Hypotalmo-pituitary-adrenal axis dysfunction as a contributory factor to chronic pain and depression

被引:87
作者
Blackburn-Munro G. [1 ]
机构
[1] Department of Pharmacology, NeuroSearch A/S, DK-2750 Ballerup
关键词
Chronic Pain; Neuropathic Pain; Fibromyalgia; Dorsal Horn; Chronic Fatigue Syndrome;
D O I
10.1007/s11916-004-0025-9
中图分类号
学科分类号
摘要
Chronic pain and depressive illness are variably resistant to treatment with current pharmacologic therapies. Pain as a reflex sensory response is accompanied by a fast autonomic and delayed neuroendocrine response mediated by the sympathoadrenal and hypothalamo-pituitary-adrenal (HPA) axis, respectively. The emotional aspect of the pain response is encoded by corticolimbic systems (including the HPA axis) to encapsulate the relationship between pain, memory, and mood. These same systems contribute to the symptomatology of depression, a common symptom of which is pain. Conversely, many chronic pain patients may suffer from depressive illness, which appears to develop as a consequence of chronic pain. A comparison of key changes in HPA function after chronic stress in animals with clinical depression in humans, reveals some striking similarities. In this article, the role of the HPA axis in the etiology of chronic pain and depression is discussed. Copyright © 2004 by Current Science Inc.
引用
收藏
页码:116 / 124
页数:8
相关论文
共 66 条
[61]  
Wolfe F., Smythe H.A., Yunus M.B., Et al., The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia: Report of the Multicenter Criteria Committee, Arthritis Rheum., 33, pp. 160-172, (1990)
[62]  
Wolfe F., Ross K., Anderson J., Et al., The prevalence and characteristics of fibromyalgia in the general population, Arthritis Rheum., 38, pp. 19-28, (1995)
[63]  
Price D.D., Staud R., Robinson M.E., Et al., Enhanced temporal summation of second pain and its central modulation in fibromyalgia patients, Pain, 99, pp. 49-59, (2002)
[64]  
Gracely R.H., Petzke F., Wolf J.M., Et al., Functional magnetic resonance imaging evidence of augmented pain processing in fibromyalgia, Arthritis Rheum., 46, pp. 1333-1343, (2002)
[65]  
Parker A.J.R., Wessely S., Cleare A.J., The neuroendocrinology of chronic fatigue syndrome and fibromyalgia, Psycholo. Med., 31, pp. 1331-1345, (2001)
[66]  
Lentjes E.G., Griep E.N., Boersma J.W., Et al., Glucocorticoid receptors, fibromyalgia, and low back pain, Psychoneuroendocrinology, 22, pp. 603-614, (1997)