在实验诱导的敏感化状态下对与疼痛相关的自主反应的nocebo效应
Florin Allmendinger1, Jan Rosner1,2, Thomas Egger1
1Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
European journal of pain (London, England)
|April 19, 2025
概括
负面的期望放大了与疼痛相关的自主反应,继二次机械痛 (SMH) 之后. 这凸显了自上而下的过程,如期望,如何显著地塑造自主对疼痛的反应,以及自下而上的感知输入.
科学领域:
- 神经科学是一个神经科学.
- 疼痛研究 疼痛研究
- 心理生理学 心理生理学
背景情况:
- 与疼痛相关的自主反应的增强在像二次机械痛 (SMH) 这样的条件下观察到.
- 对刺激的自主反应受到积极和消极期望的影响.
- 负面期望对SMH后与疼痛相关的自主反应的影响需要进一步研究.
研究的目的:
- 研究消极期望对与疼痛相关的自主反应的影响.
- 检查实验诱导的SMH如何与负面期望相互作用.
- 在疼痛感知中区分自下而上和自上而下调节过程.
主要方法:
- 40名健康的参与者被分为NOCEBO和NAïVE组.
- 皮肤导电反应 (SCR) 和皮肤导电水平 (SCL) 在针刺刺激期间被测量.
- 通过在一只手臂 (EXP-手臂) 上使用热疼痛模型诱导二次机械痛 (SMH),而另一只手臂作为控制 (CTRL-手臂).
- 诺塞博集团收到了负期望指令,而NAïVE集团没有.
主要成果:
- 负面预期与SMH相结合,显著增加了针刺引起的相性SCR.
- 性SCL从评估前到评估后增加,不论是组或刺激手臂.
- 主观疼痛评级在各个条件之间进行匹配,以隔离预期效应.
结论:
- 负面期望在实验性超痛症状态下促进与疼痛相关的自主反应.
- 与疼痛相关的自主反应是由感知输入 (自下而上) 和期望 (自上而下) 调节的.
- 临床影响表明,夸张的负面期望可能会导致慢性疼痛患者的自主反应升高.
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