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document
Is altered central pain processing related to disease stage in chronic pancreatitis patients with pain ? An exploratory study . BACKGROUND 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 . METHODOLOGY/PRINCIPAL FINDINGS 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 . CONCLUSIONS/SIGNIFICANCE 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 .
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Intervention_Educational
altered pain processing
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Intervention_Educational
pressure and electric stimuli
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Intervention_Educational
pain modulation response
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Intervention_Educational
cold pressor task
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Intervention_Educational
altered central processing
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Outcome_Pain
Pain detection and tolerance thresholds for pressure and electric stimuli
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Outcome_Pain
pain thresholds
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Outcome_Pain
pain modulation
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Participant_Condition
chronic pancreatitis patients with pain