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Liu S, Kazonda P, Leyna GH, Rohr JK, Fawzi WW, Shinde S, Abioye AI, Francis JM, Probst C, Sando D, Mwanyka-Sando M, Killewo J, Bärnighausen T. Emotional and cognitive influences on alcohol consumption in middle-aged and elderly Tanzanians: a population-based study. Sci Rep 2024; 14:17520. [PMID: 39079984 PMCID: PMC11289436 DOI: 10.1038/s41598-024-64694-1] [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: 04/14/2024] [Accepted: 06/12/2024] [Indexed: 08/02/2024] Open
Abstract
Alcohol consumption in Tanzania exceeds the global average. While sociodemographic difference in alcohol consumption in Tanzania have been studied, the relationship between psycho-cognitive phenomena and alcohol consumption has garnered little attention. Our study examines how depressive symptoms and cognitive performance affect alcohol consumption, considering sociodemographic variations. We interviewed 2299 Tanzanian adults, with an average age of 53 years, to assess their alcohol consumption, depressive symptoms, cognitive performance, and sociodemographic characteristics using a zero-inflated negative binomial regression model. The logistic portion of our model revealed that the likelihood alcohol consumption increased by 8.4% (95% confidence interval [CI] 3.6%, 13.1%, p < 0.001) as depressive symptom severity increased. Conversely, the count portion of the model indicated that with each one-unit increase in the severity of depressive symptoms, the estimated number of drinks decreased by 2.3% (95% CI [0.4%, 4.0%], p = .016). Additionally, the number of drinks consumed decreased by 4.7% (95% CI [1.2%, 8.1%], p = .010) for each increased cognitive score. Men exhibited higher alcohol consumption than women, and Christians tended to consume more than Muslims. These findings suggest that middle-aged and elderly adults in Tanzania tend to consume alcohol when they feel depressed but moderate their drinking habits by leveraging their cognitive abilities.
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Affiliation(s)
- Shuyan Liu
- Department of Psychiatry and Psychotherapy (Campus Charité Mitte), Charité - Universitätsmedizin Berlin, Berlin, Germany.
- German Center for Mental Health (DZPG), Berlin and Heidelberg, Germany.
| | | | - Germana H Leyna
- Department of Epidemiology, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | - Julia K Rohr
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Wafaie W Fawzi
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Sachin Shinde
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ajibola Ibraheem Abioye
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Joel M Francis
- Department of Family Medicine and Primary Care, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Charlotte Probst
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - David Sando
- Management and Development for Health, Dar Es Salaam, Tanzania
| | | | - Japhet Killewo
- Department of Epidemiology, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | - Till Bärnighausen
- German Center for Mental Health (DZPG), Berlin and Heidelberg, Germany.
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany.
- Africa Health Research Institute, Somkhele and Durban, South Africa.
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Li X, Kass G, Wiers CE, Shi Z. The Brain Salience Network at the Intersection of Pain and Substance use Disorders: Insights from Functional Neuroimaging Research. CURRENT ADDICTION REPORTS 2024; 11:797-808. [PMID: 39156196 PMCID: PMC11329602 DOI: 10.1007/s40429-024-00593-9] [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] [Accepted: 07/22/2024] [Indexed: 08/20/2024]
Abstract
Purpose of Review The brain's salience network (SN), primarily comprising the anterior insula and anterior cingulate cortex, plays a key role in detecting salient stimuli and processing physical and socioemotional pain (e.g., social rejection). Mounting evidence underscores an altered SN in the etiology and maintenance of substance use disorders (SUDs). This paper aims to synthesize recent functional neuroimaging research emphasizing the SN's involvement in SUDs and physical/socioemotional pain and explore the therapeutic prospects of targeting the SN for SUD treatment. Recent Findings The SN is repeatedly activated during the experience of both physical and socioemotional pain. Altered activation within the SN is associated with both SUDs and chronic pain conditions, characterized by aberrant activity and connectivity patterns as well as structural changes. Among individuals with SUDs, functional and structural alterations in the SN have been linked to abnormal salience attribution (e.g., heightened responsiveness to drug-related cues), impaired cognitive control (e.g., impulsivity), and compromised decision-making processes. The high prevalence of physical and socioemotional pain in the SUD population may further exacerbate SN alterations, thus contributing to hindered recovery progress and treatment failure. Interventions targeting the restoration of SN functioning, such as real-time functional MRI feedback, neuromodulation, and psychotherapeutic approaches, hold promise as innovative SUD treatments. Summary The review highlights the significance of alterations in the structure and function of the SN as potential mechanisms underlying the co-occurrence of SUDs and physical/socioemotional pain. Future work that integrates neuroimaging with other research methodologies will provide novel insights into the mechanistic role of the SN in SUDs and inform the development of next-generation treatment modalities.
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Affiliation(s)
- Xinyi Li
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104 USA
| | - Gabriel Kass
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104 USA
| | - Corinde E. Wiers
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104 USA
| | - Zhenhao Shi
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104 USA
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3
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Zheng H, Zhang P, Shi S, Zhang X, Cai Q, Gong X. Sub-anesthetic dose of esketamine decreases postoperative opioid self-administration after spine surgery: a retrospective cohort analysis. Sci Rep 2024; 14:3909. [PMID: 38365958 PMCID: PMC10873399 DOI: 10.1038/s41598-024-54617-5] [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: 11/15/2023] [Accepted: 02/14/2024] [Indexed: 02/18/2024] Open
Abstract
The use of intraoperative sub-anesthetic esketamine for postoperative analgesia is controversial. In this study, the impact of sub-anesthetic esketamine on postoperative opioid self-administration was determined. Patients who underwent spinal surgery with patient-controlled analgesia (PCA) from January 2019 to December 2021 were respectively screened for analysis. Postoperative PCA was compared between patients who received a sub-anesthetic esketamine dose and patients who were not treated with esketamine (non-esketamine group) with or without propensity score matching. Negative binomial regression analysis was used to identify factors associated with postoperative PCA. Patients who received intraoperative sub-anesthetic esketamine self-administered less PCA (P = 0.001). Azasetron, esketamine, and dexamethasone lowered the self-administration of PCA (IRR with 95% confidential interval, 0.789 [0.624, 0.993]; 0.581 [0.458, 0.741]; and 0.777 [0.627, 0.959], respectively). Fixation surgery and drinking were risk factors for postoperative PCA (1.737 [1.373, 2.188] and 1.332 [1.032, 1.737] for fixation surgery and drinking, respectively). An intraoperative sub-anesthetic dose of esketamine decreases postoperative opioid self-administration. Azasetron and dexamethasone also decrease postoperative opioid consumption. The study is registered at www.chictr.org.cn (ChiCTR2300068733).
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Affiliation(s)
- Hongyu Zheng
- Department of Anesthesiology, Institution of Neuroscience and Brain Disease, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Peng Zhang
- Department of Emergency, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Shengnan Shi
- Department of Anesthesiology, Institution of Neuroscience and Brain Disease, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Xue Zhang
- Department of Anesthesiology, Institution of Neuroscience and Brain Disease, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Qiang Cai
- Department of Orthopedics, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China.
| | - Xingrui Gong
- Department of Anesthesiology, Institution of Neuroscience and Brain Disease, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China.
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Lucero MM, Palfai TP, Heeren TC, Stein MD, Kim TW, Saitz R. Heavy Alcohol Use and HIV Outcomes: The Moderating Role of Pain. AIDS Behav 2024; 28:636-644. [PMID: 38236321 PMCID: PMC11129659 DOI: 10.1007/s10461-023-04250-6] [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] [Accepted: 12/08/2023] [Indexed: 01/19/2024]
Abstract
Pain and heavy alcohol consumption are prevalent among people living with HIV/AIDS (PLWH), each contributing to impaired functioning and diminished quality of life. Each of these conditions may have negative effects on the HIV care continuum, but less is known about their combined influences. The current study examined how heavy drinking and pain were associated with HIV viral suppression and CD4 cell count among participants receiving antiretroviral therapy (ART). The study sample consisted of 220 PLWH with past 12-month substance dependence or ever injection drug use enrolled in a large HIV cohort study. Logistic regression analyses showed an interaction between pain level (no/mild pain vs moderate/severe) and heavy drinking on viral suppression such that heavy drinking was a significant predictor of poorer viral suppression only for those who experienced moderate/severe pain. We also examined whether ART adherence differentially mediated the association between heavy drinking and HIV viral suppression by level of pain. Although there was a significant indirect effect of heavy drinking on viral suppression among those with moderate/severe pain, moderated mediational analyses did not indicate that the indirect effect of heavy drinking on viral suppression through ART adherence differed significantly by level of pain. Pain level did not significantly moderate the association between heavy drinking and CD4 cell count. We conclude that heavy drinking may be particularly likely to be associated with poorer HIV viral suppression among PLWH with moderate or severe pain. Providers should routinely address comorbid heavy drinking and pain to improve HIV outcomes.
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Affiliation(s)
- Mora M Lucero
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Tibor P Palfai
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA.
| | - Timothy C Heeren
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Michael D Stein
- Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, MA, USA
| | - Theresa W Kim
- Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center, Boston, MA, USA
- Grayken Center for Addiction, Boston Medical Center, Boston, MA, USA
| | - Richard Saitz
- Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center, Boston, MA, USA
- Grayken Center for Addiction, Boston Medical Center, Boston, MA, USA
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
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5
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Vigorito M, Chang SL. Alcohol use and the pain system. ADVANCES IN DRUG AND ALCOHOL RESEARCH 2024; 4:12005. [PMID: 38389900 PMCID: PMC10880763 DOI: 10.3389/adar.2024.12005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 01/12/2024] [Indexed: 02/24/2024]
Abstract
The World Health Organization's epidemiological data from 2016 revealed that while 57% of the global population aged 15 years or older had abstained from drinking alcohol in the previous year, more than half of the population in the Americas, Europe, and Western Pacific consumed alcohol. The spectrum of alcohol use behavior is broad: low-risk use (sensible and in moderation), at-risk use (e.g., binge drinking), harmful use (misuse) and dependence (alcoholism; addiction; alcohol use disorder). The at-risk use and misuse of alcohol is associated with the transition to dependence, as well as many damaging health outcomes and preventable causes of premature death. Recent conceptualizations of alcohol dependence posit that the subjective experience of pain may be a significant contributing factor in the transition across the spectrum of alcohol use behavior. This narrative review summarizes the effects of alcohol at all levels of the pain system. The pain system includes nociceptors as sensory indicators of potentially dangerous stimuli and tissue damage (nociception), spinal circuits mediating defensive reflexes, and most importantly, the supraspinal circuits mediating nocifensive behaviors and the perception of pain. Although the functional importance of pain is to protect from injury and further or future damage, chronic pain may emerge despite the recovery from, and absence of, biological damage (i.e., in the absence of nociception). Like other biological perceptual systems, pain is a construction contingent on sensory information and a history of individual experiences (i.e., learning and memory). Neuroadaptations and brain plasticity underlying learning and memory and other basic physiological functions can also result in pathological conditions such as chronic pain and addiction. Moreover, the negative affective/emotional aspect of pain perception provides embodied and motivational components that may play a substantial role in the transition from alcohol use to dependence.
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Affiliation(s)
- Michael Vigorito
- Institute of NeuroImmune Pharmacology, Seton Hall University, South Orange, NJ, United States
| | - Sulie L Chang
- Institute of NeuroImmune Pharmacology, Seton Hall University, South Orange, NJ, United States
- Department of Biological Sciences, Seton Hall University, South Orange, NJ, United States
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Bertagna NB, Wilson L, Bailey CK, Cruz FC, Albrechet-Souza L, Wills TA. Long-lasting mechanical hypersensitivity and CRF receptor type-1 neuron activation in the BNST following adolescent ethanol exposure. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:48-57. [PMID: 38206283 PMCID: PMC10784637 DOI: 10.1111/acer.15228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/26/2023] [Accepted: 11/08/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Adolescent alcohol use can produce long-lasting alterations in brain function, potentially leading to adverse health outcomes in adulthood. Emerging evidence suggests that chronic alcohol use can increase pain sensitivity or exacerbate existing pain conditions, but the potential neural mechanisms underlying these effects require further investigation. Here, we evaluate the impact of chronic ethanol vapor on mechanical sensitivity over the course of acute and protracted withdrawal in adolescent and adult male and female mice, and its potential association with alterations in corticotropin-releasing factor (CRF) signaling within the bed nucleus of the stria terminalis (BNST). METHODS Adolescent and adult male and female mice underwent intermittent ethanol vapor exposure on 4 days/week for 2 weeks. Mechanical thresholds were evaluated 5 h and 7, 14, 21, and 28 d after cessation of ethanol exposure using the von Frey test. For mice with a history of adolescent ethanol exposure, brains were collected for in situ RNAscope processing after the final test. Messenger RNA expression of c-Fos, Crfr1, and Crf in the BNST subregions was examined. RESULTS Exposure to intermittent ethanol vapor induced persistent mechanical hypersensitivity during withdrawal in both adolescent and adult mice. Notably, the effect was more transient in mice exposed to ethanol during adulthood, resolving by day 28 after ethanol exposure. Furthermore, both male and female mice with a history of adolescent ethanol exposure exhibited increased activation of CRF receptor type 1 (CRFR1) neurons within the dorsolateral BNST. CONCLUSIONS Our results support the conclusion that intermittent ethanol exposure can induce mechanical hypersensitivity, potentially through the activation of BNST CRFR1 neurons. These findings provide a basis for future studies aimed at evaluating specific subpopulations of BNST neurons and their contribution to pain in individuals with a history of alcohol use.
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Affiliation(s)
- Natalia B. Bertagna
- Department of Cell Biology & Anatomy, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA
- Department of Pharmacology, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Lisa Wilson
- Department of Cell Biology & Anatomy, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA
- Alcohol & Drug Center of Excellence, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Connor K. Bailey
- Department of Cell Biology & Anatomy, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Fabio C. Cruz
- Department of Pharmacology, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Lucas Albrechet-Souza
- Department of Cell Biology & Anatomy, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA
- Alcohol & Drug Center of Excellence, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Tiffany A. Wills
- Department of Cell Biology & Anatomy, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA
- Alcohol & Drug Center of Excellence, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA
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Dreismickenbecker E, Zinn S, Romero-Richter M, Kohlhaas M, Fricker LR, Petzel-Witt S, Walter C, Kreuzer M, Toennes SW, Anders M. Electroencephalography-Based Effects of Acute Alcohol Intake on the Pain Matrix. Brain Sci 2023; 13:1659. [PMID: 38137107 PMCID: PMC10741681 DOI: 10.3390/brainsci13121659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 11/24/2023] [Accepted: 11/28/2023] [Indexed: 12/24/2023] Open
Abstract
The effects of acute and chronic intakes of high doses of alcohol on pain perception are well known, ranging from short-term analgesic effects to long-term sensitization and polyneuropathies. The short-term analgesic effects of ethanol consumption on subjective pain perception have been well studied in the literature. Recent advances in neuroimaging allow for an insight into pain-related structures in the brain, fostering the mechanistic understanding of the processing of nociceptive input and pain. We aimed to utilize EEG, combined with standardized noxious mechanical/thermal stimulation and subjective pain testing, to research the effects of acute alcohol intake on nociceptive processing and pain perception. We recruited 12 healthy subjects in an unblinded cross-over study design and aimed at achieving a blood alcohol level of 0.1%. Our data revealed a significant reduction in subjective pain ratings to noxious thermal and mechanical stimuli after alcohol ingestion. Our EEG data revealed suppressing effects on the cortical structures responsible for processing pain, the "pain matrix". We conclude that in addition to its analgesic effects, as expressed by the reduction in subjective pain, alcohol has a further impact on the "pain matrix" and directly affects the salience to a nociceptive stimulus.
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Affiliation(s)
- Elias Dreismickenbecker
- Center for Pediatric and Adolescent Medicine, Department of Pediatric Hematology/Oncology, University Medical Center Mainz, 55131 Mainz, Germany
- Clinical Development and Human Pain Models, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, 60596 Frankfurt, Germany
| | - Sebastian Zinn
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Goethe University Frankfurt, University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Mara Romero-Richter
- Clinical Development and Human Pain Models, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, 60596 Frankfurt, Germany
| | - Madeline Kohlhaas
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Goethe University Frankfurt, University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Lukas R. Fricker
- Clinical Development and Human Pain Models, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, 60596 Frankfurt, Germany
| | - Silvana Petzel-Witt
- Institute of Legal Medicine, University Hospital, Goethe University, 60590 Frankfurt, Germany
| | - Carmen Walter
- Clinical Development and Human Pain Models, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, 60596 Frankfurt, Germany
| | - Matthias Kreuzer
- Department of Anesthesiology and Intensive Care, School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany
| | - Stefan W. Toennes
- Institute of Legal Medicine, University Hospital, Goethe University, 60590 Frankfurt, Germany
| | - Malte Anders
- Clinical Development and Human Pain Models, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, 60596 Frankfurt, Germany
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Borgonetti V, Roberts AJ, Bajo M, Galeotti N, Roberto M. Chronic alcohol induced mechanical allodynia by promoting neuroinflammation: A mouse model of alcohol-evoked neuropathic pain. Br J Pharmacol 2023; 180:2377-2392. [PMID: 37050867 PMCID: PMC10898491 DOI: 10.1111/bph.16091] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 04/05/2023] [Accepted: 04/06/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND AND PURPOSE Chronic pain is considered a key factor contributing to alcohol use disorder (AUD). The mechanisms responsible for chronic pain associated with chronic alcohol consumption are unknown. We evaluated the development of chronic pain in a mouse model of alcohol dependence and investigate the role of neuroinflammation. EXPERIMENTAL APPROACH The chronic-intermittent ethanol two-bottle choice CIE-2BC paradigm generates three groups: alcohol-dependent with escalating alcohol intake, nondependent (moderate drinking) and alcohol-naïve control male and female mice. We measured mechanical allodynia during withdrawal and after the last voluntary drinking. Immunoblotting was used to evaluate the protein levels of IBA-1, CSFR, IL-6, p38 and ERK2/1 in spinal cord tissue of dependent and non-dependent animals. KEY RESULTS We found significant escalation of drinking in the dependent group in male and female compared with the non-dependent group. The dependent group developed mechanical allodynia during 72 h of withdrawal, which was completely reversed after voluntary drinking. We observed an increased pain hypersensitivity compared with the naïve in 50% of non-dependent group. Increased IBA-1 and CSFR expression was observed in spinal cord tissue of both hypersensitivity-abstinence related and neuropathy-alcohol mice, and increased IL-6 expression and ERK1/2 activation in mice with hypersensitivity-related to abstinence, but not in mice with alcohol-evoked neuropathic pain. CONCLUSIONS AND IMPLICATIONS The CIE-2BC model induces two distinct pain conditions specific to the type of ethanol exposure: abstinence-related hypersensitivity in dependent mice and alcohol-evoked neuropathic pain in about a half of the non-dependent mice.
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Affiliation(s)
- Vittoria Borgonetti
- Department of Neuroscience, Psychology, Drug Research, and Child Health (NEUROFARBA), Section of Pharmacology, University of Florence, Viale G. Pieraccini 6, Florence, 50139, Italy
- Department of Molecular Medicine and Neuroscience, The Scripps Research Institute, 10550 N. Torrey Pines Rd, La Jolla, CA 92037, USA
| | - Amanda J. Roberts
- Animal Models Core, The Scripps Research Institute, 10550 N. Torrey Pines Rd, La Jolla, CA 92037, USA
| | - Michal Bajo
- Department of Molecular Medicine and Neuroscience, The Scripps Research Institute, 10550 N. Torrey Pines Rd, La Jolla, CA 92037, USA
| | - Nicoletta Galeotti
- Department of Neuroscience, Psychology, Drug Research, and Child Health (NEUROFARBA), Section of Pharmacology, University of Florence, Viale G. Pieraccini 6, Florence, 50139, Italy
| | - Marisa Roberto
- Department of Molecular Medicine and Neuroscience, The Scripps Research Institute, 10550 N. Torrey Pines Rd, La Jolla, CA 92037, USA
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Brandner AJ, Baratta AM, Rathod RS, Ferguson C, Taylor BK, Farris SP. Mechanical and Heat Hyperalgesia upon Withdrawal From Chronic Intermittent Ethanol Vapor Depends on Sex, Exposure Duration, and Blood Alcohol Concentration in Mice. THE JOURNAL OF PAIN 2023; 24:1262-1274. [PMID: 36868488 PMCID: PMC10599355 DOI: 10.1016/j.jpain.2023.02.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 02/16/2023] [Accepted: 02/22/2023] [Indexed: 03/05/2023]
Abstract
Approximately half of patients with alcohol use disorder report pain and this can be severe during withdrawal. Many questions remain regarding the importance of biological sex, alcohol exposure paradigm, and stimulus modality to the severity of alcohol withdrawal-induced hyperalgesia. To examine the impact of sex and blood alcohol concentration on the time course of the development of mechanical and heat hyperalgesia, we characterized a mouse model of chronic alcohol withdrawal-induced pain in the presence or absence the alcohol dehydrogenase inhibitor, pyrazole. Male and female C57BL/6J mice underwent chronic intermittent ethanol vapor ± pyrazole exposure for 4 weeks, 4 d/wk to induce ethanol dependence. Hind paw sensitivity to the plantar application of mechanical (von Frey filaments) and radiant heat stimuli were measured during weekly observations at 1, 3, 5, 7, 24, and 48 hours after cessation of ethanol exposure. In the presence of pyrazole, males developed mechanical hyperalgesia after the first week of chronic intermittent ethanol vapor exposure, peaking at 48 hours after cessation of ethanol. By contrast, females did not develop mechanical hyperalgesia until the fourth week; this also required pyrazole and did not peak until 48 hours. Heat hyperalgesia was consistently observed only in females exposed to ethanol and pyrazole; this developed after the first weekly session and peaked at 1 hour. We conclude that Chronic alcohol withdrawal-induced pain develops in a sex-, time-, and blood alcohol concentration-dependent manner in C57BL/6J mice. PERSPECTIVE: Alcohol withdrawal-induced pain is a debilitating condition in individuals with AUD. Our study found mice experience alcohol withdrawal-induced pain in a sex and time course specific manor. These findings will aid in elucidating mechanisms of chronic pain and AUD and will help individuals remain abstinent from alcohol.
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Affiliation(s)
- Adam J Brandner
- Center for Neuroscience, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Pittsburgh Center for Pain Research, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Pittsburgh Project to end Opioid Misuse, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Annalisa M Baratta
- Center for Neuroscience, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Pittsburgh Center for Pain Research, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Richa S Rathod
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Carolyn Ferguson
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Bradley K Taylor
- Center for Neuroscience, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Pittsburgh Center for Pain Research, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Pittsburgh Project to end Opioid Misuse, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Sean P Farris
- Center for Neuroscience, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Pittsburgh Center for Pain Research, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Pittsburgh Project to end Opioid Misuse, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Biomedical Informatics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
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Hidradenitis Suppurativa Burdens on Mental Health: A Literature Review of Associated Psychiatric Disorders and Their Pathogenesis. LIFE (BASEL, SWITZERLAND) 2023; 13:life13010189. [PMID: 36676137 PMCID: PMC9865498 DOI: 10.3390/life13010189] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/01/2023] [Accepted: 01/03/2023] [Indexed: 01/11/2023]
Abstract
Skin, mental health and the central nervous system (CNS) are connected by a deep link. It is not only the aesthetic and sometimes the disfiguring aspects of dermatological conditions that can cause a severe psychological burden; also, different studies have shown how chronic skin-inflammatory diseases may influence the activity of the CNS and vice versa. Moreover, the skin and brain share a common embryogenic origin. Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease affecting the hair follicles of the apocrine regions. The main clinical features are nodules, abscesses, cysts, fistulae and disfiguring scars. Pain and stinking discharge from fistulae are often present. It is not surprising that the psychological burden associated with HS is frequently a challenge in dermatologists' daily routines. Patients often suffer from depression and anxiety, but also from substance abuse, psychotic and bipolar disorders and an increased suicide risk. The aim of this article is to review the main psychiatric disorders associated with HS and their pathophysiology. Research on Pubmed was conducted with the key words Hidradenitis suppurativa, psychiatric, depression, anxiety, bipolar, schizophrenia, abuse, suicidal. A high incidence of psychiatric disorders has been described in HS compared to controls. Hidradenitis suppurativa is not a rare disease, and acknowledging the HS psychological burden, psychiatric-associated diseases and associated biomolecular pathways will help dermatologists to better care for their patients.
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11
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Eagen K, Rabson L, Kellum R. Management of Chronic Pain in Patients with Substance Use Disorders. Prim Care 2022; 49:455-468. [DOI: 10.1016/j.pop.2022.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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12
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Sakamoto R, Koyama A. Analysis of Various Factors Associated With Opioid Dose Escalation in Patients With Cancer Pain. Cureus 2022; 14:e25266. [PMID: 35755532 PMCID: PMC9224761 DOI: 10.7759/cureus.25266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction Pain is one of the most important symptoms in terms of prevalence and a major cause of distress in patients with cancer. Therefore, this study aimed to analyze and identify the factors that influence the worsening of pain in patients with cancer necessitating opioid dose escalation. Methods The study was conducted in a single center. This study is a retrospective cohort study of 390 adult cancer patients. The primary endpoint was dose escalation for strong opioids. Adjusted odds ratios (aORs) and their 95% confidence intervals (CIs) were calculated using a logistic regression model to evaluate the relationships of factors with opioid dose escalation for cancer pain. Results Polypharmacy was associated with opioid dose escalation (aOR = 2.54, 95% CI = 1.486-4.370, p = 0.001). Conversely, alcohol consumption was associated with a reduced need for dose escalation (aOR = 0.60, 95% CI = 0.376-0.985, p = 0.043). Conclusion The results of this study indicate that moderate alcohol consumption does not reduce the efficacy of opioids in patients with cancer pain. Meanwhile, patients receiving polypharmacy may be able to more rapidly alleviate their pain via early opioid dose modification.
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Baj J, Forma A, Kobak J, Tyczyńska M, Dudek I, Maani A, Teresiński G, Buszewicz G, Januszewski J, Flieger J. Toxic and Nutritional Optic Neuropathies—An Updated Mini-Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053092. [PMID: 35270784 PMCID: PMC8910489 DOI: 10.3390/ijerph19053092] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/27/2022] [Accepted: 03/03/2022] [Indexed: 12/20/2022]
Abstract
Optic neuropathies constitute a group of conditions with various etiologies and might be caused by different factors; we can distinguish the genetic and acquired causes of optic neuropathies. Even though the symptoms are not highly specific, this condition is primarily characterized by unilateral or bilateral vision loss with worsening color detection. The loss may be acute or gradual depending on the causation. In this article, we included a specification of toxic optic neuropathy (TON) mainly triggered by alcohol abuse and also the usage of other substances, including drugs or methanol, as well as intoxication by metals, organic solvents, or carbon dioxide. Nutritional deficiencies, vitamin absorption disorder, and anemia, which usually appear during excessive alcohol intake, and their effect on the etiology of the optic neuropathy have been likewise discussed.
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Affiliation(s)
- Jacek Baj
- Department of Human Anatomy, Medical University of Lublin, Jaczewskiego 4, 20-090 Lublin, Poland; (J.B.); (A.M.)
| | - Alicja Forma
- Department of Forensic Medicine, Medical University of Lublin, Jaczewskiego 8b, 20-090 Lublin, Poland; (J.K.); (M.T.); (I.D.); (G.T.); (G.B.); (J.J.)
- Correspondence:
| | - Joanna Kobak
- Department of Forensic Medicine, Medical University of Lublin, Jaczewskiego 8b, 20-090 Lublin, Poland; (J.K.); (M.T.); (I.D.); (G.T.); (G.B.); (J.J.)
| | - Magdalena Tyczyńska
- Department of Forensic Medicine, Medical University of Lublin, Jaczewskiego 8b, 20-090 Lublin, Poland; (J.K.); (M.T.); (I.D.); (G.T.); (G.B.); (J.J.)
| | - Iga Dudek
- Department of Forensic Medicine, Medical University of Lublin, Jaczewskiego 8b, 20-090 Lublin, Poland; (J.K.); (M.T.); (I.D.); (G.T.); (G.B.); (J.J.)
| | - Amr Maani
- Department of Human Anatomy, Medical University of Lublin, Jaczewskiego 4, 20-090 Lublin, Poland; (J.B.); (A.M.)
| | - Grzegorz Teresiński
- Department of Forensic Medicine, Medical University of Lublin, Jaczewskiego 8b, 20-090 Lublin, Poland; (J.K.); (M.T.); (I.D.); (G.T.); (G.B.); (J.J.)
| | - Grzegorz Buszewicz
- Department of Forensic Medicine, Medical University of Lublin, Jaczewskiego 8b, 20-090 Lublin, Poland; (J.K.); (M.T.); (I.D.); (G.T.); (G.B.); (J.J.)
| | - Jacek Januszewski
- Department of Forensic Medicine, Medical University of Lublin, Jaczewskiego 8b, 20-090 Lublin, Poland; (J.K.); (M.T.); (I.D.); (G.T.); (G.B.); (J.J.)
| | - Jolanta Flieger
- Department of Analytical Chemistry, Medical University of Lublin, Chodźki 4A, 20-093 Lublin, Poland;
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14
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Green PG, Alvarez P, Levine JD. Probiotics attenuate alcohol-induced muscle mechanical hyperalgesia: Preliminary observations. Mol Pain 2022; 18:17448069221075345. [PMID: 35189754 PMCID: PMC8874179 DOI: 10.1177/17448069221075345] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Alcohol use disorder (AUD) is a major health problem that causes millions of deaths annually world-wide. AUD is considered to be a chronic pain disorder, that is exacerbated by alcohol withdrawal, contributing to a high (∼80%) relapse rate. Chronic alcohol consumption has a marked impact on the gut microbiome, recognized to have a significant effect on chronic pain. We tested the hypothesis that modulating gut microbiota through feeding rats with probiotics can attenuate alcohol-induced muscle mechanical hyperalgesia. To test this hypothesis, rats were fed alcohol (6.5%, 4 days on 3 days off) for 3 weeks, which induced skeletal muscle mechanical hyperalgesia. Following alcohol feeding, at which time nociceptive thresholds were ∼37% below pre-alcohol levels, rats received probiotics in their drinking water, either Lactobacillus Rhamnosus GG (Culturelle) or De Simone Formulation (a mixture of 8 bacterial species) for 8 days; control rats received plain water to drink. When muscle mechanical nociceptive threshold was evaluated 1 day after beginning probiotic feeding, nociceptive thresholds were significantly higher than rats not receiving probiotics. Mechanical nociceptive thresholds continued to increase during probiotic feeding, with thresholds approaching pre-alcohol levels 5 days after starting probiotics; nociceptive threshold in rats not receiving probiotics remained low. After probiotics were removed from the drinking water, nociceptive thresholds gradually decreased in these two groups, although they remained higher than the group not treated with probiotic (21 days after ending alcohol feeding). These observations suggest that modification of gut microbiota through probiotic feeding has a marked effect on chronic alcohol-induced muscle mechanical hyperalgesia. Our results suggest that administration of probiotics to individuals with AUD may reduce pain associated with alcohol consumption and withdrawal, and may be a novel therapeutic intervention to reduce the high rate of relapse seen in individuals with AUD attempting to abstain from alcohol.
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Affiliation(s)
- Paul G Green
- Departments of Oral and Maxillofacial Surgery, 8785University of California San Francisco, San Francisco, CA, USA.,Departments of Preventative and Restorative Dental Sciences, 8785University of California San Francisco, San Francisco, CA, USA.,Division of Neuroscience, 8785University of California San Francisco, San Francisco, CA, USA
| | - Pedro Alvarez
- Departments of Oral and Maxillofacial Surgery, 8785University of California San Francisco, San Francisco, CA, USA.,Division of Neuroscience, 8785University of California San Francisco, San Francisco, CA, USA
| | - Jon D Levine
- Departments of Oral and Maxillofacial Surgery, 8785University of California San Francisco, San Francisco, CA, USA.,Division of Neuroscience, 8785University of California San Francisco, San Francisco, CA, USA.,Departments of Medicine, 8785University of California San Francisco, San Francisco, CA, USA
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15
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Amatsu T, Tsujiguchi H, Hara A, Miyagi S, Kannon T, Suzuki K, Shimizu Y, Nguyen TTT, Pham KO, Suzuki F, Kasahara T, Nakamura M, Hayashi K, Shibata A, Ogino N, Konoshita T, Kambayashi Y, Tsuboi H, Tajima A, Nakamura H. Relationship between Alcohol Intake and Chronic Pain with Depressive Symptoms: A Cross-Sectional Analysis of the Shika Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042024. [PMID: 35206213 PMCID: PMC8871655 DOI: 10.3390/ijerph19042024] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/27/2022] [Accepted: 02/08/2022] [Indexed: 11/16/2022]
Abstract
Although alcohol intake is associated with chronic pain (CP) and analgesia, epidemiological studies have not yet examined the factors affecting the relationship between alcohol intake and CP in detail. Therefore, the present cross-sectional study investigated the relationship between alcohol intake and CP in community-dwelling middle-aged and elderly individuals with/without depressive symptoms. Participants comprised 2223 inhabitants of Shika town in Ishikawa prefecture, located on the Noto Peninsula facing the Sea of Japan, and included 1007 males and 1216 females. CP, depressive symptoms, and alcohol intake were assessed using a CP questionnaire, the Geriatric Depression Scale-15 and the brief-type self-administered diet history questionnaire, respectively. In males without depressive symptoms, mean alcohol intake was significantly higher at 5.70% energy (27.92 g/day) in the CP group than that of 3.75% energy (20.00 g/day) in the non-CP group. The prevalence of low back/knee pain was also significantly higher in males with than in those without depressive symptoms. The present results suggest that long-term alcohol intake is related to CP by reducing the pain threshold and enhancing nociceptive pain as a possible mechanism. However, even a low alcohol intake was associated with psychogenic pain in participants with depressive symptoms. Further studies to investigate the involvement of depressive symptoms and alcohol intake in CP and its prevention are needed.
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Affiliation(s)
- Takashi Amatsu
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan; (T.A.); (H.T.); (A.H.); (K.-O.P.); (T.K.); (K.H.)
| | - Hiromasa Tsujiguchi
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan; (T.A.); (H.T.); (A.H.); (K.-O.P.); (T.K.); (K.H.)
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8640, Japan; (K.S.); (F.S.); (M.N.); (A.S.)
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa 920-8640, Japan; (T.K.); (A.T.)
| | - Akinori Hara
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan; (T.A.); (H.T.); (A.H.); (K.-O.P.); (T.K.); (K.H.)
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8640, Japan; (K.S.); (F.S.); (M.N.); (A.S.)
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa 920-8640, Japan; (T.K.); (A.T.)
| | - Sakae Miyagi
- Innovative Clinical Research Center, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8641, Japan;
| | - Takayuki Kannon
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa 920-8640, Japan; (T.K.); (A.T.)
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
| | - Keita Suzuki
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8640, Japan; (K.S.); (F.S.); (M.N.); (A.S.)
| | - Yukari Shimizu
- Faculty of Health Sciences, Department of Nursing, Komatsu University, 14-1 Mukaimotorimachi, Komatsu 923-0961, Japan;
| | - Thao Thi Thu Nguyen
- Faculty of Public Health, Haiphong University of Medicine and Pharmacy, Ngo Quyen, Hai Phong 180000, Vietnam;
| | - Kim-Oanh Pham
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan; (T.A.); (H.T.); (A.H.); (K.-O.P.); (T.K.); (K.H.)
| | - Fumihiko Suzuki
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8640, Japan; (K.S.); (F.S.); (M.N.); (A.S.)
- Community Medicine Support Dentistry, Ohu University Hospital, Koriyama 963-8611, Japan
| | - Tomoko Kasahara
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan; (T.A.); (H.T.); (A.H.); (K.-O.P.); (T.K.); (K.H.)
| | - Masaharu Nakamura
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8640, Japan; (K.S.); (F.S.); (M.N.); (A.S.)
| | - Koichiro Hayashi
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan; (T.A.); (H.T.); (A.H.); (K.-O.P.); (T.K.); (K.H.)
| | - Aki Shibata
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8640, Japan; (K.S.); (F.S.); (M.N.); (A.S.)
| | - Noriyoshi Ogino
- Department of Environmental Medicine, Faculty of Medicine, Kochi University, Kohasu, Oko-cho, Nankoku City 783-8505, Japan;
- Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Iseigaoka 1-1, Yahatanishi-ku, Kitakyushu 807-8555, Japan
| | - Tadashi Konoshita
- Third Department of Internal Medicine, University of Fukui Faculty of Medical Sciences, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan;
| | - Yasuhiro Kambayashi
- Department of Public Health, Faculty of Veterinary Medicine, Okayama University of Science, 1-3 Ikoinooka, Imabari 794-8555, Japan;
| | - Hirohito Tsuboi
- Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 1 Kakuma-machi, Kanazawa 920-1192, Japan;
| | - Atsushi Tajima
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa 920-8640, Japan; (T.K.); (A.T.)
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
| | - Hiroyuki Nakamura
- Department of Hygiene and Public Health, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan; (T.A.); (H.T.); (A.H.); (K.-O.P.); (T.K.); (K.H.)
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-8640, Japan; (K.S.); (F.S.); (M.N.); (A.S.)
- Advanced Preventive Medical Sciences Research Center, Kanazawa University, 1-13 Takaramachi, Kanazawa 920-8640, Japan; (T.K.); (A.T.)
- Correspondence: ; Tel.: +81-76-265-2218
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16
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Ghin F, Beste C, Stock AK. Neurobiological mechanisms of control in alcohol use disorder - moving towards mechanism-based non-invasive brain stimulation treatments. Neurosci Biobehav Rev 2021; 133:104508. [PMID: 34942268 DOI: 10.1016/j.neubiorev.2021.12.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 12/14/2021] [Accepted: 12/19/2021] [Indexed: 12/13/2022]
Abstract
Alcohol use disorder (AUD) is characterized by excessive habitual drinking and loss of control over alcohol intake despite negative consequences. Both of these aspects foster uncontrolled drinking and high relapse rates in AUD patients. Yet, common interventions mostly focus on the phenomenological level, and prioritize the reduction of craving and withdrawal symptoms. Our review provides a mechanistic understanding of AUD and suggests alternative therapeutic approaches targeting the mechanisms underlying dysfunctional alcohol-related behaviours. Specifically, we explain how repeated drinking fosters the development of rigid drinking habits and is associated with diminished cognitive control. These behavioural and cognitive effects are then functionally related to the neurobiochemical effects of alcohol abuse. We further explain how alterations in fronto-striatal network activity may constitute the neurobiological correlates of these alcohol-related dysfunctions. Finally, we discuss limitations in current pharmacological AUD therapies and suggest non-invasive brain stimulation (like TMS and tDCS interventions) as a potential addition/alternative for modulating the activation of both cortical and subcortical areas to help re-establish the functional balance between controlled and automatic behaviour.
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Affiliation(s)
- Filippo Ghin
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany; University Neuropsychology Center, Faculty of Medicine, TU Dresden, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany; University Neuropsychology Center, Faculty of Medicine, TU Dresden, Germany
| | - Ann-Kathrin Stock
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany; University Neuropsychology Center, Faculty of Medicine, TU Dresden, Germany; Biopsychology, Faculty of Psychology, TU Dresden, Dresden, Germany.
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17
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Cherrier MM, Shen DD, Shireman L, Saxon AJ, Simpson T, Men A, Kooner P, Terman GW. Elevated customary alcohol consumption attenuates opioid effects. Pharmacol Biochem Behav 2021; 211:173295. [PMID: 34742948 DOI: 10.1016/j.pbb.2021.173295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 08/11/2021] [Accepted: 11/01/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Regular alcohol consumption is on the rise among older adults and has the potential of altering the subjective experience of pain and response to pain medications. This study examined the cognitive, analgesic and side effect response to oxycodone in middle age and older adults with elevated levels of customary alcohol consumption in a human laboratory setting. METHODS After refraining from alcohol for one day, eligible participants underwent baseline assessment cognition and side effects by means of questionnaires that were repeated at three time points (90 min, 5 and 8 h) following administration of a 10 mg oral dose of oxycodone. Response to pain stimulus (Cold Pressor Test (CPT)), pupil size, and plasma oxycodone were also measured. RESULTS One hundred twenty-eight adults (age 35-85) completed the study day. Compared to those with lower customary alcohol consumption, participants with elevated alcohol consumption showed attenuated opioid-induced pupil constriction and cognitive decline on objective measures of working memory, sustained attention, inhibitory control, coordination on a simulated driving task, and subjective dysphoric effects with enhanced subjective euphoric effects. Oxycodone pharmacokinetics, pain tolerance to CPT, and Berg balance were impacted comparably between alcohol consumption groups. Women endorsed greater negative drug effects, whereas men endorsed positive drug effects. CONCLUSION Independent of subject's age, elevated customary alcohol consumption attenuates opioid central effects (i.e., pupil miosis, impaired cognition) and gender influences subjective drug effects. Clinicians should consider alcohol consumption and gender when prescribing opioid medications.
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Affiliation(s)
- Monique M Cherrier
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA 98195, United States of America.
| | - Danny D Shen
- Department of Pharmaceutics, School of Pharmacy, University of Washington, Seattle, WA 98195, United States of America
| | - Laura Shireman
- Department of Pharmaceutics, School of Pharmacy, University of Washington, Seattle, WA 98195, United States of America
| | - Andrew J Saxon
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA 98195, United States of America; Center of Excellence in Substance Addiction Treatment and Education VA Puget Sound Health Care System, Seattle, WA 98108, United States of America
| | - Tracy Simpson
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA 98195, United States of America; Center of Excellence in Substance Addiction Treatment and Education VA Puget Sound Health Care System, Seattle, WA 98108, United States of America
| | - Alex Men
- Department of Pharmaceutics, School of Pharmacy, University of Washington, Seattle, WA 98195, United States of America
| | - Preetma Kooner
- Department of Anesthesiology and Pain Medicine, School of Medicine; University of Washington, Seattle, WA 98195, United States of America
| | - Gregory W Terman
- Department of Anesthesiology and Pain Medicine, School of Medicine; University of Washington, Seattle, WA 98195, United States of America
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18
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Cucinello-Ragland JA, Mitchell-Cleveland R, Bradley Trimble W, Urbina AP, Yeh AY, Edwards KN, Molina PE, Simon Peter L, Edwards S. Alcohol amplifies cingulate cortex signaling and facilitates immobilization-induced hyperalgesia in female rats. Neurosci Lett 2021; 761:136119. [PMID: 34280506 PMCID: PMC8387454 DOI: 10.1016/j.neulet.2021.136119] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 07/14/2021] [Indexed: 12/28/2022]
Abstract
Complex Regional Pain Syndrome (CRPS) is a musculoskeletal pain condition that often develops after limb injury and/or immobilization. Although the exact mechanisms underlying CRPS are unknown, the syndrome is associated with central and autonomic nervous system dysregulation and peripheral hyperalgesia symptoms. These symptoms also manifest in alcoholic neuropathy, suggesting that the two conditions may be pathophysiologically accretive. Interestingly, people assigned female at birth (AFAB) appear to be more sensitive to both CRPS and alcoholic neuropathy. To better understand the biobehavioral mechanisms underlying these conditions, we investigated a model of combined CRPS and alcoholic neuropathy in female rats. Animals were pair-fed either a Lieber-DeCarli alcohol liquid diet or a control diet for ten weeks. CRPS was modeled via unilateral hind limb cast immobilization for seven days, allowing for the other limb to serve as a within-subject control for hyperalgesia measures. To investigate the role of circulating ovarian hormones on pain-related behaviors, half of the animals underwent ovariectomy (OVX). Using the von Frey procedure to record mechanical paw withdrawal thresholds, we found that cast immobilization and chronic alcohol drinking separately and additively produced mechanical hyperalgesia observed 3 days after cast removal. We then examined neuroadaptations in AMPA GluR1 and NMDA NR1 glutamate channel subunits, extracellular signal-regulated kinase (ERK), and cAMP response element-binding protein (CREB) in bilateral motor and cingulate cortex across all groups. Consistent with increased pain-related behavior, chronic alcohol drinking increased GluR1, NR1, ERK, and CREB phosphorylation in the cingulate cortex. OVX did not alter any of the observed effects. Our results suggest accretive relationships between CRPS and alcoholic neuropathy symptoms and point to novel therapeutic targets for these conditions.
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Affiliation(s)
- Jessica A Cucinello-Ragland
- Department of Physiology and School of Medicine, LSU Health-New Orleans, United States; Alcohol & Drug Abuse Center of Excellence, LSU Health-New Orleans, United States
| | | | - W Bradley Trimble
- Department of Physiology and School of Medicine, LSU Health-New Orleans, United States
| | - Amy P Urbina
- Department of Physiology and School of Medicine, LSU Health-New Orleans, United States
| | - Alice Y Yeh
- Department of Physiology and School of Medicine, LSU Health-New Orleans, United States
| | - Kimberly N Edwards
- Department of Physiology and School of Medicine, LSU Health-New Orleans, United States; Alcohol & Drug Abuse Center of Excellence, LSU Health-New Orleans, United States
| | - Patricia E Molina
- Department of Physiology and School of Medicine, LSU Health-New Orleans, United States; Alcohol & Drug Abuse Center of Excellence, LSU Health-New Orleans, United States; Comprehensive Alcohol-HIV/AIDS Research Center, LSU Health-New Orleans, United States
| | - Liz Simon Peter
- Department of Physiology and School of Medicine, LSU Health-New Orleans, United States; Alcohol & Drug Abuse Center of Excellence, LSU Health-New Orleans, United States; Comprehensive Alcohol-HIV/AIDS Research Center, LSU Health-New Orleans, United States
| | - Scott Edwards
- Department of Physiology and School of Medicine, LSU Health-New Orleans, United States; Alcohol & Drug Abuse Center of Excellence, LSU Health-New Orleans, United States; Neuroscience Center of Excellence, LSU Health-New Orleans, United States; Comprehensive Alcohol-HIV/AIDS Research Center, LSU Health-New Orleans, United States.
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19
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You DS, Hahn HA, Welsh TH, Meagher MW. Hyperalgesia after a Drinking Episode in Young Adult Binge Drinkers: A Cross-Sectional Study. Alcohol Alcohol 2021; 55:608-615. [PMID: 32476005 DOI: 10.1093/alcalc/agaa035] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 04/13/2020] [Accepted: 04/15/2020] [Indexed: 11/13/2022] Open
Abstract
AIMS Rodent studies propose potential mechanisms linking excessive drinking and pain hypersensitivity (hyperalgesia), such that stress hormones (i.e. epinephrine and cortisol) mediate induction and maintenance of alcohol withdrawal-induced hyperalgesia. The first aim of this study was to examine whether hyperalgesia would occur within 48 h after a drinking episode in healthy young adult binge drinkers. The second was to examine whether stress hormones and negative effect would be associated with binge drinking or alcohol withdrawal-associated hyperalgesia. METHODS A cross-sectional experiment was conducted in five groups with naturally occurring drinking (mean age = 19.6, range 18-29 years): abstainers (n = 43, 54% female), moderate drinkers with (n = 50, 50% female) or without recent drinking (i.e. within 48 h, n = 23, 26% female) and binge drinkers with (n = 36, 58% female) or without recent drinking (n = 25, 44% female). All types of drinkers endorsed drinking about 2-3 times a month and 2-3 years of drinking history. RESULTS Muscle pressure pain thresholds were significantly lower in the binge group with recent drinking compared to other groups, but cutaneous mechanical and heat pain thresholds were not significantly different across the five groups. Basal epinephrine levels were significantly higher in binge groups regardless of recent drinking, but cortisol and negative effect were not significantly different across the five groups. CONCLUSIONS This is the first study to show that alcohol withdrawal-associated muscle hyperalgesia may occur in healthy episodic binge drinkers with only 2-3 years of drinking history, and epinephrine may play a role in binge drinking-associated hyperalgesia.
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Affiliation(s)
- Dokyoung S You
- Department of Psychology, Texas A&M University, 425 Ross Street, College Station, TX 77843-4235, USA
| | - Hunter A Hahn
- Department of Psychology, Texas A&M University, 425 Ross Street, College Station, TX 77843-4235, USA
| | - Thomas H Welsh
- Departments of Animal Science and Veterinary Integrative Biosciences, Texas A&M University, 474 Olsen Blvd, College Station, TX 77843-2471, USA
| | - Mary W Meagher
- Department of Psychology, Texas A&M University, 425 Ross Street, College Station, TX 77843-4235, USA
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Quadir SG, Tanino SM, Sami YN, Minnig MA, Iyer MR, Rice KC, Cottone P, Sabino V. Antagonism of Sigma-1 receptor blocks heavy alcohol drinking and associated hyperalgesia in male mice. Alcohol Clin Exp Res 2021; 45:1398-1407. [PMID: 34060104 PMCID: PMC8295198 DOI: 10.1111/acer.14635] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 04/16/2021] [Accepted: 05/10/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Alcohol use disorder (AUD) is a complex psychiatric disease characterized by high alcohol intake as well as hyperkatifeia and hyperalgesia during withdrawal. A role for Sigma-1 receptors (Sig-1Rs) in the rewarding and reinforcing effects of alcohol has started to emerge in recent years, as rat studies have indicated that Sig-1R hyperactivity may result in excessive alcohol drinking. Sig-1R studies in mice are very scarce, and its potential role in alcohol-induced hyperalgesia is also unknown. METHODS In this study, we investigated the role of Sig-1R in alcohol drinking and associated hyperalgesia in male mice, using an intermittent access 2-bottle choice model of heavy drinking. RESULTS The Sig-1R antagonist BD-1063 was found dose dependently to reduce both alcohol intake and preference, without affecting either water or sucrose intake, suggesting that the effects are specific for alcohol. Notably, the ability of BD-1063 to suppress ethanol intake correlated with the individual baseline levels of alcohol drinking, suggesting that the treatment was more efficacious in heavy drinking animals. In addition, BD-1063 reversed alcohol-induced hyperalgesia during withdrawal, assessed using an automatic Hargreaves test, without affecting thermal sensitivity in alcohol-naïve animals or locomotor activity in either group. CONCLUSIONS These data show that Sig-1R antagonism dose-dependently reduced ethanol consumption in heavy drinking mice as well as its efficacy in reducing alcohol-induced hyperalgesia. These findings provide a foundation for the development of novel treatments for AUD and associated pain states.
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Affiliation(s)
- Sema G. Quadir
- Laboratory of Addictive Disorders, Departments of Pharmacology and Psychiatry, Boston University School of Medicine, 72 E. Concord St., Boston, MA, USA
| | - Sean M. Tanino
- Laboratory of Addictive Disorders, Departments of Pharmacology and Psychiatry, Boston University School of Medicine, 72 E. Concord St., Boston, MA, USA
| | - Yasmine N. Sami
- Laboratory of Addictive Disorders, Departments of Pharmacology and Psychiatry, Boston University School of Medicine, 72 E. Concord St., Boston, MA, USA
| | - Margaret A. Minnig
- Laboratory of Addictive Disorders, Departments of Pharmacology and Psychiatry, Boston University School of Medicine, 72 E. Concord St., Boston, MA, USA
| | - Malliga R. Iyer
- Section on Medicinal Chemistry, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Kenner C. Rice
- Drug Design and Synthesis, National Institute on Drug Abuse and National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Pietro Cottone
- Laboratory of Addictive Disorders, Departments of Pharmacology and Psychiatry, Boston University School of Medicine, 72 E. Concord St., Boston, MA, USA
| | - Valentina Sabino
- Laboratory of Addictive Disorders, Departments of Pharmacology and Psychiatry, Boston University School of Medicine, 72 E. Concord St., Boston, MA, USA
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Pain Sensitivity, Negative Affect, and Alcohol Use Disorder Status: A Moderated Mediation Study of Emotion Dysregulation. J Clin Med 2021; 10:jcm10061321. [PMID: 33806849 PMCID: PMC8005076 DOI: 10.3390/jcm10061321] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/13/2021] [Accepted: 03/18/2021] [Indexed: 12/24/2022] Open
Abstract
Previous work suggests that the association between pain and emotional processes among individuals with alcohol use disorder (AUD) may differ from healthy controls. This study investigates whether pain sensitivity mediates the association between negative affect and emotional dysregulation and whether this association differs across AUD status using moderated mediation. The sample included 165 individuals diagnosed with AUD and 110 healthy controls. Of interest was pain sensitivity, as assessed with the Pain Sensitivity Questionnaire, negative affect, as assessed with the Beck Depression Inventory, and emotional dysregulation, as assessed with the Difficulties in Emotional regulation Scale. Age, biological sex, and current pain severity were included as covariates. The results support a moderated partial mediation model that explained 44% of the variance in emotional dysregulation. The findings indicate that negative affect is related to higher pain sensitivity across groups. Moreover, pain sensitivity partially mediated the association between negative affect and emotional dysregulation, but in opposite directions depending on AUD status. Among healthy controls, greater pain sensitivity was related to better emotional regulation, while greater pain sensitivity led to greater emotional dysregulation among individuals with AUD. The potential parallels in the underlying neurobiological mechanisms of emotionality, pain, and AUD suggest that interventions targeting pain may improve adaptive affect regulation skills, which in turn could reduce negative affect and its effect on pain sensitivity among individuals with AUD.
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Nazarian A, Negus SS, Martin TJ. Factors mediating pain-related risk for opioid use disorder. Neuropharmacology 2021; 186:108476. [PMID: 33524407 PMCID: PMC7954943 DOI: 10.1016/j.neuropharm.2021.108476] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 12/03/2020] [Accepted: 01/23/2021] [Indexed: 12/23/2022]
Abstract
Pain is a complex experience with far-reaching organismal influences ranging from biological factors to those that are psychological and social. Such influences can serve as pain-related risk factors that represent susceptibilities to opioid use disorder. This review evaluates various pain-related risk factors to form a consensus on those that facilitate opioid abuse. Epidemiological findings represent a high degree of co-occurrence between chronic pain and opioid use disorder that is, in part, driven by an increase in the availability of opioid analgesics and the diversion of their use in a non-medical context. Brain imaging studies in individuals with chronic pain that use/abuse opioids suggest abuse-related mechanisms that are rooted within mesocorticolimbic processing. Preclinical studies suggest that pain states have a limited impact on increasing the rewarding effects of opioids. Indeed, many findings indicate a reduction in the rewarding and reinforcing effects of opioids during pain states. An increase in opioid use may be facilitated by an increase in the availability of opioids and a decrease in access to non-opioid reinforcers that require mobility or social interaction. Moreover, chronic pain and substance abuse conditions are known to impair cognitive function, resulting in deficits in attention and decision making that may promote opioid abuse. A better understanding of pain-related risk factors can improve our knowledge in the development of OUD in persons with pain conditions and can help identify appropriate treatment strategies. This article is part of the special issue on 'Vulnerabilities to Substance Abuse.'.
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Affiliation(s)
- Arbi Nazarian
- Department of Pharmaceutical Sciences, Western University of Health Sciences, Pomona, CA 91766, USA.
| | - S Stevens Negus
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Thomas J Martin
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
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Preliminary study of the impact of elevated circulating plasma levels of catecholamines on opioid requirements for acute surgical pain. J Clin Transl Sci 2021; 5:e114. [PMID: 34221456 PMCID: PMC8223169 DOI: 10.1017/cts.2020.573] [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] [Indexed: 11/21/2022] Open
Abstract
Introduction: The objective of this study is to determine whether elevated circulating plasma catecholamine levels significantly impact opioid requirements during the first 24 hours postoperative period in individuals with acute surgical pain. Methods: We retrospectively reviewed 15 electronic medical records (EMRs) from adults 18 years and older, with confirmed elevated plasma catecholamine levels (experimental) and 15 electronic health records (EHRs) from matched-controls for age, gender, race and type of surgery, with a follow up of 24 hours postoperatively. Results: The total morphine milligram equivalents (MMEs) requirements from the experimental group were not statistically different when compared with controls [44.1 (13 to 163) mg versus 47.5 (13 to 151) mg respectively; p 0.4965]. However, the intraoperative MMEs showed a significant difference, among the two groups; [(experimental) 32.5 (13. to 130) mg, (control) 15 (6.5 to 130) mg; p 0.0734]. The intraoperative dosage of midazolam showed a highly significant positive correlation to the total MMEs (p 0.0005). The subjects with both elevated plasma catecholamines and hypertension used significantly higher intraoperative MMEs compared to controls [34.1 (13 to 130) mg versus 15 (6.5 to 130) mg, respectively; p 0.0292)]. Those 51 years and younger, with elevated circulating levels of catecholamines, required significantly higher levels of both the postoperative MMEs [29.1 (0 to 45) mg versus 12 (0 to 71.5) mg; (p 0.0553)] and total MMEs [544.05 (13 to 81) mg versus 29.42 (13 to 92.5) mg; (p 0.00018), when compared to controls with history of nicotine and alcohol use. Conclusion: This preliminary study evaluated a biologic factor, which have promising clinical usefulness for predicting analgesic requirements that can drive clinical decisions on acute surgical pain.
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24
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The synergistic effect between interoceptive accuracy and alcohol use disorder status on pain sensitivity. Addict Behav 2021; 112:106607. [PMID: 32827968 DOI: 10.1016/j.addbeh.2020.106607] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/09/2020] [Accepted: 08/09/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND Interoceptive accuracy and pain sensitivity are both risk factors in the development of alcohol use disorder (AUD). However, the synergistic association between these two factors has not been investigated in an AUD sample. Therefore, the aim of the current study was to investigate whether the association between interoceptive accuracy and sensitivity to pain differed across AUD status. METHODS The study group included 165 individuals diagnosed with AUD (88.1% men) and 110 healthy controls (HCs; 74.5% men). Interoceptive accuracy was assessed with the Schandry Task. The Pain Sensitivity Questionnaire was utilized to measure sensitivity to pain. Anxiety, biological sex, and age were included as covariates in a model examining the role of AUD status as a moderator in the association between interoceptive accuracy and pain sensitivity. RESULTS A significant interaction was found between interoceptive accuracy and AUD status (b = -4.580, 95% CI = [-8.137, -1.022], p = 0.012, ΔR2 = 0.032). Findings indicate that interoceptive accuracy was negatively associated with pain sensitivity among individuals with AUD, while there was a trend for an opposite association among healthy controls. CONCLUSION We hypothesize that persistent alcohol drinking may contribute to disruption of the normative association between interoception and pain. Future studies should be conducted to develop knowledge on this association and to investigate its possible therapeutic significance and implications.
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25
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Nieto SJ, Green R, Grodin EN, Cahill CM, Ray LA. Pain catastrophizing predicts alcohol craving in heavy drinkers independent of pain intensity. Drug Alcohol Depend 2021; 218:108368. [PMID: 33143942 PMCID: PMC7750265 DOI: 10.1016/j.drugalcdep.2020.108368] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/13/2020] [Accepted: 10/14/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Chronic pain and alcohol use disorder (AUD) are often co-occurring conditions. Pain catastrophizing, an emotional component of pain, and pain intensity are related to alcohol use as a coping mechanism; however, how pain interacts with tonic alcohol craving is an understudied area. This study sought to determine the unique and independent effects of pain intensity and pain catastrophizing on alcohol craving in heavy drinkers. METHOD Non-treatment seeking heavy drinkers (n = 128) completed self-report measures of pain (both intensity and catastrophizing), depression, alcohol use and problems, and reasons for heavy drinking. A hierarchical regression examined the unique contribution of pain intensity to alcohol craving. Depression, pain catastrophizing, and alcohol use measures were added to the hierarchical model in sequential blocks. RESULTS The final model of the hierarchical regression demonstrated that pain catastrophizing has an independent effect on alcohol craving over and above demographic, pain intensity, depression, and alcohol measures. Exploratory analyses suggest that individuals in the high intensity pain grade have higher levels of depression symptomology, pain catastrophizing, alcohol use and problems, as well as engaging in heavy drinking to "feel normal" compared to the no pain and low intensity pain grades. CONCLUSIONS These results demonstrate that pain catastrophizing predicts alcohol craving independent of self-reported chronic pain intensity. Individuals with high intensity chronic pain have more severe alcohol use and mood-related symptomology. Upon replication in clinical samples, these findings can inform clinical care for pain management.
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Affiliation(s)
- Steven J Nieto
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA, United States
| | - ReJoyce Green
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA, United States
| | - Erica N Grodin
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA, United States
| | - Catherine M Cahill
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, United States
| | - Lara A Ray
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA, United States; Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, United States.
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Quadir SG, Tanino SM, Rohl CD, Sahn JJ, Yao EJ, Cruz LDR, Cottone P, Martin SF, Sabino V. The Sigma-2 receptor / transmembrane protein 97 (σ2R/TMEM97) modulator JVW-1034 reduces heavy alcohol drinking and associated pain states in male mice. Neuropharmacology 2020; 184:108409. [PMID: 33221481 DOI: 10.1016/j.neuropharm.2020.108409] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/27/2020] [Accepted: 11/17/2020] [Indexed: 12/15/2022]
Abstract
Alcohol Use Disorder (AUD) is a chronic relapsing disorder characterized by compulsive alcohol intake, loss of control over alcohol intake, and a negative emotional state when access to alcohol is prevented. AUD is also closely tied to pain, as repeated alcohol drinking leads to increased pain sensitivity during withdrawal. The sigma-2 receptor, recently identified as transmembrane protein 97 (σ2R/TMEM97), is an integral membrane protein involved in cholesterol homeostasis and lipid metabolism. Selective σ2R/Tmem97 modulators have been recently shown to relieve mechanical hypersensitivity in animal models of neuropathic pain as well as to attenuate alcohol withdrawal signs in C. elegans and to reduce alcohol drinking in rats, suggesting a potential key role for this protein in alcohol-related behaviors. In this study, we tested the effects of a potent and selective σ2R/TMEM97 ligand, JVW-1034, on heavy alcohol drinking and alcohol-induced heightened pain states in mice using an intermittent access model. Administration of JVW-1034 decreased both ethanol intake and preference for ethanol, without affecting water intake, total fluid intake, or food intake. Notably, this effect was specific for alcohol, as JVW-1034 had no effect on sucrose intake. Furthermore, JVW-1034 reduced both thermal hyperalgesia and mechanical hypersensitivity in ethanol withdrawn mice. Our data provide important evidence that modulation of σ2R/TMEM97 with small molecules can mediate heavy alcohol drinking as well as chronic alcohol-induced heightened pain sensitivity, thereby identifying a promising novel pharmacological target for AUD and associated pain states.
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Affiliation(s)
- Sema G Quadir
- Laboratory of Addictive Disorders, Departments of Pharmacology and Psychiatry, Boston University School of Medicine, 72 E. Concord St, Boston, MA, USA
| | - Sean M Tanino
- Laboratory of Addictive Disorders, Departments of Pharmacology and Psychiatry, Boston University School of Medicine, 72 E. Concord St, Boston, MA, USA
| | - Christian D Rohl
- Laboratory of Addictive Disorders, Departments of Pharmacology and Psychiatry, Boston University School of Medicine, 72 E. Concord St, Boston, MA, USA
| | - James J Sahn
- Department of Chemistry and Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, Austin, TX, USA
| | - Emily J Yao
- Laboratory of Addictive Disorders, Departments of Pharmacology and Psychiatry, Boston University School of Medicine, 72 E. Concord St, Boston, MA, USA
| | - Luíza Dos Reis Cruz
- Department of Chemistry and Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, Austin, TX, USA
| | - Pietro Cottone
- Laboratory of Addictive Disorders, Departments of Pharmacology and Psychiatry, Boston University School of Medicine, 72 E. Concord St, Boston, MA, USA
| | - Stephen F Martin
- Department of Chemistry and Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, Austin, TX, USA.
| | - Valentina Sabino
- Laboratory of Addictive Disorders, Departments of Pharmacology and Psychiatry, Boston University School of Medicine, 72 E. Concord St, Boston, MA, USA.
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Quadir SG, Rohl CD, Zeabi A, Moore CF, Cottone P, Sabino V. Effect of different standard rodent diets on ethanol intake and associated allodynia in male mice. Alcohol 2020; 87:17-23. [PMID: 32330590 DOI: 10.1016/j.alcohol.2020.04.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/20/2020] [Accepted: 04/14/2020] [Indexed: 11/16/2022]
Abstract
Alcohol is the most ubiquitously consumed and misused mind-altering substance in the world. Various animal models exist to aid in our neurobiological understanding of alcohol addiction. One variable too often taken for granted and not consistently controlled is the "standard" chow diet rodents are maintained on. In this set of experiments, we sought to determine the effect of different commonly used diets on ethanol intake, ethanol preference, and mechanical pain sensitivity in a widely used mouse model of heavy alcohol drinking, the intermittent access to 20% alcohol model. We found that male mice kept on LabDiet 5001 (Diet 2 [LD5001]) and on Teklad Diet 7012 (Diet 3 [H7012]) consistently drank more ethanol than mice kept on Teklad Diet 2918 (Diet 1 [H2918]) as well as compared to mice on LabDiet 5V75 (Diet 4 [LD5V75]). In addition, water intake was consistently lower in mice kept on LabDiet 5001 (Diet 2 [LD5001]), and occasionally in mice kept on Teklad Diet 7012 (Diet 3 [H7012]), compared to the Teklad Diet 2918 (Diet 1 [H2918]) group. We found that male mice showed a strong mechanical allodynia following 8 weeks of intermittent ethanol drinking at 72 h of withdrawal, compared to water Control mice, regardless of the diet and hence of the different amount of ethanol consumed. Our data provide evidence that the type of rodent diet subjects are exposed to is an important variable to report and control, in all ethanol drinking studies.
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Affiliation(s)
- Sema G Quadir
- Laboratory of Addictive Disorders, Departments of Pharmacology and Psychiatry, Boston University School of Medicine, 72 E. Concord St., Boston, MA, United States
| | - Christian D Rohl
- Laboratory of Addictive Disorders, Departments of Pharmacology and Psychiatry, Boston University School of Medicine, 72 E. Concord St., Boston, MA, United States
| | - Aya Zeabi
- Laboratory of Addictive Disorders, Departments of Pharmacology and Psychiatry, Boston University School of Medicine, 72 E. Concord St., Boston, MA, United States
| | - Catherine F Moore
- Laboratory of Addictive Disorders, Departments of Pharmacology and Psychiatry, Boston University School of Medicine, 72 E. Concord St., Boston, MA, United States
| | - Pietro Cottone
- Laboratory of Addictive Disorders, Departments of Pharmacology and Psychiatry, Boston University School of Medicine, 72 E. Concord St., Boston, MA, United States
| | - Valentina Sabino
- Laboratory of Addictive Disorders, Departments of Pharmacology and Psychiatry, Boston University School of Medicine, 72 E. Concord St., Boston, MA, United States.
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Adrienne McGinn M, Edwards KN, Edwards S. Chronic inflammatory pain alters alcohol-regulated frontocortical signaling and associations between alcohol drinking and thermal sensitivity. NEUROBIOLOGY OF PAIN (CAMBRIDGE, MASS.) 2020; 8:100052. [PMID: 33005820 PMCID: PMC7509777 DOI: 10.1016/j.ynpai.2020.100052] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 09/09/2020] [Indexed: 12/22/2022]
Abstract
Alcohol use disorder (AUD) is a chronic, relapsing psychiatric disorder that is characterized by the emergence of negative affective states. The transition from recreational, limited intake to uncontrolled, escalated intake is proposed to involve a transition from positive to negative reinforcement mechanisms for seeking alcohol. Past work has identified the emergence of significant hyperalgesia/allodynia in alcohol-dependent animals, which may serve as a key negative reinforcement mechanism. Chronic pain has been associated with enhanced extracellular signal-regulated kinase (ERK) activity in cortical and subcortical nociceptive areas. Additionally, both pain and AUD have been associated with increased activity of the glucocorticoid receptor (GR), a key mediator of stress responsiveness. The objectives of the current study were to first determine relationships between thermal nociceptive sensitivity and alcohol drinking in male Wistar rats. While inflammatory pain induced by complete Freund's adjuvant (CFA) administration did not modify escalation of home cage drinking in animals over four weeks, the relationship between drinking levels and hyperalgesia symptoms reversed between acute (1 week) and chronic (3-4 week) periods post-CFA administration, suggesting that either the motivational or analgesic effects of alcohol may be altered over the time course of chronic pain. We next examined ERK and GR phosphorylation in pain-related brain areas (including the central amygdala and prefrontal cortex subregions) in animals experiencing acute withdrawal from binge alcohol administration (2 g/kg, 6 h withdrawal) and CFA administration (four weeks) to model the neurobiological consequences of binge alcohol exposure in the context of pain. We observed a significant interaction between alcohol and pain state, whereby alcohol withdrawal increased ERK phosphorylation across all four frontocortical areas examined, although this effect was absent in animals experiencing chronic inflammatory pain. Alcohol withdrawal also increased GR phosphorylation across all four frontocortical areas, but these changes were not altered by CFA. Interestingly, we observed significant inter-brain regional correlations in GR phosphorylation between the insula and other regions investigated only in animals exposed to both alcohol and CFA, suggesting coordinated activity in insula circuitry and glucocorticoid signaling in this context. The results of these studies provide a greater understanding of the neurobiology of AUD and will contribute to the development of effective treatment strategies for comorbid AUD and pain.
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Affiliation(s)
- M. Adrienne McGinn
- Neurobiology of Addiction Section, National Institute on Drug Abuse IRP, United States
| | - Kimberly N. Edwards
- Department of Physiology, LSU Health-New Orleans, United States
- Alcohol & Drug Abuse Center of Excellence, LSU Health-New Orleans, United States
| | - Scott Edwards
- Department of Physiology, LSU Health-New Orleans, United States
- Alcohol & Drug Abuse Center of Excellence, LSU Health-New Orleans, United States
- Neuroscience Center of Excellence, LSU Health-New Orleans, United States
- Comprehensive Alcohol-HIV/AIDS Research Center, LSU Health-New Orleans, United States
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Le TM, Zhornitsky S, Zhang S, Li CSR. Pain and reward circuits antagonistically modulate alcohol expectancy to regulate drinking. Transl Psychiatry 2020; 10:220. [PMID: 32636394 PMCID: PMC7341762 DOI: 10.1038/s41398-020-00909-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/11/2020] [Accepted: 06/23/2020] [Indexed: 02/02/2023] Open
Abstract
Expectancy of physical and social pleasure (PSP) promotes excessive drinking despite the potential aversive effects of misuse, suggesting an imbalance in the response to reward and pain in alcohol seeking. Here, we investigated the competing roles of the reward and pain circuits in PSP expectancy and problem drinking in humans. Using fMRI data during resting (n = 180) and during alcohol cue exposure (n = 71), we examined the antagonistic effects of the reward-related medial orbitofrontal cortex (mOFC) and pain-related periaqueductal gray (PAG) connectivities on PSP expectancy and drinking severity. The two regions' connectivity maps and strengths were characterized to assess their shared substrates and net relationship with PSP expectancy. We evaluated mediation and path models to further delineate how mOFC and PAG connectivities interacted through the shared substrates to differentially impact expectancy and alcohol use. During resting, whole-brain regressions showed mOFC connectivity in positive and PAG connectivity in negative association with PSP scores, with convergence in the precentral gyrus (PrCG). Notably, greater PAG-PrCG relative to mOFC-PrCG connectivity strength predicted lower PSP expectancy. During the alcohol cue exposure task, the net strength of the PAG vs. mOFC cue-elicited connectivity with the occipital cortex again negatively predicted PSP expectancy. Finally, mediation and path models revealed that the PAG and mOFC connectivities indirectly and antagonistically modulated problem drinking via their opposing influences on expectancy and craving. Thus, the pain and reward circuits exhibit functional antagonism such that the mOFC connectivity increases expectancy of drinking pleasure whereas the PAG serves to counter that effect.
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Affiliation(s)
- Thang M Le
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06519, USA.
| | - Simon Zhornitsky
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06519, USA
| | - Sheng Zhang
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06519, USA
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06519, USA
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, 06520, USA
- Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, CT, 06520, USA
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Edwards S, Vendruscolo LF, Gilpin NW, Wojnar M, Witkiewitz K. Alcohol and Pain: A Translational Review of Preclinical and Clinical Findings to Inform Future Treatment Strategies. Alcohol Clin Exp Res 2020; 44:368-383. [PMID: 31840821 PMCID: PMC11004915 DOI: 10.1111/acer.14260] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 11/28/2019] [Indexed: 12/13/2022]
Abstract
Alcohol use disorder (AUD) and chronic pain are enduring and devastating conditions that share an intersecting epidemiology and neurobiology. Chronic alcohol use itself can produce a characteristic painful neuropathy, while the regular analgesic use of alcohol in the context of nociceptive sensitization and heightened affective pain sensitivity may promote negative reinforcement mechanisms that underlie AUD maintenance and progression. The goal of this review was to provide a broad translational framework that communicates research findings spanning preclinical and clinical studies, including a review of genetic, molecular, behavioral, and social mechanisms that facilitate interactions between persistent pain and alcohol use. We also consider recent evidence that will shape future investigations into novel treatment mechanisms for pain in individuals suffering from AUD.
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Affiliation(s)
- Scott Edwards
- Department of Physiology and Comprehensive Alcohol-HIV/AIDS Research Center, LSU Health Sciences Center, New Orleans, LA 70112
| | - Leandro F. Vendruscolo
- National Institute on Drug Abuse (NIDA), Intramural Research Program (IRP), Baltimore, MD 21224
| | - Nicholas W. Gilpin
- Department of Physiology and Comprehensive Alcohol-HIV/AIDS Research Center, LSU Health Sciences Center, New Orleans, LA 70112
| | - Marcin Wojnar
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109
| | - Katie Witkiewitz
- Department of Psychology, University of New Mexico, Albuquerque NM 87131
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