Increased Capsaicin-induced Secondary Hyperalgesia in Patients With Multiple Chemical Sensitivity

Holst, Helle; Arendt-Nielsen, Lars; Mosbech, H.; Elberling, Jesper

doi:10.1097/ajp.0b013e3181f9d60c

Cited by 21 publications

(7 citation statements)

References 28 publications

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“…Since it is likely that the aetiology is multi-factorial, and as in functional disorders [38], it can be argued that the complexities of IEI should be studied from a bio-psycho-social perspective. Such an approach would involve considering (1) the influence of biological factors, such as central sensitization processes, which have been suggested as a mechanism involved in the acquisition and maintenance of IEI [39][40][41], (2) changes in the reactivity of the hypothalamic-pituitaryadrenal axis [42] and/or psychopathological processes, such as the role of anxiety and depression [17], (3) processes involved in symptom perception and amplification and in emotional regulation [43,44] and (4) socioeconomic factors [7].…”

Section: Discussionmentioning

confidence: 99%

The association between idiopathic environmental intolerance and psychological distress, and the influence of social support and recent major life events

Skovbjerg

Rasmussen

Zachariae

et al. 2011

Environ Health Prev Med

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Section: Discussionmentioning

confidence: 99%

The association between idiopathic environmental intolerance and psychological distress, and the influence of social support and recent major life events

Skovbjerg

Rasmussen

Zachariae

et al. 2011

Environ Health Prev Med

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“…This is a target population because TMD prevalence is higher in patients with FM [28]. Pain is a the main symptom of these conditions [33–35], and it limits the patient’s activities of daily living, such as walking, carrying objects, occupational, eating, talking, yawning, and smiling, as well as a worsened in quality of life [35, 36]. Moreover, pain is associated to sleep disturbances, fatigue, and mood and memory disorders [36, 37].…”

Section: Discussionmentioning

confidence: 99%

Effects of exercise training and photobiomodulation therapy (EXTRAPHOTO) on pain in women with fibromyalgia and temporomandibular disorder: study protocol for a randomized controlled trial

Silva

Albertini

Leal-Junior

et al. 2015

Trials

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BackgroundFibromyalgia (FM) is a syndrome most prevalent in women, in whom it is characterized mainly by chronic pain. An important issue is that many patients with FM are reported to have temporomandibular dysfunction (TMD), and the coexistence of these pathologies generates a clinical outcome of high complexity. The literature is unclear regarding an effective therapy for reducing pain in patients with both comorbidities. Exercise training and phototherapy (low-level laser therapy with light-emitting diode) are two of the approaches used to treat pain. Thus, the aim of this study is to assess the potential role of exercise training plus phototherapy in reducing chronic pain in women with FM and TMD. A further aim is to determine whether the interventions can improve quality of life and modulate endogenous serotonin.Methods/DesignA randomized controlled clinical trial will be conducted. It will involve 60 women ≥ 35 years of age with a diagnosis of FM and TMD. After recruitment, patients will be randomly allocated to one of four groups: a control group (no intervention), a group that will receive a phototherapy intervention (PHO), a group that will be prescribed muscle-stretching, aerobic, and facial exercises (EXT), or a group that will receive phototherapy plus exercise interventions (PHO + EXT). The trial will last 10 weeks, and the following outcomes will be evaluated on two separate occasions (baseline and within 24 h after the last day of the protocol). Pain intensity will be analyzed using a visual analogue scale and the McGill Pain Questionnaire, and pain thresholds will be punctuated using a digital algometer. FM symptoms will be assessed using the Fibromyalgia Impact Questionnaire, and quality of life will be determined with the 36-item Short Form Health Survey. Serotonin levels will be evaluated in salivary samples using a competitive enzyme-linked immunosorbent assay.DiscussionThis is the first randomized controlled trial in which the role of phototherapy, exercise training, and a combination of these interventions will be evaluated for chronic pain in patients with FM and TMD. The results will offer valuable clinical evidence for objective assessment of the potential benefits and risks of procedures.Trial registrationClinicalTrials.gov Identifier: NCT02279225. Registered 27 October 2014.

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“…Suggestions have been made that the observed reduction in cerebral activity reflects reduced activity in the inhibitory brain circuits, thus resulting in an increased response to normal sensory input [19]; that is, central sensitization. In controlled experimental pain studies, the presence of central sensitization in MCS has also been supported by findings of enlarged areas of capsaicin-induced secondary mechanical hyperalgesia [20,21]. Capsaicin (the active component in chili peppers) injections in the skin induce secondary mechanical hyperalgesia, which is an increased sensitivity to mechanical stimuli in the skin surrounding the injection site and is considered to be a CNS response.…”

Section: Introductionmentioning

confidence: 97%

Transcranial pulsed electromagnetic fields for multiple chemical sensitivity: study protocol for a randomized, double-blind, placebo-controlled trial

Tran

Skovbjerg

Arendt-Nielsen

et al. 2013

Trials

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BackgroundMultiple chemical sensitivity (MCS) is a chronic condition of unknown etiology. MCS is characterized by recurrent nonspecific symptoms from multiple organ systems in response to chemical exposures in concentrations that are normally tolerated by the majority of the population. The symptoms may have severe impact on patients’ lives, but an evidence-based treatment for the condition is nonexisting. The pathophysiology is unclarified, but several indicators point towards abnormal processing of sensory signals in the central nervous system. Pulsed electromagnetic fields (PEMF) offer a promising new treatment for refractory depression and can be targeted at the brain, thereby activating biochemical cell processes.Methods/DesignIn a parallel, randomized, double-blind, placebo-controlled trial conducted at the Danish Research Centre for Chemical Sensitivities, the effects of PEMF in MCS patients will be assessed using the Re5 Independent System. Based on sample size estimation, 40 participants will be randomized to either PEMF therapy or placebo. The allocation sequence will be generated by computer. All involved parties (that is, participants, investigators, the research nurse, and the statistician) will be blinded to group allocation. The participants will receive PEMF therapy or placebo applied transcranially 30 minutes twice a day for 7 days a week over 6 consecutive weeks. Outcomes will be measured at baseline, once weekly during treatment, post treatment, and at 2.5-month and 4.5-month follow-up according to a predefined timetable. The primary outcome will be a measurement of the impact of MCS on everyday life. The secondary outcomes will be measurements of MCS symptoms, psychological distress (stress, anxiety or depressive symptoms), capsaicin-induced secondary punctate hyperalgesia, immunological markers in serum, and quality of life.DiscussionThis trial will assess the effects of PEMF therapy for MCS. Currently, there is no treatment with a documented effect on MCS, and in terms of healthcare there is very little to offer these patients. There is thus a great need for well-conducted randomized trials aimed at assessing possible treatment effects. A positive outcome will pave the way for improved healthcare and understanding of this very disabling and overlooked condition.Trial registrationClinicalTrials.gov, NCT01834781

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Increased Capsaicin-induced Secondary Hyperalgesia in Patients With Multiple Chemical Sensitivity

Abstract: this is the ﬁrst study to show facilitated pain processing in MCS and EC patients with the most abnormal responses in MCS.

Cited by 21 publications

References 28 publications

The association between idiopathic environmental intolerance and psychological distress, and the influence of social support and recent major life events

The association between idiopathic environmental intolerance and psychological distress, and the influence of social support and recent major life events

Effects of exercise training and photobiomodulation therapy (EXTRAPHOTO) on pain in women with fibromyalgia and temporomandibular disorder: study protocol for a randomized controlled trial

Transcranial pulsed electromagnetic fields for multiple chemical sensitivity: study protocol for a randomized, double-blind, placebo-controlled trial

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