Role of cold and emotional stress in Raynaud's disease and scleroderma.

Abstract

Research on the aetiology of Raynaud's disease and phenomenon has been hindered by the difficulty of provoking attacks in the laboratory. A study was therefore conducted in which digital and ambient temperatures, electrocardiograms, and stress ratings were obtained during ambulatory monitoring in patients with idiopathic Raynaud's disease, Raynaud's phenomenon secondary to scleroderma, and in normal subjects. In Raynaud's disease about one third of the vasospastic attacks were associated with tachycardia and increased stress ratings without declines in ambient temperature. In contrast, cold alone was enough to provoke most attacks of Raynaud's phenomenon in scleroderma.Chronically increased stress ratings in patients with scleroderma and increased muscle tension in anticipation of a cold stimulus suggest that these patients have different patterns of stress responses from those with Raynaud's disease. IntroductionThe symptoms of Raynaud's disease and phenomenon consist of episodic vasospasms in the fingers and toes precipitated by cold or emotional stress, or both. When these attacks occur in the presence of identifiable pathological processes the term Raynaud's phenomenon is used. This is the case for a variety of diseases such as scleroderma, where Raynaud's attacks occur in over 95% of patients.' When the attacks occur in the absence

Cold‐induced potentiation of α2‐adrenergic vasoconstriction in primary raynaud's disease

“…The present data replicate previous findings (6) that patients with primary Raynaud's disease have greater vasoconstrictive responses to a,-and a2-adrenergic agonists in uncooled fingers. Some attacks of Raynaud's disease are triggered by emotional stress (23), which is typically accompanied by catecholamine release (24). Although Raynaud's disease patients do not have consistently higher plasma catecholamine levels than controls (25-27), normal stress-induced catecholamine elevations, acting upon hypersensitive al-and a2-adrenoceptors, would produce greater digital vasoconstriction in the patients.…”

Early Nurturing Experiences, Self-Compassion, Hyperarousal and Scleroderma The Way We Relate to Ourselves May Determine Disease Progression

“…It forms part of the fight and flight response that functions to protect an individual from threat, however over-reactive protection defences that create excessive arousal reactions are a risk factor in the development of autoimmunity (e.g., Schore, 1994). It has been suggested that individuals diagnosed with scleroderma have a heightened stress response, when compared to individuals without scleroderma (Freedman & Ianni, 1983). Hyper-arousal is involved in the stress response and autoimmunity (e.g., Every & Lating, 2002) and is higher in individuals who are more physiologically and emotionally reactive (Pfaff, 2005).…”

“…Self-compassion reflects an ability to positively regulate emotions that lead to increased feelings of autonomy and the capacity to provide care and compassion for both self and others that are associated with positive health outcomes (Reyes, 2011). Individuals diagnosed with scleroderma tend to have a heightened stress response (Freedman & Ianni, 1983), when compared with individuals without scleroderma. This response is likely to be linked to feelings associated with fear or threat and the ability to self sooth; and may reflect an inability to regulate emotions through insufficient self-compassion.…”

Psychometrische Tests bei primärem Raynaud-Phänomen – Untersuchungsergebnisse an einem Tiroler Patientenkollektiv

“…Eine Normstichprobe mit einem n = 630 einer deutschen Normalpopulation stand als Kontrollgruppe zur Verfügung (Hampel und Selg, 1975). Normen liegen getrennt für beide Geschlechter und innerhalb der Geschlechter für drei Altersstufen (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) Jahre, 31-50 Jahre, über 50 Jahre) vor.…”