Naloxone-Reversible Analgesic Response to Combat-Related Stimuli in Posttraumatic Stress Disorder

Pitman, Roger K.; Kolk, Bessel A. van der; Orr, Scott P.; Greenberg, Mark S.

doi:10.1001/archpsyc.1990.01810180041007

Cited by 258 publications

(106 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The standard program using the "method of limits" (Pitman et al, 1990) was applied and subjects were instructed to push a button when they detected change in temperature (detection thresholds) and when the temperature became painful (pain thresholds). Mechanical detection thresholds were obtained using standardized Von Frey hairs delivering increasing force when pushed onto the skin at the same location on the thigh (range: 0.008-300 g).…”

Section: Qstmentioning

confidence: 99%

Posttraumatic stress disorder influences the nociceptive and intrathecal cytokine response to a painful stimulus in combat veterans

Lerman

Davis

Bertram

et al. 2016

Psychoneuroendocrinology

View full text Add to dashboard Cite

a b s t r a c tObjective: Although posttraumatic stress disorder (PTSD) and chronic pain frequently occur in tandem, the pathophysiological mechanisms mediating this comorbidity are poorly understood. Because excessive inflammation occurs in both conditions, we examined the cerebrospinal fluid (CSF) concentrations of inflammatory response mediators interleukin 1-beta (IL-1␤), interleukin 6 (IL-6), interleukin 8 (IL-8), tumor necrosis factor-alpha (TNF␣) and interleukin 10 (IL-10) after prolonged suprathreshold pain stimulus in 21 male combat veterans; 10 with PTSD and 11 combat controls (CC). Methods: After completing baseline quantitative sensory testing (QST) and psychological profiling, all patients received an injection of capsaicin into the quadriceps muscle. Spontaneously reported pain was measured for 30 min after the capsaicin injection. The evoked pain measure of temporal summation was tested between 70 and 110 min post capsaicin injection. Inflammatory (IL-1␤, IL-6, IL-8 TNF␣) and antiinflammatory (IL-10) CSF cytokines were measured before (baseline) and after capsaicin injection over a time frame of 110 min. Results: Following intramuscular capsaicin injection, pro-inflammatory cytokines [TNF␣, IL-6, IL-8] significantly increased (percent rise from baseline) in both groups, whereas IL-1␤ significantly increased in the PTSD group only. The anti-inflammatory cytokine IL-10 showed an immediate (within 10 min) increase in the CC group; however, the IL-10 increase in the PTSD group was delayed and not consistently elevated until 70 min post injection. Conclusion: These findings show significant central nervous system (CNS) differences in the inflammatory response to a deep pain stimulus in combat veterans with and without PTSD. They support the concept that abnormally elevated neuroinflammatory response to pain stimuli may be one CNS mechanism accounting for the high co-occurrence of PTSD and pain.Published by Elsevier Ltd.

show abstract

Section: Qstmentioning

confidence: 99%

Posttraumatic stress disorder influences the nociceptive and intrathecal cytokine response to a painful stimulus in combat veterans

Lerman

Davis

Bertram

et al. 2016

Psychoneuroendocrinology

View full text Add to dashboard Cite

show abstract

“…In contrast, when subjects were exposed to a more uncontrollable stress situation, that of a first time parachute jump for example, an opioid-mediated analgesia was observed [22]. Similarly, study of SIA in war veterans with post traumatic stress disorder (PTSD), demonstrated that re-exposure to a stimulus resembling the original traumatic event increased pain tolerance to a heat stimulus, an effect which could be attenuated by prior administration of naloxone [28]. It appears, therefore, that activation of the endogenous opioid system during SIA is dependent not only on exposure to aversive stimuli, but also requires that the stimulus be uncontrollable or a perception that this is the case.…”

Section: Fear Versus Anxiety and The Influence Of Attention And Contrmentioning

confidence: 99%

Clinical correlates of stress-induced analgesia: Evidence from pharmacological studies

Ford

Finn

2008

Pain

View full text Add to dashboard Cite

“…In human research, µ-opioid receptor blockade antagonized stress-induced analgesia evoked by noxious electric shocks [47,48], immersion of a limb in ice-water [28,40], the perception of failure on a difficult cognitive task [2,3,20], a combat video shown to Vietnam veterans with post-traumatic stress disorder [38], and a first-time parachute jump [27]. Effects of µ-opioid receptor blockade on experimental pain are more variable [16,23,40], possibly because of individual differences in sensitivity to or release of opioid peptides.…”

Section: Stress-induced Analgesiamentioning

confidence: 99%

Stress-evoked opioid release inhibits pain in major depressive disorder

Frew

Drummond

2008

Pain

View full text Add to dashboard Cite

To determine whether stress-evoked release of endogenous opioids might account for hypoalgesia in major depressive disorder (MDD), the µ-opioid antagonist naltrexone (50 mg) or placebo was administered double-blind to 24 participants with MDD and to 31 non-depressed controls. Eighty minutes later participants completed a painful foot cold pressor test and, after a 5-minute interval, began a 25-minute arithmetic task interspersed with painful electric shocks. Ten minutes later participants completed a second cold pressor test. Negative affect was greater in participants with MDD than in non-depressed controls throughout the experiment, and increased significantly in both groups during mental arithmetic. Before the math task, naltrexone unmasked direct linear relationships between severity of depression, negative affect while resting quietly, and cold-induced pain in participants with MDD. In contrast, facilitatory effects of naltrexone on cold-and shock-induced pain were greatest in controls with the lowest depression scores. Naltrexone strengthened the relationship between negative affect and shock-induced pain during the math task, particularly in the depressed group, and heightened anxiety in both groups toward the end of the task. Thus, µ-opioid activity apparently masked a positive association between negative affect and pain in the most distressed participants. These findings suggest that psychological distress inhibits pain via stress-evoked release of opioid peptides in severe cases of MDD. In addition, tonic endogenous opioid neurotransmission could inhibit depressive symptoms and pain in people with low depression scores.

show abstract

Naloxone-Reversible Analgesic Response to Combat-Related Stimuli in Posttraumatic Stress Disorder

Cited by 258 publications

References 27 publications

Posttraumatic stress disorder influences the nociceptive and intrathecal cytokine response to a painful stimulus in combat veterans

Posttraumatic stress disorder influences the nociceptive and intrathecal cytokine response to a painful stimulus in combat veterans

Clinical correlates of stress-induced analgesia: Evidence from pharmacological studies

Stress-evoked opioid release inhibits pain in major depressive disorder

Contact Info

Product

Resources

About