Abstract
Irritable bowel syndrome (IBS) is a common gastrointestinal disorder in which the
pathophysiological mechanisms of the pain and hypersensitivity are not well understood.
IBS patients frequently complain of pain in body regions somatotopically distinct
from the gut, suggesting that central hyperalgesic mechanisms may be involved. In
the current study, during the wind-up testing session, a series of 6 heat pulses were
presented with an interstimulus interval (ISI) of 3 seconds. Following the 1st, 3rd,
and 6th thermal stimuli, subjects were asked to rate the late thermal sensation or
second pain. IBS patients who demonstrated temporal summation of pain (TSSP) then
received dextromethorphan and placebo in a randomized, double-blind, fashion to block
wind-up. The results showed: 1) a subset of IBS patients, but not controls, showed
TSSP in response to a series of noxious heat pulses; and 2) TSSP was blocked by administration
of dextromethorphan, an NMDA receptor antagonist. In summary, these findings further
elucidate mechanisms of somatic hypersensitivity in a subset of IBS patients. Our
results also support an etiologic basis for abnormal NMDA receptor mechanisms in some
IBS patients. Future studies are needed to determine if NMDA receptor antagonists
may be used to treat IBS patients.
Perspective
This study evaluates temporal summation of second pain in a subset of IBS patients
that is blocked by Dextromethorphan, an NMDA receptor antagonist. Theses results could
lead to the use of an NMDA receptor antagonist in the treatment of pain in a subset
of IBS patients.
Key words
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Article info
Publication history
Published online: December 13, 2010
Accepted:
September 21,
2010
Received in revised form:
September 12,
2010
Received:
August 8,
2010
Footnotes
Supported by an NIH grant (NIH RO1-NS053090) to G.N. Verne and by a VA Merit Review Award to G.N. Verne from the Medical Research Service of the Department of Veterans Affairs. The authors have no financial or other relationship to the report that might lead to a conflict of interest.
Identification
Copyright
© 2011 American Pain Society. Published by Elsevier Inc. All rights reserved.
