压力疼痛阈值，在患者的压痛点（斜方肌）和非压痛对照点（前臂内侧）均低于对照组。使用接触式热刺激器测量的热痛阈值情况相同。相比之下，电皮肤刺激的疼痛阈值仅在压痛点降低。纤维肌痛患者对非疼痛刺激（热、冷和电刺激）的检测阈值似乎受影响较小，仅冷刺激的检测阈值在两个部位均较低。压痛点对机械压力比对照点更敏感。对于所测试的其他方式则发现相反情况。尽管3种实验性疼痛阈值呈现出全身性或部位特异性疼痛高反应性模式，但方法间的相关性不是很高。患者的实验性疼痛阈值与各种临床疼痛指标（局部疼痛评分、麦吉尔疼痛问卷）之间的相关性通常较低，不过两个部位的压力疼痛阈值与局部疼痛评分评估的当前疼痛程度之间存在显著负相关。我们得出结论，在有害刺激部位和应激源物理性质方面均呈现全身性的疼痛高反应性模式与纤维肌痛相关。（摘要截选至250字）
