Highlights
- •Descending pain inhibition is deficient in chronic musculoskeletal pain subjects.
- •There was no change in cerebrospinal fluid monoamine levels in chronic pain subjects compared to controls.
- •Plasma norepinephrine and metanephrine levels decreased in chronic pain subjects versus controls.
- •Positive associations were found between plasma norepinephrine and metanephrine levels and conditioned pain modulation efficacy.
Abstract
Descending pain inhibition is an endogenous pain control system thought to depend
partially on the activation of bulbospinal monoaminergic pathways. Deficits in descending
pain inhibition have been reported in numerous human chronic pain conditions, but
there is currently no consensus regarding the neurochemical correlates responsible
for this deficit. The aims of this study were to 1) assess the efficacy of descending
pain inhibition in pain-free and chronic pain subjects, 2) screen for changes in centrally
(ie, cerebrospinal fluid) and peripherally (ie, plasma) acting monoamine concentrations,
and 3) explore the relationship between descending pain inhibition and monoamine neurotransmitter
concentrations. Our results clearly show a deficit in pain inhibition, along with
lower plasma norepinephrine and metanephrine concentrations in chronic pain subjects,
compared to pain-free subjects. No differences were found in cerebrospinal fluid neurotransmitter
concentrations. Finally, our results revealed a positive relationship between blood-bound
norepinephrine and metanephrine concentrations and the efficacy of descending pain
inhibition. Thus, basal monoamine levels in blood were related to descending pain
inhibition. This finding supports the emerging idea that individual differences in
descending pain inhibition may be linked to individual differences in peripheral processes,
such as monoamines release in blood, which are possibly related to cardiovascular
control.
Perspectives
This article presents psychophysical and neurochemical findings that indicate that
the latent potential of descending pain inhibitory responses is associated with differential
activity in peripheral processes governed by monoamine neurotransmitter release, bringing
insights into the relationship between descending pain inhibition and cardiovascular
control in humans.
Key words
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Article info
Publication history
Published online: February 04, 2015
Accepted:
January 16,
2015
Received in revised form:
January 12,
2015
Received:
November 27,
2014
Footnotes
P.S. and P.G. contributed equally to directing this study.
This work was supported by research funding from the Canadian Institutes of Health Research (P.S.), the Fonds de Recherche du Québec–Santé (P.G.) and by the Natural Sciences and Engineering Research Council of Canada (P.G., P.S.). A.J.P. is supported by a graduate scholarship from the Fonds de Recherche du Québec - Santé.
The authors report no conflict of interest.
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© 2015 American Pain Society. Published by Elsevier Inc. All rights reserved.
