Somatosensory perception and function of diffuse noxious inhibitory controls (DNIC) in patients suffering from rheumatoid arthritis

European Journal of Pain - Tập 6 Số 2 - Trang 161-176 - 2002
Ann‐Sofie Leffler1,2,3, Eva Kosek1,3, T Lerndal4, Birgitta Nordmark4, Per Hansson1,2,3
1Department of Rehabilitation Medicine Multidisciplinary Pain Centre
2Department of Rehabilitation Medicine Neurogenic Pain Unit
3Department of Surgical Sciences, Section of Clinical Pain Research and Department of Rehabilitation Medicine
4Department of Rheumatology, Karolinska Hospital/Institutet, S-171 76 Stockholm, Sweden

Tóm tắt

The purpose was to investigate the influence of ongoing pain from an inflammatory nociceptive pain with two different disease durations on somatosensory functions and the effect of heterotopic noxious conditioning stimulation (HNCS) on ‘diffuse noxious inhibitory controls’ (DNIC) related mechanisms. Eleven patients with rheumatoid arthritis of a short duration (< 1 year) (RAI), and 10 patients with rheumatoid arthritis of longer duration (>5 years) (RA5) as well as 21 age‐and sex‐matched healthy controls participated. Pressure pain sensitivity, low threshold mechanoreceptive function and thermal sensitivity, including thermal pain, were assessed over a painful and inflamed joint as well as in a pain‐free area, i.e. the right thigh before HNCS (cold‐pressor test) and repeated at the thigh only during and following HNCS. In RAI and RA5 allodynia to pressure was seen over the joint (p < 0.02 and p < 0.001 respectively) in conjunction with hypoaesthesia to light touch (p < 0.02) and hyperaesthesia to innocuous cold (p < 0.05) in RA5. At the thigh, allodynia to pressure was found in RA5 (p < 0.002). During HNCS, the sensitivity to pressure pain decreased in patients and controls alike (p < 0.001). In conclusion, over an inflamed joint allodynia to pressure was found in both RA groups, with additional sensory abnormalities in RA5. In a non‐painful area, allodynia to pressure was found in RA5, suggesting altered central processing of somatosensory functions in RA5 patients. The response to HNCS was similar in both RA groups and controls, indicating preserved function of DNIC‐related mechanisms. © 2002 European Federation of Chapters of the International Association for the Study of Pain

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European Journal of Pain

Tập 6 Số 2

161-176

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