Distress is positively associated with induced secondary hyperalgesia in people with suppressed HIV.

Luyanduthando Mqadi, Gillian J Bedwell, Ncumisa Msolo, Gwendoline Arendse, Maia Lesosky, Peter R Kamerman, Mark R Hutchinson, Andrew Schrepf, Robert R Edwards, John A Joska, Romy Parker, Victoria J Madden
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Abstract

Pain and symptoms of depression and anxiety (here, 'psychological distress') are frequently reported by people with HIV. Although pain is widely acknowledged to contribute to distress, distress may also contribute to pain and its persistence. Facilitation of nociceptive signalling is one pathway by which distress could exacerbate pain. The current study investigated the relationships between symptoms of depression and anxiety, secondary hyperalgesia (SH), and persistent pain in people with HIV, reporting pain (n=19) or no pain (n=26). We hypothesised that self-reported distress would be positively associated with the surface area (primary measure) and magnitude (secondary measure) of induced SH, and that participants reporting persistent pain would display greater induced SH than those reporting no pain. We found that distress was positively associated with the surface area (p=0.02) and the magnitude (p=0.01) of induced SH. However, participants with persistent pain showed no difference in the surface area of SH compared to pain-free participants (p=0.87), and those with pain displayed a marginally lower magnitude of SH (p=0.05). These findings position SH as a potentially useful mechanistic outcome for interventions that aim to address pain by reducing symptoms of depression and anxiety.

Perspective: Symptoms of depression and anxiety were positively associated with induced secondary hyperalgesia in people with suppressed HIV.

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在HIV感染者中,痛苦与继发性痛觉过敏呈正相关。
艾滋病毒感染者经常报告疼痛和痛苦。尽管人们普遍认为疼痛会导致痛苦,但痛苦也可能导致疼痛及其持续。鉴于有证据支持痛苦和临床疼痛之间的关系,本研究调查了痛苦、继发性痛觉过敏(SH)和持续疼痛之间的关系。我们预计SH是痛苦和持续性疼痛之间的重要联系,痛苦可能通过增加中枢神经系统神经元对伤害性信号的反应而加剧疼痛。我们的主要假设是,自我报告的痛苦与诱导的SH表面积(主要测量)和大小(次要测量)呈正相关。次要假设是,与报告无疼痛的个体相比,持续疼痛的个体会表现出更大的诱导SH。结果显示,痛苦与诱导的SH表面积和大小呈正相关。然而,与无痛的参与者相比,持续疼痛的参与者的SH表面积没有差异,而疼痛的参与者的SH大小略低。这些发现表明,在暴露于急性疼痛事件的人群中,痛苦可能是一个有价值的干预目标。虽然这种关系可能不是艾滋病毒感染者所特有的,但需要进一步研究以确定其与非艾滋病毒感染者的相关性。
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