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早期的生活逆境增加了慢性创伤后疼痛的风险,来自人类和动物的数据
Lauren A McKibben1, Alice Woolard1,2, Samuel A McLean3,4
1Department of Anesthesiology, Institute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
Pain
|August 21, 2025
概括
在创伤性应激暴露 (TSE) 后,早期的逆境 (ELA) 显著增加了慢性创伤后肌肉骨疼痛 (CPMP) 的风险. 特定的逆境,如虐待和欺凌, 是更高疼痛水平的关键预测因素.
科学领域:
- 神经科学
- 心理学
- 疼痛研究
背景情况:
- 创伤性应激暴露很常见,但许多幸存者患有慢性创伤后肌肉骨疼痛 (CPMP).
- 对CPMP的脆弱性因素尚不清楚,这限制了针对性的干预措施.
- 早期的生活逆境 (ELA) 是各种疼痛疾病的已知风险因素,但其与CPMP的具体联系需要调查.
研究的目的:
- 测试ELA增加TSE幸存者的CPMP风险的假设.
- 确定最能预测CPMP的特定ELA亚型.
- 通过使用鼠标ELA和压力模型验证发现.
主要方法:
- 来自前性"每次创伤后的恢复"研究 (AURA) 的数据分析 (n=2480).
- 多项逻辑回归建模以评估ELA和潜痛类之间的关联.
- 使用了结合新生儿限床和成年单一长期应激 (SPS) 的老鼠模型.
主要成果:
- 与高持续性疼痛 (OR=1. 047),中度疼痛 (OR=1. 031) 和中度恢复性疼痛 (OR=1. 018) 的易感性显著相关.
- 身体上的虐待,情绪上的虐待和欺凌是最强烈的疼痛预测因素.
- 与单独使用SPS相比,大鼠模型表明ELA与SPS相结合会引起更高的敏感性和长期的机械过敏性.
结论:
- 对于TSE后的CPMP发展来说,ELA是一个显著的脆弱性因素.
- 儿童虐待和欺凌是关键的ELA亚型,与更高的疼痛严重程度有关.
- 这些发现凸显了对ELA在CPMP中作用的机制的进一步研究的需要.
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