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Abstract(s)
Os estudos sobre dor deparam-se com as dificuldades inerentes ao facto de esta ser
uma experiência complexa, subjetiva e difícil de medir. O Focused Analgesia Selection
Test ( FAST) foi desenvolvido com o objetivo de melhorar a avaliação da dor, através do
estudo da variabilidade nos relatos de dor. No entanto, continuam por esclarecer as razões
das diferenças no desempenho neste paradigma e os mecanismos cognitivos subjacentes.
O presente estudo tem como objetivo estudar a relação entre variabilidade, sensibilidade e
modulação da dor e a importância das funções executivas nestes mecanismos.
Foram estudadas 29 participantes com Fibromialgia e 15 participantes
saudáveis através de uma tarefa de avaliação de funções executivas, o Teste do Stroop, e
um protocolo de avaliação de dor que incluiu a variabilidade, medida através do FAST a
sensibilidade, medida através de limiares de diferentes modalidades (elétrica, térmica e
pressão) e tolerância térmica, assim como a modulação medida através do Paradigma da
Dor Condicionada e da Somação Temporal. Foram ainda avaliadas características
clínicas, através do Inventário Resumido da Dor, Questionário de Impacto da
Fibromialgia, FACIT, Escala Hospitalar de Depressão e Ansiedade e Questionário de
Estado de Saúde.
Os resultados mostraram que as participantes com Fibromialgia, apesar de
apresentarem maior sensibilidade à dor revelavam uma menor variabilidade nos relatos
de dor, ou seja, eram mais precisas na avaliação da dor, do que as participantes do grupo
de controlo, e que esta variabilidade não se relacionava com a sensibilidade e
modulação. Ao nível cognitivo, a tarefa de funções executivas utilizada não detetou
diferenças sistemáticas entre os grupos ou mecanismos de dor.
A variabilidade nos relatos de dor parece constituir uma competência específica
que poderá estar relacionada com a exposição prolongada à dor e não com a
sensibilidade e modulação. São necessários mais estudos para investigar o papel das
funções executivas nesta competência.
Pain studies face the difficulties inherent in pain being a complex, subjective and difficult experience to measure. The Focused Analgesia Selection Test (FAST) was developed to improve pain assessment by studying the variability in pain reports. However, the reasons for the differences in performance in this paradigm and the underlying cognitive mechanisms remain unclear. The present research aims to study the relationship between pain variability, sensitivity and modulation and the importance of executive functions in these mechanisms. Twenty-nine participants with fibromyalgia and fifteen healthy participants were studied through an executive function assessment task, the Stroop Test, and a pain assessment protocol that included variability, measured by FAST, sensitivity, measured by thresholds of different modalities (electrical, thermal and pressure) and thermal tolerance, as well as modulation measured through the Conditioned Pain and Temporal Summing Paradigm. Clinical characteristics were also evaluated through the Brief Pain Inventory, Fibromyalgia Impact Questionnaire, FACIT, Hospital Depression and Anxiety Scale and Health Status Questionnaire. The results showed that participants with fibromyalgia, despite having greater sensitivity to pain, showed less variability in pain reports, that is, they were more accurate in pain assessment than those in the control group. There were no differences between groups related to sensitivity and modulation measures. At the cognitive level, the executive function task used did not detect systematic differences between pain groups or mechanisms. Variability in pain reports seems to be a specific skill that may be related to prolonged exposure to pain rather than sensitivity and modulation. Further studies are needed to investigate the role of executive functions in this competence.
Pain studies face the difficulties inherent in pain being a complex, subjective and difficult experience to measure. The Focused Analgesia Selection Test (FAST) was developed to improve pain assessment by studying the variability in pain reports. However, the reasons for the differences in performance in this paradigm and the underlying cognitive mechanisms remain unclear. The present research aims to study the relationship between pain variability, sensitivity and modulation and the importance of executive functions in these mechanisms. Twenty-nine participants with fibromyalgia and fifteen healthy participants were studied through an executive function assessment task, the Stroop Test, and a pain assessment protocol that included variability, measured by FAST, sensitivity, measured by thresholds of different modalities (electrical, thermal and pressure) and thermal tolerance, as well as modulation measured through the Conditioned Pain and Temporal Summing Paradigm. Clinical characteristics were also evaluated through the Brief Pain Inventory, Fibromyalgia Impact Questionnaire, FACIT, Hospital Depression and Anxiety Scale and Health Status Questionnaire. The results showed that participants with fibromyalgia, despite having greater sensitivity to pain, showed less variability in pain reports, that is, they were more accurate in pain assessment than those in the control group. There were no differences between groups related to sensitivity and modulation measures. At the cognitive level, the executive function task used did not detect systematic differences between pain groups or mechanisms. Variability in pain reports seems to be a specific skill that may be related to prolonged exposure to pain rather than sensitivity and modulation. Further studies are needed to investigate the role of executive functions in this competence.
Description
Keywords
Avaliação da dor Variabilidade da dor Sensibilidade à dor Modulação da dor Funções executivas Pain assessment Pain variability Pain sensitivity Pain modulation Executive functions