Is altered central pain processing related to disease stage in chronic pancreatitis patients with pain? An exploratory study.

<h4>Background</h4>The most dominant feature in chronic pancreatitis is intense abdominal pain. Changes in spinal and/or supraspinal central nervous system pain processing due to visceral nociceptive input play an important role in this pain. How altered pain processing is related to dis...

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Autores principales:	Stefan A W Bouwense, Søren S Olesen, Asbjørn M Drewes, Jens B Frøkjær, Harry van Goor, Oliver H G Wilder-Smith
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/98a665707f1a450fbecb4a1495292386
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spelling	oai:doaj.org-article:98a665707f1a450fbecb4a14952923862021-11-18T07:58:36ZIs altered central pain processing related to disease stage in chronic pancreatitis patients with pain? An exploratory study.1932-620310.1371/journal.pone.0055460https://doaj.org/article/98a665707f1a450fbecb4a14952923862013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23405154/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>The most dominant feature in chronic pancreatitis is intense abdominal pain. Changes in spinal and/or supraspinal central nervous system pain processing due to visceral nociceptive input play an important role in this pain. How altered pain processing is related to disease stage still needs study.<h4>Methodology/principal findings</h4>Sixty chronic pancreatitis patients were compared to 15 healthy controls. Two subgroups of pancreatitis patients were defined based on the M-ANNHEIM severity index of chronic pancreatitis; i.e. moderate and severe. Pain detection and tolerance thresholds for pressure and electric stimuli were measured in six selected dermatomes (C5, T4, T10, L1, L4 and T10BACK). In addition, the conditioned pain modulation response to cold pressor task was determined. These measures were compared between the healthy controls and chronic pancreatitis patients. Severe pancreatitis patients showed lower pain thresholds than moderate pancreatitis patients or healthy volunteers. Healthy controls showed a significantly larger conditioned pain modulation response compared to all chronic pancreatitis patients taken together.<h4>Conclusions/significance</h4>The present study confirms that chronic pancreatitis patients show signs of altered central processing of nociception compared to healthy controls. The study further suggests that these changes, i.e. central sensitization, may be influenced by disease stage. These findings underline the need to take altered central pain processing into account when managing the pain of chronic pancreatitis.Stefan A W BouwenseSøren S OlesenAsbjørn M DrewesJens B FrøkjærHarry van GoorOliver H G Wilder-SmithPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 2, p e55460 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Stefan A W Bouwense Søren S Olesen Asbjørn M Drewes Jens B Frøkjær Harry van Goor Oliver H G Wilder-Smith Is altered central pain processing related to disease stage in chronic pancreatitis patients with pain? An exploratory study.
description	<h4>Background</h4>The most dominant feature in chronic pancreatitis is intense abdominal pain. Changes in spinal and/or supraspinal central nervous system pain processing due to visceral nociceptive input play an important role in this pain. How altered pain processing is related to disease stage still needs study.<h4>Methodology/principal findings</h4>Sixty chronic pancreatitis patients were compared to 15 healthy controls. Two subgroups of pancreatitis patients were defined based on the M-ANNHEIM severity index of chronic pancreatitis; i.e. moderate and severe. Pain detection and tolerance thresholds for pressure and electric stimuli were measured in six selected dermatomes (C5, T4, T10, L1, L4 and T10BACK). In addition, the conditioned pain modulation response to cold pressor task was determined. These measures were compared between the healthy controls and chronic pancreatitis patients. Severe pancreatitis patients showed lower pain thresholds than moderate pancreatitis patients or healthy volunteers. Healthy controls showed a significantly larger conditioned pain modulation response compared to all chronic pancreatitis patients taken together.<h4>Conclusions/significance</h4>The present study confirms that chronic pancreatitis patients show signs of altered central processing of nociception compared to healthy controls. The study further suggests that these changes, i.e. central sensitization, may be influenced by disease stage. These findings underline the need to take altered central pain processing into account when managing the pain of chronic pancreatitis.
format	article
author	Stefan A W Bouwense Søren S Olesen Asbjørn M Drewes Jens B Frøkjær Harry van Goor Oliver H G Wilder-Smith
author_facet	Stefan A W Bouwense Søren S Olesen Asbjørn M Drewes Jens B Frøkjær Harry van Goor Oliver H G Wilder-Smith
author_sort	Stefan A W Bouwense
title	Is altered central pain processing related to disease stage in chronic pancreatitis patients with pain? An exploratory study.
title_short	Is altered central pain processing related to disease stage in chronic pancreatitis patients with pain? An exploratory study.
title_full	Is altered central pain processing related to disease stage in chronic pancreatitis patients with pain? An exploratory study.
title_fullStr	Is altered central pain processing related to disease stage in chronic pancreatitis patients with pain? An exploratory study.
title_full_unstemmed	Is altered central pain processing related to disease stage in chronic pancreatitis patients with pain? An exploratory study.
title_sort	is altered central pain processing related to disease stage in chronic pancreatitis patients with pain? an exploratory study.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/98a665707f1a450fbecb4a1495292386
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Is altered central pain processing related to disease stage in chronic pancreatitis patients with pain? An exploratory study.

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