Monoaminerge Transmitter in der Zerebrospinalflüssigkeit von Patienten mit akuten, chronischen und episodischen Schmerzen

Abstract

The pathological decrease of NE and 5-HIAA in the CSF points to the crucial role of noradrenergic and serotonergic transmitter systems in the generation, modulation, and perpetuation of chronic and episodic pain syndromes. It indicates that antidepressants are effective drugs in these diseases. However, a discriminative neurochemical pattern between pain and depression could not be established. The demonstration of polyvalent correlations between different neurotransmitters is indicative of complex neurobiological coupling between cortical, limbic, and hypothalamic neuronal networks on the one hand and the nociceptive descending system on the other hand in the genesis of pain and depression.

The interface between inhibition of descending noradrenergic pain control pathways and negative affects in post-traumatic pain patients

“…Our research showed a relationship between affective symptoms and pain, and the correlation coefficient ( r = 0.433) was not low. Strittmatter et al (15) showed that NA, serotonin, and dopamine did not change significantly in patients with acute pain. This finding may be explained by the fact that different patients were selected in the acute pain group.…”

“…Patients with chronic and episodic pain often show depressive and affective symptoms. Moreover, decreased NA and 5-hydroxyindoleacetic acid (5-HIAA) concentrations illustrate that monoaminergic transmitters may be the interface between pain and depression (15). Because pain usually encompasses emotional aspects, in post-traumatic pain patients and in women experiencing labor pain, we hypothesize that the descending monoaminergic pathway is altered and that CSF concentrations of monoamine neurotransmitters may be more closely related to affective symptoms.…”

Central nervous system monoaminergic activity in hip osteoarthritis patients with disabling pain: associations with pain severity and central sensitization

“…8 For this secondary analysis of the neuroPSI data, we confirmed that the sample size was adequate for between-group comparisons of monoamine metabolites. Using previously reported results comparing CSF 5-HIAA levels between patients with chronic pain and controls, 44 we found that detection of a significant CSF 5-HIAA difference, with a 2-sided significance level of 5% and power of 90%, produced estimates of 24 subjects in each group.…”

“…2 Whereas our study found consistent associations between CSF levels of monoamine metabolites and pain intensity, as characterized by multiple instruments, previous results are equivocal. 2,21,23,44 Results from other areas of research confirm the complex relationship between concentrations of CSF monoamine metabolites and clinical outcomes; for example, meta-analyses of studies conducted in major depressive disorder populations has revealed no clear pattern of alterations in monoaminergic activity vs controls. 35…”

“…21 This study supports potential sex differences in CSF 5-HIAA levels, given that female individuals had higher levels than male individuals (full sample, n 5 82). By contrast, another study (n 5 40) reported that patients with chronic pain had lower CSF concentrations of noradrenaline and 5-HIAA compared with controls, 44 and patients diagnosed with idiopathic pain disorders were also found to have lower 5-HIAA levels compared with healthy controls. 2 Whereas our study found consistent associations between CSF levels of monoamine metabolites and pain intensity, as characterized by multiple instruments, previous results are equivocal.…”