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Sedighimehr N, Razeghi M, Rezaei I. Effect of dry needling on pain and central sensitization in women with chronic pelvic pain: A randomized parallel-group controlled clinical trial. Heliyon 2024; 10:e31699. [PMID: 38841514 PMCID: PMC11152953 DOI: 10.1016/j.heliyon.2024.e31699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 05/05/2024] [Accepted: 05/21/2024] [Indexed: 06/07/2024] Open
Abstract
Chronic pelvic pain (CPP) is a debilitating problem in women with clear evidence of myofascial dysfunction. It seems that Myofascial trigger points (MTrPs) contribute to the development of central sensitization (CS). This study aimed to investigate the effect of dry needling on pain and CS in women with CPP. Thirty-six women with CPP participated in this randomized controlled clinical trial and randomly assigned into three groups: dry needling group (DNG), placebo needling group (PNG) and control group (CG). The DNG received five sessions of DN using the "static needling", the PNG received non-penetrating method, and the CG did not receive any intervention. Assessment of outcomes including central sensitization inventory (CSI), short-form McGill pain questionnaire (SF-MPQ), electroencephalography (EEG), conditioned pain modulation (CPM), salivary cortisol concentration, 7-item general anxiety disorder scale (GAD-7), pain catastrophizing scale (PCS), and SF-36 questionnaire was performed pre-intervention, post-intervention, and three months post-intervention by a blind examiner. The result showed a significant group-by-time interaction for CSI, SF-MPQ, and PCS. There was a significant decrease in CSI score in post-intervention and three-months post-intervention compare to pre-intervention in the DNG and PNG. SF-MPQ-PPI score in DNG significantly decreased post-intervention. PCS-Total score decreased significantly post-intervention in DNG and PNG. No significant group-by-time interactions were observed for other variables. EEG results showed regional changes in the activity of frequency bands in both eye closed and eye open conditions. It seems that DN can affect central pain processing by removing the source of peripheral nociception. Trial registration: Iranian Registry of Clinical Trials (IRCT20211114053057N1, registered on: December 03, 2021. https://irct.behdasht.gov.ir/search/result?query=IRCT20211114053057N1).
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Affiliation(s)
- Najmeh Sedighimehr
- Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Razeghi
- Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Iman Rezaei
- Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Borbély É, Kecskés A, Kun J, Kepe E, Fülöp B, Kovács-Rozmer K, Scheich B, Renner É, Palkovits M, Helyes Z. Hemokinin-1 is a mediator of chronic restraint stress-induced pain. Sci Rep 2023; 13:20030. [PMID: 37973885 PMCID: PMC10654722 DOI: 10.1038/s41598-023-46402-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 10/31/2023] [Indexed: 11/19/2023] Open
Abstract
The Tac4 gene-derived hemokinin-1 (HK-1) binds to the NK1 receptor, similarly to Substance P, and plays a role in acute stress reactions and pain transmission in mice. Here we investigated Tac4 mRNA expression in stress and pain-related regions and its involvement in chronic restraint stress-evoked behavioral changes and pain using Tac4 gene-deleted (Tac4-/-) mice compared to C57Bl/6 wildtypes (WT). Tac4 mRNA was detected by in situ hybridization RNAscope technique. Touch sensitivity was assessed by esthesiometry, cold tolerance by paw withdrawal latency from 0°C water. Anxiety was evaluated in the light-dark box (LDB) and open field test (OFT), depression-like behavior in the tail suspension test (TST). Adrenal and thymus weights were measured at the end of the experiment. We found abundant Tac4 expression in the hypothalamic-pituitary-adrenal axis, but Tac4 mRNA was also detected in the hippocampus, amygdala, somatosensory and piriform cortices in mice, and in the frontal regions and the amygdala in humans. In Tac4-/- mice of both sexes, stress-induced mechanical, but not cold hyperalgesia was significantly decreased compared to WTs. Stress-induced behavioral alterations were mild or absent in male WT animals, while significant changes of these parameters could be detected in females. Thymus weight decrease can be observed in both sexes. Higher baseline anxiety and depression-like behaviors were detected in male but not in female HK-1-deficient mice, highlighting the importance of investigating both sexes in preclinical studies. We provided the first evidence for the potent nociceptive and stress regulating effects of HK-1 in chronic restraint stress paradigm. Identification of its targets might open new perspectives for therapy of stress-induced pain.
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Affiliation(s)
- Éva Borbély
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary.
- Centre for Neuroscience, University of Pécs, Pécs, Hungary.
| | - Angéla Kecskés
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
- Centre for Neuroscience, University of Pécs, Pécs, Hungary
| | - József Kun
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Eszter Kepe
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
- Centre for Neuroscience, University of Pécs, Pécs, Hungary
| | - Barbara Fülöp
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
- Centre for Neuroscience, University of Pécs, Pécs, Hungary
| | - Katalin Kovács-Rozmer
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
- Chronic Pain Research Group, Hungarian Research Network, University of Pécs, Pécs, Hungary
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Pécs, Pécs, Hungary
| | - Bálint Scheich
- Department of Pathology and Experimental Cancer Research, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Éva Renner
- Human Brain Tissue Bank, Semmelweis University, Budapest, Hungary
| | - Miklós Palkovits
- Human Brain Tissue Bank, Semmelweis University, Budapest, Hungary
| | - Zsuzsanna Helyes
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
- Centre for Neuroscience, University of Pécs, Pécs, Hungary
- PharmInVivo Ltd, Pécs, Hungary
- Chronic Pain Research Group, Hungarian Research Network, University of Pécs, Pécs, Hungary
- National Laboratory for Drug Research and Development, Magyar Tudósok Krt. 2, Budapest, 1117, Hungary
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3
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Metabolomic study combined with the low-level light therapy of Chinese acupuncture points and combined oral contraceptives in treatment of primary dysmenorrhea: A prospective, multicenter, randomized controlled study. Heliyon 2023; 9:e13821. [PMID: 36915513 PMCID: PMC10006448 DOI: 10.1016/j.heliyon.2023.e13821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023] Open
Abstract
Objective To compare the changes of metabolites between Low-level light therapy (LLLT) and combined oral contraceptive (COC) after treatment of primary dysmenorrhea (PD), and to compare and analyze the biological and biochemical effects of the two treatments by analyzing the differences in metabolite profiles. Methods A multicenter, double-blind, prospective, parallel, randomized controlled study was conducted on 69 women aged 16-35 years old with PD who were randomly divided into COC treatment group or LLLT treatment group. Low-level light therapy with light-emitting diodes (LED) was applied on two acupoints named "Guanyuan" (CV4) and "Qihai" (CV6). After 12 weeks of treatment intervention, blood samples were collected before and after treatment for metabolomic analysis. We used UPLC-MS/MS analysis to compare the differences in metabolite changes between LLLT and COC before and after treatment. Results 76 differential metabolites were detected in the LLLT group, and 92 differential metabolites were detected in the COC group, which were up-regulated or down-regulated (p < 0.001). Prostaglandin D2 (PG D2) was down-regulated and biliverdin was up-regulated after LLLT treatment, 4a-Hydroxytetrahydrobiopterin, Prostaglandin D2, 5-Hydroxy-l-tryptophan, Cholic acid were down-regulated and cortisol was up-regulated after COC treatment, and the differences were statistically significant. Cortisol and testosterone glucuronide in LLLT group were significantly lower than those in COC group. The metabolic pathways affected were glycerophospholipid metabolism, linoleic acid metabolism and arachidonic acid metabolism in the LLLT group, and glycerophospholipid metabolism, folate biosynthesis, arachidonic-acid-metabolism, and tryptophan metabolism in the COC group. The differential metabolic pathway were linoleic acid metabolism, steroid hormone biosynthesis, and alpha-Linolenic acid metabolism after the comparison of LLLT with COC. Conclusion LLLT and COC might relieve dysmenorrhea by down-regulating PGD2, and LLLT might also relieve dysmenorrhea by up-regulating biliverdin. The level of cortisol and testosterone glucuronide after LLLT treatment was lower than that after COC treatment, which might lead to the difference in the clinical efficacy of the two treatments for dysmenorrhea.
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Filaretova L, Podvigina T, Yarushkina N. Physiological and Pharmacological Effects of Glucocorticoids on the Gastrointestinal Tract. Curr Pharm Des 2020; 26:2962-2970. [DOI: 10.2174/1381612826666200521142746] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 04/15/2020] [Indexed: 02/08/2023]
Abstract
The review considers the data on the physiological and pharmacological effects of glucocorticoids on
the gastric mucosa and focuses on the gastroprotective role of stress-produced glucocorticoids as well as on the
transformation of physiological gastroprotective effects of glucocorticoids to pathological proulcerogenic consequences.
The results of experimental studies on the re-evaluation of the traditional notion that stress-produced
glucocorticoids are ulcerogenic led us to the opposite conclusion suggested that these hormones play an important
role in the maintenance of the gastric mucosal integrity. Exogenous glucocorticoids may exert both gastroprotective
and proulcerogenic effects. Initially, gastroprotective effect of dexamethasone but not corticosterone, cortisol
or prednisolone can be transformed into proulcerogenic one. The most significant factor for the transformation is
the prolongation of its action rather the dose. Gastrointestinal injury can be accompanied by changes in somatic
pain sensitivity and glucocorticoids contribute to these changes playing a physiological and pathological role.
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Affiliation(s)
- Ludmila Filaretova
- Laboratory of Experimental Endocrinology, Pavlov Institute of Physiology, Russian Academy of Sciences, St. Petersburg, Russian Federation
| | - Tatiana Podvigina
- Laboratory of Experimental Endocrinology, Pavlov Institute of Physiology, Russian Academy of Sciences, St. Petersburg, Russian Federation
| | - Natalia Yarushkina
- Laboratory of Experimental Endocrinology, Pavlov Institute of Physiology, Russian Academy of Sciences, St. Petersburg, Russian Federation
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Pain and stress: functional evidence that supra-spinal mechanisms involved in pain-induced analgesia mediate stress-induced analgesia. Behav Pharmacol 2020; 31:159-167. [DOI: 10.1097/fbp.0000000000000529] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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6
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Coxon L, Horne AW, Vincent K. Pathophysiology of endometriosis-associated pain: A review of pelvic and central nervous system mechanisms. Best Pract Res Clin Obstet Gynaecol 2018. [DOI: 10.1016/j.bpobgyn.2018.01.014] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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7
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The peripheral corticotropin-releasing factor (CRF)-induced analgesic effect on somatic pain sensitivity in conscious rats: involving CRF, opioid and glucocorticoid receptors. Inflammopharmacology 2018; 26:305-318. [DOI: 10.1007/s10787-018-0445-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 01/23/2018] [Indexed: 12/30/2022]
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8
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Gaab J, Jiménez J, Voneschen L, Oschwald D, Meyer AH, Nater UM, Krummenacher P. Psychosocial Stress-Induced Analgesia: An Examination of Effects on Heat Pain Threshold and Tolerance and of Neuroendocrine Mediation. Neuropsychobiology 2017; 74:87-95. [PMID: 28190009 DOI: 10.1159/000454986] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 12/04/2016] [Indexed: 11/19/2022]
Abstract
Stress-induced analgesia (SIA) is an adaptive response of reduced nociception following demanding acute internal and external stressors. Although a psychobiological understanding of this phenomenon is of importance for stress-related psychiatric and pain conditions, comparably little is known about the psychobiological mechanisms of SIA in humans. The aim of this study was to investigate the effects of acute psychosocial stress on heat pain perception and its possible neuroendocrine mediation by salivary cortisol levels and α-amylase activity in healthy men. Employing an intra-individual assessment of heat pain parameters, acute psychosocial stress did not influence heat pain threshold but significantly, albeit slightly, increased heat pain tolerance. Using linear mixed-model analysis, this effect of psychosocial stress on heat pain tolerance was not mediated by increases of salivary cortisol and state anxiety levels or by the activity of α-amylase. These results show that while psychosocial stress is selectively analgesic for heat pain tolerance, this observed effect is not mediated by stress-induced increases of salivary cortisol and α-amylase activity, as proxies of both the hypothalamus-pituitary-adrenal axis and the autonomic nervous system activation.
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Affiliation(s)
- Jens Gaab
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, University of Basel, Basel, Switzerland
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9
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Hu SSJ, Ho YC, Chiou LC. No more pain upon Gq-protein-coupled receptor activation: role of endocannabinoids. Eur J Neurosci 2014; 39:467-84. [PMID: 24494686 DOI: 10.1111/ejn.12475] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Revised: 12/02/2013] [Accepted: 12/05/2013] [Indexed: 01/24/2023]
Abstract
Marijuana has been used to relieve pain for centuries. The analgesic mechanism of its constituents, the cannabinoids, was only revealed after the discovery of cannabinoid receptors (CB1 and CB2) two decades ago. The subsequent identification of the endocannabinoids, anandamide and 2-arachidonoylglycerol (2-AG), and their biosynthetic and degradation enzymes discloses the therapeutic potential of compounds targeting the endocannabinoid system for pain control. Inhibitors of the anandamide and 2-AG degradation enzymes, fatty acid amide hydrolase and monoacylglycerol lipase, respectively, may be superior to direct cannabinoid receptor ligands as endocannabinoids are synthesized on demand and rapidly degraded, focusing action at generating sites. Recently, a promising strategy for pain relief was revealed in the periaqueductal gray (PAG). It is initiated by Gq-protein-coupled receptor (Gq PCR) activation of the phospholipase C-diacylglycerol lipase enzymatic cascade, generating 2-AG that produces inhibition of GABAergic transmission (disinhibition) in the PAG, thereby leading to analgesia. Here, we introduce the antinociceptive properties of exogenous cannabinoids and endocannabinoids, involving their biosynthesis and degradation processes, particularly in the PAG. We also review recent studies disclosing the Gq PCR-phospholipase C-diacylglycerol lipase-2-AG retrograde disinhibition mechanism in the PAG, induced by activating several Gq PCRs, including metabotropic glutamatergic (type 5 metabotropic glutamate receptor), muscarinic acetylcholine (M1/M3), and orexin 1 receptors. Disinhibition mediated by type 5 metabotropic glutamate receptor can be initiated by glutamate transporter inhibitors or indirectly by substance P, neurotensin, cholecystokinin and capsaicin. Finally, the putative role of 2-AG generated after activating the above neurotransmitter receptors in stress-induced analgesia is discussed.
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Affiliation(s)
- Sherry Shu-Jung Hu
- Department of Psychology, National Cheng Kung University, Tainan, Taiwan
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10
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Taylor AMW, Roberts KW, Pradhan AA, Akbari HA, Walwyn W, Lutfy K, Carroll FI, Cahill CM, Evans CJ. Anti-nociception mediated by a κ opioid receptor agonist is blocked by a δ receptor agonist. Br J Pharmacol 2014; 172:691-703. [PMID: 24923251 PMCID: PMC4292979 DOI: 10.1111/bph.12810] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Revised: 05/23/2014] [Accepted: 06/06/2014] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND AND PURPOSE The opioid receptor family comprises four structurally homologous but functionally distinct sub-groups, the μ (MOP), δ (DOP), κ (KOP) and nociceptin (NOP) receptors. As most opioid agonists are selective but not specific, a broad spectrum of behaviours due to activation of different opioid receptors is expected. In this study, we examine whether other opioid receptor systems influenced KOP-mediated antinociception. EXPERIMENTAL APPROACH We used a tail withdrawal assay in C57Bl/6 mice to assay the antinociceptive effect of systemically administered opioid agonists with varying selectivity at KOP receptors. Pharmacological and genetic approaches were used to analyse the interactions of the other opioid receptors in modulating KOP-mediated antinociception. KEY RESULTS Etorphine, a potent agonist at all four opioid receptors, was not anti-nociceptive in MOP knockout (KO) mice, although etorphine is an efficacious KOP receptor agonist and specific KOP receptor agonists remain analgesic in MOP KO mice. As KOP receptor agonists are aversive, we considered KOP-mediated antinociception might be a form of stress-induced analgesia that is blocked by the anxiolytic effects of DOP receptor agonists. In support of this hypothesis, pretreatment with the DOP antagonist, naltrindole (10 mg·kg(-1) ), unmasked etorphine (3 mg·kg(-1) ) antinociception in MOP KO mice. Further, in wild-type mice, KOP-mediated antinociception by systemic U50,488H (10 mg·kg(-1) ) was blocked by pretreatment with the DOP agonist SNC80 (5 mg·kg(-1) ) and diazepam (1 mg·kg(-1) ). CONCLUSIONS AND IMPLICATIONS Systemic DOP receptor agonists blocked systemic KOP antinociception, and these results identify DOP receptor agonists as potential agents for reversing stress-driven addictive and depressive behaviours mediated through KOP receptor activation. LINKED ARTICLES This article is part of a themed section on Opioids: New Pathways to Functional Selectivity. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2015.172.issue-2.
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Affiliation(s)
- A M W Taylor
- University of California, Los Angeles, CA, USA; University of California Irvine, Irvine, CA, USA
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11
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Brawn J, Morotti M, Zondervan KT, Becker CM, Vincent K. Central changes associated with chronic pelvic pain and endometriosis. Hum Reprod Update 2014; 20:737-47. [PMID: 24920437 DOI: 10.1093/humupd/dmu025] [Citation(s) in RCA: 161] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Chronic pelvic pain (CPP) is a significant public health problem with 1 million affected women in the UK. Although many pathologies are associated with CPP, the pain experienced is often disproportionate to the extent of disease identified and frequently no pathology is found (chronic pelvic pain syndrome). The central nervous system (CNS) is central to the experience of pain and chronic pain conditions in general are associated with alterations in both the structure and function of the CNS. This review describes the available evidence for central changes in association with conditions presenting with CPP. METHODS A detailed literature search was performed to identify relevant papers, however, this is not a systematic review. RESULTS CPP is associated with central changes similar to those identified in other pain conditions. Specifically these include, alterations in the behavioural and central response to noxious stimulation, changes in brain structure (both increases and decreases in the volume of specific brain regions), altered activity of both the hypothalamic-pituitary-adrenal axis and the autonomic nervous system (ANS) and psychological distress. CONCLUSIONS The evidence reviewed in this paper demonstrates that CPP is associated with significant central changes when compared with healthy pain-free women. Moreover, the presence of these changes has the potential to both exacerbate symptoms and to predispose these women to the development of additional chronic conditions. These findings support the use of adjunctive medication targeting the CNS in these women.
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Affiliation(s)
- Jennifer Brawn
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Matteo Morotti
- Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Women's Centre, John Radcliffe Hospital, Oxford, UK Department of Obstetrics and Gynaecology, University of Genoa, Genoa 16100, Italy
| | - Krina T Zondervan
- Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Women's Centre, John Radcliffe Hospital, Oxford, UK
| | - Christian M Becker
- Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Women's Centre, John Radcliffe Hospital, Oxford, UK
| | - Katy Vincent
- Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Women's Centre, John Radcliffe Hospital, Oxford, UK
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12
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Rodgers HM, Liban S, Wilson LM. Attenuated pain response of obese mice (B6.Cg-lep(ob)) is affected by aging and leptin but not sex. Physiol Behav 2013; 123:80-5. [PMID: 24161513 DOI: 10.1016/j.physbeh.2013.10.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Revised: 09/23/2013] [Accepted: 10/15/2013] [Indexed: 10/26/2022]
Abstract
Genetically obese mice (B6.Cg-lep(ob)) manifest decreased responses to noxious thermal stimuli (hotplate test) suggesting endogenous analgesia (Roy et al., 1981). To examine further the analgesic response of these mice, we conducted 4 experiments. Experiment 1 assessed the response of ob/ob mice to tail flick, another noxious thermal test. Tail-flick testing was performed on B6.Cg-lep(ob) mice (n=14) and B6.Cg-lep(OB/?) (n=12) across a range of temperatures. Ob/ob mice exhibited longer latencies than control mice at all temperatures tested. In Experiment 2, potential sex differences were examined. Tail-flick latencies in male and female ob/ob mice (n=6/group) did not differ. The final 2 experiments examined factors that could modulate endogenous analgesia. Experiment 3 assessed the effects of aging in ob/ob mice (n=10/group). Older mice displayed longer tail-flick latencies than did younger mice. Experiment 4 examined the effect of leptin administration in the leptin-deficient ob/ob mice. Two groups (n=10/group) of ob/ob mice received osmotic pump implants filled with either leptin or vehicle, and were tail-flick tested at days 7 and 14 post-implantation. Ob/ob mice receiving leptin showed shorter latencies than did vehicle-receiving ob/ob mice. Taken together, these results support earlier reports of heightened analgesia in ob/ob mice and suggest that aging further reduces the already impaired pain response. Furthermore, leptin deficiency partially contributes to decreased pain sensation of ob/ob mice.
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Affiliation(s)
- Helen M Rodgers
- Department of Psychology, P404 Duff Roblin Bldg, 190 Dysart Rd, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
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13
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Kao CH, Wang SJ, Tsai CF, Chen SP, Wang YF, Fuh JL. Psychiatric comorbidities in allodynic migraineurs. Cephalalgia 2013; 34:211-8. [PMID: 24048892 DOI: 10.1177/0333102413505238] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To evaluate the prevalence and the association of psychological disturbance in migraine patients with allodynia. METHODS We recruited 434 migraine patients from an outpatient clinic. The participants completed three self-administered questionnaires, including a headache questionnaire, an allodynia symptoms checklist, and the Hospital Anxiety and Depression Scale (HADS). RESULTS Among the migraineurs, 48.4% participants reported allodynia. The HADS total score (15.5 ± 7.8 vs. 13.7 ± 8.5, P = 0.022) and anxiety subscore (9.1 ± 4.5 vs. 7.6 ± 4.7, P = 0.001) were higher in migraineurs with allodynia than in those without allodynia. The anxiety subscore in patients with moderate to severe allodynia, mild allodynia, and no allodynia were 10.0 ± 4.5, 8.4 ± 4.3, and 7.6 ± 4.7 ( P < 0.001, by one-way analysis of variance). Among patients with moderate to severe allodynia, there was a trend of higher depression subscore (7.1 ± 4.0, P = 0.059) than those with no (6.1 ± 4.4) or mild allodynia (5.8 ± 4.0). In a regression model, the presence of allodynia is an independent risk factor for clinically significant anxiety. Moderate to severe allodynia is an independent risk factor for clinically significant depression. CONCLUSIONS In migraineurs, the severity of cutaneous allodynia was associated with their mood status, especially anxiety.
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Affiliation(s)
- Chi-Han Kao
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taiwan
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Experimental characterization of the effects of acute stresslike doses of hydrocortisone in human neurogenic hyperalgesia models. Pain 2012; 153:420-428. [DOI: 10.1016/j.pain.2011.10.043] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2011] [Accepted: 10/31/2011] [Indexed: 11/24/2022]
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15
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Albayrak Y, Saglam MB, Yildirim K, Karatay S, Polat B, Uslu T, Suleyman H, Akcay F. Effects of epinephrine and cortisol on the analgesic activity of metyrosine in rats. Arch Pharm Res 2011; 34:1519-25. [PMID: 21975814 DOI: 10.1007/s12272-011-0914-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2010] [Revised: 03/10/2011] [Accepted: 03/18/2011] [Indexed: 02/02/2023]
Abstract
Some endogenous hormones (epinephrine and cortisol) can change an individual's pain threshold. Propranolol is a non-selective β adrenergic receptor blocker which antagonises the anti-inflammatory effect of non-steroidal anti-inflammatory drugs via the β1 and β2 adrenergic receptors. The roles of epinephrine and cortisol were investigated in the analgesic activity of metyrosine in rats with reduced epinephrine levels induced by metyrosine. Pain threshold measurement was performed using an analgesimeter with different doses and the single or combined usage of metyrosine, prednisolone, metyrapone and propranolol in rats. Epinephrine and corticosterone levels were measured by high-performance liquid chromatography in metyrosineadministered rats. Metyrosine reduces the epinephrine levels without affecting the corticosterone levels, thereby creating an analgesic effect. It was determined that prednisolone did not have an analgesic effect in rats with normal epinephrine levels, but its analgesic activity increased with a parallel decrease in the epinephrine levels. Similarly, the combined use of prednisolone and metyrosine provided a stronger analgesic effect than that rendered by metyrosine alone. The strongest analgesic effect, however, was observed in the group of rats with the lowest epinephrine level in whom the metyrosine + prednisolone combination was administered. The findings of this study may be useful in severe pain cases in which the available analgesics are unable to relieve the individual's pain.
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Affiliation(s)
- Yavuz Albayrak
- Department of General Surgery, Regional Education and Research Hospital, 25240 Erzurum, Turkey
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Vincent K, Warnaby C, Stagg CJ, Moore J, Kennedy S, Tracey I. Dysmenorrhoea is associated with central changes in otherwise healthy women. Pain 2011; 152:1966-1975. [DOI: 10.1016/j.pain.2011.03.029] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Revised: 03/17/2011] [Accepted: 03/23/2011] [Indexed: 01/02/2023]
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Abstract
PURPOSE OF REVIEW Pelvic pain is a common complaint of women that is frequently poorly managed. This review considers the current understanding of the mechanisms of pain perception and the development of chronic pain in the context of three gynaecological pain conditions. Recent advances in the management of these conditions are then discussed. RECENT FINDINGS Persistent pelvic pain is associated with central changes, reflected by alterations in psychology, brain structure and function, and dysfunction of the hypothalamic-pituitary-adrenal axis. The many similarities among the conditions support the notion that chronic pain should be treated as a symptom in its own right, however, obtaining a diagnosis remains important to patients. Few new treatments have been developed recently, however, older treatments are being subjected to more rigorous testing and improvements in phenotyping should lead to better design of clinical trials. SUMMARY Good quality, well designed clinical trials are urgently required to improve the treatment of pelvic pain in women. However, a variety of successful treatments exist and outcomes can be optimized by individualizing treatment strategies in the context of a multidisciplinary package.
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Indirect role of beta2-adrenergic receptors in the mechanism of analgesic action of nonsteroidal antiinflammatory drugs. Crit Care Med 2010; 38:1860-7. [PMID: 20601862 DOI: 10.1097/ccm.0b013e3181e8ae24] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Adrenal gland hormones have been shown to have a role in the antiinflammatory effect mechanism of nonsteroidal antiinflammatory drugs. This study investigates whether the analgesic effects of indomethacin, diclofenac sodium, aspirin, and nimesulide (IDAN; upper case letters of the four drugs we used) are also related to adrenal gland hormones. DESIGN The analgesic effects of IDAN were studied in the carrageenan-induced inflammatory pain model using both intact and adrenalectomized rats. Paw withdrawal tests were performed in adrenalectomized rats that had been pretreated with phenoxybenzamine, propranolol, and metoprolol. SETTING This study was performed in Pharmacology and Biochemistry Laboratories of Faculty of Medicine. PATIENTS/SUBJECTS A total of 306 (114 intact and 192 adrenalectomized) male Albino Wistar rats were used. INTERVENTIONS Adrernalectomy, drug administrations, pain model induction and pain threshold measurements were performed during the study. MEASUREMENTS AND MAIN RESULTS Although the analgesic effects of nonsteroidal antiinflammatory drugs were lost in adrenalectomized rats, they exerted significant analgesia in adrenalectomized rats that had been pretreated with prednisolone and adrenalin. All these drugs were found to decrease serum adrenalin concentration but did not change serum cortisole (corticosterone in rats) concentration. Prednisolone and adrenalin inhibited carrageenan-induced hyperalgesia in adrenalectomized rat groups pretreated with metoprolol or phenoxybenzamine, but not in rats given propranolol. Propranolol also negated the analgesic effects of IDAN in intact rats. The analgesic effects provided by either prednisolone or adrenalin could not be inhibited by the alpha1, alpha2, or beta1 blockers but disappeared when beta2 receptors were blocked. CONCLUSIONS The analgesic effects of nonsteroidal antiinflammatory drugs appear to be related to endogenous adrenalin and cortisole. We have demonstrated that adrenalin and prednisolone play important roles in the analgesic effect mechanism of IDAN. Prednisolone and adrenalin produce analgesic effects through beta2-adrenergic receptors, suggesting an indirect role for beta2-adrenergic receptors in the analgesic effect mechanism of the nonsteroidal antiinflammatory drugs mentioned.
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Butler RK, Finn DP. Stress-induced analgesia. Prog Neurobiol 2009; 88:184-202. [PMID: 19393288 DOI: 10.1016/j.pneurobio.2009.04.003] [Citation(s) in RCA: 444] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2008] [Revised: 03/15/2009] [Accepted: 04/15/2009] [Indexed: 12/21/2022]
Abstract
For over 30 years, scientists have been investigating the phenomenon of pain suppression upon exposure to unconditioned or conditioned stressful stimuli, commonly known as stress-induced analgesia. These studies have revealed that individual sensitivity to stress-induced analgesia can vary greatly and that this sensitivity is coupled to many different phenotypes including the degree of opioid sensitivity and startle response. Furthermore, stress-induced analgesia is influenced by age, gender, and prior experience to stressful, painful, or other environmental stimuli. Stress-induced analgesia is mediated by activation of the descending inhibitory pain pathway. Pharmacological and neurochemical studies have demonstrated involvement of a large number of neurotransmitters and neuropeptides. In particular, there are key roles for the endogenous opioid, monoamine, cannabinoid, gamma-aminobutyric acid and glutamate systems. The study of stress-induced analgesia has enhanced our understanding of the fundamental physiology of pain and stress and can be a useful approach for uncovering new therapeutic targets for the treatment of pain and stress-related disorders.
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Affiliation(s)
- Ryan K Butler
- Department of Pharmacology and Therapeutics, NCBES Neuroscience Cluster and Centre for Pain Research, National University of Ireland, Galway, University Road, Galway, Ireland
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Fukuda T, Nishimoto C, Miyabe M, Toyooka H. Unilateral adrenalectomy attenuates hemorrhagic shock-induced analgesia in rats. J Anesth 2007; 21:348-53. [PMID: 17680187 DOI: 10.1007/s00540-007-0521-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2006] [Accepted: 03/06/2007] [Indexed: 10/23/2022]
Abstract
PURPOSE To assess the importance of the pituitary adrenal axis in producing stress-induced analgesia (SIA) after hemorrhagic shock, we performed formalin tests after hemorrhage and reinfusion in unilaterally adrenalectomized or sham-operated rats. METHODS Fifty-two adult Sprague-Dawley rats were divided into seven groups: sham-operation normotensive (n = 8), sham-operation shock (n = 8), adrenalectomy normotensive (n = 7), adrenalectomy shock (n = 7), sham-operation shock + yohimbine (n = 7), sham-operation normotensive + corticosterone (n = 7), and adrenalectomy shock + corticosterone (n = 8). The left adrenal gland was cauterized 24 h before the experiment. The mean blood pressure in the shock groups was kept at 50-60 mmHg for 30 min by draining arterial blood. After the blood-reinfusion or observation period, 10% formalin was injected into the rear paw. Nociceptive behaviors and locomotion were observed and rated for 1 h, using the criteria of Dubuisson and Dennis. In 12 other sham-operated and adrenalectomized rats, plasma adrenalin, noradrenalin, and corticosterone concentrations were measured before and after hemorrhagic shock. RESULTS Although the sham-operation shock group showed a lower pain score, the adrenalectomy shock group showed nociceptive behavior similar to that in the normotensive groups. Yohimbine did not affect the SIA; however, corticosterone administration reversed the effects of the adrenalectomy on the SIA. The plasma corticosterone levels in the unilaterally adrenalectomized rats were lower than those in the sham-operated rats and did not increase after hemorrhagic shock. CONCLUSION These results suggest that adrenocortical systems play an important role in hemorrhagic shock-induced SIA.
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Affiliation(s)
- Taeko Fukuda
- Department of Anesthesiology, Graduate School of Comprehensive Human Sciences, Tsukuba University, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
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Vitale G, Arletti R, Sandrini M. Acute noise stress analgesia in relation to 5-HT2 and μ-opioid receptor changes in the frontal cortex of young mice. Life Sci 2005; 77:2500-13. [PMID: 15935399 DOI: 10.1016/j.lfs.2005.01.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2004] [Accepted: 01/11/2005] [Indexed: 12/17/2022]
Abstract
A number of studies have reported that exposure to stress provoked behavioural changes, including analgesia, in rodents. Differences have been observed in these responses to different types of stress and a link between hormones and neurotransmitters proposed. We studied the effect of acute noise stress on nociception and the possible changes in the serotonergic and opioidergic systems in young mice of both sexes. Naloxone pre-treatment was also investigated. Noise stress was produced by a sound source, nociception was measured by the hot-plate test and binding characteristics were evaluated by a radioligand binding technique using membrane preparation from the total frontal cortex. Acute noise stress provoked an antinociceptive effect, associated with an increase in plasma corticosterone levels, a decrease in the number of 5-HT2 receptors in stressed male and female mice and a decrease in the number of mu receptors in both sexes. The behavioural and biochemical effects were antagonized by 1 mg/kg of naloxone. Acute noise stress behaves like other types of stress on nociception. The opioidergic system seems to be involved in this behaviour but also the serotonergic system may play a role. Sex differences were detected in the number of 5-HT2 and mu receptors between male and female mice not subjected to stress, while the percentage decrease in 5-HT2 and mu receptors did not differ significantly between the two sexes.
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MESH Headings
- Animals
- Behavior, Animal/physiology
- Binding Sites
- Cell Membrane/metabolism
- Cerebral Cortex/metabolism
- Corticosterone/blood
- Female
- Male
- Mice
- Motor Activity/physiology
- Narcotic Antagonists/pharmacology
- Noise/adverse effects
- Pain Measurement
- Radioligand Assay
- Receptors, Opioid, mu/antagonists & inhibitors
- Receptors, Opioid, mu/metabolism
- Receptors, Serotonin, 5-HT2/metabolism
- Serotonin 5-HT2 Receptor Antagonists
- Serotonin Antagonists/pharmacology
- Stress, Physiological/etiology
- Stress, Physiological/metabolism
- Stress, Physiological/physiopathology
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Affiliation(s)
- Giovanni Vitale
- Department of Biomedical Science, Section of Pharmacology, University of Modena and Reggio Emilia, via G. Campi 287, 41100 Modena, Italy
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Rothermund K, Brandtstädter J, Meiniger C, Anton F. Nociceptive Sensitivity and Control: Hypo- and Hyperalgesia Under Two Different Modes of Coping. Exp Psychol 2002. [DOI: 10.1027//1618-3169.49.1.57] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Effects of perceived control on nociceptive sensitivity were investigated in an experimental arrangement with N = 40 healthy volunteers in which the duration of painful pressure stimuli was made contingent on success in a tracking task. Perceived control over the pain duration was manipulated through varying the frequency of success in the tracking task. The amount of painful stimulation applied in the high and low control conditions was balanced by a yoked-control design. Pain sensitivity was measured before and after the tracking task by means of a thermal sensory analyzer. Pain sensitivity was found to decrease in the low control condition (hypoalgesia), and to increase slightly in the high control condition (hyperalgesia). These effects are explained with reference to a dual process model of coping.
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Affiliation(s)
| | | | | | - Fernand Anton
- Centre Universitaire de Luxembourg and Center for Psychobiological and Psychosomatic Research, University of Trier, Germany
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