PDF(Pubmed)
Abstract：
UNASSIGNED: Central sensitization cannot be demonstrated directly in humans. Therefore, studies used different proxy markers (signs, symptoms and tools) to identify factors assumed to relate to central sensitization in humans, that is, Human Assumed Central Sensitization (HACS). The aims of this systematic review were to identify non-invasive objective markers of HACS and the instruments to assess these markers in patients with fibromyalgia (FM).
UNASSIGNED: A systematic review was conducted with the following inclusion criteria: (1) adults, (2) diagnosed with FM, and (3) markers and instruments for HACS had to be non-invasive. Data were subsequently extracted, and studies were assessed for risk of bias using the quality assessment tools developed by the National Institute of Health.
UNASSIGNED: 78 studies (n= 5234 participants) were included and the findings were categorized in markers identified to assess peripheral and central manifestations of HACS. The identified markers for peripheral manifestations of HACS, with at least moderate evidence, were pain after-sensation decline rates, mechanical pain thresholds, pressure pain threshold, sound \'pressure\' pain threshold, cutaneous silent period, slowly repeated evoked pain sensitization and nociceptive flexion reflex threshold. The identified markers for central manifestations of HACS were efficacy of conditioned pain modulation with pressure pain conditioning and brain perfusion analysis. Instruments to assess these markers are: pin-prick stimulators, cuff-algometry, repetitive pressure stimulation using a pressure algometer, sound, electrodes and neuroimaging techniques.
UNASSIGNED: This review provides an overview of non-invasive markers and instruments for the assessment of HACS in patients with FM. Implementing these findings into clinical settings may help to identify HACS in patients with FM.
UNASSIGNED: A systematic review was conducted with the following inclusion criteria: (1) adults, (2) diagnosed with FM, and (3) markers and instruments for HACS had to be non-invasive. Data were subsequently extracted, and studies were assessed for risk of bias using the quality assessment tools developed by the National Institute of Health.
UNASSIGNED: 78 studies (n= 5234 participants) were included and the findings were categorized in markers identified to assess peripheral and central manifestations of HACS. The identified markers for peripheral manifestations of HACS, with at least moderate evidence, were pain after-sensation decline rates, mechanical pain thresholds, pressure pain threshold, sound \'pressure\' pain threshold, cutaneous silent period, slowly repeated evoked pain sensitization and nociceptive flexion reflex threshold. The identified markers for central manifestations of HACS were efficacy of conditioned pain modulation with pressure pain conditioning and brain perfusion analysis. Instruments to assess these markers are: pin-prick stimulators, cuff-algometry, repetitive pressure stimulation using a pressure algometer, sound, electrodes and neuroimaging techniques.
UNASSIGNED: This review provides an overview of non-invasive markers and instruments for the assessment of HACS in patients with FM. Implementing these findings into clinical settings may help to identify HACS in patients with FM.
摘要：
背景：中枢致敏在人类中无法直接证明。因此,研究使用了不同的代理标记(标志，症状和工具)，以确定假定与人类中枢致敏有关的因素，也就是说,人类假设中心敏感化(HACS)。这项系统评价的目的是确定HACS的非侵入性客观标志物以及评估纤维肌痛（FM）患者这些标志物的仪器。
方法：以以下纳入标准进行系统评价：（1）成年人，（2）诊断为FM，（3）HACS的标记和仪器必须是非侵入性的。随后提取了数据，并使用美国国立卫生研究院开发的质量评估工具对偏倚风险进行评估.
结果：包含78项研究（n=5234名参与者），并将研究结果分类为鉴定的标志物，以评估HACS的外周和中枢表现。确定的HACS外周表现的标志物，至少有适度的证据，疼痛后感觉下降率，机械性疼痛阈值,压力痛阈值，声音\'压力\'疼痛阈值，皮肤沉默期，缓慢重复诱发的疼痛致敏和伤害性屈曲反射阈值。确定的HACS中枢表现的标志物是具有压力疼痛调节和脑灌注分析的条件性疼痛调节的功效。评估这些标记的仪器是:针刺刺激器，袖带-藻酸盐,使用压力计进行重复压力刺激，声音,电极和神经成像技术。
结论：这篇综述概述了用于评估FM患者HACS的非侵入性标志物和仪器。将这些发现实施到临床环境中可能有助于识别FM患者的HACS。
方法：以以下纳入标准进行系统评价：（1）成年人，（2）诊断为FM，（3）HACS的标记和仪器必须是非侵入性的。随后提取了数据，并使用美国国立卫生研究院开发的质量评估工具对偏倚风险进行评估.
结果：包含78项研究（n=5234名参与者），并将研究结果分类为鉴定的标志物，以评估HACS的外周和中枢表现。确定的HACS外周表现的标志物，至少有适度的证据，疼痛后感觉下降率，机械性疼痛阈值,压力痛阈值，声音\'压力\'疼痛阈值，皮肤沉默期，缓慢重复诱发的疼痛致敏和伤害性屈曲反射阈值。确定的HACS中枢表现的标志物是具有压力疼痛调节和脑灌注分析的条件性疼痛调节的功效。评估这些标记的仪器是:针刺刺激器，袖带-藻酸盐,使用压力计进行重复压力刺激，声音,电极和神经成像技术。
结论：这篇综述概述了用于评估FM患者HACS的非侵入性标志物和仪器。将这些发现实施到临床环境中可能有助于识别FM患者的HACS。
