Hypothalamic-pituitary-adrenal axis feedback sensitivity in different states of back pain

Nees, Frauke; Löffler, Martin; Usai, Katrin; Flor, Herta

doi:10.1016/j.psyneuen.2018.10.026

Cited by 39 publications

(29 citation statements)

References 44 publications

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“…Based on the premise that 1) stress affects threat learning, 2) threat learning is of major importance in chronic pain, and 3) patients with chronic pain have stress dysfunctions, one would expect altered threat learning in patients with chronic pain. Indeed, alterations in pain-related fear acquisition have been identified in patients, including in patients with fibromyalgia (Meulders et al, 2015), subacute back pain (Nees et al, 2019), chronic low back pain (Klinger et al, 2010;Schneider et al, 2004), irritable bowel syndrome (Icenhour et al, 2015), hand pain (Meulders et al, 2014), and headache (Klinger et al, 2010). Fig.…”

Section: Impairments In Threat Learning In Chronic Painmentioning

confidence: 99%

“…This would then be followed by hypocortisolism, which may impair activation of the HPA axis when necessary. Supporting evidence for this idea comes from a study comparing individuals with subacute versus chronic back pain (Nees et al, 2019), showing that patients with subacute pain showed increased feedback sensitivity of the HPA axis (i.e., in response to a dexamethasone suppression test, to investigate the HPA axis regulation), while patients with chronic back pain and healthy controls did not. This was further correlated with pain intensity, and mediated by anxiety, further supporting the relevance of psychological mechanisms.…”

Section: Theoretical Integration Of Stress (Chronic) Pain and Threat Learningmentioning

confidence: 99%

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The interaction between stress and chronic pain through the lens of threat learning

Timmers

Quaedflieg

Hsu

et al. 2019

Neuroscience & Biobehavioral Reviews

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Section: Impairments In Threat Learning In Chronic Painmentioning

confidence: 99%

Section: Theoretical Integration Of Stress (Chronic) Pain and Threat Learningmentioning

confidence: 99%

The interaction between stress and chronic pain through the lens of threat learning

Timmers

Quaedflieg

Hsu

et al. 2019

Neuroscience & Biobehavioral Reviews

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“…Herein, we hypothesize that neuroactive effects of music may involve: (1) the brain neuroplasticity through upregulation of BDNF (84,85), (2) modulation of the parasympathetic tone (28,33,83), and (3) possible contributions from the dopaminergic system (4, 28, 100) and opioid receptors (101). Since music was shown to decrease stress hormone cortisol (94,102,103), an additional target for music-evoked antiseizure and analgesic activities can be modulation of the HPA axis (103)(104)(105)(106)(107)(108) and proinflammatory cytokines such as IL-6 (94,95,(109)(110)(111)(112). However, it is important to note that these potential mechanisms were not evaluated in the current study and further investigation is required to test this underlying hypothesis.…”

Section: Mechanisms Of Analgesic and Antiseizure Effects Of Musicmentioning

confidence: 99%

Music-Enhanced Analgesia and Antiseizure Activities in Animal Models of Pain and Epilepsy: Toward Preclinical Studies Supporting Development of Digital Therapeutics and Their Combinations With Pharmaceutical Drugs

Metcalf

Huntsman

Garcia³

et al. 2019

Front. Neurol.

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Digital therapeutics (software as a medical device) and mobile health (mHealth) technologies offer a means to deliver behavioral, psychosocial, disease self-management and music-based interventions to improve therapy outcomes for chronic diseases, including pain and epilepsy. To explore new translational opportunities in developing digital therapeutics for neurological disorders, and their integration with pharmacotherapies, we examined analgesic and antiseizure effects of specific musical compositions in mouse models of pain and epilepsy. The music playlist was created based on the modular progression of Mozart compositions for which reduction of seizures and epileptiform discharges were previously reported in people with epilepsy. Our results indicated that music-treated mice exhibited significant analgesia and reduction of paw edema in the carrageenan model of inflammatory pain. Among analgesic drugs tested (ibuprofen, cannabidiol (CBD), levetiracetam, and the galanin analog NAX 5055), music intervention significantly decreased paw withdrawal latency difference in ibuprofen-treated mice and reduced paw edema in combination with CBD or NAX 5055. To the best of our knowledge, this is the first animal study on music-enhanced antinociceptive activity of analgesic drugs. In the plantar incision model of surgical pain, music-pretreated mice had significant reduction of mechanical allodynia. In the corneal kindling model of epilepsy, the cumulative seizure burden following kindling acquisition was lower in animals exposed to music. The music-treated group also exhibited significantly improved survival, warranting further research on music interventions for preventing Sudden Unexpected Death in Epilepsy (SUDEP). We propose a working Metcalf et al. Music-Enhanced Analgesic and Antiseizure Activities model of how musical elements such as rhythm, sequences, phrases and punctuation found in K.448 and K.545 may exert responses via parasympathetic nervous system and the hypothalamic-pituitary-adrenal (HPA) axis. Based on our findings, we discuss: (1) how enriched environment (EE) can serve as a preclinical surrogate for testing combinations of non-pharmacological modalities and drugs for the treatment of pain and other chronic diseases, and (2) a new paradigm for preclinical and clinical development of therapies leading to drug-device combination products for neurological disorders, depression and cancer. In summary, our present results encourage translational research on integrating non-pharmacological and pharmacological interventions for pain and epilepsy using digital therapeutics.

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“… 1 HPA-axis function in chronic pain, including the direction (hyperexpression or hypoexpression) of cortisol is however still unclear. 60 In addition, the interpretation of an immediate increase in cortisol after joint mobilisation or manipulation is still unclear. 71 …”

Section: Discussionmentioning

confidence: 99%

Effects of joint and nerve mobilisation on neuroimmune responses in animals and humans with neuromusculoskeletal conditions: a systematic review and meta-analysis

Schipholt

Coppieters

Meijer

et al. 2021

PR9

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Hypothalamic-pituitary-adrenal axis feedback sensitivity in different states of back pain

Cited by 39 publications

References 44 publications

The interaction between stress and chronic pain through the lens of threat learning

The interaction between stress and chronic pain through the lens of threat learning

Music-Enhanced Analgesia and Antiseizure Activities in Animal Models of Pain and Epilepsy: Toward Preclinical Studies Supporting Development of Digital Therapeutics and Their Combinations With Pharmaceutical Drugs

Effects of joint and nerve mobilisation on neuroimmune responses in animals and humans with neuromusculoskeletal conditions: a systematic review and meta-analysis

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