The relationship between depression, clinical pain, and experimental pain in a chronic pain cohort.
OBJECTIVE: Individuals with chronic pain frequently display comorbid depression, but the impact of symptoms of depression on pain processing is not completely understood. This study evaluated the effect of symptoms of depression and/or clinically diagnosed major depressive disorder (MDD) on pain pro...
| Publicado en: | Arthritis & Rheumatism Vol. 52; no. 5; pp. 1577 - 1585 |
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| Autores principales: | , , , , , |
| Formato: | clinical trial research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
May2005
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106299058&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106299058 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00043591 04N jtl: Arthritis & Rheumatism issn: 00043591 maglogo: Y pubinfo: dt: May2005 vid: 52 iid: 5 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106299058 2009578216 10.1002/art.21008 NLM15880832 106299058 ppf: 1577 ppct: 8 formats: tig: atl: The relationship between depression, clinical pain, and experimental pain in a chronic pain cohort. aug: au: Giesecke T Gracely RH Williams DA Geisser ME Petzke FW Clauw DJ affil: University of Michigan, Ann Arbor, USA. sug: subj: Brain Pathology Depression Physiopathology Pain Etiology Adult Chronic Disease Clinical Trials Data Analysis Software Depression Complications Female Fibromyalgia Complications Fibromyalgia Physiopathology Funding Source Magnetic Resonance Imaging Male Middle Age Pearson's Correlation Coefficient Questionnaires Human Adult: 19-44 years Middle Aged: 45-64 years Female Male ab: OBJECTIVE: Individuals with chronic pain frequently display comorbid depression, but the impact of symptoms of depression on pain processing is not completely understood. This study evaluated the effect of symptoms of depression and/or clinically diagnosed major depressive disorder (MDD) on pain processing in patients with fibromyalgia (FM). METHODS: Results of quantitative sensory testing and neural responses to equally painful pressure stimuli (measured by functional magnetic resonance imaging [fMRI]) were compared with the levels of symptoms of depression and comorbid MDD among patients with FM. RESULTS: Neither the level of symptoms of depression nor the presence of comorbid MDD was associated with the results of sensory testing or the magnitude of neuronal activation in brain areas associated with the sensory dimension of pain (primary and secondary somatosensory cortices). However, symptoms of depression and the presence of MDD were associated with the magnitude of pain-evoked neuronal activations in brain regions associated with affective pain processing (the amygdalae and contralateral anterior insula). Clinical pain intensity was associated with measures of both the sensory dimension of pain (results of sensory testing) and the affective dimension of pain (activations in the insula bilaterally, contralateral anterior cingulate cortex, and prefrontal cortex). CONCLUSION: In patients with FM, neither the extent of depression nor the presence of comorbid major depression modulates the sensory-discriminative aspects of pain processing (i.e., localizing pain and reporting its level of intensity), as measured by sensory testing or fMRI. However, depression is associated with the magnitude of neuronal activation in brain regions that process the affective-motivational dimension of pain. These data suggest that there are parallel, somewhat independent neural pain-processing networks for sensory and affective pain elements. The implication for treatment is that addressing an individual's depression (e.g., by prescribing an antidepressant medication that has no analgesic properties) will not necessarily have an impact on the sensory dimension of pain. pubtype: Academic Journal doctype: clinical trial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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