Schizophrénies et réactivité à la douleur

Bonnot, Olivier; Tordjman, Sylvie

doi:10.1016/j.lpm.2008.05.013

Cited by 12 publications

(2 citation statements)

References 63 publications

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“…¿En todo caso no sería una reducida expresión de dolor debido a las alteraciones afectivas, cognitivas y comportamentales? Existen hipótesis que tratan de clarificar estas cuestiones (30): a) psicopatológica: anomalías sensoriales, afectivas y factores socio-psicológicos, todo lo cual produciría una disminución de la reactividad comportamental al dolor (35); b) biológicas: alteración de opiáceos, elevación de β-endorfina en el líquido cefalorraquídeo, disfunción endógena de la neurotransmisión mediada por el receptor N-metil-D-aspartato (NMDA); superponiendo los resultados en investigaciones de conductas automutilatorias en pacientes con el síndrome de Lesch-Nyhan, se postula que el sistema dopaminérgico se encuentra alterado con una sensibilidad incrementada a los receptores de dopamina (36). Lo más plausible sería considerar la disminución de la sensibilidad al dolor como un endofenotipo de las esquizofrenias (37).…”

Section: Rev Neuropsiquiatr 79 (3) 2016unclassified

Automutilación genital y de falanges en un paciente con esquizofrenia: reporte de un caso.

2016

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Automutilación genital y de falanges en un paciente con esquizofrenia: reporte de un caso. RESUMENLa automutilación es una rara, pero a la vez dramática y devastadora complicación de diversos trastornos mentales, más frecuente en pacientes con psicosis que presentan delusiones de contenido religioso. Las variedades más reportadas de automutilaciones mayores, que ocurren súbitamente e implican considerable daño tisular son la ocular, genital y de extremidades. Se revisan algunos factores predisponentes, características clínicas y tratamiento, a raíz del caso de un paciente varón de 49 años con esquizofrenia crónica, de larga evolución que, previamente se había mutilado varias falanges de ambas manos y recientemente el pene y los testículos, siguiendo las órdenes de sus alucinaciones. El paciente fue tratado con clozapina y ácido valproico, mostrando mejoría conductual pero también persistencia de las alucinaciones auditivas que lo conminan a que se ampute el miembro inferior derecho.PALABRAS CLAVE: Automutilación genital, esquizofrenia, trastornos psicóticos. SUMMARYSelf-mutilation is a rare, yet dire and dramatic complication of various mental disorders, more frequently seen in psychotic patients with delusions of religious content. The most reported cases of major self-mutilation, which occurs suddenly and with considerable tissue damage affect the ocular, genital and limb areas. Some predisposing factors, clinical features and treatment approaches are reviewed a propos of the case of a 49-year-old male patient with chronic schizophrenia who had previously mutilated several phalanges in both hands and, recently, cut out his penis and testicles following orders from his hallucinations. The patient was treated with clozapine and valproic acid, showing behavioral improvement, but persistence of the imperative auditory hallucinations that compel himto amputate his right lower limb.

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Section: Rev Neuropsiquiatr 79 (3) 2016unclassified

Automutilación genital y de falanges en un paciente con esquizofrenia: reporte de un caso.

2016

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“…Studies have shown that patients with social defected disorders may suffer from chronic pain [ 4 – 6 ]. Chronic pain is one of the risks involved in a series of physical, psychological, familiar, or social adverse events, with 20% classified to be neuropathic pain.…”

Section: Introductionmentioning

confidence: 99%

Modeled Behavioral Evaluation of the Neuropathic Pain with Social Defect in Rats: A Preliminary Methodology Evaluation

Xian

Feng

2014

Med Sci Monit Basic Res

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BackgroundSocial defect and chronic pain are 2 major health problems and recent data has demonstrated that they generally exist concurrently. However, a powerful evaluation model on the behavioral change is lacking. This study was designed to evaluate the behavioral curves using a statistically modeled trajectory analysis in neuropathic animals with or without social defect exposure.Material/MethodsAfter approval by the institutional animal care committee, Sprague-Dawley rats were randomized into different interventional groups with 15 animals each. Sprague-Dawley rats underwent spared nerve injury (SNI) to establish the neuropathic pain model, of which the mechanical withdrawal threshold was measured using von Frey filaments for a period of 105 days. Otherwise, a modified version of the resident (Long-Evans rats)-intruder paradigm was applied to produce a social defect animal model through the elevated plus maze (EPM). After raw data collection, we modeled them into a powerful statistical effects analysis to build up the behavioral change tendency in single SNI or in combined SNI and social defect animals.ResultsThe random and fixed effects analyses of the pain behavior after SNI were successfully modeled and demonstrated a gradient recovery tendency during the 15-week post-injury observational period. Correspondingly, SNI rats exhibited increased social defected symptoms, as indicated by the increased anxiety-like behavior in the EPM test. In addition, continuous social defect stress for 5 days or 10 days, respectively, partially attenuated and exacerbated SNI-induced allodynia in both random and fixed effects models. Five days but not 10 days social defect ameliorated SNI-associated anxiety-like behavior.ConclusionsThese data suggest that statistically powerful analysis of nerve injury-induced neuropathic pain is a highly sensitive model to determine the behavioral change tendency and distinguish them among behavior curves with or without social defect, and the combination of SNI with resident-intruder paradigm may be a suitable model for behavior evaluation of neuropathic pain with social defect.

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Fibromyalgia—pathways and neurotransmitters

Stahl

2009

Human Psychopharmacology

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Fibromyalgia is a syndrome of widespread chronic pain associated with sleep disorders, depressed mood, cognitive impairment and fatigue. Its etiology and pharmacopathology are poorly understood but it is thought to result from a dysfunction of central pain processing mechanisms leading to generalised pain sensitisation. Pain perception is the result of a bidirectional process of ascending and descending pathways. Nociceptive input from peripheral afferent neurons is sent via the dorsal horn of the spinal cord to the higher brain centres involved in pain perception. Some descending inhibitory projections to the spinal cord attenuate the nociceptive effects. Numerous neurotransmitters including serotonin, dopamine, noradrenaline and substance P are involved in these processes. In other neuronal pathways in the brain, the same neurotransmitters are involved in mood control, sleep regulation and cognitive function providing a neurochemical substrate for the wide range of symptoms seen in fibromyalgia. Attenuation of neuronal hyperactivity through ligands acting at the a2-d subunits of voltage-dependent calcium channels and increased inhibitory activity of the descending pathways by inhibition of serotonin and noradrenaline reuptake are two mechanisms that are currently exploited by new medication for the treatment of fibromyalgia.

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Schizophrénies et réactivité à la douleur

Cited by 12 publications

References 63 publications

Automutilación genital y de falanges en un paciente con esquizofrenia: reporte de un caso.

Automutilación genital y de falanges en un paciente con esquizofrenia: reporte de un caso.

Modeled Behavioral Evaluation of the Neuropathic Pain with Social Defect in Rats: A Preliminary Methodology Evaluation

Fibromyalgia—pathways and neurotransmitters

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