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Schwandt ML, Ramchandani VA, Upadhyay J, Ramsden C, Diazgranados N, Goldman D. Pain in alcohol use disorder: Evaluating effects of childhood trauma, perceived stress, and psychological comorbidity. Alcohol 2024; 117:43-54. [PMID: 38537764 PMCID: PMC11042973 DOI: 10.1016/j.alcohol.2024.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/18/2024] [Accepted: 03/24/2024] [Indexed: 04/05/2024]
Abstract
The relationship between pain and alcohol use disorder (AUD) is complex and bidirectional. The current study examines risk factors for pain in a large comprehensively phenotyped sample including individuals from across the spectrum of alcohol use and misuse. Participants (n = 1101) were drawn from the National Institute on Alcohol Abuse and Alcoholism Natural History Protocol and included treatment-seeking AUD inpatients (AUD+Tx, n = 369), individuals with AUD not seeking treatment (AUD+, n = 161), and individuals without AUD (AUD-, n = 571). General linear models were utilized to test the effects of AUD status, history of childhood trauma exposure, perceived stress, and psychological comorbidity on daily percent time in pain, as well as change in daily percent time in pain across the inpatient stay in AUD+Tx individuals. Overall, 60.2% individuals reported any pain, with a significantly higher prevalence in the AUD+Tx group (82.1%) compared to the AUD+ (56.5%) and AUD- (47.1%) groups. Daily percent time in pain was also highest in the AUD+Tx group (30.2%) and was further increased in those with a history of childhood abuse and comorbid posttraumatic stress disorder (PTSD). Years of heavy drinking and craving were also associated with increased percent time in pain in the AUD+Tx group. Percent time in pain decreased following acute withdrawal in the AUD+Tx group but plateaued around 25% just prior to discharge. Individuals seeking inpatient treatment for AUD, especially those with a history of childhood trauma and/or comorbid PTSD, report greater percent time in pain compared to those not seeking treatment and those without AUD. The prolonged experience of pain in abstinent AUD inpatients after the resolution of acute withdrawal may signal the early stages of protracted withdrawal. Integrative treatments targeting pain and other symptoms of protracted withdrawal may be effective in improving overall function in people with severe AUD.
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Affiliation(s)
- M L Schwandt
- Office of the Clinical Director, National Institute on Alcoholism and Alcohol Abuse (NIAAA), Bethesda, MD, USA.
| | - V A Ramchandani
- Human Psychopharmacology Laboratory, NIAAA, Bethesda, MD, USA
| | - J Upadhyay
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - C Ramsden
- Laboratory of Clinical Investigation, National Institute on Aging, Baltimore, MD, USA
| | - N Diazgranados
- Office of the Clinical Director, National Institute on Alcoholism and Alcohol Abuse (NIAAA), Bethesda, MD, USA
| | - D Goldman
- Office of the Clinical Director, National Institute on Alcoholism and Alcohol Abuse (NIAAA), Bethesda, MD, USA; Laboratory of Neurogenetics, NIAAA, Rockville, MD, USA
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Zheng X, Lin J, Wang Z, Zeng Z, Chen H. Research of the analgesic effects and central nervous system impact of electroacupuncture therapy in rats with knee osteoarthritis. Heliyon 2024; 10:e21825. [PMID: 38226224 PMCID: PMC10788782 DOI: 10.1016/j.heliyon.2023.e21825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 09/14/2023] [Accepted: 10/30/2023] [Indexed: 01/17/2024] Open
Abstract
It aimed to observe the effects of TongDu TiaoShen (TDTS) electroacupuncture (EA) on the analgesia and central system of knee osteoarthritis (KOA) rats and explore its mechanism. SD rats were rolled into the blank group, model group (KOA), control group (duloxetine 500 mg/kg/d, Ctrl), conventional EA group, and TDTS-EA group. Radiometric pain measurements and the Lequesne MG scale were used to evaluate the behavioral performance of the rats. Dopamine (DA), norepinephrine (NE), 5-hydroxytryptamine (5-HT), β-endorphin (β-EP), and leucine-enkephalin (L-ENK) were detected in the midbrain and spinal cord of lumbar enlargement. Interleukin (IL)-1β protein expression was detected by Western blot. The incubation period of thermal pain and foot contraction was decreased in the KOA group versus blank group, the Lequesne MG score was increased, DA, NE, 5-HT, β-EP, and L-ENK in the midbrain and spinal cord were increased, and synovial tissue IL-1β protein expression was increased (P < 0.05). EA group and TDTS-EA group had an increased incubation period of thermal pain contraction, decreased Lequesne MG score, decreased DA, NE, etc. In the midbrain, increased 5-HT and NE in the spinal cord, and decreased IL-1β in the synovial tissue versus KOA group (P < 0.05). The Lequesne MG score and midbrain DA, NE, 5-HT, β-EP, and synovial tissue IL-1β expression were decreased in TDTS-EA group versus EA group (P < 0.05). EA can effectively improve the behavioral score of KOA and participate in central analgesia by regulating central DA, NE, 5-HT, β-EP, and L-ENK.
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Affiliation(s)
- Xiahai Zheng
- Department of Rehabilitation, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510375, Guangdong Province, China
| | - Jing Lin
- Department of Rehabilitation, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510375, Guangdong Province, China
| | - Zhenzhen Wang
- Department of Rehabilitation, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510375, Guangdong Province, China
| | - Zhenming Zeng
- Department of Rehabilitation, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510375, Guangdong Province, China
| | - Haoxiong Chen
- Department of Rehabilitation, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510375, Guangdong Province, China
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Zhang P, Lan X, Fan B, Chen Y, Wei X, Li X, Fan N, Tang C, Lu L. A protocol for the integration of multi-omics bioinformatics: Mechanism of acupuncture as an adjunctive therapy for alcohol use disorder. Front Neurol 2023; 13:977487. [PMID: 36686540 PMCID: PMC9849375 DOI: 10.3389/fneur.2022.977487] [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: 06/24/2022] [Accepted: 11/28/2022] [Indexed: 01/06/2023] Open
Abstract
Background Alcohol use disorder (AUD) has become a significant global factor in various diseases. As a non-pharmacological therapy, certain therapeutic potential has been found in acupuncture; however, in-depth mechanistic studies related to acupuncture for patients with AUD are still insufficient. Methods Based on a randomized control design and a multi-omics analysis plan, this protocol details the recruitment (42 AUD patients), group allocation (21 in acupuncture group vs. 21 in sham acupuncture group), intervention and follow-up (replacement drugs as a normal treatment, 2 weeks acupuncture duration, and 3 month follow-up), and data collection and analytical processes. For the clinical outcomes, in addition to the time required for alcohol withdrawal symptoms to subside as the primary outcome, changes in the alcohol withdrawal symptoms, alcohol craving, mood dysfunction, sleep disorder, fatigue, self-efficacy, gastrointestinal symptoms, the quality of life, and the relapse outcomes will be compared between the groups to confirm the acupuncture clinical effectiveness on alcohol withdraw. The gut microbiome and the fecal metabolomics will also be assessed to explore the association of the structure and the function of gut microflora and the mediation of acupuncture effect on AUD fully utilizing gut microflora multi-modal data and clinical information, via the combination of multi-omics methods, feature screening algorithms and appropriate models. Discussion The results of this study may help to strengthen clinical evidence of the mechanism of acupuncture intervention in patients with AUD, through understanding of the regulatory mechanism of acupuncture in the gut microbiome and its metabolism as well as AUD-related clinical manifestations. Trial registration Chinese Clinical Trial Registry ChiCTR2200058120. Registered on 24 Mar 2022.
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Affiliation(s)
- Peiming Zhang
- Clinical Research and Big Data Laboratory, South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Xiaochang Lan
- Department of Substance Dependence, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
| | - Baochao Fan
- Clinical Research and Big Data Laboratory, South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Yiming Chen
- Clinical Research and Big Data Laboratory, South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Xiaojing Wei
- Clinical Research and Big Data Laboratory, South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Xiangli Li
- Department of Chinese Medicine, Guangzhou First People's Hospital, Guangzhou, Guangdong Province, China
| | - Ni Fan
- Department of Substance Dependence, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
| | - Chunzhi Tang
- Clinical Research and Big Data Laboratory, South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Liming Lu
- Clinical Research and Big Data Laboratory, South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
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