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Нейрофизиологические механизмы боли и ее количественная оценка при эндометриозе
Логинов В.В., Вартанов А.В., Фейгин С.А., Павлович С.В. Нейрофизиологические механизмы боли и ее количественная оценка при эндометриозе. Гинекология. 2021;23(6):493–498.
DOI: 10.26442/20795696.2021.6.201254
DOI: 10.26442/20795696.2021.6.201254
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Loginov VV, Vartanov AV, Feigin SA, Pavlovich SV. Neurophysiological mechanisms of pain and its quantitative assessment in endometriosis. Gynecology. 2021;23(6):493–498. DOI: 10.26442/20795696.2021.6.201254
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Аннотация
Решение многих клинических задач, в том числе и вопросов происхождения боли как составляющей отдельных патологий, лежит в плоскости количественной объективизации основного заболевания и выяснения роли в нем болевого синдрома (БС). Проведен анализ данных литературы о методах оценки боли, включая количественные шкалы и опросники, биохимические и инструментальные исследования. Рассмотрены различные корреляты БС, применяемые в фундаментальных и прикладных исследованиях. Изучены нейрофизиологические механизмы формирования боли и специфические методы оценки БС при эндометриозе.
Ключевые слова: болевой синдром, тазовая боль, эндометриоз
Ключевые слова: болевой синдром, тазовая боль, эндометриоз
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The solution of many clinical problems, including the issues of the origin of pain as a component of individual pathologies, lies in the plane of quantitative objectification of the underlying disease and elucidation of the role of pain syndrome (PS) in it. The analysis of literature data on methods of pain assessment, including quantitative scales and questionnaires, biochemical and instrumental studies, was carried out. Various PS correlates used in fundamental and applied research are considered. The neurophysiological mechanisms of pain formation and specific methods for assessing PS in endometriosis were studied.
Keywords: pain syndrome, pelvic pain, endometriosis
Полный текст
Список литературы
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8. Stull DE, Wasiak R, Kreif N, et al. Validation of the SF-36 in patients with endometriosis. Qual Life Res. 2014;23(1):103-17. DOI:10.1007/s11136-013-0442-5
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10. Cozzolino M, Coccia ME, Lazzeri G, et al. Variables Associated with Endometriosis-related Pain: A Pilot Study using a Visual Analogue Scale. Rev Bras Ginecol Obstet. 2019;41(3):170-5. DOI:10.1055/s-0039-1679879
11. Minson FP, Abrão MS, Sardá Júnior J, et al. Importance of quality of life assessment in patients with endometriosis. Rev Bras Ginecol Obstet. 2012;34(1):11-5 (in Portuguese).
12. Bourdel N, Alves J, Pickering G, et al. Systematic review of endometriosis pain assessment: how to choose a scale? Hum Reprod Update. 2015;21(1):136-52. DOI:10.1093/humupd/dmu046
13. Лисовская Е.В., Хилькевич Е.Г., Чупрынин В.Д., и др. Качество жизни женщин с глубоким инфильтративным эндометриозом. Акушерство и гинекология. 2020;3:116-26 [Lisovskaia EV, Khil'kevich EG, Chuprynin VD, et al. Kachestvo zhizni zhenshchin s glubokim infil'trativnym endometriozom. Akusherstvo i ginekologiia. 2020;3:116-26 (in Russian)]. DOI:10.18565/aig.2020.3.116-126
14. Fabbri E, Villa G, Mabrouk M, et al. McGill Pain Questionnaire: a multi-dimensional verbal scale assessing postoperative changes in pain symptoms associated with severe endometriosis. J Obstet Gynaecol Res. 2009;35(4):753-60. DOI:10.1111/j.1447-0756.2008.00994.x
15. Адамян Л.В., Сонова М.М., Арсланян К.Н., Логинова О.Н. Особенности хронической тазовой боли у пациенток с наружным генитальным эндометриозом. Лечащий врач. 2019;9:83-7 [Adamyan LV, Sonova MM, Arslanyan KN, Loginova ON. Features of chronic pelvic pain in patients with external genital endometriosis. Lechashchii vrach. 2019;9:83-7 (in Russian)]. DOI:10.26295/OS.2019.44.85.018
16. Харченко Ю.А. Адекватная оценка боли – залог ее успешного лечения. Universum: медицина и фармакология. 2014;4(5). Режим доступа: https://7universum.com/ru/med/archive/item/1229. Ссылка активна на 16.11.2021 [Kharchenko IuA. AAdequate assessment of pain is the pledge of successful treatment. Universum: meditsina i farmakologiia. 2014;4(5). Available at: https://7universum.com/ru/med/archive/item/1229. Accessed: 16.11.2021 (in Russian)].
17. Данилов А.Б. Ноцицептивный флексорный рефлекс: метод изучения церебральных механизмов боли (обзор). Журнал невропатологии и психиатрии им. С.С. Корсакова. 1996;1:107-12 [Danilov AB. Notsitseptivnyi fleksornyi refleks: metod izucheniia tserebral'nykh mekhanizmov boli (obzor). Zhurnal nevropatologii i psikhiatrii im. S.S. Korsakova. 1996;1:107-12 (in Russian)].
18. France CR, Rhudy JL, McGlone S. Using normalized EMG to define the nociceptive flexion reflex (NFR) threshold: further evaluation of standardized NFR scoring criteria. Pain. 2009;145(1-2):211-8. DOI:10.1016/j.pain.2009.06.022
19. Willer JC. Nociceptive flexion reflexes as a tool for pain research in man. Adv Neurol. 1983;39:809-27.
20. Джелдубаева Э.Р., Чуян Е.Н. Особенности исследования ноцицептивого флексорного рефлекса в оценке болевой чувствительности (обзор литературы). Ученые записки Крымского федерального университета имени В.И. Вернадского. Биология. Химия. 2011;4(63):57-66 [Dzheldubaeva ER, Chuian EN. Osobennosti issledovaniia notsitseptivogo fleksornogo refleksa v otsenke bolevoi chuvstvitel'nosti (obzor literatury). Uchenye zapiski Krymskogo federal'nogo universiteta imeni V.I. Vernadskogo. Biologiia. Khimiia. 2011;4(63):57-66 (in Russian)].
21. Сапон Н.А., Чеботарева Л.Л. Использование инструментальных методов исследования для оценки нейрофизиологических коррелятов боли. Украинский нейрохирургический журнал. 2004;4 [Sapon NA, Chebotareva LL. Ispol'zovanie instrumental'nykh metodov issledovaniia dlia otsenki neirofiziologicheskikh korreliatov boli. Ukrainian Neurosurgical Journal. 2004;4:69-75 (in Russian)].
22. Anisman H, Zacharko RM. Behavioral and neurochemical consequences associated with stressors. Ann N Y Acad Sci. 1986;467:205-25. DOI:10.1111/j.1749-6632.1986.tb14630.x
23. Schmidt AP, Böhmer AE, Hansel G, et al. Changes in Purines Concentration in the Cerebrospinal Fluid of Pregnant Women Experiencing Pain During Active Labor. Neurochem Res. 2015;40(11):2262-9. DOI:10.1007/s11064-015-1716-9
24. Fernandes V, Sharma D, Vaidya S, et al. Cellular and molecular mechanisms driving neuropathic pain: recent advancements and challenges. Expert Opin Ther Targets. 2018;22(2):131-42. DOI:10.1080/14728222.2018.1420781
25. Basbaum AI, Bautista DM, Scherrer G, Julius D. Cellular and molecular mechanisms of pain. Cell. 2009;139(2):267-84. DOI:10.1016/j.cell.2009.09.028
26. Nicholson K. Pain, cognition and traumatic brain injury. Neurorehabilitation. 2000;14:95-103.
27. Аверченкова А.А. Механизмы формирования «болевой памяти» при хронической боли. РМЖ. 2016;24(7):420-2 [Averchenkova AA. Mekhanizmy formirovaniia “bolevoi pamiati” pri khronicheskoi boli. RMZh. 2016;24(7):420-2 (in Russian)].
28. As-Sanie S, Harris RE, Napadow V, et al. Changes in regional gray matter volume in women with chronic pelvic pain: a voxel-based morphometry study. Pain. 2012;153(5):1006-14. DOI:10.1016/j.pain.2012.01.032
29. Stern J, Jeanmonod D, Sarnthein J. Persistent EEG overactivation in the cortical pain matrix of neurogenic pain patients. Neuroimage. 2006;31(2):721-31. DOI:10.1016/j.neuroimage.2005.12.042
30. Sarnthein J, Stern J, Aufenberg C, et al. Increased EEG power and slowed dominant frequency in patients with neurogenic pain. Brain.
2006;129(Pt. 1):55-64. DOI:10.1093/brain/awh631
31. Vuckovic A, Hasan MA, Fraser M, et al. Dynamic oscillatory signatures of central neuropathic pain in spinal cord injury. J Pain. 2014;15(6):645-55. DOI:10.1016/j.jpain.2014.02.005
32. LeBlanc BW, Lii TR, Silverman AE, et al. Cortical theta is increased while thalamocortical coherence is decreased in rat models of acute and chronic pain. Pain. 2014;155(4):773-82. DOI:10.1016/j.pain.2014.01.013
33. Llinás R, Urbano FJ, Leznik E, et al. Rhythmic and dysrhythmic thalamocortical dynamics: GABA systems and the edge effect. Trends Neurosci. 2005;28(6):325-33. DOI:10.1016/j.tins.2005.04.006
34. Van den Broeke EN, Wilder-Smith OH, van Goor H, et al. Patients with Persistent Pain after Breast Cancer Treatment Show Enhanced Alpha Activity in Spontaneous EEG. Pain Med. 2013;14(12):1893-9. DOI:10.1111/pme.12216
35. Hunter AM, Kwan L, Ercoli LM, et al. Quantitative
electroencephalography biomarkers of cognitive complaints after adjuvant therapy in breast cancer survivors: a pilot study. Psychooncology. 2014;23(6):713-5. DOI:10.1002/pon.3487
36. Moore HC, Parsons MW, Yue GH, et al. Electroencephalogram power changes as a correlate of chemotherapy-associated fatigue and cognitive dysfunction. Support Care Cancer. 2014;22(8):2127-31. DOI:10.1007/s00520-014-2197-0
37. Drewes AM, Gratkowski M, Sami SA, et al. Is the pain in chronic pancreatitis of neuropathic origin? Support from EEG studies during experimental pain. World J Gastroenterol. 2008;14(25):4020-7. DOI:10.3748/wjg.14.4020
38. Wang Y, Li D, Bao F, et al. Thalamic metabolic alterations with cognitive dysfunction in idiopathic trigeminal neuralgia: a multivoxel spectroscopy study. Neuroradiology. 2014;56(8):685-93. DOI:10.1007/s00234-014-1376-5
39. Peng W, Babiloni C, Mao Y, Hu Y. Subjective pain perception mediated by alpha rhythms. Biol Psychol. 2015;109:141-50. DOI:10.1016/j.biopsycho.2015.05.004
40. Dowman R, Rissacher D, Schuckers S. EEG indices of tonic pain-related activity in the somatosensory cortices. Clin Neurophysiol. 2008;119(5):1201-12. DOI:10.1016/j.clinph.2008.01.019
41. Chang PF, Arendt-Nielsen L, Graven-Nielsen T, Chen AC. Psychophysical and EEG responses to repeated experimental muscle pain in humans: pain intensity encodes EEG activity. Brain Res Bull. 2003;59(6):533-43. DOI:10.1016/s0361-9230(02)00950-4
42. Chang PF, Arendt-Nielsen L, Chen AC. Comparative cerebral responses to non-painful warm vs. cold stimuli in man: EEG power spectra and coherence. Int J Psychophysiol. 2005;55(1):73-83. DOI:10.1016/j.ijpsycho.2004.06.006
43. Coghill RC, Gilron I, Iadarola MJ. Hemispheric lateralization of somatosensory processing. J Neurophysiol. 2001;85(6):2602-12. DOI:10.1152/jn.2001.85.6.2602
44. Sitges C, Bornas X, Llabrés J, et al. Linear and nonlinear analyses of EEG dynamics during non-painful somatosensory processing in chronic pain patients. Int J Psychophysiol. 2010;77(2):176-83. DOI:10.1016/j.ijpsycho.2010.05.010
45. Pinheiro ES, de Queirós FC, Montoya P, et al. Electroencephalographic Patterns in Chronic Pain: A Systematic Review of the Literature. Plos ONE. 2016;11(2):e0149085. DOI:10.1371/journal.pone.0149085
46. Wei Y, Liang Y, Lin H, et al. Autonomic nervous system and inflammation interaction in endometriosis-associated pain. J Neuroinflammation. 2020;17(1):80.
DOI:10.1186/s12974-020-01752-1
47. Овсянников В.Г., Бойченко А.Е., Алексеев В.В., Алексеева Н.С. Инициальные механизмы формирования боли. Журнал фундаментальной медицины и биологии. 2015;3:4-12 [Ovsiannikov VG, Boichenko AE, Alekseev VV, Alekseeva NS. Initsial'nye mekhanizmy formirovaniia boli. Zhurnal fundamental'noi meditsiny i biologii. 2015;3:4-12 (in Russian)].
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37. Drewes AM, Gratkowski M, Sami SA, et al. Is the pain in chronic pancreatitis of neuropathic origin? Support from EEG studies during experimental pain. World J Gastroenterol. 2008;14(25):4020-7. DOI:10.3748/wjg.14.4020
38. Wang Y, Li D, Bao F, et al. Thalamic metabolic alterations with cognitive dysfunction in idiopathic trigeminal neuralgia: a multivoxel spectroscopy study. Neuroradiology. 2014;56(8):685-93. DOI:10.1007/s00234-014-1376-5
39. Peng W, Babiloni C, Mao Y, Hu Y. Subjective pain perception mediated by alpha rhythms. Biol Psychol. 2015;109:141-50. DOI:10.1016/j.biopsycho.2015.05.004
40. Dowman R, Rissacher D, Schuckers S. EEG indices of tonic pain-related activity in the somatosensory cortices. Clin Neurophysiol. 2008;119(5):1201-12. DOI:10.1016/j.clinph.2008.01.019
41. Chang PF, Arendt-Nielsen L, Graven-Nielsen T, Chen AC. Psychophysical and EEG responses to repeated experimental muscle pain in humans: pain intensity encodes EEG activity. Brain Res Bull. 2003;59(6):533-43. DOI:10.1016/s0361-9230(02)00950-4
42. Chang PF, Arendt-Nielsen L, Chen AC. Comparative cerebral responses to non-painful warm vs. cold stimuli in man: EEG power spectra and coherence. Int J Psychophysiol. 2005;55(1):73-83. DOI:10.1016/j.ijpsycho.2004.06.006
43. Coghill RC, Gilron I, Iadarola MJ. Hemispheric lateralization of somatosensory processing. J Neurophysiol. 2001;85(6):2602-12. DOI:10.1152/jn.2001.85.6.2602
44. Sitges C, Bornas X, Llabrés J, et al. Linear and nonlinear analyses of EEG dynamics during non-painful somatosensory processing in chronic pain patients. Int J Psychophysiol. 2010;77(2):176-83. DOI:10.1016/j.ijpsycho.2010.05.010
45. Pinheiro ES, de Queirós FC, Montoya P, et al. Electroencephalographic Patterns in Chronic Pain: A Systematic Review of the Literature. Plos ONE. 2016;11(2):e0149085. DOI:10.1371/journal.pone.0149085
46. Wei Y, Liang Y, Lin H, et al. Autonomic nervous system and inflammation interaction in endometriosis-associated pain. J Neuroinflammation. 2020;17(1):80.
DOI:10.1186/s12974-020-01752-1
47. Ovsiannikov VG, Boichenko AE, Alekseev VV, Alekseeva NS. Initsial'nye mekhanizmy formirovaniia boli. Zhurnal fundamental'noi meditsiny i biologii. 2015;3:4-12 (in Russian).
Авторы
В.В. Логинов*1, А.В. Вартанов1,2, С.А. Фейгин1, С.В. Павлович1
1 ФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии
имени академика В.И. Кулакова» Минздрава России, Москва, Россия;
2 ФГБОУ ВО «Московский государственный университет им. М.В. Ломоносова», Москва, Россия
*vikloginov@yandex.ru
1 ФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии
имени академика В.И. Кулакова» Минздрава России, Москва, Россия;
2 ФГБОУ ВО «Московский государственный университет им. М.В. Ломоносова», Москва, Россия
*vikloginov@yandex.ru
________________________________________________
Viktor V. Loginov*1, Alexander V. Vartanov1,2, Semen A. Feigin1, Stanislav V. Pavlovich1
1 Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russia;
2 Lomonosov Moscow State University, Moscow, Russia
*vikloginov@yandex.ru
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