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Regard critique sur les modèles animaux de douleur aiguë

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Résumé

Les modèles de douleur aiguë utilisés chez l’animal d’expérience au cours des études précliniques et dans la recherche «fondamentale» sont analysés de façon critique. Les rapports entre tests de douleur aiguë et motricité sont abordés sous différents angles, notamment l’influence que les ajustements posturaux de l’animal exercent sur une réponse motrice des membres et la signification des réflexes de flexion et d’extension. Il est souligné que les réflexes de flexion ne sont pas tous nociceptifs. Comme la plupart des tests ne permettent qu’une mesure de seuil alors que la douleur clinique en est toujours éloignée lorsque le médecin doit la prendre en charge, le problème de leur sensibilité se trouve posé. Certaines questions sont plus particulièrement développées, notamment (1) la signification des mesures de «latence» lorsque le stimulus est croissant et (2) la nature des fibres à l’origine de la réaction observée qui pourrait être différente selon que l’on stimule un territoire sain ou enflammé. La prédictivité de ces tests sur le plan clinique est passée en revue avec quelques exemples. Puis les facteurs pouvant perturber la mesure des réponses comportementales de l’animal sont analysés, notamment les interactions entre stimulus hétérotopiques, les facteurs environnementaux et les fonctions psychophysiologiques et psychologiques intercurrentes (phénomènes subjectifs «indésirables», phénomènes d’apprentissage). Les fonctions physiologiques intercurrentes (thermorégulation, vasomotricité, pression artérielle) sont plus particulièrement commentées. Ces dernières considérations invitent à replacer la nociception dans un cadre homéostatique plus vaste qui, outre la douleur, inclue d’autres fonctions comme l’anxiété et les fonctions végétatives. Enfin, la validité de certaines méthodes d’analyse des résultats est analysée.

Summary

The animal models of acute pain used in preclinical studies and «fundamental» research are analysed critically. We review the relationship between tests of acute pain and motor activity from a number of viewpoints; in particular we consider the influence which postural adjustments of the animal may exert on motor responses in the limbs and the significance of the flexor and extensor reflexes. It is emphasised that not all flexion reflexes are nociceptive. Since the majority of tests permit only a measurement of threshold, whereas clinical pain almost always lasts until the doctor deals with it, the problem of their sensitivity is put forward. Several questions are more particularly developed, namely (1) what significance do measurements of «latency» have when a stimulus is increasing; (2) what type(s) of fibres underlie the observed responses and might these be different depending on whether one is stimulating a healthy or an inflamed tissue. The predictivity of tests is illustrated with examples. Then, we review those factors which may distort behavioural measurements in animals, notably—interactions between heterotopics stimuli, environmental factors and related psychophysiological/psychological considerations (subjectively «undesirable» phenomena, learning phenomena). We pay particular attention to related physiological functions (thermoregulation, vasomotricity and blood pressure). These considerations lead us to re-position nociception within a much larger homeostatic framework which in addition to pain, includes phenomena such as anxiety and vegetative functions. Finally, we questioned the validity are some methods of analysing the results.

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Correspondence to D. Le Bars.

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Texte présenté lors du Congrès SFD-SOFRED des 15–17 juin 2000.

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Le Bars, D. Regard critique sur les modèles animaux de douleur aiguë. Doul. et Analg. 14, 21–38 (2001). https://doi.org/10.1007/BF03007507

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Key-words

  • Acute pain
  • behaviour
  • reflexes
  • Aδ-fibres
  • C-fibres
  • learning
  • anxiety
  • vegetative system