Pain disorders linked to patient’s perception

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Patients with chronic pain disorders, such as fibromyalgia, appear to have abnormalities in the self-monitoring mechanism that allows the discrimination of internally produced versus externally produced stimuli, new research shows.

The findings, which appear in Psychosomatic Medicine, are based on a study of 20 patients with a chronic pain disorder (including 10 with fibromyalgia),10 with schizophrenia, and 10 normal controls.

The subjects were asked to rate a tactile sensation to the hands that was either self-produced by the patient moving the hand, or produced externally by an experimenter.

In normal subjects, the sensation from self-produced stimuli was rated as less intense than the sensation from the same externally produced stimuli, lead author Dr. Matthias Karst, from Hannover Medical School in Germany, and colleagues note.

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In contrast, patients in the other groups rated these sensations as being comparable, the investigators point out. Further analysis showed that this observation was largely confined to patients with a chronic pain disorder.

“This is the first study of the self-monitoring in patients with chronic widespread pain,” the researchers state.

The results suggest that chronic pain disorders “interfere with the correct function of the self-monitoring mechanism that normally allows us to distinguish self-produced from externally produced tactile stimuli.”

SOURCE: Psychosomatic Medicine, January/February 2005.

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