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Viudez-Martínez A, Torregrosa AB, Navarrete F, García-Gutiérrez MS. Understanding the Biological Relationship between Migraine and Depression. Biomolecules 2024; 14:163. [PMID: 38397400 PMCID: PMC10886628 DOI: 10.3390/biom14020163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 02/25/2024] Open
Abstract
Migraine is a highly prevalent neurological disorder. Among the risk factors identified, psychiatric comorbidities, such as depression, seem to play an important role in its onset and clinical course. Patients with migraine are 2.5 times more likely to develop a depressive disorder; this risk becomes even higher in patients suffering from chronic migraine or migraine with aura. This relationship is bidirectional, since depression also predicts an earlier/worse onset of migraine, increasing the risk of migraine chronicity and, consequently, requiring a higher healthcare expenditure compared to migraine alone. All these data suggest that migraine and depression may share overlapping biological mechanisms. Herein, this review explores this topic in further detail: firstly, by introducing the common epidemiological and risk factors for this comorbidity; secondly, by focusing on providing the cumulative evidence of common biological aspects, with a particular emphasis on the serotoninergic system, neuropeptides such as calcitonin-gene-related peptide (CGRP), pituitary adenylate cyclase-activating polypeptide (PACAP), substance P, neuropeptide Y and orexins, sexual hormones, and the immune system; lastly, by remarking on the future challenges required to elucidate the etiopathological mechanisms of migraine and depression and providing updated information regarding new key targets for the pharmacological treatment of these clinical entities.
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Affiliation(s)
- Adrián Viudez-Martínez
- Hospital Pharmacy Service, Hospital General Dr. Balmis de Alicante, 03010 Alicante, Spain;
| | - Abraham B. Torregrosa
- Instituto de Neurociencias, Universidad Miguel Hernández, 03550 San Juan de Alicante, Spain; (A.B.T.); (F.N.)
- Research Network on Primary Addictions, Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
| | - Francisco Navarrete
- Instituto de Neurociencias, Universidad Miguel Hernández, 03550 San Juan de Alicante, Spain; (A.B.T.); (F.N.)
- Research Network on Primary Addictions, Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
| | - María Salud García-Gutiérrez
- Instituto de Neurociencias, Universidad Miguel Hernández, 03550 San Juan de Alicante, Spain; (A.B.T.); (F.N.)
- Research Network on Primary Addictions, Instituto de Salud Carlos III, MICINN and FEDER, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
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Calcitonin Gene-Related Peptide Is Potential Therapeutic Target OF Osteoporosis. Heliyon 2022; 8:e12288. [DOI: 10.1016/j.heliyon.2022.e12288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/31/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022] Open
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Zelic Kerep A, Pirsl F, Steinberg S, Mitchell S, Curtis L, Holtzman N, Goklemez S, Bilic E, Cowen E, Pichard D, Joe G, Comis L, Im A, Berger A, Parsons-Wandell L, Pulanic D, Baird K, Gress R, Pavletic S. Determinants and Clinical Significance of Musculoskeletal Symptoms in Patients With Chronic Graft-Versus-Host Disease. Hemasphere 2022; 6:e730. [PMID: 35747850 PMCID: PMC9208866 DOI: 10.1097/hs9.0000000000000730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/26/2022] [Indexed: 11/30/2022] Open
Abstract
Musculoskeletal symptoms in chronic graft-versus-host disease (cGVHD) are rare manifestations contributing to disease burden. This study assesses the frequency of muscle cramps, joint and muscle aches, and muscle weakness in a cohort of patients severely affected by cGVHD. Three hundred thirty-four patients participated in the NCI natural history study of cGVHD (NCT00092235) from October 2004 to March 2017. Five-point Lee cGVHD Symptom Scale was dichotomized (less symptom bother—0, 1, 2; severe symptom bother—3, 4) and tested for associations with: Short Form 36 (SF36), 2-minute walk test, grip strength, joint range of motion, and human activity profile, clinical and laboratory data. Seventy-five point four percent of patients reported joint and muscle aches (36.8% severe, Lee Symptom Scale score 3–4), 74.3% muscle cramps (33.5% severe), and 82.34% muscle weakness (45.51% severe), which were associated with reduced functional capacity (SF36 Physical Component Scale, P < 0.0001). Muscle cramps were associated with limited joint movement (P < 0.0001) and skin manifestations (skin thickening, P = 0.0008; itchy skin, P = 0.0003). Muscle cramps did not show association with potential causative agents, such as concomitant calcineurin inhibitors therapy, statins, or use of antidiabetic drugs. Joint and muscle aches showed associations with multiple variables (including strong associations with mood symptoms and fatigue, P < 0.0001). Muscle weakness was not associated with steroid dose, but was significantly associated with depression (P < 0.0001) and anxiety (P = 0.0009). This study documents a high frequency of musculoskeletal symptoms in a cohort of adult patients with cGVHD. The multivariable logistic regression models showed that a joint set of factors were moderately well associated with musculoskeletal symptoms in this study.
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Hashikawa-Hobara N, Otsuka A, Okujima C, Hashikawa N. CGRP overexpression does not alter depression-like behavior in mice. PeerJ 2021; 9:e11720. [PMID: 34249519 PMCID: PMC8256807 DOI: 10.7717/peerj.11720] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/13/2021] [Indexed: 12/11/2022] Open
Abstract
Background The calcitonin gene-related peptide (CGRP) is a neuropeptide that is released from capsaicin-sensitive nerves as a potent vasodilator involved in nociceptive transmission. While CGRP has been rigorously studied for its role in migraines owing to its vasodilation and inflammation activities, the effects of CGRP overexpression on depressive-like behaviors remain insufficiently understood. Methods In the present study, we performed a battery of behavioral tests, including the social interaction test, open field test, and sucrose preference test, to evaluate social defeat stress using male C57BL6J or CGRP overexpression in transgenic (Tg) mice (CGRP Tg). We performed mRNA and protein analyses on the brain-derived neurotrophic factor (BDNF), phosphorylated Akt, mTOR, and p70S6K in the hippocampi. Results CGRP Tg mice showed increased levels of Bdnf mRNAs, low locomotor activity, and no deficits in social interaction, which indicate that CGRP Tg mice exhibit stress resistance and not depression. However, the open field test significantly decreased after 15-day social defeat stress exposure. We also evaluated depressive-like behavior using the sucrose preference and social interaction tests. Our data indicate that defeated CGRP Tg mice exhibited a depressive-like phenotype, which was inferred from increased social avoidance and reduced sucrose preference compared with non-defeated controls. Although stress exposure did not change the BDNF levels in CGRP Tg mice, it significantly decreased the expression levels of p-Akt, p-mTOR and p-p70S6K in the mice hippocampi. We conclude that CGRP-overexpressing Tg mice have normal sensitivity to stress and down-regulated hippocampal Akt/mTOR/p70S6K pathways.
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Affiliation(s)
| | - Ami Otsuka
- Department of Life Science, Okayama University of Science, Okayama, Japan
| | - Chihiro Okujima
- Department of Life Science, Okayama University of Science, Okayama, Japan
| | - Naoya Hashikawa
- Department of Life Science, Okayama University of Science, Okayama, Japan
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Bahouq H, Soulaymani A. Depression, Quality of Life, and Self-Esteem of Moroccan Postmenopausal Women with Osteoporosis before the Occurrence of Fractures. J Menopausal Med 2020; 26:121-129. [PMID: 32893513 PMCID: PMC7475288 DOI: 10.6118/jmm.19008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 01/17/2020] [Accepted: 06/18/2020] [Indexed: 11/27/2022] Open
Abstract
Objectives Previous researches have investigated depression in postmenopausal women (PMW) with osteoporosis and fractures, but little is known regarding Moroccan PMW without fractures. We investigated depression prevalence and severity in Moroccan PMW with osteoporosis without fractures and its relationship with quality of life (QoL) and physical and psychological state. Methods This cross-sectional study enrolled 100 PMW with osteoporosis without fractures. Depressive symptoms, QoL, self-esteem, and fatigue were evaluated using the Patient Health Questionnaire-9 (PHQ-9), Arabic version of ECOS-16 questionnaire, Rosenberg self-esteem scale, and Arabic version of the Multidimensional Assessment of Fatigue scale, respectively. A questionnaire including sociodemographic factors, bone density features, pain intensity, and sleep disturbance was completed. Results Overall, 58% patients suffered from depression and 55% from pain (63.8% depressed women vs. 42.9% nondepressed patients; P = 0.03). Bone mineral density, lumbar spine T-score, ECOS-16, and self-esteem in depressed and nondepressed women were 0.791 (0.738–0.840) vs. 0.835 (0.790–0.866); −3.25 (−3.8 to −2.875) vs. −2.9 (−3.425 to −2.700), P = 0.02; 2.338 ± 0.605 vs. 1.638 ± 0.455; and 13.517 ± 5.487 vs. 18.404 ± 5.771, P < 0.0001, respectively. Depression severity correlated with pain, QoL, self-esteem, and fatigue (r = 0.367, r = −0.390, r = −0.390, and r = 0.369, respectively; P < 0.0001) as well as lumbar spine bone mineral density and T-score (r = −0.258 and r = −0.255, respectively; P = 0.01). Multiple linear regression analysis revealed impaired QoL (β = 0.526; P < 0.0001), fatigue (β = 0.177; P = 0.02), and lower self-esteem (β = −2.170; P = 0.005) as the strongest risk factors of depression. Conclusions Our study shows that even without fractures, Moroccan PMW with osteoporosis suffered from depression, pain, impaired QoL, and lower self-esteem.
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Affiliation(s)
- Hanane Bahouq
- Genetic and Biometric Laboratory, Biology Department, Faculty of Science, University Ibn Tofail Kenitra, Kenitra, Morocco.,Regional Public Hospital of Specialities, Tanger, Morocco.
| | - Abdelmajid Soulaymani
- Genetic and Biometric Laboratory, Biology Department, Faculty of Science, University Ibn Tofail Kenitra, Kenitra, Morocco
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Endogenous calcitonin gene-related peptide in cerebrospinal fluid and early quality of life and mental health after good-grade spontaneous subarachnoid hemorrhage-a feasibility series. Neurosurg Rev 2020; 44:1479-1492. [PMID: 32572710 PMCID: PMC8121729 DOI: 10.1007/s10143-020-01333-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 04/22/2020] [Accepted: 06/05/2020] [Indexed: 12/17/2022]
Abstract
The vasodilatory calcitonin gene-related peptide (CGRP) is excessively released after spontaneous subarachnoid hemorrhage (sSAH) and modulates psycho-behavioral function. In this pilot study, we prospectively analyzed the treatment-specific differences in the secretion of endogenous CGRP into cerebrospinal fluid (CSF) during the acute stage after good-grade sSAH and its impact on self-reported health-related quality of life (hrQoL). Twenty-six consecutive patients (f:m = 13:8; mean age 50.6 years) with good-grade sSAH were enrolled (drop out 19% (n = 5)): 35% (n = 9) underwent endovascular aneurysm occlusion, 23% (n = 6) microsurgery, and 23% (n = 6) of the patients with perimesencephalic SAH received standardized intensive medical care. An external ventricular drain was inserted within 72 h after the onset of bleeding. CSF was drawn daily from day 1–10. CGRP levels were determined via competitive enzyme immunoassay and calculated as “area under the curve” (AUC). All patients underwent a hrQoL self-report assessment (36-Item Short Form Health Survey (SF-36), ICD-10-Symptom-Rating questionnaire (ISR)) after the onset of sSAH (t1: day 11–35) and at the 6-month follow-up (t2). AUC CGRP (total mean ± SD, 5.7 ± 1.8 ng/ml/24 h) was excessively released into CSF after sSAH. AUC CGRP levels did not differ significantly when dichotomizing the aSAH (5.63 ± 1.77) and pSAH group (5.68 ± 2.08). aSAH patients revealed a higher symptom burden in the ISR supplementary item score (p = 0.021). Multiple logistic regression analyses corroborated increased mean levels of AUC CGRP in CSF at t1 as an independent prognostic factor for a significantly higher symptom burden in most ISR scores (compulsive-obsessive syndrome (OR 5.741, p = 0.018), anxiety (OR 7.748, p = 0.021), depression (OR 2.740, p = 0.005), the supplementary items (OR 2.392, p = 0.004)) and for a poorer performance in the SF-36 physical component summary score (OR 0.177, p = 0.001). In contrast, at t2, CSF AUC CGRP concentrations no longer correlated with hrQoL. To the best of our knowledge, this study is the first to correlate the levels of endogenous CSF CGRP with hrQoL outcome in good-grade sSAH patients. Excessive CGRP release into CSF may have a negative short-term impact on hrQoL and emotional health like anxiety and depression. While subacutely after sSAH, higher CSF levels of the vasodilator CGRP are supposed to be protective against vasospasm-associated cerebral ischemia, from a psychopathological point of view, our results suggest an involvement of CSF CGRP in the dysregulation of higher integrated behavior.
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Torre C, Guerreiro J, Longo P, Raposo JF, Leufkens H, Martins AP. Health-related quality of life in adults with type 2 diabetes mellitus starting with new glucose lowering drugs: An inception cohort study. Prim Care Diabetes 2019; 13:221-232. [PMID: 30573348 DOI: 10.1016/j.pcd.2018.11.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 11/06/2018] [Accepted: 11/15/2018] [Indexed: 01/27/2023]
Abstract
AIMS To assess baseline and change after 26-weeks in health-related quality of life (HRQoL) among adults with type 2 diabetes mellitus (T2DM) initiating one of the new glucose lowering drugs (GLD) in daily practice. METHODS Inception cohort of patients who initiated one of dipeptidyl peptidase 4 inhibitors (DPP-4), glucagon-like peptide-1 analogues (GLP-1) or sodium-glucose cotransporter inhibitors (SGLT2) drugs. A baseline questionnaire collected socio-demographic and self-reported clinical data. HRQoL was assessed by the Euroqol-5D. Participants were divided into: (1) incident new users (INU) (who used for the first time one of the monitored GLD and had no current or prior experience with DPP-4/GLP-1/SGLT2) and (2) prevalent new users (PNU) (who had previously used at least one GLD of the monitored drug classes, but not the inception drug). Multivariate regression explored factors associated with a meaningful change in HRQoL. RESULTS 1303 patients. Over 26weeks, a mean positive change in the EQ-5D scores, were observed. No differences between INU and PNU were found. Participants with worse health conditions (e.g. presence and number of chronic diseases, obese) at baseline were more likely to experience larger improvements in HRQoL. CONCLUSIONS Over 26-weeks, T2DM patients starting with, or switching to new GLD maintained or modestly increased their HRQoL.
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Affiliation(s)
- Carla Torre
- Centre for Health Evaluation & Research (CEFAR), National Association of Pharmacies, Lisboa, Portugal; Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, University of Lisbon, Lisboa, Portugal.
| | - José Guerreiro
- Centre for Health Evaluation & Research (CEFAR), National Association of Pharmacies, Lisboa, Portugal
| | - Patrícia Longo
- Centre for Health Evaluation & Research (CEFAR), National Association of Pharmacies, Lisboa, Portugal
| | - João Filipe Raposo
- Nova Medical School, New University of Lisbon, Lisboa, Portugal; Portuguese Diabetes Association (APDP), Lisboa, Portugal
| | - Hubert Leufkens
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Ana Paula Martins
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, University of Lisbon, Lisboa, Portugal; Faculty of Pharmacy, University of Lisbon, Lisboa, Portugal
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Sanchez C, El Khoury A, Hassan M, Wegener G, Mathé AA. Sex-dependent behavior, neuropeptide profile and antidepressant response in rat model of depression. Behav Brain Res 2018; 351:93-103. [PMID: 29857028 DOI: 10.1016/j.bbr.2018.05.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 05/26/2018] [Accepted: 05/28/2018] [Indexed: 01/27/2023]
Abstract
A plethora of animal models of depression is described in the literature, aiming at mimicking different aspects of depression. Understanding the link between depression and stress has been and remains a major focus area for development of animal models, but lines of research with a more mechanistic focus targeting deficiencies in neurotransmitter systems or dysfunctional neuronal circuitries and neuroinflammation are also pursued vigorously. The main objectives of the present study were systematically to evaluate strain and sex characteristics of a genetic animal model, the Flinders Sensitive Line (FSL)/ Flinders Resistant Line (FRL), by applying behavioral, molecular and pharmacological measures relevant to depression, and compare it with the outbred Sprague Dawley rat. In addition, we aimed at comparing across strains and sex the expression of NPY, CRF, CGRP in brain regions critically involved in mood regulation, and investigating the responses to escitalopram. In line with the comparisons of FSL and FRL rats, the FSL rats weighed significantly less than SD rats. Overall, escitalopram treatment for 5-6 weeks did not have a major impact on weight, but displayed a significant antidepressant-like effect, however without any changes in NPY, CRH and CGRP expression. Our comparative study of FSL and SD rat with respect to behavioral characteristic, neuropeptide levels in various brain regions (protein and mRNA levels), and response to long-term antidepressant treatment revealed that female FSL rats showed the most pronounced depressive-like phenotype and response to SSRI treatment. However, these findings were not paralleled by changes in measures of NPY, CRH and CGRP function.
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Affiliation(s)
- Connie Sanchez
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Lundbeck US Q10 LLC, Paramus, NJ, United States.
| | - Aram El Khoury
- Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Moustapha Hassan
- Department of Laboratory Medicine (LABMED), Karolinska Institutet, Huddinge, Sweden
| | - Gregers Wegener
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Centre of Excellence for Pharmaceutical Sciences, North-West University, Potchefstroom, South Africa; Department of Clinical Medicine, AUGUST Centre, Aarhus University, Risskov, Denmark
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Peters EMJ, Müller Y, Snaga W, Fliege H, Reißhauer A, Schmidt-Rose T, Max H, Schweiger D, Rose M, Kruse J. Hair and stress: A pilot study of hair and cytokine balance alteration in healthy young women under major exam stress. PLoS One 2017; 12:e0175904. [PMID: 28423056 PMCID: PMC5397031 DOI: 10.1371/journal.pone.0175904] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 04/02/2017] [Indexed: 12/25/2022] Open
Abstract
Mouse models show that experimental stress mimicking prolonged life-stress exposure enhances neurogenic inflammation, induces adaptive immunity cytokine-imbalance characterized by a shift to Type 1 T-helper cell cytokines and increases apoptosis of epithelial cells. This affects hair growth in otherwise healthy animals. In this study, we investigate whether a prolonged naturalistic life-stress exposure affects cytokine balance and hair parameters in healthy humans. 33 (18 exam, 15 comparison) female medical students with comparable sociobiological status were analyzed during a stressful final examination period, at three points in time (T) 12 weeks apart. T1 was before start of the learning period, T2 between the three-day written exam and an oral examination, and T3 after a 12 week rest and recovery from the stress of the examination period. Assessments included: self-reported distress and coping strategies (Perceived Stress Questionnaire [PSQ], Trier Inventory for the Assessment of Chronic Stress [TICS]), COPE), cytokines in supernatants of stimulated peripheral blood mononucleocytes (PBMCs), and trichogram (hair cycle and pigmentation analysis). Comparison between students participating in the final medical exam at T2 and non-exam students, revealed significantly higher stress perception in exam students. Time-wise comparison revealed that stress level, TH1/TH2 cytokine balance and hair parameters changed significantly from T1 to T2 in the exam group, but not the control. However, no group differences were found for cytokine balance or hair parameters at T2. The study concludes that in humans, naturalistic stress, as perceived during participation in a major medical exam, has the potential to shift the immune response to TH1 and transiently hamper hair growth, but these changes stay within a physiological range. Findings are instructive for patients suffering from hair loss in times of high stress. Replication in larger and more diverse sample populations is required, to assess suitability of trichogram analysis as biological outcome for stress studies.
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Affiliation(s)
- Eva M. J. Peters
- Universitätsmedizin Charité, Center 12 for Internal Medicine and Dermatology, Division for General Internal Medicine, Psychosomatics and Psychotherapy: Psycho-Neuro-Immunology Skin Research Group, Berlin, Germany
- Justus-Liebig-University, Department of Psychosomatics and Psychotherapy, Psychoneuroimmunology Laboratory, Gießen, Germany
- * E-mail:
| | - Yvonne Müller
- Justus-Liebig-University, Department of Psychosomatics and Psychotherapy, Psychoneuroimmunology Laboratory, Gießen, Germany
| | - Wenke Snaga
- Universitätsmedizin Charité, Center 12 for Internal Medicine and Dermatology, Division for General Internal Medicine, Psychosomatics and Psychotherapy: Psycho-Neuro-Immunology Skin Research Group, Berlin, Germany
| | - Herbert Fliege
- Foreign Office, Health Service, Psychosocial Counseling, Auswärtiges Amt, Berlin, Germany
| | - Anett Reißhauer
- Universitätsmedizin Charité, Center 12 for Internal Medicine and Dermatology, Division for Physical Medicine and Rehabilitation, Berlin, Germany
| | | | | | | | - Matthias Rose
- Universitätsmedizin Charité, Center 12 for Internal Medicine and Dermatology, Division for General Internal Medicine, Psychosomatics and Psychotherapy: Psycho-Neuro-Immunology Skin Research Group, Berlin, Germany
| | - Johannes Kruse
- Justus-Liebig-University, Department of Psychosomatics and Psychotherapy, Psychoneuroimmunology Laboratory, Gießen, Germany
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Alamdari G, Laganà L. The Relationship of Older Adults' Physical Pain to Depression and Post-Traumatic Stress Disorder (PTSD): A Review. JOURNAL OF GERIATRIC MEDICINE AND GERONTOLOGY 2015; 1:007. [PMID: 27642644 PMCID: PMC5023019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Physical pain is very common in older age and is often accompanied by depressive as well as PTSD symptomatology. Many conceptualizations of the comorbidity of pain with depression and with PTSD exist, but they need to be tested on older adult populations. PURPOSE This article covers existing literature on the relation between depression and pain in older age, as well as between older adults' PTSD and pain. Additionally, several physiological, cognitive, and behavioral conceptualizations of why depression and PTSD are often related to pain are presented. METHODS The PsychInfo, PubMed, and Google Scholar databases were searched for relevant articles by utilizing the following terms in combination with chronic pain (as well as with pain alone): aging, older adults, elderly, depression, depressive, post-traumatic stress, and PTSD. Additionally, Thomson Reuters Web of Science database searches were conducted using the terms "elderly (and older adults) pain depression PTSD." This review includes various articles that conceptualize the pain-depression, pain-PTSD, and pain-depression-PTSD links, yet, due to space limitations, the review is not comprehensive. Several pertinent reviews are referenced throughout the paper for readers interested in obtaining additional information in this area. RESULTS Depression and PTSD are comorbidities for pain at any age, and are characterized by several and often complex mechanisms that can exacerbate pain. CONCLUSION The comorbidity of pain and factors such as depression and PTSD in older age should be addressed in more research studies, as few investigations are available in this area on the general population of older individuals. This is particularly the case for non-Caucasian older adults living with chronic pain.
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Affiliation(s)
- Golnar Alamdari
- Graduate School of Education and Psychology, Pepperdine University, USA
| | - Luciana Laganà
- Department of Psychology, California State University Northridge, USA
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Lin C, Shao B, Huang H, Zhou Y, Lin Y. Maternal high fat diet programs stress-induced behavioral disorder in adult offspring. Physiol Behav 2015; 152:119-27. [DOI: 10.1016/j.physbeh.2015.09.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 09/18/2015] [Accepted: 09/25/2015] [Indexed: 01/28/2023]
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Florea I, Danchenko N, Brignone M, Loft H, Rive B, Abetz-Webb L. The Effect of Vortioxetine on Health-related Quality of Life in Patients With Major Depressive Disorder. Clin Ther 2015; 37:2309-2323.e6. [DOI: 10.1016/j.clinthera.2015.08.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 07/31/2015] [Accepted: 08/04/2015] [Indexed: 10/23/2022]
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Chang MY, Velez FG, Demer JL, Isenberg SJ, Coleman AL, Pineles SL. Quality of life in adults with strabismus. Am J Ophthalmol 2015; 159:539-44.e2. [PMID: 25498355 DOI: 10.1016/j.ajo.2014.12.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 11/29/2014] [Accepted: 12/01/2014] [Indexed: 11/28/2022]
Abstract
PURPOSE To assess relative quality of life in patients with strabismus. DESIGN Retrospective cohort study. METHODS The 25-item National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) was performed in 42 strabismic adults over the age of 50 years at a single institution. Subscale scores were compared with those of patients with other ocular diseases, including diabetic retinopathy, age-related macular degeneration (AMD), glaucoma, cataract, cytomegalovirus (CMV) retinitis, and low vision. RESULTS Median visual acuity was 20/20 (range 20/12.5-20/50), and 34 patients (81%) reported diplopia. Strabismic patients performed the same or worse on nearly all vision-related subscales than did patients with diabetic retinopathy, age-related macular degeneration, glaucoma, cataract, and CMV retinitis. Additionally, strabismic patients reported significantly worse ocular pain than all comparison groups before any surgery was performed. CONCLUSIONS Strabismus impacts quality of life through both functional and psychosocial factors. Physicians treating strabismic patients should recognize these quality-of-life issues and address them accordingly.
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Affiliation(s)
- Melinda Y Chang
- Stein Eye Institute and the Department of Ophthalmology, University of California, Los Angeles, Los Angeles, California
| | - Federico G Velez
- Stein Eye Institute and the Department of Ophthalmology, University of California, Los Angeles, Los Angeles, California
| | - Joseph L Demer
- Stein Eye Institute and the Department of Ophthalmology, University of California, Los Angeles, Los Angeles, California
| | - Sherwin J Isenberg
- Stein Eye Institute and the Department of Ophthalmology, University of California, Los Angeles, Los Angeles, California
| | - Anne L Coleman
- Stein Eye Institute and the Department of Ophthalmology, University of California, Los Angeles, Los Angeles, California
| | - Stacy L Pineles
- Stein Eye Institute and the Department of Ophthalmology, University of California, Los Angeles, Los Angeles, California.
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Shao B, Zhou YL, Wang H, Lin YS. The role of calcitonin gene-related peptide in post-stroke depression in chronic mild stress-treated ischemic rats. Physiol Behav 2015; 139:224-30. [DOI: 10.1016/j.physbeh.2014.11.049] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Revised: 11/10/2014] [Accepted: 11/11/2014] [Indexed: 11/15/2022]
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15
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Lee KM, Chung CY, Kwon SS, Kim TG, Lee IH, Jung KJ, Park JW, Moon SY, Park MS. Bone mineral density is not associated with musculoskeletal pain in postmenopausal Korean women aged ≥50 years. Clin Rheumatol 2014; 34:337-43. [PMID: 25288023 DOI: 10.1007/s10067-014-2790-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 09/24/2014] [Indexed: 10/24/2022]
Abstract
Although many studies reported improvement of back pain after osteoporosis treatment, there is insufficient evidence to determine whether osteoporosis is painful. We investigated whether bone mineral density correlated with musculoskeletal pain in postmenopausal Korean women aged ≥50 years. Data for postmenopausal women aged ≥50 years were obtained from the fifth Korea National Health and Nutrition Examination Survey database. Demographics, Kellgren-Lawrence grade, and numeric rating scale for pain in the hip and knee joints, presence of back pain, and activity level were analyzed. Only subjects with dual-energy X-ray absorptiometry scans and hip and knee radiographs were included. Those with malignancy, pain medication use, or a history of fragility fractures were excluded. After univariate analysis, multiple linear regression analysis was performed to examine the significant factors correlated with the degree of hip and knee pain. Binary logistic regression analysis was performed to identify factors significantly associated with the presence of back pain. In total, 387 women were included in the data analysis. Age (p = 0.005) was the only significant factor correlated with the intensity of hip pain, while Kellgren-Lawrence grade (p < 0.001) was the only significant factor correlated with knee pain intensity in multiple regression analysis. Binary logistic regression analysis showed that age (p = 0.002) was the only significant factor associated with the presence of back pain. Musculoskeletal pain was not affected by or associated with the bone mineral density (BMD) of the affected body part in postmenopausal Korean women aged ≥50 years after adjusting for the degree of osteoarthritis.
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Affiliation(s)
- Kyoung Min Lee
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, 300 Gumi-Dong, Bundang-Gu, Sungnam, Kyungki, 463-707, South Korea
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Liu L, Wang H, Liu N, Yang Q, Luo E. Osteoporosis in the jawbones: a correlative factor of primary trigeminal neuralgia? Med Sci Monit 2014; 20:1481-5. [PMID: 25141822 PMCID: PMC4148358 DOI: 10.12659/msm.890935] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Trigeminal neuralgia (TN), a neuropathic disorder of one or both of the trigeminal nerves, occurs most often in people over age 50. Extreme, sporadic, sudden burning or shock-like face pain in common activities greatly lowers quality of life. The precise cause of primary TN remains unknown, but it may be caused by vascular pressing on the trigeminal nerve in its root entry zone (REZ), demyelinization of trigeminal sensory fibers, or jawbone cavity. Accordingly, many treatments carry risks of adverse effects, recurrence, and complications. TN and osteoporosis have similar high-risk populations and a common influential factor – emotional stress – is also closed related to primary TN for calcitonin gene-related peptide and calcitonin. Jawbone cavity, which is a possible pathogenesis of TN, may be another form of jawbone osteoporosis. Therefore, we hypothesized that osteoporosis in jaws could be a correlative factor of primary TN. If this hypothesis is verified, it may suggest specific new ideas for the early preventive treatment of primary TN.
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Affiliation(s)
- Li Liu
- Department of Oral Radiology, State Key Laboratory of Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China (mainland)
| | - Hu Wang
- Department of Oral Radiology, State Key Laboratory of Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China (mainland)
| | - Na Liu
- Department of Oral and Maxillofacial Surgery, State Key Laboratory of Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China (mainland)
| | - Qianmei Yang
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China (mainland)
| | - En Luo
- Department of Oral and Maxillofacial Surgery, State Key Laboratory of Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China (mainland)
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Danckworth F, Karabul N, Posa A, Hanisch F. Risk factors for osteoporosis, falls and fractures in hereditary myopathies and sporadic inclusion body myositis - A cross sectional survey. Mol Genet Metab Rep 2014; 1:85-97. [PMID: 27896078 PMCID: PMC5121322 DOI: 10.1016/j.ymgmr.2013.12.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 12/20/2013] [Indexed: 11/10/2022] Open
Abstract
Background The risk of osteoporosis is known in myopathies requiring long-term steroid treatment and Pompe disease, but not in other hereditary myopathies or sporadic inclusion body myositis (sIBM). Methods Risk factors of osteoporosis, laboratory parameters of bone metabolism, frequency of falls and fractures, walking ability, and pain were surveyed using questionnaires in 89 patients with sIBM and genetically confirmed myopathies facioscapulohumeral muscular dystrophy (FSHD), myotonic dystrophy types 1 and 2 (DM1, DM2), limb girdle muscular dystrophies (LGMD2A, LGMD2B, LGMD2I), MATR3 myopathy, and oculopharyngeal muscular dystrophy (OPMD). Additionally laboratory parameters of bone metabolism were determined. Results The mean age at examination per disease group ranged from 32 years in LGMD2A to 70 years in sIBM. Myopathies with a higher degree of walking impairment had a higher risk of falls (sIBM, LGMD2A, LGMD2B). At the time of examination 3.4% had a history of osteoporosis. The 25-OH D3 level was decreased in 20% of patients (and in 55% of patients with LGMDs), 57% of them were ambulatory. The 25-OH D3 level was significantly lower in patients with myopathies than in other neurological disorders (p < 0.001). 2.7 falls per year per person occurred. Fractures were reported in 6.8% of patients within the last year. They involved frequently the tibia bone. The pain score didn't correlate with either the walking disability (WGMS) score or the 25-OH D3 level. Conclusion The risk for osteoporosis and reduced 25-OH D3 level seems to be increased in wheelchair-bound patients with myopathy but also in patients with DM1 and autosomal-recessive myopathies. Risk factors for osteoporosis and fractures were analysed in hereditary myopathies. Wheelchair-bound patients - high risk for osteoporosis and fractures of tibia bone. Myopathy patients have lower vitamin D3 levels than controls.
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Affiliation(s)
- F Danckworth
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - N Karabul
- Villa Metabolica, Centre for Pediatric and Adolescent Medicine, Langenbeckstr. 2, 55131 Mainz, Germany
| | - A Posa
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - F Hanisch
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
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18
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Zhang M, Dai W, Liang J, Chen X, Hu Y, Chu B, Pan M, Dong Z, Yu S. Effects of UCMS-induced depression on nociceptive behaviors induced by electrical stimulation of the dura mater. Neurosci Lett 2013; 551:1-6. [DOI: 10.1016/j.neulet.2013.04.038] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 04/17/2013] [Accepted: 04/19/2013] [Indexed: 11/16/2022]
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Prevalence and predictors of pain in patients with major depressive disorder. Asian J Psychiatr 2013; 6:288-91. [PMID: 23810134 DOI: 10.1016/j.ajp.2012.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Revised: 10/10/2012] [Accepted: 12/05/2012] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Pain is common in patients with major depressive disorder (MDD). This paper aimed to determine the prevalence of and examine the predictors of pain in patients with MDD. METHOD This study was conducted at a university hospital. The prevalence of pain in adult outpatients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition MDD was compared with that in a matched age and sex control group of general patients in the waiting area within the hospital. Depression and pain were measured using the 17-item Hamilton Rating Scale for Depression (HAM-D) and a 10-point rating scale for pain (RSP) (from no pain at all to the most severe pain), respectively. RESULTS Forty MDD and 40 general patients with matched age and sex (controls) participated in this study. Compared with the control group (47.5%), 95% of MDD patients had pain (p<0.001). The RSP scores of MDD patients were significantly higher than those of the controls (p<0.001). The mean number of pain locations was also significantly larger than in the MDD patients (p<0.001). Among the 11 male and 29 female patients with MDD, the multiple linear regression analysis revealed that the HAM-D score and history of sexual assault were significant predictors of pain. SUMMARY The present findings suggest that, compared with general patients, individuals with MDD have more pain in terms of the prevalence, severity, and number of locations. Severe depression and history of sexual assault are predictors of pain in MDD patients. Pain and depression are highly correlated and should be taken into account in individuals with these symptoms.
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Wilson M, Roll J, Pritchard P, Masterson B, Howell D, Barbosa-Leiker C. Depression and pain interference among patients with chronic pain after ED encounters. J Emerg Nurs 2013; 40:e55-61. [PMID: 23628422 DOI: 10.1016/j.jen.2013.03.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2012] [Revised: 02/12/2013] [Accepted: 03/20/2013] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Patients with chronic pain who frequent emergency departments present a challenge to health care providers. Mental health, substance abuse, and pain issues are difficult to distinguish in fast-paced clinical settings, and significant symptoms may remain unaddressed. This pilot study sought to determine whether electronically delivered screening tools measuring pain and mood could identify areas to target for improving emergency care. METHODS A prospective, descriptive pilot study used repeated measures of validated instruments to investigate the status of patients after their ED encounter. Persons with chronic pain not related to cancer and documented opioid use were recruited by nursing personnel after an ED encounter. Consenting participants (n = 52) were invited to perform an online survey that included self-reported measurements of pain intensity, pain interference, depression, subjective health, and health distress. The survey was repeated after 8 weeks. RESULTS The baseline survey was completed by 42.3% of 52 patients who provided consent (n = 22, 68.2% female). The mean pain severity score was 5.96 (SD 1.57) and the mean pain interference score was 7.52 (SD 1.81) using 0 to 10 scales of the Brief Pain Inventory. Personal Health Questionnaire Depression Scale ratings indicated that a major depressive disorder should be considered for 54% of the participants. DISCUSSION Online surveys delivered to patients with chronic pain detected unmet needs for depression and persisting high levels of pain interference after ED encounters. Adding mood-specific screening tools to pain assessments may be necessary in clinical settings to identify depression and refer for appropriate treatment.
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Affiliation(s)
| | - John Roll
- Spokane and Pullman, WA; Coeur d'Alene, ID
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21
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Iwamoto J, Sato Y, Uzawa M, Matsumoto H. Eleven years of experience with bisphosphonate plus alfacalcidol treatment in a man with osteogenesis imperfecta type I. Ther Clin Risk Manag 2013; 9:1-7. [PMID: 23293527 PMCID: PMC3534324 DOI: 10.2147/tcrm.s38404] [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: 11/23/2022] Open
Abstract
We report the 11-year follow-up of a man with osteogenesis imperfecta type I who was treated with bisphosphonates and alfacalcidol. A 36-year-old Japanese man with osteogenesis imperfecta type I who had frequently experienced painful fragility fractures consulted our clinic because of chronic back pain. The patient had multiple morphometric vertebral fractures and a low bone mineral density (BMD) at the lumbar spine. The patient was treated with cyclical etidronate 200 mg, for 2 weeks every 3 months, plus alfacalcidol 1 μg daily, for 2 years; and alendronate 5 mg daily or 35 mg weekly, plus alfacalcidol 1 μg daily for 9 years. After 11 years of treatment, BMD at the lumbar spine increased by 6.4%, following a 20.3% reduction in serum alkaline phosphatase. Serum calcium, phosphorus, and intact parathyroid hormone levels remained within the normal ranges. Three clinical fractures occurred at two ribs and the metacarpus, and two morphometric vertebral fractures occurred at the thoracic spine during the 11-year treatment period, but the patient experienced no adverse effects. Thus, the present case report shows the long-term outcome and safety of bisphosphonate plus alfacalcidol treatment in a man with osteogenesis imperfecta type I.
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Affiliation(s)
- Jun Iwamoto
- Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo
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22
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Reza A, Sievert LL, Rahberg N, Morrison LA, Brown DE. Prevalence and determinants of headaches in Hawaii: the Hilo Women's Health Study. Ann Hum Biol 2012; 39:305-14. [PMID: 22747070 DOI: 10.3109/03014460.2012.700069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Headache frequency has been associated with ethnicity, menopause, abdominal obesity and stress. AIM To examine the prevalence and determinants of headaches in the multi-ethnic community of Hilo, Hawaii. SUBJECTS AND METHODS A random sample of 1824 women aged 16-100 was recruited by postal survey; 206 women aged 45-55 were recruited for clinical measures. Both studies queried the presence/absence of headaches during the past 2 weeks. The clinical study also examined migraines and tension headaches. Headaches were examined in relation to demographic, reproductive and lifestyle variables, stress, symptoms and anthropometric measures. RESULTS Headache prevalence was 47%. Japanese women were less likely to report headaches compared to women of European descent, but, after controlling for measures of stress, Japanese women were at a higher risk for headaches. Post-menopausal women were half as likely to report headaches compared with pre-menopausal women. Women with children younger than 18 were 4-times as likely to report migraines compared with women who did not have children younger than 18. CONCLUSION Standardized measures of daily hassles, life and job satisfaction were not associated with headaches. The relationship between headaches and having young children suggests that the everyday stress of family life is a headache risk. This may be particularly true in Hilo, Hawaii, where the value of family is culturally prioritized.
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Affiliation(s)
- Angela Reza
- Department of Anthropology, UMass Amherst, Amherst, MA, USA
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23
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Fehér J, Kovács I, Balacco Gabrieli C. [Role of gastrointestinal inflammations in the development and treatment of depression]. Orv Hetil 2011; 152:1477-85. [PMID: 21893478 DOI: 10.1556/oh.2011.29166] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Recent studies have revealed that inflammation, among other factors, may be involved in the pathogenesis of depression. One line of studies has shown that depression is frequently associated with manifest gastrointestinal inflammations and autoimmune diseases as well as with cardiovascular diseases, neurodegenerative diseases, type 2-diabetes and also cancer, in which chronic low-grade inflammation is a significant contributing factor. Thus depression may be a neuropsychiatric manifestation of a chronic inflammatory syndrome. Another line of studies has shown that the primary cause of inflammation may be the dysfunction of the "gut-brain axis". Although, this is a bidirectional mechanism, life style factors may primarily affect the symbiosis between host mucous membrane and the microbiota. Local inflammation through the release of cytokines, neuropeptides and eicosanoids may also influence the function of the brain and of other organs. Role of metabolic burst due to inflammation represents a new aspect in both pathophysiology and treatment of the depression. Finally, an increasing number of clinical studies have shown that treating gastrointestinal inflammations with probiotics, vitamin B, D and omega 3 fatty acids, through attenuating proinflammatory stimuli to brain, may also improve depression symptoms and quality of life. All these findings justify an assumption that treating gastrointestinal inflammations may improve the efficacy of the currently used treatment modalities of depression and related diseases. However, further studies are certainly needed to confirm these findings.
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Affiliation(s)
- János Fehér
- Sapienza Tudományegyetem Szemészeti Klinika 00187 Roma Via Sardegna, 139.
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Liang J, Yu S, Dong Z, Wang X, Liu R, Chen X, Li Z. The effects of OB-induced depression on nociceptive behaviors induced by electrical stimulation of the dura mater surrounding the superior sagittal sinus. Brain Res 2011; 1424:9-19. [DOI: 10.1016/j.brainres.2011.09.048] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2011] [Revised: 09/22/2011] [Accepted: 09/22/2011] [Indexed: 12/15/2022]
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Iwamoto J, Makita K, Sato Y, Takeda T, Matsumoto H. Alendronate is more effective than elcatonin in improving pain and quality of life in postmenopausal women with osteoporosis. Osteoporos Int 2011; 22:2735-42. [PMID: 21104227 DOI: 10.1007/s00198-010-1495-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Accepted: 10/27/2010] [Indexed: 11/29/2022]
Abstract
UNLABELLED A randomized controlled trial was performed to compare the short-term effects of alendronate (ALN) and ECT on pain and quality of life (QOL) in postmenopausal women with osteoporosis. Back pain and QOL [Short-Form Health Survey (SF-8)] significantly improved at 1, 3, and 6 months in both groups, with greater improvements in the ALN group than in the ECT group. These results suggested that ALN reduced back pain and improved QOL more markedly than ECT in postmenopausal osteoporotic women with back pain. INTRODUCTION Intramuscular ECT is known to reduce pain via the central nervous system. A multicenter randomized controlled trial was performed to compare the short-term effects of ALN and ECT on pain and QOL in postmenopausal women with osteoporosis. METHODS One hundred and 94 postmenopausal osteoporotic women with back pain (mean age 79.8 years, range 60-96 years) were randomly divided into two groups: the ALN group (35 mg weekly) and the ECT group (intramuscular 20 units a week). The duration of the study was 6 months. The trial was completed in 97 (100%) women of the ALN group and 96 (99.0%) women of the ECT group. Urinary levels of cross-linked N-terminal telopeptide of type I collagen (NTX), serum alkaline phosphatase (ALP), face scale score (FSS, back pain), and SF-8 (QOL) were monitored. RESULTS Urinary NTX levels significantly decreased at 3 months in the ALN group, but not in the ECT group. Serum ALP levels significantly decreased at 6 months in the both groups, with a greater reduction in the ALN group. The FSS and SF-8 significantly improved at 1, 3, and 6 months in both groups, with greater improvements in the ALN group than in the ECT group. CONCLUSIONS ALN suppressed bone turnover, reduced back pain, and improved QOL more markedly than ECT in postmenopausal osteoporotic women with back pain.
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Affiliation(s)
- J Iwamoto
- Institute for Integrated Sports Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
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Iwamoto J, Sato Y, Uzawa M, Takeda T, Matsumoto H. Seven years' experience with etidronate in a woman with anorexia nervosa and vertebral fractures. Ther Clin Risk Manag 2011; 7:275-81. [PMID: 21845050 PMCID: PMC3150473 DOI: 10.2147/tcrm.s21357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
We report the case of a 30-year-old Japanese woman with anorexia nervosa and vertebral fractures who was treated with etidronate. She had a history of anorexia nervosa, chronic back pain, osteoporosis, and multiple vertebral fractures (morphometric fractures) that responded poorly to treatment with alfacalcidol (1 μg daily) for 1 year and was treated with cyclical etidronate (200 mg for 2 weeks every 3 months) for 7 years. The lumbar spine bone mineral density (BMD) increased, and the serum alkaline phosphatase and urinary cross-linked N-terminal telopeptides of type I collagen levels and back pain decreased. During the 7-year period of treatment with etidronate, no osteoporotic fractures occurred. The patient experienced neither renal dysfunction nor hyperparathyroidism caused by osteomalacia. No gastrointestinal tract symptoms were observed. Thus, etidronate was effective for increasing the lumbar spine BMD and reducing back pain over a 7-year period without causing either osteoporotic fractures or adverse events.
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Affiliation(s)
- Jun Iwamoto
- Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan
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27
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Cizza G. Major depressive disorder is a risk factor for low bone mass, central obesity, and other medical conditions. DIALOGUES IN CLINICAL NEUROSCIENCE 2011. [PMID: 21485748 PMCID: PMC3181971 DOI: 10.31887/dcns.2011.13.1/gcizza] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Major depressive disorder (MDD) is one of the most common psychiatric illnesses in the adult population. It is often associated with an increased risk of cardiovascular disease. Osteoporosis is also a major public health threat. Multiple studies have reported an association between depression and low bone mineral density, but a causal link between these two conditions is disputed. Here the most important findings of the POWER (Premenopausal, Osteoporosis Women, Alendronate, Depression) Study, a large prospective study of bone turnover in premenopausal women with major depression, are summarized. The endocrine and immune alterations secondary to depression that might affect bone mass, and the possible role of poor lifestyle in the etiology of osteoporosis in subjects with depression, are also reviewed, as is the potential effect of antidepressants on bone loss. It is proposed that depression induces bone loss and osteoporotic fractures, primarily via specific immune and endocrine mechanisms, with poor lifestyle habits as potential contributory factors.
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Affiliation(s)
- Giovanni Cizza
- Diabetes, Obesity, Endocrine Branch, NIDDK, NIH, DHHS, Department of Laboratory Medicine, Clinical Center, Bethesda, Maryland 20892-1613, USA.
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Recober A, Goadsby PJ. Calcitonin gene-related peptide: A molecular link between obesity and migraine? DRUG NEWS & PERSPECTIVES 2010; 23:112-7. [PMID: 20369076 PMCID: PMC2947336 DOI: 10.1358/dnp.2010.23.2.1475909] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Epidemiological studies have begun to suggest obesity is a risk factor for chronic migraine, although no causal relationship has been established and risk factors for progression from episodic to chronic migraine remain unknown. The neuropeptide calcitonin gene-related peptide (CGRP) plays a important role in the pathophysiology of migraine. Here, the potential role of CGRP as a molecular link between obesity and migraine is reviewed. A mechanistic association is supported by several lines of evidence: 1) common markers are elevated in obesity and migraine, 2) adipose tissue secretes proinflammatory cytokines and adipocytokines that have been implicated in migraine pathophysiology and 3) elevated levels of CGRP have been found in plasma of obese individuals. We propose that CGRP released from trigeminal neurons may represent a biological link between obesity and migraine. Enhanced trigeminal CGRP production in obese susceptible individuals may lower the threshold necessary to trigger migraine attacks, leading to more frequent episodes and eventually to chronic migraine.
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Affiliation(s)
- Ana Recober
- Headache Division-Department of Neurology, University of Iowa, IA, USA
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Abstract
The review summarizes recent findings with respect to pathophysiological role of calcitonin gene-related peptide (CGRP), in postmenopausal symptoms and diseases, which has opened horizons in understanding pathophysiology of menopause in a better way. Current evidences strongly propose a need to develop CGRP receptor antagonists, which may prove beneficial in many prevalent menopausal symptom/diseases such as vasomotor symptoms, cardiovascular risk, obesity, and major depressive disorder, in which CGRP levels are elevated.
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Affiliation(s)
- Sudhaa Sharma
- Post-Graduate Department of Obstetrics and Gynecology, Government Medical College, Jammu, Jammu and Kashmir, India
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Rezaeian AH, Isokane T, Nishibori M, Chiba M, Hiraiwa N, Yoshizawa M, Yasue H. alphaCGRP and betaCGRP transcript amount in mouse tissues of various developmental stages and their tissue expression sites. Brain Dev 2009; 31:682-93. [PMID: 19062206 DOI: 10.1016/j.braindev.2008.10.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2008] [Revised: 10/08/2008] [Accepted: 10/20/2008] [Indexed: 11/15/2022]
Abstract
The calcitonin gene-related peptides (CGRP), alphaCGRP and betaCGRP, have been implicated to play various roles in primates and rodent. However, since the expression information has been limited, in the present study, we measured the amount of gene expression in mouse brain, liver, kidney, heart, and testis at embryonic day (E) 14, E17, postnatal day (P) 1, P7, and adult using real-time PCR, and determined the precise localization of alphaCGRP and betaCGRP sense/antisense transcripts in tissues using in situ hybridization. The sense transcripts of alphaCGRP and betaCGRP were found mainly in brain, and their amount profiles were similar in the course of development: one expression peak was observed at E17 and the other at P7. The amounts of alphaCGRP transcripts were greater than those of betaCGRP transcripts in the range between 3.6 and 31 times. In the E17 and P7 brains, the localization pattern of alphaCGRP sense transcripts was similar with that of alphaCGRP antisense transcripts. Fewer transcripts were found in neuroblasts of E17 corpus callosum, and neuroblasts of P7 corpus callosum, olfactory bulb, plexus chorioideus, and ventriculus lateralis than in other brain areas. The localization pattern of betaCGRP sense and antisense transcripts was similar to that for alphaCGRP except that the betaCGRP antisense transcripts showed spot-like localizations. Additionally, the alphaCGRP sense transcript, and betaCGRP sense and antisense transcripts were found in parafollicular cells (C cells) of E17 thyroid lobe. These findings together indicate that alphaCGRP and betaCGRP have their own roles in the ontogenic process.
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31
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Paschos KA, Veletza S, Chatzaki E. Neuropeptide and sigma receptors as novel therapeutic targets for the pharmacotherapy of depression. CNS Drugs 2009; 23:755-72. [PMID: 19689166 DOI: 10.2165/11310830-000000000-00000] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Among the most prevalent of mental illnesses, depression is increasing in incidence in the Western world. It presents with a wide variety of symptoms that involve both the CNS and the periphery. Multiple pharmacological observations led to the development of the monoamine theory as a biological basis for depression, according to which diminished neurotransmission within the CNS, including that of the dopamine, noradrenaline (norepinephrine) and serotonin systems, is the leading cause of the disorder. Current conventional pharmacological antidepressant therapies, using selective monoamine reuptake inhibitors, tricyclic antidepressants and monoamine oxidase inhibitors, aim to enhance monoaminergic neurotransmission. However, the use of these agents presents severe disadvantages, including a delay in the alleviation of depressive symptoms, significant adverse effects and high frequencies of non-responding patients. Neuroendocrinological data of recent decades reveal that depression and anxiety disorders may occur simultaneously due to hypothalamus-pituitary-adrenal (HPA) axis hyperactivity. As a result, the stress-diathesis model was developed, which attempts to associate genetic and environmental influences in the aetiology of depression. The amygdala and the hippocampus control the activity of the HPA axis in a counter-balancing way, and a plethora of regulatory neuropeptide signalling pathways are involved. Intervention at these molecular targets may lead to alternative antidepressant therapeutic solutions that are expected to overcome the limitations of existing antidepressants. This prospect is based on preclinical evidence from pharmacological and genetic modifications of the action of neuropeptides such as corticotropin-releasing factor, substance P, galanin, vasopressin and neuropeptide Y. The recent synthesis of orally potent non-peptide micromolecules that can selectively bind to various neuropeptide receptors permits the onset of clinical trials to evaluate their efficacy against depression.
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Affiliation(s)
- Konstantinos A Paschos
- Laboratory of Pharmacology, School of Medicine, Democritus University of Thrace (DUTH), Alexandroupolis 68100, Thrace, Greece
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Cizza G, Marques AH, Eskandari F, Christie IC, Torvik S, Silverman MN, Phillips TM, Sternberg EM. Elevated neuroimmune biomarkers in sweat patches and plasma of premenopausal women with major depressive disorder in remission: the POWER study. Biol Psychiatry 2008; 64:907-11. [PMID: 18657799 PMCID: PMC2610843 DOI: 10.1016/j.biopsych.2008.05.035] [Citation(s) in RCA: 138] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2007] [Revised: 05/19/2008] [Accepted: 05/30/2008] [Indexed: 12/24/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is inconsistently associated with elevations in proinflammatory cytokines and neuropeptides. We used a skin sweat patch, recently validated in healthy control subjects, and recycling immunoaffinity chromatography to measure neuroimmune biomarkers in patients with MDD mostly in remission. METHODS We collected blood at 8:00 am and applied skin sweat patches for 24 hours in 21- to 45-year-old premenopausal women (n = 19) with MDD (17/19 in remission) and age-matched healthy controls (n = 17) participating in the POWER (Premenopausal, Osteopenia/Osteoporosis, Women, Alendronate, Depression) Study. RESULTS Proinflammatory cytokines, neuropeptide Y, substance P, and calcitonin-gene-related peptide were significantly higher and vasoactive intestinal peptide, a marker of parasympathetic activity, was significantly lower in patients compared to controls, and depressive symptomatology strongly correlated with biomarker levels. All analytes were strongly correlated in the skin sweat patch and plasma in patients (r = .73 to .99; p < .0004). CONCLUSIONS The skin sweat patch allows detection of disrupted patterns of proinflammatory cytokines and neuropeptides in women with MDD in clinical remission, which could predispose to medical consequences such as cardiovascular disease, osteoporosis, and diabetes. This method permits measurement of cytokines in ambulatory settings where blood collection is not feasible.
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Affiliation(s)
| | - Andrea H. Marques
- Section on Neuroendocrine Immunology and Behavior, Integrative Neural Immune Program, NIMH, NIH
| | - Farideh Eskandari
- Section on Neuroendocrine Immunology and Behavior, Integrative Neural Immune Program, NIMH, NIH,Case Western Reserve University, Department of Medicine, Division of Clinical and Molecular Endocrinology, Cleveland, OH
| | - Israel C. Christie
- Cardiovascular Behavioral Medicine Program, Department of Psychiatry, University of Pittsburgh Medical Center
| | | | - Marni N. Silverman
- Section on Neuroendocrine Immunology and Behavior, Integrative Neural Immune Program, NIMH, NIH,Prince of Wales, NCCAM Director’s Fellow, NIH
| | - Terry M. Phillips
- Nanoscale Immunodiagnosis, Laboratory of Bioengineering & Physical Science, NIBIB, NIH
| | - Esther M. Sternberg
- Section on Neuroendocrine Immunology and Behavior, Integrative Neural Immune Program, NIMH, NIH
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Baune BT, Caniato RN, Garcia-Alcaraz MA, Berger K. Combined effects of major depression, pain and somatic disorders on general functioning in the general adult population. Pain 2008; 138:310-317. [PMID: 18258371 DOI: 10.1016/j.pain.2008.01.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2007] [Revised: 12/18/2007] [Accepted: 01/02/2008] [Indexed: 11/29/2022]
Abstract
This study was carried out to assess the prevalence of major depressive disorder (MDD) in persons suffering from pain symptoms in various locations, both with and without comorbid somatic disorders and to analyze the single and combined effects of MDD, pain symptoms and somatic disorders on general functioning in the community. The 12-month prevalence of MDD, somatic disorders and pain symptoms, grouped according to location, were determined among 4181 participants from a community sample. Depression was assessed utilising the Composite International Diagnostic Interview. Pain symptoms were self-reported by participants whereas medical diagnoses were validated by medical examinations. General functioning was evaluated utilising the established MOS-SF-36 scale. The prevalence of MDD was significantly increased for persons with pain in any location. In the absence of a somatic disorder, MDD prevalence was highest in persons with abdominal/chest pain (9.3%) and arm or leg pain (7.9%) and lowest in persons with back pain (6.2%). Mental and physical well-being were lowest for persons with both MDD and a somatic disorder, irrespective of pain locations. Increasing numbers of pain locations impaired mental and physical well-being across all groups, but the effect on mental well-being was most marked in participants with MDD and comorbid somatic disorders. The presence of pain increases risk of associated MDD. The number of pain locations experienced, rather than the specific location of pain, has the greatest impact on general functioning. Not only chronic pain, but pain of any type may be an indicator of MDD and decreased general functioning.
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Affiliation(s)
- Bernhard T Baune
- Department of Psychiatry, School of Medicine, James Cook University, Qld 4811, Australia Department of Psychiatry and Psychotherapy, University of Muenster, Germany Institute of Epidemiology and Social Medicine, University of Muenster, Germany
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Edwards RR, Klick B, Buenaver L, Max MB, Haythornthwaite JA, Keller RB, Atlas SJ. Symptoms of distress as prospective predictors of pain-related sciatica treatment outcomes. Pain 2006; 130:47-55. [PMID: 17156925 DOI: 10.1016/j.pain.2006.10.026] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2006] [Revised: 09/11/2006] [Accepted: 10/25/2006] [Indexed: 10/23/2022]
Abstract
Prior studies evaluating predictors of pain-related outcomes following treatment for sciatica have been limited by methodological problems, including retrospective study design, use of unvalidated outcome measures, and short-term follow-up periods. Despite these limitations, some reports have suggested that symptoms of psychological distress may predict individual differences in pain treatment-related outcomes (e.g., higher levels of depressive and anxious symptomatology are associated with greater pain and disability after treatment). In this study, we sought to determine whether acute symptoms of depression and anxiety were prospectively associated with treatment outcomes over a 3-year follow-up period in surgically treated and non-surgically treated patients with sciatica. Patients were recruited from the practices of community-based physicians throughout the state of Maine, and underwent in-person baseline assessments, with mailed follow-up questionnaires at 3, 6, 12, 24, and 36 months. Study outcomes included patient-reported symptoms of pain and disability. For each outcome variable, we examined whether baseline mood (i.e., mood assessed prior to the initiation of treatment), as well as mood at the immediately preceding assessment point, prospectively predicted outcomes over 3 years in multivariate repeated-measures analyses. In most analyses, symptoms of depression and anxiety, both at baseline and at the preceding time point, were significant independent predictors of worse pain and function after controlling for relevant covariates. Collectively, elevated distress appears to be a significant risk factor for reduced treatment benefit (i.e., less improvement in pain and disability) over short and medium-term follow-up periods in patients with sciatica. Future research should determine whether the prospective identification and treatment of patients with high levels of distress (a "yellow flag") is associated with improved treatment outcomes.
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Affiliation(s)
- Robert R Edwards
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Meyer 1-108, Baltimore, MD 21287, United States.
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