声源性疼痛的临床表型和管理:从患有痛性听力障碍的成年人身上获得的启示。

IF 4 2区 医学 Q1 CLINICAL NEUROLOGY Journal of Pain Pub Date : 2024-11-23 DOI:10.1016/j.jpain.2024.104741
Kelly N. Jahn , Sean Takamoto Kashiwagura , Muhammad Saad Yousuf
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引用次数: 0

摘要

疼痛性听觉障碍(pain hyperacusis),又称 "无听觉障碍"(noxacusis),会对大多数人并不感到困扰的声音产生生理疼痛。人们对声音如何引起可持续数周或数月的剧烈疼痛尚不十分清楚,因此缺乏有效的治疗方法。为了深入了解该病症的潜在机制,32 名成年人参加了一个虚拟焦点小组,描述他们由声音引起的疼痛。焦点小组的数据被用于制定三项后续调查,旨在确定痛性听力障碍最常见的症状以及参与者使用的止痛疗法。所有参与者都认可痛性听觉障碍对社会心理和身体功能的负面影响。大多数人报告了声音引起的烧灼感(80.77%)、刺痛感(76.92%)、悸动感(73.08%)和针刺感(53.85%),这些感觉发生在耳朵或身体其他部位。参与者曾使用多种药物和非药物干预措施来缓解疼痛,但疼痛缓解程度各不相同。苯二氮卓类药物和神经阻滞剂是最有效的镇痛选择,而非药物疗法大多无效。症状和治疗方法与痛觉减退的外周机理理论(如三叉神经受累)基本一致。需要采用跨学科方法进行临床研究和开发动物模型,以确定和治疗痛性听力障碍的病理机制。观点:这篇文章介绍了使人衰弱的声音引起的疼痛(即痛觉过强)对身体和社会心理造成的后果,以及患者为缓解疼痛而寻求的干预措施。研究结果与外周机制理论(如三叉神经受累)基本一致,并将指导未来研究神经机制和有效疗法的工作。
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Clinical phenotype and management of sound-induced pain: Insights from adults with pain hyperacusis
Pain hyperacusis, also known as noxacusis, causes physical pain in response to sounds that do not bother most people. How sound causes excruciating pain that can last for weeks or months is not well understood, resulting in a lack of effective treatments. To gain insight into the underlying mechanisms of the condition, 32 adults attended a virtual focus group to describe their sound-induced pain. Focus group data were used to develop three follow-up surveys that aimed to identify the most common symptoms of pain hyperacusis as well as the participants’ use of therapies for pain relief. All participants endorsed negative effects of pain hyperacusis on psychosocial and physical function. Most reported sound-induced burning (80.77%), stabbing (76.92%), throbbing (73.08%), and pinching (53.85%) sensations that occur either in the ear or elsewhere in the body. Participants have used numerous pharmaceutical and non-pharmaceutical interventions to alleviate their pain with varying degrees of pain relief. Benzodiazepines and nerve blockers emerged as the most effective analgesic options while non-pharmaceutical therapies were largely ineffective. Symptoms and therapeutic approaches were generally consistent with peripheral mechanistic theories of pain hyperacusis (e.g., trigeminal nerve involvement). An interdisciplinary approach to clinical studies and the development of animal models are needed to identify and treat the pathological mechanisms of pain hyperacusis.

Perspective

This article presents the physical and psychosocial consequences of debilitating sound-induced pain (i.e., pain hyperacusis) and the interventions that sufferers have sought for pain relief. The results are largely consistent with peripheral mechanistic theories (e.g., trigeminal nerve involvement) and will guide future work to investigate neural mechanisms and effective therapies.
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来源期刊
Journal of Pain
Journal of Pain 医学-临床神经学
CiteScore
6.30
自引率
7.50%
发文量
441
审稿时长
42 days
期刊介绍: The Journal of Pain publishes original articles related to all aspects of pain, including clinical and basic research, patient care, education, and health policy. Articles selected for publication in the Journal are most commonly reports of original clinical research or reports of original basic research. In addition, invited critical reviews, including meta analyses of drugs for pain management, invited commentaries on reviews, and exceptional case studies are published in the Journal. The mission of the Journal is to improve the care of patients in pain by providing a forum for clinical researchers, basic scientists, clinicians, and other health professionals to publish original research.
期刊最新文献
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