Hormonal Status and Cognitivo-Emotional Profile in Real-Life Patients With Neuropathic Pain: A Case Control Study.
Adrenocorticotropic Hormone
/ analysis
Adult
Anticonvulsants
Case-Control Studies
Cytokines
/ physiology
Dehydroepiandrosterone Sulfate
/ analysis
Emotions
Estradiol
/ analysis
Female
Follicle Stimulating Hormone
/ analysis
Humans
Hydrocortisone
/ analysis
Hypothalamo-Hypophyseal System
/ physiopathology
Luteinizing Hormone
/ analysis
Male
Middle Aged
Neuralgia
/ physiopathology
Pituitary-Adrenal System
/ physiopathology
Prospective Studies
Quality of Life
Sex Hormone-Binding Globulin
/ analysis
Testosterone
/ analysis
analgesics
hormonal status
hypothalamic-pituitary-adrenal-gonadal axis
neuropathic pain
Journal
Pain practice : the official journal of World Institute of Pain
ISSN: 1533-2500
Titre abrégé: Pain Pract
Pays: United States
ID NLM: 101130835
Informations de publication
Date de publication:
09 2019
09 2019
Historique:
received:
29
03
2019
accepted:
17
05
2019
pubmed:
28
5
2019
medline:
10
3
2020
entrez:
26
5
2019
Statut:
ppublish
Résumé
The specific impact of neuropathic pain and recommended neuropathic pain treatments on the hormonal and immune status of patients has been so far poorly explored. This study aimed at studying, in real life, the hypothalamic-pituitary-adrenal axis and the cytokine profile of patients with neuropathic pain. It also explored their links with cognition, emotion, quality of life, and drug treatment. This prospective study (clinicaltrials.gov NCT01543425) included 60 patients with neuropathic pain and 60 age- and gender-matched healthy volunteers after obtaining signatures of informed consent. A number of parameters were measured: adrenocorticotropic hormone, cortisol, cortisol awakening response, dehydroepiandrosterone sulphate, sex hormone binding globulin, testosterone, 17-β-estradiol, progesterone, luteinizing hormone, follicle-stimulating hormone, cytokines, brain-derived neurotrophic factor, and vitamin D. Psychological parameters were assessed by questionnaires. Patients with neuropathic pain had lower levels of adrenocorticotropic hormone (P = 0.009) and dehydroepiandrosterone sulphate (P < 0.001) than controls, and the cortisol awakening response was impaired. Patients were more depressed and anxious (P < 0.001) and had a diminished quality of life (P < 0.001), which was influenced by cytokines (P = 0.0067) and testosterone (P = 0.028). Antidepressants and antiepileptics appeared to interfere with testosterone and cognitivo-emotional domains. An impairment of the hormonal status and of the immune system was observed in patients. It identified testosterone as a potential pivotal mediator between antidepressants/antiepileptics and quality of life. Further studies must address the exact impact of different types of drugs on central effects, of gender differences, and of the immune system of neuropathic pain.
Sections du résumé
BACKGROUND
The specific impact of neuropathic pain and recommended neuropathic pain treatments on the hormonal and immune status of patients has been so far poorly explored. This study aimed at studying, in real life, the hypothalamic-pituitary-adrenal axis and the cytokine profile of patients with neuropathic pain. It also explored their links with cognition, emotion, quality of life, and drug treatment.
METHODS
This prospective study (clinicaltrials.gov NCT01543425) included 60 patients with neuropathic pain and 60 age- and gender-matched healthy volunteers after obtaining signatures of informed consent. A number of parameters were measured: adrenocorticotropic hormone, cortisol, cortisol awakening response, dehydroepiandrosterone sulphate, sex hormone binding globulin, testosterone, 17-β-estradiol, progesterone, luteinizing hormone, follicle-stimulating hormone, cytokines, brain-derived neurotrophic factor, and vitamin D. Psychological parameters were assessed by questionnaires.
RESULTS
Patients with neuropathic pain had lower levels of adrenocorticotropic hormone (P = 0.009) and dehydroepiandrosterone sulphate (P < 0.001) than controls, and the cortisol awakening response was impaired. Patients were more depressed and anxious (P < 0.001) and had a diminished quality of life (P < 0.001), which was influenced by cytokines (P = 0.0067) and testosterone (P = 0.028). Antidepressants and antiepileptics appeared to interfere with testosterone and cognitivo-emotional domains.
CONCLUSION
An impairment of the hormonal status and of the immune system was observed in patients. It identified testosterone as a potential pivotal mediator between antidepressants/antiepileptics and quality of life. Further studies must address the exact impact of different types of drugs on central effects, of gender differences, and of the immune system of neuropathic pain.
Substances chimiques
Anticonvulsants
0
Cytokines
0
Sex Hormone-Binding Globulin
0
Testosterone
3XMK78S47O
Estradiol
4TI98Z838E
Dehydroepiandrosterone Sulfate
57B09Q7FJR
Adrenocorticotropic Hormone
9002-60-2
Luteinizing Hormone
9002-67-9
Follicle Stimulating Hormone
9002-68-0
Hydrocortisone
WI4X0X7BPJ
Banques de données
ClinicalTrials.gov
['NCT01543425']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
703-714Informations de copyright
© 2019 World Institute of Pain.
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