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Chen ZK, Liu YY, Zhou JC, Chen GH, Liu CF, Qu WM, Huang ZL. Insomnia-related rodent models in drug discovery. Acta Pharmacol Sin 2024:10.1038/s41401-024-01269-w. [PMID: 38671193 DOI: 10.1038/s41401-024-01269-w] [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: 11/09/2023] [Accepted: 03/24/2024] [Indexed: 04/28/2024] Open
Abstract
Despite the widespread prevalence and important medical impact of insomnia, effective agents with few side effects are lacking in clinics. This is most likely due to relatively poor understanding of the etiology and pathophysiology of insomnia, and the lack of appropriate animal models for screening new compounds. As the main homeostatic, circadian, and neurochemical modulations of sleep remain essentially similar between humans and rodents, rodent models are often used to elucidate the mechanisms of insomnia and to develop novel therapeutic targets. In this article, we focus on several rodent models of insomnia induced by stress, diseases, drugs, disruption of the circadian clock, and other means such as genetic manipulation of specific neuronal activity, respectively, which could be used to screen for novel hypnotics. Moreover, important advantages and constraints of some animal models are discussed. Finally, this review highlights that the rodent models of insomnia may play a crucial role in novel drug development to optimize the management of insomnia.
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Affiliation(s)
- Ze-Ka Chen
- Department of Pharmacology, School of Basic Medical Sciences; State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science; Joint International Research Laboratory of Sleep; and Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
- Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Yuan-Yuan Liu
- Department of Pharmacology, School of Basic Medical Sciences; State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science; Joint International Research Laboratory of Sleep; and Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Ji-Chuan Zhou
- Department of Pharmacology, School of Basic Medical Sciences; State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science; Joint International Research Laboratory of Sleep; and Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Gui-Hai Chen
- Department of Neurology (Sleep Disorders), the Affiliated Chaohu Hospital of Anhui Medical University, Hefei, 238000, China
| | - Chun-Feng Liu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China.
| | - Wei-Min Qu
- Department of Pharmacology, School of Basic Medical Sciences; State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science; Joint International Research Laboratory of Sleep; and Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
| | - Zhi-Li Huang
- Department of Pharmacology, School of Basic Medical Sciences; State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science; Joint International Research Laboratory of Sleep; and Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
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2
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Chen QY, Zhuo M. Anterior cingulate cortex and insomnia: A cingulate-striatum connection. Neuron 2024; 112:1202-1204. [PMID: 38636453 DOI: 10.1016/j.neuron.2024.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 03/13/2024] [Accepted: 03/13/2024] [Indexed: 04/20/2024]
Abstract
Insomnia is an important comorbidity of chronic pain. In this issue of Neuron, Li et al. report that chronic-pain-induced insomnia is mediated by the pyramidal neurons in the anterior cingulate cortex and their dopaminergic projections to the dorsal medial striatum.
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Affiliation(s)
- Qi-Yu Chen
- School of Basic Medical Sciences, Fujian Medical University, Fuzhou 350108, Fujian Province, China; Zhuomin Institute of Brain Research, Qingdao, Shandong, China
| | - Min Zhuo
- Zhuomin Institute of Brain Research, Qingdao, Shandong, China; Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
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3
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Alexandre C, Miracca G, Holanda VD, Sharma A, Kourbanova K, Ferreira A, Bicca MA, Zeng X, Nassar VA, Lee S, Kaur S, Sarma SV, Sacré P, Scammell TE, Woolf CJ, Latremoliere A. Nociceptor spontaneous activity is responsible for fragmenting non-rapid eye movement sleep in mouse models of neuropathic pain. Sci Transl Med 2024; 16:eadg3036. [PMID: 38630850 PMCID: PMC11106840 DOI: 10.1126/scitranslmed.adg3036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/27/2024] [Indexed: 04/19/2024]
Abstract
Spontaneous pain, a major complaint of patients with neuropathic pain, has eluded study because there is no reliable marker in either preclinical models or clinical studies. Here, we performed a comprehensive electroencephalogram/electromyogram analysis of sleep in several mouse models of chronic pain: neuropathic (spared nerve injury and chronic constriction injury), inflammatory (Freund's complete adjuvant and carrageenan, plantar incision) and chemical pain (capsaicin). We find that peripheral axonal injury drives fragmentation of sleep by increasing brief arousals from non-rapid eye movement sleep (NREMS) without changing total sleep amount. In contrast to neuropathic pain, inflammatory or chemical pain did not increase brief arousals. NREMS fragmentation was reduced by the analgesics gabapentin and carbamazepine, and it resolved when pain sensitivity returned to normal in a transient neuropathic pain model (sciatic nerve crush). Genetic silencing of peripheral sensory neurons or ablation of CGRP+ neurons in the parabrachial nucleus prevented sleep fragmentation, whereas pharmacological blockade of skin sensory fibers was ineffective, indicating that the neural activity driving the arousals originates ectopically in primary nociceptor neurons and is relayed through the lateral parabrachial nucleus. These findings identify NREMS fragmentation by brief arousals as an effective proxy to measure spontaneous neuropathic pain in mice.
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Affiliation(s)
- Chloe Alexandre
- Department of Neurosurgery, Neurosurgery Pain Research institute, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
- Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Giulia Miracca
- Department of Neurology, Beth israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
- FM Kirby Neurobiology Center, Boston Children’s Hospital and Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Victor Duarte Holanda
- Department of Neurosurgery, Neurosurgery Pain Research institute, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
- Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Ashley Sharma
- Department of Neurosurgery, Neurosurgery Pain Research institute, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
- Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Kamila Kourbanova
- Department of Neurosurgery, Neurosurgery Pain Research institute, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
- Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Ashley Ferreira
- Department of Neurology, Beth israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
- FM Kirby Neurobiology Center, Boston Children’s Hospital and Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Maíra A. Bicca
- Department of Neurosurgery, Neurosurgery Pain Research institute, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
- Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Xiangsunze Zeng
- FM Kirby Neurobiology Center, Boston Children’s Hospital and Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Victoria A. Nassar
- Department of Neurosurgery, Neurosurgery Pain Research institute, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
- Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Seungkyu Lee
- FM Kirby Neurobiology Center, Boston Children’s Hospital and Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Satvinder Kaur
- Department of Neurology, Beth israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Sridevi V. Sarma
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Pierre Sacré
- Department of Electrical Engineering and Computer Science, School of Engineering, University of Liège, Liège, Belgium
| | - Thomas E. Scammell
- Department of Neurology, Beth israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Clifford J. Woolf
- FM Kirby Neurobiology Center, Boston Children’s Hospital and Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Alban Latremoliere
- Department of Neurosurgery, Neurosurgery Pain Research institute, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
- Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
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4
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Li YD, Luo YJ, Su WK, Ge J, Crowther A, Chen ZK, Wang L, Lazarus M, Liu ZL, Qu WM, Huang ZL. Anterior cingulate cortex projections to the dorsal medial striatum underlie insomnia associated with chronic pain. Neuron 2024; 112:1328-1341.e4. [PMID: 38354737 DOI: 10.1016/j.neuron.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 11/29/2023] [Accepted: 01/12/2024] [Indexed: 02/16/2024]
Abstract
Chronic pain often leads to the development of sleep disturbances. However, the precise neural circuit mechanisms responsible for sleep disorders in chronic pain have remained largely unknown. Here, we present compelling evidence that hyperactivity of pyramidal neurons (PNs) in the anterior cingulate cortex (ACC) drives insomnia in a mouse model of nerve-injury-induced chronic pain. After nerve injury, ACC PNs displayed spontaneous hyperactivity selectively in periods of insomnia. We then show that ACC PNs were both necessary for developing chronic-pain-induced insomnia and sufficient to mimic sleep loss in naive mice. Importantly, combining optogenetics and electrophysiological recordings, we found that the ACC projection to the dorsal medial striatum (DMS) underlies chronic-pain-induced insomnia through enhanced activity and plasticity of ACC-DMS dopamine D1R neuron synapses. Our findings shed light on the pivotal role of ACC PNs in developing chronic-pain-induced sleep disorders.
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Affiliation(s)
- Ya-Dong Li
- Department of Pharmacology, School of Basic Medical Sciences, State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Joint International Research Laboratory of Sleep, and Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China; Songjiang Research Institute, Songjiang Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Emotions and Affective Disorders (LEAD), Shanghai 201699, China.
| | - Yan-Jia Luo
- Department of Pharmacology, School of Basic Medical Sciences, State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Joint International Research Laboratory of Sleep, and Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China; Department of Anesthesiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Wei-Kun Su
- Songjiang Research Institute, Songjiang Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Emotions and Affective Disorders (LEAD), Shanghai 201699, China
| | - Jing Ge
- Department of Pharmacology, School of Basic Medical Sciences, State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Joint International Research Laboratory of Sleep, and Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Andrew Crowther
- Department of Anatomy, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Ze-Ka Chen
- Department of Pharmacology, School of Basic Medical Sciences, State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Joint International Research Laboratory of Sleep, and Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Lu Wang
- Department of Pharmacology, School of Basic Medical Sciences, State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Joint International Research Laboratory of Sleep, and Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Michael Lazarus
- International Institute for Integrative Sleep Medicine (WPI-IIIS) and Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Zi-Long Liu
- Department of Pharmacology, School of Basic Medical Sciences, State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Joint International Research Laboratory of Sleep, and Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China; Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
| | - Wei-Min Qu
- Department of Pharmacology, School of Basic Medical Sciences, State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Joint International Research Laboratory of Sleep, and Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
| | - Zhi-Li Huang
- Department of Pharmacology, School of Basic Medical Sciences, State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Joint International Research Laboratory of Sleep, and Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
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5
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Zaręba P, Łątka K, Mazur G, Gryzło B, Pasieka A, Godyń J, Panek D, Skrzypczak-Wiercioch A, Höfner GC, Latacz G, Maj M, Espargaró A, Sabaté R, Jóźwiak K, Wanner KT, Sałat K, Malawska B, Kulig K, Bajda M. Discovery of novel multifunctional ligands targeting GABA transporters, butyrylcholinesterase, β-secretase, and amyloid β aggregation as potential treatment of Alzheimer's disease. Eur J Med Chem 2023; 261:115832. [PMID: 37837674 DOI: 10.1016/j.ejmech.2023.115832] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/12/2023] [Accepted: 09/23/2023] [Indexed: 10/16/2023]
Abstract
Alzheimer's disease (AD) is a global health problem in the medical sector that will increase over time. The limited treatment of AD leads to the search for a new clinical candidate. Considering the multifactorial nature of AD, a strategy targeting number of regulatory proteins involved in the development of the disease is an effective approach. Here, we present a discovery of new multi-target-directed ligands (MTDLs), purposely designed as GABA transporter (GAT) inhibitors, that successfully provide the inhibitory activity against butyrylcholinesterase (BuChE), β-secretase (BACE1), amyloid β aggregation and calcium channel blockade activity. The selected GAT inhibitors, 19c and 22a - N-benzylamide derivatives of 4-aminobutyric acid, displayed the most prominent multifunctional profile. Compound 19c (mGAT1 IC50 = 10 μM, mGAT4 IC50 = 12 μM and BuChE IC50 = 559 nM) possessed the highest hBACE1 and Aβ40 aggregation inhibitory activity (IC50 = 1.57 μM and 99 % at 10 μM, respectively). Additionally, it showed a decrease in both the elongation and nucleation constants of the amyloid aggregation process. In contrast compound 22a represented the highest activity and a mixed-type of eqBuChE inhibition (IC50 = 173 nM) with hBACE1 (IC50 = 9.42 μM), Aβ aggregation (79 % at 10 μM) and mGATs (mGAT1 IC50 = 30 μM, mGAT4 IC50 = 25 μM) inhibitory activity. Performed molecular docking studies described the mode of interactions with GATs and enzymatic targets. In ADMET in vitro studies both compounds showed acceptable metabolic stability and low neurotoxicity. Successfully, compounds 19c and 22a at the dose of 30 mg/kg possessed statistically significant antiamnesic properties in a mouse model of amnesia caused by scopolamine and assessed in the novel object recognition (NOR) task or the passive avoidance (PA) task.
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Affiliation(s)
- Paula Zaręba
- Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9 St., 30-688, Kraków, Poland
| | - Kamil Łątka
- Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9 St., 30-688, Kraków, Poland
| | - Gabriela Mazur
- Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9 St., 30-688, Kraków, Poland
| | - Beata Gryzło
- Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9 St., 30-688, Kraków, Poland
| | - Anna Pasieka
- Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9 St., 30-688, Kraków, Poland
| | - Justyna Godyń
- Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9 St., 30-688, Kraków, Poland
| | - Dawid Panek
- Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9 St., 30-688, Kraków, Poland
| | - Anna Skrzypczak-Wiercioch
- Department of Animal Anatomy and Preclinical Sciences, University Centre of Veterinary Medicine JU-UA, University of Agriculture in Kraków, Mickiewicz 24/28 St., 30-059, Kraków, Poland
| | - Georg C Höfner
- Department of Pharmacy, Center for Drug Research, Ludwig-Maximilians-Universität München Butenandtstr., 5-13, 81377, Munich, Germany
| | - Gniewomir Latacz
- Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9 St., 30-688, Kraków, Poland
| | - Maciej Maj
- Department of Biopharmacy, Medical University of Lublin, W. Chodzki 4a St., 20-093, Lublin, Poland
| | - Alba Espargaró
- Department of Pharmacy and Pharmaceutical Technology and Physical-Chemistry, School of Pharmacy and Food Sciences, University of Barcelona, Av Joan XXIII 27-31, 08028, Barcelona, Spain; Institute of Nanoscience and Nanotechnology (IN2UB), Av Joan XXIII, S/N, 08028, Barcelona, Spain
| | - Raimon Sabaté
- Department of Pharmacy and Pharmaceutical Technology and Physical-Chemistry, School of Pharmacy and Food Sciences, University of Barcelona, Av Joan XXIII 27-31, 08028, Barcelona, Spain; Institute of Nanoscience and Nanotechnology (IN2UB), Av Joan XXIII, S/N, 08028, Barcelona, Spain
| | - Krzysztof Jóźwiak
- Department of Biopharmacy, Medical University of Lublin, W. Chodzki 4a St., 20-093, Lublin, Poland
| | - Klaus T Wanner
- Department of Pharmacy, Center for Drug Research, Ludwig-Maximilians-Universität München Butenandtstr., 5-13, 81377, Munich, Germany
| | - Kinga Sałat
- Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9 St., 30-688, Kraków, Poland
| | - Barbara Malawska
- Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9 St., 30-688, Kraków, Poland
| | - Katarzyna Kulig
- Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9 St., 30-688, Kraków, Poland
| | - Marek Bajda
- Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9 St., 30-688, Kraków, Poland.
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Zhang Y, Wang T, Wu S, Tang L, Wang J, Yang J, Yao S, Zhang Y. Notch signaling pathway: a new target for neuropathic pain therapy. J Headache Pain 2023; 24:87. [PMID: 37454050 PMCID: PMC10349482 DOI: 10.1186/s10194-023-01616-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 06/19/2023] [Indexed: 07/18/2023] Open
Abstract
The Notch gene, a highly evolutionarily conserved gene, was discovered approximately 110 years ago and has been found to play a crucial role in the development of multicellular organisms. Notch receptors and their ligands are single-pass transmembrane proteins that typically require cellular interactions and proteolytic processing to facilitate signal transduction. Recently, mounting evidence has shown that aberrant activation of the Notch is correlated with neuropathic pain. The activation of the Notch signaling pathway can cause the activation of neuroglia and the release of pro-inflammatory factors, a key mechanism in the development of neuropathic pain. Moreover, the Notch signaling pathway may contribute to the persistence of neuropathic pain by enhancing synaptic transmission and calcium inward flow. This paper reviews the structure and activation of the Notch signaling pathway, as well as its potential mechanisms of action, to provide novel insights for future treatments of neuropathic pain.
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Affiliation(s)
- Yan Zhang
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, China
- Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Key Laboratory of Anesthesiology and Resuscitation (Huazhong University of Science and Technology), Ministry of Education, Wuhan, China
| | - Tingting Wang
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, China
- Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Key Laboratory of Anesthesiology and Resuscitation (Huazhong University of Science and Technology), Ministry of Education, Wuhan, China
| | - Sanlan Wu
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Li Tang
- Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Department of Pain, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, China
| | - Jia Wang
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, Research Center for Brain-Inspired Intelligence, School of Life Science and Technology, Xi'an Jiaotong University, The Key Laboratory of Neuro-Informatics & Rehabilitation En-Gineering of Ministry of Civil Affairs, Xi'an, Shaanxi, P. R. China
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Ave, Wuhan, 430022, Hubei, China
| | - Jinghan Yang
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, China
- Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Key Laboratory of Anesthesiology and Resuscitation (Huazhong University of Science and Technology), Ministry of Education, Wuhan, China
| | - Shanglong Yao
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, China.
- Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
- Key Laboratory of Anesthesiology and Resuscitation (Huazhong University of Science and Technology), Ministry of Education, Wuhan, China.
| | - Yan Zhang
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, China.
- Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
- Key Laboratory of Anesthesiology and Resuscitation (Huazhong University of Science and Technology), Ministry of Education, Wuhan, China.
- Department of Pain, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, China.
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7
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Qiu XT, Guo C, Ma LT, Li XN, Zhang QY, Huang FS, Zhang MM, Bai Y, Liang GB, Li YQ. Transcriptomic and proteomic profiling of the anterior cingulate cortex in neuropathic pain model rats. Front Mol Neurosci 2023; 16:1164426. [PMID: 37396788 PMCID: PMC10311218 DOI: 10.3389/fnmol.2023.1164426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 05/25/2023] [Indexed: 07/04/2023] Open
Abstract
Background Neuropathic pain (NP) takes a heavy toll on individual life quality, yet gaps in its molecular characterization persist and effective therapy is lacking. This study aimed to provide comprehensive knowledge by combining transcriptomic and proteomic data of molecular correlates of NP in the anterior cingulate cortex (ACC), a cortical hub responsible for affective pain processing. Methods The NP model was established by spared nerve injury (SNI) in Sprague-Dawley rats. RNA sequencing and proteomic data from the ACC tissue isolated from sham and SNI rats 2 weeks after surgery were integrated to compare their gene and protein expression profiles. Bioinformatic analyses were performed to figure out the functions and signaling pathways of the differentially expressed genes (DEGs) and differentially expressed proteins (DEPs) enriched in. Results Transcriptomic analysis identified a total of 788 DEGs (with 49 genes upregulated) after SNI surgery, while proteomic analysis found 222 DEPs (with 89 proteins upregulated). While Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses of the DEGs suggested that most of the altered genes were involved in synaptic transmission and plasticity, bioinformatics analysis of the DEPs revealed novel critical pathways associated with autophagy, mitophagy, and peroxisome. Notably, we noticed functionally important NP-related changes in the protein that occurred in the absence of corresponding changes at the level of transcription. Venn diagram analysis of the transcriptomic and proteomic data identified 10 overlapping targets, among which only three genes (XK-related protein 4, NIPA-like domain-containing 3, and homeodomain-interacting protein kinase 3) showed concordance in the directions of change and strong correlations between mRNA and protein levels. Conclusion The present study identified novel pathways in the ACC in addition to confirming previously reported mechanisms for NP etiology, and provided novel mechanistic insights for future research on NP treatment. These findings also imply that mRNA profiling alone fails to provide a complete landscape of molecular pain in the ACC. Therefore, explorations of changes at the level of protein are necessary to understand NP processes that are not transcriptionally modulated.
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Affiliation(s)
- Xin-Tong Qiu
- Department of Anatomy, Histology and Embryology, Preclinical School of Medicine, Air Force Medical University, Xi’an, China
| | - Chen Guo
- Department of Neurosurgery, General Hospital of Northern Theater Command, Shenyang, China
| | - Li-Tian Ma
- Department of Gastroenterology, Tangdu Hospital, Air Force Medical University, Xi'an, China
| | - Xin-Ning Li
- Department of Neurosurgery, General Hospital of Northern Theater Command, Shenyang, China
| | - Qi-Yan Zhang
- Department of Neurosurgery, General Hospital of Northern Theater Command, Shenyang, China
| | - Fen-Sheng Huang
- Institute of Neuroscience and Physiology, University of Göteborg, Göteborg, Sweden
| | - Ming-Ming Zhang
- Department of Anatomy, Histology and Embryology, Preclinical School of Medicine, Air Force Medical University, Xi’an, China
| | - Yang Bai
- Department of Neurosurgery, General Hospital of Northern Theater Command, Shenyang, China
| | - Guo-Biao Liang
- Department of Neurosurgery, General Hospital of Northern Theater Command, Shenyang, China
| | - Yun-Qing Li
- Department of Anatomy, Histology and Embryology, Preclinical School of Medicine, Air Force Medical University, Xi’an, China
- Department of Geriatrics, Tangdu Hospital, Air Force Medical University, Xi’an, China
- Department of Human Anatomy, Basic Medical College, Zunyi Medical University, Zunyi, China
- Department of Anatomy, College of Basic Medicine, Dali University, Dali, China
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8
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Duo L, Yu X, Hu R, Duan X, Zhou J, Wang K. Sleep disorders in chronic pain and its neurochemical mechanisms: a narrative review. Front Psychiatry 2023; 14:1157790. [PMID: 37324825 PMCID: PMC10267346 DOI: 10.3389/fpsyt.2023.1157790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/15/2023] [Indexed: 06/17/2023] Open
Abstract
Chronic pain (CP) is a prevalent problem, and more than half of patients with CP have sleep disorders. CP comorbidity with sleep disorders imposes immense suffering and seriously affects the patient's quality of life, which is a challenging issue encountered by clinicians. Although the reciprocal interactions between pain and sleep have been studied to some degree, there is still a lack of awareness and comprehensive description of CP comorbidity with sleep disorders. In this narrative review article, we summarize the current knowledge about the present estimates of the prevalence of comorbid sleep disorders in CP patients, sleep detection methods, sleep characterization in CP, and the effect of sleep disorders on CP and current therapies. We also summarize current knowledge of the neurochemical mechanisms of CP comorbidity with sleep disorders. In conclusion, insufficient attention has been paid to the role of sleep disorders in CP patients, and CP patients should be screened for sleep disorders in the clinic. Special attention should be given to a possible risk of drug-drug interaction when using two types of drugs targeting pain and sleep simultaneously. The current insight into the neurobiological mechanisms underlying CP comorbidity with sleep disorders is still rather limited.
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Das S, Taylor K, Kozubek J, Sardell J, Gardner S. Genetic risk factors for ME/CFS identified using combinatorial analysis. J Transl Med 2022; 20:598. [PMCID: PMC9749644 DOI: 10.1186/s12967-022-03815-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 12/07/2022] [Indexed: 12/15/2022] Open
Abstract
Abstract
Background
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating chronic disease that lacks known pathogenesis, distinctive diagnostic criteria, and effective treatment options. Understanding the genetic (and other) risk factors associated with the disease would begin to help to alleviate some of these issues for patients.
Methods
We applied both GWAS and the PrecisionLife combinatorial analytics platform to analyze ME/CFS cohorts from UK Biobank, including the Pain Questionnaire cohort, in a case–control design with 1000 cycles of fully random permutation. Results from this study were supported by a series of replication and cohort comparison experiments, including use of disjoint Verbal Interview CFS, post-viral fatigue syndrome and fibromyalgia cohorts also derived from UK Biobank, and compared results for overlap and reproducibility.
Results
Combinatorial analysis revealed 199 SNPs mapping to 14 genes that were significantly associated with 91% of the cases in the ME/CFS population. These SNPs were found to stratify by shared cases into 15 clusters (communities) made up of 84 high-order combinations of between 3 and 5 SNPs. p-values for these communities range from 2.3 × 10–10 to 1.6 × 10–72. Many of the genes identified are linked to the key cellular mechanisms hypothesized to underpin ME/CFS, including vulnerabilities to stress and/or infection, mitochondrial dysfunction, sleep disturbance and autoimmune development. We identified 3 of the critical SNPs replicated in the post-viral fatigue syndrome cohort and 2 SNPs replicated in the fibromyalgia cohort. We also noted similarities with genes associated with multiple sclerosis and long COVID, which share some symptoms and potentially a viral infection trigger with ME/CFS.
Conclusions
This study provides the first detailed genetic insights into the pathophysiological mechanisms underpinning ME/CFS and offers new approaches for better diagnosis and treatment of patients.
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Morris EE, Howell MJ, Pickup E, Iber C, Wang SG. Pediatric sleep and pain: etiologies, consequences, and clinical considerations. J Clin Sleep Med 2022; 18:2281-2289. [PMID: 35499282 PMCID: PMC9435332 DOI: 10.5664/jcsm.10008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 03/31/2022] [Accepted: 03/31/2022] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES To examine current evidence of the relationship between sleep and pain from the neonatal period through adolescence. This review serves as a critical review of the literature and of the needs for future research on pediatric sleep and pain. METHODS The PubMed online database was queried from January 1, 1960, to March 1, 2020, producing 149 articles applicable to pain and sleep in the pediatric population. Of those, 97 articles were cited in this review with the key articles including over 3800 participants. RESULTS The pediatric literature supports the relationship between poor sleep (both sleep efficiency and nighttime awakenings) and subsequent risk for pain, especially among children with chronic disease. The reverse effect of pain on sleep is not yet well delineated. The key moderating factors explored in the literature are pharmacologic and nonpharmacologic therapies, psychologic health, and the etiology of pain. There is evidence that both altered sleep and pain early in life impact neurodevelopment, as seen by changes in sleep structure in clinical studies and alterations in brain development in animal models. CONCLUSIONS The complicated relationship between sleep and pain is critically important during pediatric development when alterations to a normal sleep structure can have a lifelong impact. It is becoming clear that sleep deprivation and poor sleep quality exacerbate pain. Further research is needed into the complex alterations of sleep in chronic pain conditions as well as treatments to improve sleep in pediatric care. CITATION Morris EE, Howell MJ, Pickup E, Iber C, Wang SG. Pediatric sleep and pain: etiologies, consequences, and clinical considerations. J Clin Sleep Med. 2022;18(9):2281-2289.
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Affiliation(s)
- Erin E. Morris
- Department of Pediatrics, University of Minnesota–Twin Cities, Minneapolis, Minnesota
| | - Michael J. Howell
- Department of Neurology, University of Minnesota–Twin Cities, Minneapolis, Minnesota
| | - Elizabeth Pickup
- Pediatric Neurology, Children’s National Hospital, Washington, DC
| | - Conrad Iber
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, University of Minnesota–Twin Cities, Minneapolis, Minnesota
| | - Sonya G. Wang
- Department of Pediatrics, University of Minnesota–Twin Cities, Minneapolis, Minnesota
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Lawrence A, Khataniar H, Joseph S, Nagarajan T, Umesh S, Michael Raj A J. Sleep impairment: Is it an overlooked burden in painful diabetic peripheral neuropathy? A single-centre, cross-sectional study from south India. Diabetes Metab Syndr 2022; 16:102568. [PMID: 35926431 DOI: 10.1016/j.dsx.2022.102568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/22/2022] [Accepted: 07/06/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Painful diabetic peripheral neuropathy (PDPN) is a common complication of type 2 diabetes. The unrelenting pain associated with PDPN adversely affects a patient's quality of life. Recognizing the crucial role that sleep plays in the metabolic control of diabetes, this study aims to estimate the prevalence of sleep impairment in painful diabetic peripheral neuropathy (PDPN) and identify the factors associated with it. METHODS We conducted a cross-sectional study among 156 patients in a tertiary care hospital in south India. We recruited consenting adults with PDPN. Sleep quality was analyzed using the Pittsburg sleep quality index (PSQI), a self-rating scale. Hba1c served as a measure of glycemic control. Anxiety and depression were assessed using the hospital anxiety and depression (HAD) scale. Data were analyzed in SPSS 26.0. RESULTS A total of 156 patients were included in the study with a mean age of 58.39 ± 9.12 years. In 151 (96.79%) patients demonstrated sleep impairment with a global PSQI score of 10.92 ± 2.87. Female sex, ischemic heart disease (IHD), high anxiety levels and use of insulin, pregabapentin, and duloxetine; were significantly associated with poor sleep quality (p < 0.05). The median Hba1c was high (9% [7.46-11.1]). However, there was no statistical correlation between the degree of sleep impairment and glycemic control. CONCLUSION We found a high prevalence of sleep impairment in patients with PDPN. Female sex, IHD, high anxiety levels and use of neuropathic drugs were predictors of poor sleep quality.
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Affiliation(s)
- Adlin Lawrence
- St. Johns Medical College and Hospital, Bengaluru, Karnataka, India
| | | | - Sinimol Joseph
- St. Johns Medical College and Hospital, Bengaluru, Karnataka, India
| | - Thenmozhi Nagarajan
- Department of Internal Medicine, St. Johns Medical College and Hospital, Bengaluru, Karnataka, India
| | - Soumya Umesh
- Department of Internal Medicine, St. Johns Medical College and Hospital, Bengaluru, Karnataka, India.
| | - John Michael Raj A
- Department of Biostatistics, St. Johns Medical College and Hospital, Bengaluru, Karnataka, India
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12
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Cáceda R, Kim DJ, Carbajal JM, Hou W. The Experience of Pain is Strongly Associated With Poor Sleep Quality and Increased Risk for Suicide. Arch Suicide Res 2022; 26:1572-1586. [PMID: 34126041 DOI: 10.1080/13811118.2021.1939208] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Effective suicide prevention is hindered by a limited understanding of the neurobiology leading to suicide. We aimed to examine the association between changes in the experience of pain and disturbances in sleep quantity and quality in patients with elevated risk for suicide. METHODS Three groups of adult depressed individuals, including patients following a recent suicide attempt (n = 79), patients experiencing current suicidal ideation (n = 131), and patients experiencing depression but no suicidal ideation or behavior in at least 6 months (n = 51), were examined in a case-control study for sleep quantity and quality, physical and psychological pain, pressure pain threshold, suicidal ideation, and recent suicidal behavior. RESULTS Sleep quality, physical and psychological pain were positively associated with suicidal ideation severity. In both cases in which sleep quality was added to a model with either physical or psychological pain, physical or psychological pain became more significantly associated with suicidal ideation severity. Pressure pain threshold was elevated in patients suffering from any type of insomnia. There was no significant association between pressure pain threshold and suicidal ideation severity. CONCLUSIONS The impact of these findings lies in the identification of both psychological and physical pain, and sleep quality as potential biological mechanisms underlying suicidal risk. HIGHLIGHTSWe assessed the association between pain and sleep quality in suicidal patients.Sleep quality, physical and psychological pain were associated with suicide risk.Pain perception may mediate the progression to suicidal behavior.
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13
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Kim M, Min EJ, Liu K, Yan J, Saykin AJ, Moore JH, Long Q, Shen L. Multi-task learning based structured sparse canonical correlation analysis for brain imaging genetics. Med Image Anal 2022; 76:102297. [PMID: 34871929 PMCID: PMC8792314 DOI: 10.1016/j.media.2021.102297] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 09/08/2021] [Accepted: 10/29/2021] [Indexed: 02/03/2023]
Abstract
The advances in technologies for acquiring brain imaging and high-throughput genetic data allow the researcher to access a large amount of multi-modal data. Although the sparse canonical correlation analysis is a powerful bi-multivariate association analysis technique for feature selection, we are still facing major challenges in integrating multi-modal imaging genetic data and yielding biologically meaningful interpretation of imaging genetic findings. In this study, we propose a novel multi-task learning based structured sparse canonical correlation analysis (MTS2CCA) to deliver interpretable results and improve integration in imaging genetics studies. We perform comparative studies with state-of-the-art competing methods on both simulation and real imaging genetic data. On the simulation data, our proposed model has achieved the best performance in terms of canonical correlation coefficients, estimation accuracy, and feature selection accuracy. On the real imaging genetic data, our proposed model has revealed promising features of single-nucleotide polymorphisms and brain regions related to sleep. The identified features can be used to improve clinical score prediction using promising imaging genetic biomarkers. An interesting future direction is to apply our model to additional neurological or psychiatric cohorts such as patients with Alzheimer's or Parkinson's disease to demonstrate the generalizability of our method.
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Affiliation(s)
- Mansu Kim
- Department of Artificial Intelligence, Catholic University of Korea, Bucheon, Republic of Korea
| | - Eun Jeong Min
- College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Kefei Liu
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, PA, USA
| | - Jingwen Yan
- School of Informatics and Computing, Indiana University, IN, USA
| | | | - Jason H Moore
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, PA, USA
| | - Qi Long
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, PA, USA
| | - Li Shen
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, PA, USA.
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Gryzło B, Zaręba P, Malawska K, Mazur G, Rapacz A, Ła̧tka K, Höfner GC, Latacz G, Bajda M, Sałat K, Wanner KT, Malawska B, Kulig K. Novel Functionalized Amino Acids as Inhibitors of GABA Transporters with Analgesic Activity. ACS Chem Neurosci 2021; 12:3073-3100. [PMID: 34347423 PMCID: PMC8397297 DOI: 10.1021/acschemneuro.1c00351] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
![]()
Neuropathic pain
resistance to pharmacotherapy has encouraged researchers
to develop effective therapies for its treatment. γ-Aminobutyric
acid (GABA) transporters 1 and 4 (mGAT1 and mGAT4) have been increasingly
recognized as promising drug targets for neuropathic pain (NP) associated
with imbalances in inhibitory neurotransmission. In this context,
we designed and synthesized new functionalized amino acids as inhibitors
of GABA uptake and assessed their activities toward all four mouse
GAT subtypes (mGAT1–4). According to the obtained results,
compounds 2RS,4RS-39c (pIC50 (mGAT4) = 5.36), 50a (pIC50 (mGAT2) = 5.43), and 56a (with moderate subtype selectivity
that favored mGAT4, pIC50 (mGAT4) = 5.04) were of particular
interest and were therefore evaluated for their cytotoxic and hepatotoxic
effects. In a set of in vivo experiments, both compounds 50a and 56a showed antinociceptive properties
in three rodent models of NP, namely, chemotherapy-induced neuropathic
pain models (the oxaliplatin model and the paclitaxel model) and the
diabetic neuropathic pain model induced by streptozotocin; however
compound 56a demonstrated predominant activity. Since
impaired motor coordination is also observed in neuropathic pain conditions,
we have pointed out that none of the test compounds induced motor
deficits in the rotarod test.
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Affiliation(s)
- Beata Gryzło
- Faculty of Pharmacy, Jagiellonian University Medical College, 9 Medyczna Street, 30-688 Kraków, Poland
| | - Paula Zaręba
- Faculty of Pharmacy, Jagiellonian University Medical College, 9 Medyczna Street, 30-688 Kraków, Poland
| | - Katarzyna Malawska
- Faculty of Pharmacy, Jagiellonian University Medical College, 9 Medyczna Street, 30-688 Kraków, Poland
| | - Gabriela Mazur
- Faculty of Pharmacy, Jagiellonian University Medical College, 9 Medyczna Street, 30-688 Kraków, Poland
| | - Anna Rapacz
- Faculty of Pharmacy, Jagiellonian University Medical College, 9 Medyczna Street, 30-688 Kraków, Poland
| | - Kamil Ła̧tka
- Faculty of Pharmacy, Jagiellonian University Medical College, 9 Medyczna Street, 30-688 Kraków, Poland
| | - Georg C. Höfner
- Department of Pharmacy, Center for Drug Research, Ludwig-Maximilians-Universität München Butenandtstraße 5-13, 81377 Munich, Germany
| | - Gniewomir Latacz
- Faculty of Pharmacy, Jagiellonian University Medical College, 9 Medyczna Street, 30-688 Kraków, Poland
| | - Marek Bajda
- Faculty of Pharmacy, Jagiellonian University Medical College, 9 Medyczna Street, 30-688 Kraków, Poland
| | - Kinga Sałat
- Faculty of Pharmacy, Jagiellonian University Medical College, 9 Medyczna Street, 30-688 Kraków, Poland
| | - Klaus T. Wanner
- Department of Pharmacy, Center for Drug Research, Ludwig-Maximilians-Universität München Butenandtstraße 5-13, 81377 Munich, Germany
| | - Barbara Malawska
- Faculty of Pharmacy, Jagiellonian University Medical College, 9 Medyczna Street, 30-688 Kraków, Poland
| | - Katarzyna Kulig
- Faculty of Pharmacy, Jagiellonian University Medical College, 9 Medyczna Street, 30-688 Kraków, Poland
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15
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Kang D, Hesam-Shariati N, McAuley JH, Alam M, Trost Z, Rae CD, Gustin SM. Disruption to normal excitatory and inhibitory function within the medial prefrontal cortex in people with chronic pain. Eur J Pain 2021; 25:2242-2256. [PMID: 34242465 DOI: 10.1002/ejp.1838] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Growing evidence indicates a link between changes in the medial prefrontal cortex and the pathophysiology of chronic pain. In particular, chronic pain is associated with altered medial prefrontal anatomy and biochemistry. Due to the comorbid affective disorders seen across all pain conditions, the medial prefrontal cortex is a region of significance as it is involved in emotional processing. We have recently reported that a decrease in medial prefrontal N-acetylaspartate and glutamate is associated with increased emotional dysregulation, indicating there are neurotransmitter imbalances in chronic pain. Therefore, we compared medial prefrontal neurochemistry in 24 people with chronic pain conditions to 24 age and sex-matched healthy controls with no history of chronic pain. METHOD GABA-edited MEGA-PRESS was used to measure GABA+ levels, and short TE PRESS was used to measure glutamate levels in the medial prefrontal cortex. Psychometric measures regarding pain intensity a week before scanning, during the scan and the total duration of chronic pain, were also recorded and compared to measured GABA+ and glutamate levels. RESULTS This study reveals that the presence of chronic pain is associated with significant decreases in medial prefrontal GABA+ and glutamate. These findings support the hypothesis that chronic pain is associated with altered medial prefrontal biochemistry. CONCLUSION The dysregulation of glutamatergic and GABAergic neurotransmitter systems supports a model of disinhibition of chronic pain, which may play a key role in both the experience of persistent pain and its associated affective disturbances. SIGNIFICANCE This study reveals a significant reduction in γ-aminobutyric acid (GABA+ ) and glutamate within the medial prefrontal cortex in chronic pain sufferers. While the current findings should be considered with reference to a small sample size, the disruption to normal excitatory and inhibitory medial prefrontal cortex function may be key in the development and maintenance of chronic pain and comorbid mental health disorders.
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Affiliation(s)
- David Kang
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, NSW, Australia
| | - Negin Hesam-Shariati
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, NSW, Australia.,School of Psychology, University of New South, Sydney, NSW, Australia
| | - James H McAuley
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, NSW, Australia.,School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Monzurul Alam
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, NSW, Australia.,School of Psychology, University of New South, Sydney, NSW, Australia
| | - Zina Trost
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Sylvia M Gustin
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, NSW, Australia.,School of Psychology, University of New South, Sydney, NSW, Australia
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16
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Adjuvant use of melatonin for relieving symptoms of painful diabetic neuropathy: results of a randomized, double-blinded, controlled trial. Eur J Clin Pharmacol 2021; 77:1649-1663. [PMID: 34121140 DOI: 10.1007/s00228-021-03170-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 06/02/2021] [Indexed: 01/18/2023]
Abstract
PURPOSE The trial aimed to investigate the effectiveness of exogenous melatonin as an adjuvant to pregabalin for relief of pain in patients suffering from painful diabetic neuropathy (PDN). PATIENTS AND METHODS This randomized, double-blind, placebo-controlled trial was carried out between October 2019 and December 2020 in an outpatient specialty clinic in Iran. One-hundred-three type 2 diabetic patients suffering from PDN were randomized into either the melatonin group (n = 52) or the placebo group (n = 51). Besides pregabalin at a dose of 150 mg per day, patients started with melatonin or an identical placebo, at a dose of 3 mg/day at bedtime for 1 week, which was augmented to 6 mg/day for further 7 weeks. The primary outcomes were changes in mean NRS (numerical rating scale) pain score from baseline to endpoint and responder rate (patients with a reduction of 50% and higher in average pain score compared with baseline). Secondary endpoints were changes in mean NRS pain-related sleep-interference score, overall improvement evaluated by Patient and Clinical Global Impressions of Change (PGIC, CGIC), and impact of the intervention on patient's Health-related quality of life (QOL). All analyses were conducted on an Intention-to-Treat (ITT) analysis data set. RESULTS At the study endpoint, treatment with melatonin resulted in a considerably higher reduction in the mean NRS pain score in comparison with placebo (4.2 ± 1.83 vs. 2.9 ± 1.56; P-value < 0.001). In terms of treatment responders, a greater proportion of melatonin-treated patients satisfied the responder criterion than placebo-treated patients (63.5% vs. 43.1%). Melatonin also reduced pain-related sleep interference scores more than did placebo (3.38 ± 1.49 vs. 2.25 ± 1.26; P-value < 0.001). Further, at the endpoint, more improvement was also seen in terms of PGIC, CGIC, and Health-related QOL in patients treated with melatonin than placebo. Melatonin was also well tolerated. CONCLUSION The present results showed that melatonin as an adjunct therapy to pregabalin might be helpful for use in patients with PDN. However, confirmation of these results requires further studies.
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Deguchi R, Fujimoto M, Sekiyama H, Sawamura S. Effect of Yokukansan on sleep disturbance and neuropathic pain in chronic constriction injury using a rat model. Sleep Biol Rhythms 2021. [DOI: 10.1007/s41105-021-00315-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
AbstractPatients with chronic pain develop peripheral neuropathy and experience sleep disturbance. Yokukansan is used to treat insomnia and control neuropathic pain. We studied if Yokukansan affects neuropathic pain and sleep disturbance using a rat model of chronic constriction injury (CCI). Male Wistar rats (4-week age) were divided into the following groups (n = 7, per group): CCI rats fed normal chow (CCI-0); CCI rats fed powdered chow mixed with 1% Yokukansan (CCI-1); CCI rats fed powdered chow mixed with 3% Yokukansan (CCI-3); and sham-operated control rats fed normal chow (SHAM). We examined sleep duration and quality using electroencephalograms and assessed pain using the von Frey and Hargreaves tests. Results were analyzed by one-way analysis of variance and Bonferroni post hoc tests. The CCI-0 group exhibited an increased wake period, decreased non-rapid eye movement (REM) sleep time, and no change in REM sleep time in comparison to the SHAM group. The CCI-1 group exhibited a decreased wake period, increased non-REM sleep time, and no change in REM sleep time compared to the CCI-0 group. The CCI-3 group exhibited increased non-REM sleep time but no changes in wake and REM sleep times compared to the CCI-1 group. The von Frey and Hargreaves test findings revealed an increase in the pain threshold in the CCI-1 group compared to the CCI-0 group. There was no difference in pain threshold between the CCI-1 and CCI-3 groups. In our rat model of CCI, sleep disturbance was reflected. Yokukansan inhibited CCI-induced sleep disturbance.
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Xiao X, Ding M, Zhang YQ. Role of the Anterior Cingulate Cortex in Translational Pain Research. Neurosci Bull 2021; 37:405-422. [PMID: 33566301 PMCID: PMC7954910 DOI: 10.1007/s12264-020-00615-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 06/03/2020] [Indexed: 02/06/2023] Open
Abstract
As the most common symptomatic reason to seek medical consultation, pain is a complex experience that has been classified into different categories and stages. In pain processing, noxious stimuli may activate the anterior cingulate cortex (ACC). But the function of ACC in the different pain conditions is not well discussed. In this review, we elaborate the commonalities and differences from accumulated evidence by a variety of pain assays for physiological pain and pathological pain including inflammatory pain, neuropathic pain, and cancer pain in the ACC, and discuss the cellular receptors and signaling molecules from animal studies. We further summarize the ACC as a new central neuromodulation target for invasive and non-invasive stimulation techniques in clinical pain management. The comprehensive understanding of pain processing in the ACC may lead to bridging the gap in translational research between basic and clinical studies and to develop new therapies.
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Affiliation(s)
- Xiao Xiao
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education; Institute of Science and Technology for Brain-Inspired Intelligence, Behavioral and Cognitive Neuroscience Center, Fudan University, Shanghai, 200433, China.
| | - Ming Ding
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education; Institute of Science and Technology for Brain-Inspired Intelligence, Behavioral and Cognitive Neuroscience Center, Fudan University, Shanghai, 200433, China
| | - Yu-Qiu Zhang
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Department of Translational Neuroscience, Jing'an District Centre Hospital of Shanghai, Institutes of Brain Science; Institute of Integrative Medicine, Fudan University, Shanghai, 200032, China.
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19
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Hwang SN, Lee JS, Seo K, Lee H. Astrocytic Regulation of Neural Circuits Underlying Behaviors. Cells 2021; 10:cells10020296. [PMID: 33535587 PMCID: PMC7912785 DOI: 10.3390/cells10020296] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/23/2021] [Accepted: 01/29/2021] [Indexed: 02/07/2023] Open
Abstract
Astrocytes, characterized by a satellite-like morphology, are the most abundant type of glia in the central nervous system. Their main functions have been thought to be limited to providing homeostatic support for neurons, but recent studies have revealed that astrocytes actually actively interact with local neural circuits and play a crucial role in information processing and generating physiological and behavioral responses. Here, we review the emerging roles of astrocytes in many brain regions, particularly by focusing on intracellular changes in astrocytes and their interactions with neurons at the molecular and neural circuit levels.
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Affiliation(s)
- Sun-Nyoung Hwang
- Convergence Research Advanced Centre for Olfaction, Daegu Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988, Korea;
| | - Jae Seung Lee
- Department of Brain and Cognitive Sciences, DGIST, Daegu 42988, Korea; (J.S.L.); (K.S.)
| | - Kain Seo
- Department of Brain and Cognitive Sciences, DGIST, Daegu 42988, Korea; (J.S.L.); (K.S.)
| | - Hyosang Lee
- Convergence Research Advanced Centre for Olfaction, Daegu Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988, Korea;
- Department of Brain and Cognitive Sciences, DGIST, Daegu 42988, Korea; (J.S.L.); (K.S.)
- Korea Brain Research Institute (KBRI), Daegu 41062, Korea
- Correspondence: ; Tel.: +82-53-785-6147
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20
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Duan H, Shen F, Li L, Tu Z, Chen P, Chen P, Wang Z, Liang W, Wang Y. Activation of the Notch signaling pathway in the anterior cingulate cortex is involved in the pathological process of neuropathic pain. Pain 2021; 162:263-274. [PMID: 32701650 PMCID: PMC7737863 DOI: 10.1097/j.pain.0000000000002014] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 07/01/2020] [Accepted: 07/13/2020] [Indexed: 12/29/2022]
Abstract
Plastic changes in the anterior cingulate cortex (ACC) are critical in pain hypersensitivity caused by peripheral nerves injury. The Notch signaling pathway has been shown to regulate synaptic differentiation and transmission. Therefore, this study was to investigate the function of the Notch signaling pathway in the ACC during nociceptive transmission induced by neuropathic pain. We adopted Western blotting, N-[N-(3,5-difluorophenacetyl)-l-alanyl]-S-phenylglycine t-butyl ester (DAPT) microinjections, RNA interference targeting Notch1, Hairy and enhancer of split (Hes) 1 or Hes5, electrophysiological recordings, and behavioral tests to verify the link between Notch signaling in ACC and neuropathic pain with adult male Sprague-Dawley rats. Levels of the Notch intracellular domain were increased in ACC on day 7 after chronic constriction injury surgery or spared nerve injury. Meanwhile, the mRNA level of the downstream effector of Notch signaling Hes1 was increased, whereas the level of Hes5 mRNA did not change. Microinjection of DAPT, a γ-secretase (a key enzyme involved in Notch pathway) inhibitor, into ACC significantly reversed neuropathic pain behaviors. Intra-ACC injection of short hairpin RNA-Notch reduced Notch intracellular domain expression and decreased the potentiation of synaptic transmission in the ACC. Moreover, pain perceptions were also alleviated in rats subjected to chronic constriction injury or spared nerve injury. This process was mainly mediated by the downstream effector Hes1, but not Hes5. Based on these results, the activation of the Notch/Hes1 signaling pathway in the ACC participates in the development of neuropathic pain, indicating that the Notch pathway may be a new therapeutic target for treating chronic pain.
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Affiliation(s)
- Haifeng Duan
- Department of Anesthesiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Fengyan Shen
- Department of Anesthesiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Li Li
- Department of Anesthesiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhiyi Tu
- Department of Anesthesiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ping Chen
- Department of Anesthesiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Pei Chen
- Department of Anesthesiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Zhiru Wang
- Key Laboratory of Brain Functional Genomics-Ministry of Education, School of Life Science, East China Normal University, Shanghai, China
| | - Weimin Liang
- Department of Anesthesiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yingwei Wang
- Department of Anesthesiology, Huashan Hospital, Fudan University, Shanghai, China
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Analysis of the effects of a tricyclic antidepressant on secondary sleep disturbance induced by chronic pain in a preclinical model. PLoS One 2020; 15:e0243325. [PMID: 33270791 PMCID: PMC7714178 DOI: 10.1371/journal.pone.0243325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 11/18/2020] [Indexed: 11/28/2022] Open
Abstract
Chronic pain and sleep have a bidirectional relationship that promotes a vicious circle making chronic pain more difficult to treat. Therefore, pain and sleep should be treated simultaneously. In our previous study, we suggested that hyperactivation of ascending serotonergic neurons could cause secondary sleep disturbance in chronic pain. This study aimed to demonstrate the effects of a tricyclic antidepressant (amitriptyline) and a selective 5-hydroxy-tryptamine 2A (5-HT2A) antagonist (MDL 100907) that adjust serotonergic transmission, on secondary sleep disturbance induced in a preclinical chronic pain model. We produced a chronic neuropathic pain model by partial sciatic nerve ligation in mice, analyzed their electroencephalogram (EEG) and electromyogram (EMG) using the SleepSign software, and evaluated the sleep condition of the pain model mice after administration of amitriptyline or MDL 100907. Amitriptyline improved thermal hyperalgesia and the amount of sleep, especially non-REM sleep. Time change of normalized power density of δ wave in the nerve ligation group with amitriptyline administration showed a normal pattern that was similar to sham mice. In addition, MDL 100907 normalized sleep condition similar to amitriptyline, without improvement in pain threshold. In conclusion, amitriptyline could improve sleep quantity and quality impaired by chronic pain. 5-HT2A receptor antagonism could partially contribute to this sleep improvement, but is not associated with pain relief.
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da Silva MD, Guginski G, Sato KL, Sanada LS, Sluka KA, Santos AR. Persistent pain induces mood problems and memory loss by the involvement of cytokines, growth factors, and supraspinal glial cells. Brain Behav Immun Health 2020; 7:100118. [PMID: 34589875 PMCID: PMC8474185 DOI: 10.1016/j.bbih.2020.100118] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 07/20/2020] [Accepted: 07/23/2020] [Indexed: 12/27/2022] Open
Abstract
Lesions of peripheral nerves lead to pain, hyperalgesia, and psychological comorbidities. However, the relationship between mood disorders and neuropathic pain is unclear, as well as the underlying mechanisms related to these disorders. Therefore, we investigated if nerve injury induces depression, anxiety, and cognitive impairment and if there were changes in cytokines, growth factors, and glial cell activation in cortical sites involved in processing pain and mood in animals with nerve injury. Nerve injury was induced by partial sciatic nerve ligation (PSNL) in male Swiss mice and compared to sham-operated animals. Nociceptive behavioral tests to mechanical and thermal (heat and cold) stimuli confirmed the development of hyperalgesia. We further examined mood disorders and memory behaviors. We show nerve injury induces a decrease in mechanical withdrawal thresholds and thermal latency to heat and cold. We also show that nerve injury causes depressive-like and anxiety-like behaviors as well as impairment in short-term memory in mice. There were increases in proinflammatory cytokines as well as Brain-Derived Neurotrophic Factor (BDNF) in the injured nerve. In the spinal cord, there were increases in both pro and anti-inflammatory cytokines, as well as of BDNF and Nerve Growth Factor (NGF). Further, in our data was a decrease in the density of microglia and astrocytes in the hippocampus and increased microglial density in the prefrontal cortex, areas associated with neuropathic pain conditions.
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Affiliation(s)
- Morgana D. da Silva
- Laboratory of Neurobiology of Pain and Inflammation, Department of Physiological Sciences, Center for Biological Sciences, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, SC, 88040-900, Brazil
- Program of Pos-graduation in Neuroscience, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, SC, 88040-900, Brazil
| | - Giselle Guginski
- Department of Pharmacology, Center of Biological Sciences, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, SC, 88040-900, Brazil
| | - Karina L. Sato
- Department of Physical Therapy and Rehabilitation Science, Pain Research Program, University of Iowa, #1-252 MEB, Iowa City, IA, 52241, USA
| | - Luciana Sayuri Sanada
- Department of Physical Therapy and Rehabilitation Science, Pain Research Program, University of Iowa, #1-252 MEB, Iowa City, IA, 52241, USA
| | - Kathleen A. Sluka
- Department of Physical Therapy and Rehabilitation Science, Pain Research Program, University of Iowa, #1-252 MEB, Iowa City, IA, 52241, USA
| | - Adair R.S. Santos
- Laboratory of Neurobiology of Pain and Inflammation, Department of Physiological Sciences, Center for Biological Sciences, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, SC, 88040-900, Brazil
- Program of Pos-graduation in Neuroscience, Federal University of Santa Catarina, University Campus, Trindade, Florianópolis, SC, 88040-900, Brazil
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Nascimento GC, de Paula BB, Lowry CA, Leite-Panissi CRA. Temporomandibular inflammation mobilizes parvalbumin and FosB/deltaFosB neurons of amygdala and dorsal raphe. ACTA ACUST UNITED AC 2020; 53:e9950. [PMID: 32578721 PMCID: PMC7307894 DOI: 10.1590/1414-431x20209950] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 05/04/2020] [Indexed: 11/21/2022]
Abstract
Pathophysiological mechanisms involved in orofacial pain and their relationship with emotional disorders have emerged as an important research area for multidisciplinary studies. In particular, temporomandibular disorders (TMD) have been evaluated clinically from both physiological and psychological perspectives. We hypothesized that an altered neuronal activity occurs in the amygdala and the dorsal raphe nucleus (DR), encephalic regions involved in the modulation of painful and emotional information. Adult male Wistar rats were used in an experimental complete Freund's adjuvant (CFA)-induced temporomandibular joint (TMJ) inflammation model. CFA was applied for 1 or 10 days, and the animals were euthanized for brain samples dissection for FosB/ΔFosB and parvalbumin (PV) immunostaining. Our results were consistent in showing that the amygdala and DR were activated in the persistent inflammatory phase (10 days) and that the expression of PV+ interneurons in the amygdala was decreased. In contrast, in the DR, the expression of PV+ interneurons was increased in persistent states of CFA-induced TMJ inflammation. Moreover, at 10 days of inflammation, there was an increased co-localization of PV+ and FosB/ΔFosB+ neurons in the basolateral and central nucleus of the amygdala. Different nuclei of the amygdala, as well as portions of the DR, were activated in the persistent phase (10 days) of TMJ inflammation. In conclusion, altered activity of the amygdala and DR was detected during persistent inflammatory nociception in the temporomandibular joint. These regions may be essential for both sensory and affective dimensions of orofacial pain.
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Affiliation(s)
- G C Nascimento
- Departamento de Fisiologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - B B de Paula
- Departamento de Psicologia, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - C A Lowry
- Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - C R A Leite-Panissi
- Departamento de Psicologia, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Zaręba P, Gryzło B, Malawska K, Sałat K, Höfner GC, Nowaczyk A, Fijałkowski Ł, Rapacz A, Podkowa A, Furgała A, Żmudzki P, Wanner KT, Malawska B, Kulig K. Novel mouse GABA uptake inhibitors with enhanced inhibitory activity toward mGAT3/4 and their effect on pain threshold in mice. Eur J Med Chem 2020; 188:111920. [DOI: 10.1016/j.ejmech.2019.111920] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 11/16/2019] [Accepted: 11/27/2019] [Indexed: 12/12/2022]
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Dopamine D 1 and D 2 receptors mediate analgesic and hypnotic effects of l-tetrahydropalmatine in a mouse neuropathic pain model. Psychopharmacology (Berl) 2019; 236:3169-3182. [PMID: 31172225 DOI: 10.1007/s00213-019-05275-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 05/10/2019] [Indexed: 12/21/2022]
Abstract
RATIONALE Levo-tetrahydropalmatine (l-THP), an active ingredient of Corydalis yanhusuo, has been reported to be a partial agonist for dopamine D1 receptors (D1R) and an antagonist for D2R. Although it has been safely used clinically in China for decades as an analgesic with sedative/hypnotic properties, there are few studies that address the mechanisms by which l-THP exerts its beneficial effects in chronic pain-induced sleep disturbance. OBJECTIVES To investigate the effects and mechanisms of l-THP on sleep disturbance in a neuropathic pain-like condition. METHODS A mouse model of chronic neuropathic pain induced by partial sciatic nerve ligation (PSNL) was employed. The antinociceptive and hypnotic effects of l-THP were evaluated by measurement of mechanical allodynia, thermal hyperalgesia, and electroencephalogram (EEG) recordings in PSNL mice. Pharmacological approaches and c-Fos expression were used to clarify the mechanisms of l-THP. RESULTS Intraperitoneal injection of l-THP at 5 and 10 mg/kg not only significantly increased the mechanical threshold by 134.4% and 174.8%, and prolonged the thermal latency by 49.4% and 69.2%, but also increased non-rapid eye movement sleep by 17.5% and 29.6%, and decreased sleep fragmentation in PSNL mice, compared with the vehicle control. Moreover, the antinociceptive effect of l-THP was prevented by D1R antagonist SCH23390 or D2R agonist quinpirole; meanwhile, the hypnotic effect of l-THP was blocked by quinpirole rather than by SCH23390. Immunohistochemistry demonstrated that l-THP inhibited c-Fos overexpression induced by PSNL in the cingulate cortex and the periaqueductal gray. CONCLUSIONS These findings indicated that l-THP exerted analgesic effects by agonism D1R and antagonism D2R, and the antagonism of D2R mediated the hypnotic effect of l-THP in PSNL mice.
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Juarez-Salinas DL, Braz JM, Etlin A, Gee S, Sohal V, Basbaum AI. GABAergic cell transplants in the anterior cingulate cortex reduce neuropathic pain aversiveness. Brain 2019; 142:2655-2669. [PMID: 31321411 PMCID: PMC6752168 DOI: 10.1093/brain/awz203] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 03/18/2019] [Accepted: 05/12/2019] [Indexed: 01/09/2023] Open
Abstract
Dysfunction of inhibitory circuits in the rostral anterior cingulate cortex underlies the affective (aversive), but not the sensory-discriminative features (hypersensitivity) of the pain experience. To restore inhibitory controls, we transplanted inhibitory interneuron progenitor cells into the rostral anterior cingulate cortex in a chemotherapy-induced neuropathic pain model. The transplants integrated, exerted a GABA-A mediated inhibition of host pyramidal cells and blocked gabapentin preference (i.e. relieved ongoing pain) in a conditioned place preference paradigm. Surprisingly, pain aversiveness persisted when the transplants populated both the rostral and posterior anterior cingulate cortex. We conclude that selective and long lasting inhibition of the rostral anterior cingulate cortex, in the mouse, has a profound pain relieving effect against nerve injury-induced neuropathic pain. However, the interplay between the rostral and posterior anterior cingulate cortices must be considered when examining circuits that influence ongoing pain and pain aversiveness.
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Affiliation(s)
| | - Joao M Braz
- Department Anatomy, University California San Francisco, San Francisco, CA, USA
| | - Alexander Etlin
- Department Anatomy, University California San Francisco, San Francisco, CA, USA
| | - Steven Gee
- Department Psychiatry, University California San Francisco, San Francisco, CA, USA
| | - Vikaas Sohal
- Department Psychiatry, University California San Francisco, San Francisco, CA, USA
| | - Allan I Basbaum
- Department Anatomy, University California San Francisco, San Francisco, CA, USA
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Altiparmak B, Cil H, Celebi N. Efeito da melatonina sobre o efeito colateral de sonolência diurna da gabapentina em pacientes adultos com dor neuropática. Braz J Anesthesiol 2019; 69:137-143. [DOI: 10.1016/j.bjan.2018.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 08/02/2018] [Accepted: 08/21/2018] [Indexed: 12/28/2022] Open
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Altiparmak B, Cil H, Celebi N. Effect of melatonin on the daytime sleepiness side-effect of gabapentin in adults patients with neuropathic pain. BRAZILIAN JOURNAL OF ANESTHESIOLOGY (ENGLISH EDITION) 2019. [PMID: 30454846 PMCID: PMC9391827 DOI: 10.1016/j.bjane.2018.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Background and objectives Gabapentin is an antiepileptic drug. Widely used for the management of neuropathic pain. Although it is known to be well tolerated, somnolence and dizziness are the most frequent adverse effects. In this study, we aimed to evaluate the effect of melatonin on daytime sleepiness side effect of gabapentin, sleep quality and pain intensity of patients with neuropathic pain. Methods Patients suffering from “neuropathic pain” and planed to receive gabapentin therapy were randomly divided into two groups. Group 1 received melatonin 3 mg and gabapentin 900 mg orally, group 2 received matching placebo capsule and gabapentin 900 mg. The Epworth Sleepiness Scale, the Pittsburgh sleep quality index for assessment of sleep quality and Verbal Rating Scale were completed at the 0th, 10th and 30th days of treatment. Additive analgesic drug requirements were recorded. Results Eighty patients were enrolled to the study; age, gender, ratio of additive analgesic consumption, baseline Epworth Sleepiness Scale, Pittsburg Sleep Quality index and Verbal Rating Scale scores were similar between the groups. Epworth Sleepiness Scale scores, Pittsburgh sleep quality index scores and Verbal Rating Scale scores in Group 1 were significantly lower than group 2 at the 10th day of treatment (p = 0.002, p = 0.003, p = 0.002 respectively). At the 30th day of treatment, Epworth Sleepiness Scale scores and Verbal Rating Scale scores were significantly lower in Group 1 (p = 0.002, p = 0.008 respectively). However, Pittsburgh sleep quality index scores did not significantly differ between the groups (p = 0.0566). Conclusions Melatonin supplementation rapidly and significantly improved daytime sleepiness side-effect of gabapentin, however sleep quality of the patients with neuropathic pain was similar between groups.
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Affiliation(s)
- Basak Altiparmak
- Mugla Sitki Kocman University, Department of Anesthesiology and Reanimation, Mugla, Turquia.
| | - Hemra Cil
- University of California, Department of Orthopedics and Traumatology, San Francisco, Estados Unidos
| | - Nalan Celebi
- Hacettepe University, Department of Anesthesiology and Reanimation, Ankara, Turquia
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Brouwer BA, van Kuijk SMJ, Bouwhuis A, Faber CG, van Kleef M, Merkies ISJ, Hoeijmakers JGJ. The Pain Dynamics of Small Fiber Neuropathy. THE JOURNAL OF PAIN 2018; 20:655-663. [PMID: 30529697 DOI: 10.1016/j.jpain.2018.11.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 10/25/2018] [Accepted: 11/13/2018] [Indexed: 01/19/2023]
Abstract
Pain is a central feature in small fiber neuropathy (SFN), with only moderate effects of pharmacologic treatment. The evaluation of the efficacy of therapies on pain has been driven by static measures, and a circadian cycle has been suggested. The aim of this study is to evaluate the pain dynamics in SFN. A total of 165 patients completed a standardized pain diary 4 times per week over a 4-week period. Patients used the 11-point numeric rating scale for average diurnal, nocturnal, and maximum pain, taking into account the circumstances in which pain emerged most. Medication used, SFN-related complaints, sleep quality, and anatomic location of pain were also assessed. Neuropathic pain showed a length-dependent pattern. For pain intensity, marginal higher pain scores at night than during the day were shown, likely not clinically meaningful, with stable lower pain intensities in weekends compared with weekdays. The average pain intensity was stable during the 4-week period. Maximum pain was experienced mainly at rest and during sleep. Besides, pain intensity at night showed an inverse relationship with quality of sleep. In conclusion, for trials in SFN it is justified to use pain scores from any time of the day during short measurement periods. PERSPECTIVE: This article presents for the first time the pain dynamics of SFN. The effect of pharmacologic treatment in SFN is often disappointing, partly owing to insufficient trial designs. The results of this study have added value in the development of new proper clinical trials in SFN.
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Affiliation(s)
| | - Sander M J van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center+, 6202 AZ Maastricht, the Netherlands
| | - Anne Bouwhuis
- Department of Anesthesiology, VU University Medical Center, 1081 HV Amsterdam, the Netherlands
| | - Catharina G Faber
- Department of Neurology, Maastricht University Medical Center+, 6202 AZ Maastricht, the Netherlands
| | | | - Ingemar S J Merkies
- Department of Neurology, Maastricht University Medical Center+, 6202 AZ Maastricht, the Netherlands; Department of Neurology, St. Elisabeth Hospital, Willemstad, Curaçao
| | - Janneke G J Hoeijmakers
- Department of Neurology, Maastricht University Medical Center+, 6202 AZ Maastricht, the Netherlands.
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Kuthati Y, Lin SH, Chen IJ, Wong CS. Melatonin and their analogs as a potential use in the management of Neuropathic pain. J Formos Med Assoc 2018; 118:1177-1186. [PMID: 30316678 DOI: 10.1016/j.jfma.2018.09.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 08/02/2018] [Accepted: 09/19/2018] [Indexed: 12/14/2022] Open
Abstract
Melatonin (N-acetyl-5-methoxytryptamine), secreted by the pineal gland is known to perform multiple functions including, antioxidant, anti-hypertensive, anti-cancerous, immunomodulatory, sedative and tranquilizing functions. Melatonin is also known to be involved in the regulation of body mass index, control the gastrointestinal system and play an important role in cardioprotection, thermoregulation, and reproduction. Recently, several studies have reported the efficacy of Melatonin in treating various pain syndromes. The current paper reviews the studies on Melatonin and its analogs, particularly in Neuropathic pain. Here, we first briefly summarized research in preclinical studies showing the possible mechanisms through which Melatonin and its analogs induce analgesia in Neuropathic pain. Second, we reviewed research indicating the role of Melatonin in attenuating analgesic tolerance. Finally, we discussed the recent studies that reported novel Melatonin agonists, which were proven to be effective in treating Neuropathic pain.
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Affiliation(s)
- Yaswanth Kuthati
- Department of Anesthesiology, Cathay General Hospital, Taipei, Taiwan
| | - Sheng-Hsiung Lin
- Planning and Management Office, Tri-Service General Hospital, National Defense Medical Center, Taiwan
| | - Ing-Jung Chen
- Department of Anesthesiology, Cathay General Hospital, Taipei, Taiwan
| | - Chih-Shung Wong
- Department of Anesthesiology, Cathay General Hospital, Taipei, Taiwan; Planning and Management Office, Tri-Service General Hospital, National Defense Medical Center, Taiwan; Institute of Medical Sciences, National Defense Medical Center, Taiwan; Department of Anesthesiology, Tri-Service General Hospital, Taiwan.
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Kang D, McAuley JH, Kassem MS, Gatt JM, Gustin SM. What does the grey matter decrease in the medial prefrontal cortex reflect in people with chronic pain? Eur J Pain 2018; 23:203-219. [PMID: 30101509 DOI: 10.1002/ejp.1304] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 08/05/2018] [Accepted: 08/07/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND OBJECTIVE Alterations in the grey matter volume of several brain regions have been reported in people with chronic pain. The most consistent observation is a decrease in grey matter volume in the medial prefrontal cortex. These findings are important as the medial prefrontal cortex plays a critical role in emotional and cognitive processing in chronic pain. Although a logical cause of grey matter volume decrease may be neurodegeneration, this is not supported by the current evidence. Therefore, the purpose of this review was to evaluate the existing literature to unravel what the decrease in medial prefrontal cortex grey matter volume in people with chronic pain may represent on a biochemical and cellular level. DATABASES AND DATA TREATMENT A literature search for this topical review was conducted using PubMed and SCOPUS library. Search terms included chronic pain, pain, medial prefrontal cortex, anterior cingulate cortex, grey matter, neurochemistry, spectroscopy, magnetic resonance imaging, positron emission tomography, dendrite, neurodegeneration, glia, astrocyte, microglia, neurotransmitter, glutamate, GABA and different combinations of these terms. RESULTS Adopting a stress model of chronic pain, two major pathways are proposed that contribute to grey matter volume decrease in the medial prefrontal cortex: (a) changes in dendritic morphology as a result of hypothalamic-pituitary axis dysfunction and (b) neurotransmitter dysregulation, specifically glutamate and γ-Aminobutyric acid, which affects local microvasculature. CONCLUSION Our model proposes new mechanisms in chronic pain pathophysiology responsible for mPFC grey matter loss as alternatives to neurodegeneration. SIGNIFICANCE It is unclear what the decrease in medial prefrontal cortex grey matter volume represents in chronic pain. The most attractive reason is neurodegeneration. However, there is no evidence to support this. Our review reveals nondegenerative causes of decreased medial prefrontal grey matter to guide future research into chronic pain pathophysiology.
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Affiliation(s)
- David Kang
- Neuroscience Research Australia, Sydney, NSW, Australia.,UNSW Medicine, UNSW Sydney, Sydney, NSW, Australia
| | - James H McAuley
- Neuroscience Research Australia, Sydney, NSW, Australia.,UNSW Medicine, UNSW Sydney, Sydney, NSW, Australia
| | | | - Justine M Gatt
- Neuroscience Research Australia, Sydney, NSW, Australia.,School of Psychology, UNSW Sydney, Sydney, NSW, Australia
| | - Sylvia M Gustin
- Neuroscience Research Australia, Sydney, NSW, Australia.,School of Psychology, UNSW Sydney, Sydney, NSW, Australia
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Xiao X, Zhang YQ. A new perspective on the anterior cingulate cortex and affective pain. Neurosci Biobehav Rev 2018; 90:200-211. [DOI: 10.1016/j.neubiorev.2018.03.022] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 03/22/2018] [Accepted: 03/22/2018] [Indexed: 12/24/2022]
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Abstract
OBJECTIVE We aimed to evaluate the quality of sleep (QoS) in patients with neuropathic pain (NP) and to investigate the association between possible QoS impairment and NP characteristics. MATERIALS AND METHODS Patients with NP and controls were examined. Age, sex, NP duration, NP cause (central, peripheral, or mixed), and pain intensity (with a Likert-type scale and visual analog scale) were recorded. NP was screened with Douleur Neuropathique 4 questions (DN4), and QoS was evaluated using the Pittsburg Sleep Quality Index (PSQI). Mann-Whitney U test and regression analysis were performed to evaluate the data. RESULTS Seventy patients with NP and 30 age- and sex-matched controls were included. The mean age of the patients and controls were 45.04±10.21 years and 39.00±19.23 years, respectively. Significantly higher scores of sleep latency (p=0.002), sleep duration (p=0.003), sleep efficiency (p=0.002), sleep disturbance (p<0.000), daytime dysfunction (p=0.04), and PSQI total were observed in patients with NP than in controls (p<0.000). In addition, 80% of patients with NP and 37 % of controls were classified as having poor QoS (p<0.000). Female sex, pain intensity, and NP duration were found to be factors related to having poor QoS in patients with NP (p=0.026, p=0.006, and p<0.000, respectively). CONCLUSION In our study, 80% of patients with NP had poor QoS regardless of the NP cause. Female sex, pain severity, and NP duration were found to be factors correlated with poor QoS. Treatment strategies that target not only NP itself but also better QoS may contribute to the overall success of management.
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Affiliation(s)
| | - Ahmet Celik
- Department of Physical Medicine and Rehabilitation, Atatürk University School of Medicine, Erzurum, Turkey
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Hamada Y, Yamashita A, Tamura H, Narita M, Kuzumaki N, Narita M. Functional role of cortical astrocytes in sleep/affective dysregulation under the chronic pain: analysis by artificial control of astrocytes using optogenetics. Nihon Yakurigaku Zasshi 2016; 148:128-33. [PMID: 27581959 DOI: 10.1254/fpj.148.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Fiore NT, Austin PJ. Are the emergence of affective disturbances in neuropathic pain states contingent on supraspinal neuroinflammation? Brain Behav Immun 2016; 56:397-411. [PMID: 27118632 DOI: 10.1016/j.bbi.2016.04.012] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 04/11/2016] [Accepted: 04/22/2016] [Indexed: 12/28/2022] Open
Abstract
Neuro-immune interactions contribute to the pathogenesis of neuropathic pain due to peripheral nerve injury. A large body of preclinical evidence supports the idea that the immune system acts to modulate the sensory symptoms of neuropathy at both peripheral and central nervous system sites. The potential involvement of neuro-immune interactions in the highly debilitating affective disturbances of neuropathic pain, such as depression, anhedonia, impaired cognition and reduced motivation has received little attention. This is surprising given the widely accepted view that sickness behaviour, depression, cognitive impairment and other neuropsychiatric conditions can arise from inflammatory mechanisms. Moreover, there is a set of well-described immune-to-brain transmission mechanisms that explain how peripheral inflammation can lead to supraspinal neuroinflammation. In the last 5years increasing evidence has emerged that peripheral nerve injury induces supraspinal changes in cytokine or chemokine expression and alters glial cell activity. In this systematic review, based on strong preclinical evidence, we advance the argument that the emergence of affective disturbances in neuropathic pain states are contingent on pro-inflammatory mediators in the interconnected hippocampal-medial prefrontal circuitry that subserve affective behaviours. We explore how dysregulation of inflammatory mediators in these networks may result in affective disturbances through a wide variety of neuromodulatory mechanisms. There are also promising results from clinical trials showing that anti-inflammatory agents have efficacy in the treatment of a variety of neuropsychiatric conditions including depression and appear suited to sub-groups of patients with elevated pro-inflammatory profiles. Thus, although further research is required, aggressively targeting supraspinal pro-inflammatory mediators at critical time-points in appropriate clinical populations is likely to be a novel avenue to treat debilitating affective disturbances in neuropathic conditions.
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Affiliation(s)
- Nathan T Fiore
- Discipline of Anatomy & Histology, School of Medical Sciences, The University of Sydney, Sydney, NSW 2006, Australia
| | - Paul J Austin
- Discipline of Anatomy & Histology, School of Medical Sciences, The University of Sydney, Sydney, NSW 2006, Australia.
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Lee DH, Park JE, Yoon DM, Yoon KB, Kim K, Kim SH. Factors Associated with Increased Risk for Clinical Insomnia in Patients with Postherpetic Neuralgia: A Retrospective Cross-Sectional Study. PAIN MEDICINE 2016; 17:1917-1922. [PMID: 27073226 DOI: 10.1093/pm/pnw066] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To determine the risk factors associated with clinical insomnia in postherpetic neuralgia (PHN) patients. DESIGN A retrospective cross-sectional study. SETTING Outpatient department for interventional pain management at a university hospital. SUBJECTS A total of 111 patients with PHN satisfied the study inclusion criteria and were included in the analyses. METHODS The Insomnia Severity Index (ISI) was used to determine the presence of clinical insomnia (ISI score ≥ 15). Patient demographics, pain-related factors, and rash severity and location were evaluated with logistic regression analysis to identify risk factors of clinical insomnia among patients with PHN. RESULTS In total, 50.5% of patients reported mild to severe insomnia symptoms (ISI score ≥ 8) after pain development. Moderate to severe clinical insomnia (ISI score ≥ 15) was observed in 30.6% of PHN patients. Multivariate logistic regression analyses revealed that high pain intensity was the strongest predictor of clinical insomnia (odds ratio (OR) = 12.417, 95% confidence interval (CI): 2.990-51.561, P = 0.001). However, presence of mechanical allodynia (OR = 4.263, 95% CI: 1.040-17.481, P = 0.034) and high anxiety and depression level (OR = 4.452, 95% CI: 1.201-16.508, P = 0.026; OR = 6.975, 95% CI: 1.425-34.138, P = 0.017) were also significantly associated with clinical insomnia after adjusting for pain score. Clinical insomnia was not significantly related to age, gender, rash severity, or location of skin lesion. CONCLUSIONS Insomnia should be addressed as an important part of pain management in PHN patients with these risk factors, especially in patients with severe pain.
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Affiliation(s)
- Dong Hoon Lee
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ji Eun Park
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Duck Mi Yoon
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyung Bong Yoon
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kiwook Kim
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Shin Hyung Kim
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
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Paeoniflorin exerts analgesic and hypnotic effects via adenosine A1 receptors in a mouse neuropathic pain model. Psychopharmacology (Berl) 2016; 233:281-93. [PMID: 26514553 DOI: 10.1007/s00213-015-4108-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 10/05/2015] [Indexed: 10/22/2022]
Abstract
RATIONAL Neuropathic pain is frequently comorbid with sleep disturbances. Paeoniflorin, a main active compound of total glucosides of paeony, has been well documented to exhibit neuroprotective bioactivity. OBJECTIVE The present study evaluated effects of paeoniflorin on neuropathic pain and associated insomnia and the mechanisms involved. METHODS The analgesic and hypnotic effects of paeoniflorin were measured by mechanical threshold and thermal latency, electroencephalogram (EEG) and electromyogram, and c-Fos expression in a neuropathic pain insomnia model. RESULTS The data revealed that paeoniflorin (50 or 100 mg/kg, i.p.) significantly increased the mechanical threshold and prolonged the thermal latency in partial sciatic nerve ligation (PSNL) mice. Meanwhile, paeoniflorin increased non-rapid eye movement (NREM) sleep amount and concomitantly decreased wakefulness time. However, pretreatment with l,3-dimethy-8-cyclopenthylxanthine, an adenosine A1 receptor (R, A1R) antagonist, abolished the analgesic and hypnotic effects of paeoniflorin. Moreover, paeoniflorin at 100 mg/kg failed to change mechanical threshold and thermal latency and NREM sleep in A1R knockout PSNL mice. Immunohistochemical study showed that paeoniflorin inhibited c-Fos overexpression induced by PSNL in the anterior cingulate cortex and ventrolateral periaqueductal gray. CONCLUSIONS The present findings indicated that paeoniflorin exerted analgesic and hypnotic effects via adenosine A1Rs and might be of potential use in the treatment of neuropathic pain and associated insomnia.
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Wu YE, Li YD, Luo YJ, Wang TX, Wang HJ, Chen SN, Qu WM, Huang ZL. Gelsemine alleviates both neuropathic pain and sleep disturbance in partial sciatic nerve ligation mice. Acta Pharmacol Sin 2015; 36:1308-17. [PMID: 26388157 PMCID: PMC4635333 DOI: 10.1038/aps.2015.86] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 06/07/2015] [Indexed: 01/05/2023] Open
Abstract
Aim: Gelsemine, an alkaloid from the Chinese herb Gelsemium elegans (Gardn & Champ) Benth., is effective in mitigating chronic pain in rats. In the present study we investigated whether the alkaloid improved sleep disturbance, the most common comorbid symptoms of chronic pain, in a mouse model of neuropathic pain. Methods: Mice were subjected to partial sciatic nerve ligation (PSNL). After the mice were injected with gelsemine or pregabalin (the positive control) intraperitoneally, mechanical allodynia and thermal hyperalgesia were assessed, and electroencephalogram (EEG)/electromyogram (EMG) recording was performed. Motor performance of the mice was assessed using rota-rod test. c-Fos expression in the brain was analyzed with immunohistochemical staining. Results: In PSNL mice, gelsemine (2 and 4 mg/kg) increased the mechanical threshold for 4 h and prolonged the thermal latencies for 3 h. Furthermore, gelsemine (4 mg/kg, administered at 6:30 AM) increased non-rapid eye movement (non-REM, NREM) sleep, decreased wakefulness, but did not affect REM sleep during the first 3 h in PSNL mice. Sleep architecture analysis showed that gelsemine decreased the mean duration of wakefulness and increased the total number of episodes of NREM sleep during the first 3 h after the dosing. Gelsemine (4 mg/kg) did not impair motor coordination in PSNL mice. Immunohistochemical study showed that PSNL increased c-Fos expression in the neurons of the anterior cingulate cortex, and gelsemine (4 mg/kg) decreased c-Fos expression by 58%. Gelsemine (4 mg/kg, administered at either 6:30 AM or 8:30 PM) did not produce hypnotic effect in normal mice. Pregabalin produced similar antinociceptive and hypnotic effects, but impaired motor coordination in PSNL mice. Conclusion: Gelsemine is an effective agent for treatment of both neuropathic pain and sleep disturbance in PSNL mice; anterior cingulate cortex might play a role in the hypnotic effects of gelsemine.
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Romero-Grimaldi C, Berrocoso E, Alba-Delgado C, Madrigal JLM, Perez-Nievas BG, Leza JC, Mico JA. Stress Increases the Negative Effects of Chronic Pain on Hippocampal Neurogenesis. Anesth Analg 2015. [DOI: 10.1213/ane.0000000000000838] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Zhang Z, Gadotti V, Chen L, Souza I, Stemkowski P, Zamponi G. Role of Prelimbic GABAergic Circuits in Sensory and Emotional Aspects of Neuropathic Pain. Cell Rep 2015. [DOI: 10.1016/j.celrep.2015.07.001] [Citation(s) in RCA: 148] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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Antinociceptive and hypnotic activities of pregabalin in a neuropathic pain-like model in mice. Pharmacol Biochem Behav 2015; 135:31-9. [PMID: 25989046 DOI: 10.1016/j.pbb.2015.05.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 04/28/2015] [Accepted: 05/04/2015] [Indexed: 01/15/2023]
Abstract
To evaluate the antinociceptive and hypnotic effects of pregabalin, we established a neuropathic pain-like model in mice using partial sciatic nerve ligation (PSNL), and examined thermal hyperalgesia, mechanical allodynia, electroencephalogram, rota-rod testing, and c-Fos expression in the anterior cingulate cortex. Gabapentin was used as a reference drug in the study. Pregabalin administered i.g. at 12.5 and 25mg/kg prolonged the duration of thermal latencies by 1.4- and 1.6-fold and increased the mechanical threshold by 2.2- and 3.1-fold 3h after administration, respectively, but did not affect motor coordination in PSNL mice, compared with vehicle control. Pregabalin (12.5 and 25mg/kg) given at 6:30 increased the amount of non-rapid eye movement sleep in a 4-h period by 1.3- and 1.4-fold, respectively, in PSNL mice. However, pregabalin (25mg/kg) given at 20:30 did not alter the sleep pattern in normal mice. Immunohistochemical study showed that PSNL increased c-Fos expression in the neurons of anterior cingulate cortex by 2.1-fold, which could be reversed by pregabalin. These results indicate that pregabalin is an effective treatment for both neuropathic pain and sleep disturbance in PSNL mice.
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Kim SH, Sun JM, Yoon KB, Moon JH, An JR, Yoon DM. Risk factors associated with clinical insomnia in chronic low back pain: a retrospective analysis in a university hospital in Korea. Korean J Pain 2015; 28:137-43. [PMID: 25852836 PMCID: PMC4387459 DOI: 10.3344/kjp.2015.28.2.137] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 12/22/2014] [Accepted: 12/23/2014] [Indexed: 01/23/2023] Open
Abstract
Background Insomnia is becoming increasingly recognized as a clinically important symptom in patients with chronic low back pain (CLBP). In this retrospective study, we have determined risk factors associated with clinical insomnia in CLBP patients in a university hospital in Korea. Methods Data from four-hundred and eighty one CLBP patients was analyzed in this study. The Insomnia Severity Index (ISI) was used to determine the presence of clinical insomnia (ISI score ≥ 15). Patients' demographics and pain-related factors were evaluated by logistic regression analysis to identify risk factors of clinical insomnia in CLBP. Results It was found that 43% of patients reported mild to severe insomnia after the development of back pain. In addition, 20% of patients met the criteria for clinically significant insomnia (ISI score ≥ 15). In a stepwise multivariate analysis, high pain intensity, the presence of comorbid musculoskeletal pain and neuropathic pain components, and high level of depression were strongly associated with clinical insomnia in CLBP. Among these factors, the presence of comorbid musculoskeletal pain other than back pain was the strongest determinant, with the highest odds ratio of 8.074 (95% CI 4.250 to 15.339) for predicting clinical insomnia. Conclusions Insomnia should be addressed as an integral part of pain management in CLBP patients with these risk factors, especially in patients suffering from CLBP with comorbid musculoskeletal pain.
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Affiliation(s)
- Shin Hyung Kim
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Min Sun
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung Bong Yoon
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Joo Hwa Moon
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Rin An
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Duck Mi Yoon
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea
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Descalzi G, Ikegami D, Ushijima T, Nestler EJ, Zachariou V, Narita M. Epigenetic mechanisms of chronic pain. Trends Neurosci 2015; 38:237-46. [PMID: 25765319 DOI: 10.1016/j.tins.2015.02.001] [Citation(s) in RCA: 236] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 02/05/2015] [Accepted: 02/09/2015] [Indexed: 12/12/2022]
Abstract
Neuropathic and inflammatory pain promote a large number of persisting adaptations at the cellular and molecular level, allowing even transient tissue or nerve damage to elicit changes in cells that contribute to the development of chronic pain and associated symptoms. There is evidence that injury-induced changes in chromatin structure drive stable changes in gene expression and neural function, which may cause several symptoms, including allodynia, hyperalgesia, anxiety, and depression. Recent findings on epigenetic changes in the spinal cord and brain during chronic pain may guide fundamental advances in new treatments. Here, we provide a brief overview of epigenetic regulation in the nervous system and then discuss the still-limited literature that directly implicates epigenetic modifications in chronic pain syndromes.
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Affiliation(s)
- Giannina Descalzi
- Fishberg Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Daigo Ikegami
- Department of Pharmacology, Hoshi University School of Pharmacy and Pharmaceutical Sciences, 2-4-41 Ebara, Shinagawa-ku, Tokyo 142-8501, Japan
| | - Toshikazu Ushijima
- Division of Epigenomics, National Cancer Center Research Institute, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan; Life Science Tokyo Advanced Research Center (L-StaR), 2-4-41 Ebara, Shinagawa-ku, Tokyo 142-8501, Japan
| | - Eric J Nestler
- Fishberg Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Venetia Zachariou
- Fishberg Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| | - Minoru Narita
- Department of Pharmacology, Hoshi University School of Pharmacy and Pharmaceutical Sciences, 2-4-41 Ebara, Shinagawa-ku, Tokyo 142-8501, Japan; Life Science Tokyo Advanced Research Center (L-StaR), 2-4-41 Ebara, Shinagawa-ku, Tokyo 142-8501, Japan.
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Senba E. A key to dissect the triad of insomnia, chronic pain, and depression. Neurosci Lett 2015; 589:197-9. [DOI: 10.1016/j.neulet.2015.01.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Accepted: 01/05/2015] [Indexed: 01/01/2023]
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Ohsawa M, Yamamoto S, Ono H. [Contribution of the sensitization of supraspinal nociceptive transmission in chronic pain]. YAKUGAKU ZASSHI 2014; 134:387-95. [PMID: 24584020 DOI: 10.1248/yakushi.13-00236-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Central sensitization in the spinal cord is well known to be involved in chronic pain. Recent investigations indicated that the protein expressions involving the synaptic plasticity are changed in several brain areas under a chronic pain condition. These changes in supraspinal neural function might cause the emotional and memory dysfunction. It is also possible that these changes are involved in the chronic pain. Indeed, since the improvement of spinal and peripheral sensitization showed limited relief in the neuropathic pain, the sensitization of supraspinal nociceptive transmission might be involved in the expression of chronic pain. We recently found that intra-thalamic treatment with excitatory neurotransmitter glutamate caused hyperalgesia, which is mediated by the stimulation of glutamate N-methyl-D-aspartate (NMDA) and α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors. Moreover, intracerebroventricular treatment with gabapentin, a calcium channel alpha2delta-1 subunit blocker, attenuated the hyperalgesia in the nerve-injury model of mice. These results suggest that the sensitization of supraspinal nociceptive transmission is involved in neuropathic pain. It is also indicated that neuropathic pain is resulted from the activations of spinal glial cells. Likewise, the supraspinal glial activation was observed in the neuropathic pain. Therefore, the sensitization of supraspinal nociceptive transmission might be important for a chronic pain. In this review, we would like to discuss the possible involvement of the supraspinal sensitization in neuropathic pain and in its application for the curative treatment in chronic pain.
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Affiliation(s)
- Masahiro Ohsawa
- Laboratory of CNS Pharmacology, Graduate School of Pharmaceutical Sciences, Nagoya City University
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Liu YY, Yin D, Chen L, Qu WM, Chen CR, Laudon M, Cheng NN, Urade Y, Huang ZL. Piromelatine exerts antinociceptive effect via melatonin, opioid, and 5HT1A receptors and hypnotic effect via melatonin receptors in a mouse model of neuropathic pain. Psychopharmacology (Berl) 2014; 231:3973-85. [PMID: 24700387 DOI: 10.1007/s00213-014-3530-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Accepted: 03/04/2014] [Indexed: 10/25/2022]
Abstract
RATIONALE An effective and safe treatment of insomnia in patients with neuropathic pain remains an unmet need. Melatonin and its analogs have been shown to have both analgesic and hypnotic effects; however, capacity of them on sleep disturbance with neuropathic pain as well as the precise mechanism is unclear. OBJECTIVE The present study evaluated effects of piromelatine, a novel melatonin receptor agonist, on sleep disturbance in a neuropathic pain-like condition as well as the underlying mechanisms. METHODS A mouse model of chronic neuropathic pain induced by partial sciatic nerve ligation (PSL) was employed. The antinociceptive and hypnotic effects of piromelatine were evaluated by measurement of thermal hyperalgesia, mechanical allodynia, and electroencephalogram (EEG) recordings in PSL mice. Pharmacological approaches were used to clarify the mechanisms of action of piromelatine. RESULTS PSL significantly lowered thermal and mechanical latencies and decreased non-rapid eye movement (NREM) sleep, and PSL mice exhibited sleep fragmentation. Treatment with 25, 50, or 100 mg/kg of piromelatine significantly prolonged thermal and mechanical latencies and increased NREM sleep. Moreover, the antinociceptive effect of piromelatine was prevented by melatonin antagonist luzindole, opioid receptor antagonist naloxone, or 5HT1A receptor antagonist WAY-100635. The hypnotic effect of piromelatine was blocked by luzindole but neither by naloxone nor WAY-100635. CONCLUSIONS These data indicate that piromelatine is an effective treatment for both neuropathic pain and sleep disturbance in PSL mice. The antinociceptive effect of piromelatine is likely mediated by melatonin, opioid, and 5HT1A receptors; however, the hypnotic effect of piromelatine appears to be mediated by melatonin receptors.
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Affiliation(s)
- Yuan-Yuan Liu
- Department of Pharmacology, School of Basic Medical Sciences, Fudan University, Shanghai, 200032, China
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Stress-induced hyperalgesia. Prog Neurobiol 2014; 121:1-18. [DOI: 10.1016/j.pneurobio.2014.06.003] [Citation(s) in RCA: 159] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Revised: 05/17/2014] [Accepted: 06/29/2014] [Indexed: 12/25/2022]
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Nakahara K, Fujiwara Y, Tsukahara T, Yamagami H, Tanigawa T, Shiba M, Tominaga K, Watanabe T, Urade Y, Arakawa T. Acid reflux directly causes sleep disturbances in rat with chronic esophagitis. PLoS One 2014; 9:e106969. [PMID: 25215524 PMCID: PMC4162547 DOI: 10.1371/journal.pone.0106969] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Accepted: 08/04/2014] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND & AIMS Gastroesophageal reflux disease (GERD) is strongly associated with sleep disturbances. Proton pump inhibitor (PPI) therapy improves subjective but not objective sleep parameters in patients with GERD. This study aimed to investigate the association between GERD and sleep, and the effect of PPI on sleep by using a rat model of chronic acid reflux esophagitis. METHODS Acid reflux esophagitis was induced by ligating the transitional region between the forestomach and the glandular portion and then wrapping the duodenum near the pylorus. Rats underwent surgery for implantation of electrodes for electroencephalogram and electromyogram recordings, and they were transferred to a soundproof recording chamber. Polygraphic recordings were scored by using 10-s epochs for wake, rapid eye movement sleep, and non-rapid eye movement (NREM) sleep. To examine the role of acid reflux, rats were subcutaneously administered a PPI, omeprazole, at a dose of 20 mg/kg once daily. RESULTS Rats with reflux esophagitis presented with several erosions, ulcers, and mucosal thickening with basal hyperplasia and marked inflammatory infiltration. The reflux esophagitis group showed a 34.0% increase in wake (232.2±11.4 min and 173.3±7.4 min in the reflux esophagitis and control groups, respectively; p<0.01) accompanied by a reduction in NREM sleep during light period, an increase in sleep fragmentation, and more frequent stage transitions. The use of omeprazole significantly improved sleep disturbances caused by reflux esophagitis, and this effect was not observed when the PPI was withdrawn. CONCLUSIONS Acid reflux directly causes sleep disturbances in rats with chronic esophagitis.
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Affiliation(s)
- Kenichi Nakahara
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yasuhiro Fujiwara
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Takuya Tsukahara
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Hirokazu Yamagami
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Tetsuya Tanigawa
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Masatsugu Shiba
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Kazunari Tominaga
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Toshio Watanabe
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yoshihiro Urade
- Department of Molecular Behavioral Biology, Osaka Bioscience Institute, Suita, Japan
- Molecular Sleep Biology Laboratory, International Institute for Integrative Sleep Medicine, World Premier International Research Center, Tsukuba University, Tsukuba, Japan
| | - Tetsuo Arakawa
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
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