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Central nervous system monoaminergic activity in hip osteoarthritis patients with disabling pain : associations with pain severity and central sensitization

Bjurström, Martin F. LU ; Blennow, Kaj LU ; Zetterberg, Henrik LU ; Bodelsson, Mikael LU ; Waldén, Markus ; Dietz, Nicholas ; Hall, Sara LU ; Hansson, Oskar LU orcid ; Irwin, Michael R. and Mattsson-Carlgren, Niklas LU orcid (2022) In Pain Reports 7(1). p.988-988
Abstract

Introduction: Monoaminergic activity modulates nociceptive transmission in the central nervous system (CNS). Although pain is the most disabling symptom of osteoarthritis (OA), limited knowledge exists regarding the CNS mechanisms that amplify pain and drive sensitization processes in humans.Objectives:The main objective of this study was to evaluate associations between cerebrospinal fluid (CSF) monoamine metabolites, pain severity, and central sensitization in patients with OA undergoing total hip arthroplasty (THA).Methods:Patients with OA (n = 52) and pain-free controls (n = 30) provided CSF samples for measurement of serotonin (5-hydroxyindoleacetic acid [5-HIAA]), noradrenaline (3-methoxy-4-hydroxyphenylglycol [HMPG]), and... (More)

Introduction: Monoaminergic activity modulates nociceptive transmission in the central nervous system (CNS). Although pain is the most disabling symptom of osteoarthritis (OA), limited knowledge exists regarding the CNS mechanisms that amplify pain and drive sensitization processes in humans.Objectives:The main objective of this study was to evaluate associations between cerebrospinal fluid (CSF) monoamine metabolites, pain severity, and central sensitization in patients with OA undergoing total hip arthroplasty (THA).Methods:Patients with OA (n = 52) and pain-free controls (n = 30) provided CSF samples for measurement of serotonin (5-hydroxyindoleacetic acid [5-HIAA]), noradrenaline (3-methoxy-4-hydroxyphenylglycol [HMPG]), and dopamine (homovanillic acid [HVA]) monoamine metabolites. Patients with OA completed longitudinal evaluation of pain using clinical measures and quantitative sensory testing.Results:Patients with OA had higher HMPG levels when compared with controls (P = 0.036). Within patients with OA undergoing THA, higher 5-HIAA and HVA levels were consistently associated with higher preoperative pain severity. Higher concentrations of 5-HIAA and HVA were also associated with lower conditioned pain modulation levels, whereas higher HMPG levels were linked to more efficient conditioned pain modulation. Patients with higher levels of CSF HVA exhibited increased pressure pain sensitivity (arm pressure pain detection threshold < 250 kPa vs ≥ 250 kPa, P = 0.042). Higher preoperative levels of CSF 5-HIAA predicted poorer pain control 6 months postoperatively (brief pain inventory pain severity; adjusted β = 0.010, 95% CI 0.001-0.019).Conclusions:In OA patients with disabling pain, higher CSF levels of serotonin and dopamine metabolites are associated with increased pain severity and central sensitization. Increased noradrenergic activity may be associated with more efficient pain inhibitory capacity.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Central nervous system, Central sensitization, Cerebrospinal fluid, Monoamines, Osteoarthritis, Pain
in
Pain Reports
volume
7
issue
1
pages
988 - 988
publisher
Lippincott Williams & Wilkins
external identifiers
  • scopus:85128586728
  • pmid:35097309
ISSN
2471-2531
DOI
10.1097/PR9.0000000000000988
language
English
LU publication?
yes
id
03359a9f-5a6c-446b-87b8-e67d7a5d60cf
date added to LUP
2023-01-02 13:09:20
date last changed
2024-04-18 10:14:34
@article{03359a9f-5a6c-446b-87b8-e67d7a5d60cf,
  abstract     = {{<p>Introduction: Monoaminergic activity modulates nociceptive transmission in the central nervous system (CNS). Although pain is the most disabling symptom of osteoarthritis (OA), limited knowledge exists regarding the CNS mechanisms that amplify pain and drive sensitization processes in humans.Objectives:The main objective of this study was to evaluate associations between cerebrospinal fluid (CSF) monoamine metabolites, pain severity, and central sensitization in patients with OA undergoing total hip arthroplasty (THA).Methods:Patients with OA (n = 52) and pain-free controls (n = 30) provided CSF samples for measurement of serotonin (5-hydroxyindoleacetic acid [5-HIAA]), noradrenaline (3-methoxy-4-hydroxyphenylglycol [HMPG]), and dopamine (homovanillic acid [HVA]) monoamine metabolites. Patients with OA completed longitudinal evaluation of pain using clinical measures and quantitative sensory testing.Results:Patients with OA had higher HMPG levels when compared with controls (P = 0.036). Within patients with OA undergoing THA, higher 5-HIAA and HVA levels were consistently associated with higher preoperative pain severity. Higher concentrations of 5-HIAA and HVA were also associated with lower conditioned pain modulation levels, whereas higher HMPG levels were linked to more efficient conditioned pain modulation. Patients with higher levels of CSF HVA exhibited increased pressure pain sensitivity (arm pressure pain detection threshold &lt; 250 kPa vs ≥ 250 kPa, P = 0.042). Higher preoperative levels of CSF 5-HIAA predicted poorer pain control 6 months postoperatively (brief pain inventory pain severity; adjusted β = 0.010, 95% CI 0.001-0.019).Conclusions:In OA patients with disabling pain, higher CSF levels of serotonin and dopamine metabolites are associated with increased pain severity and central sensitization. Increased noradrenergic activity may be associated with more efficient pain inhibitory capacity.</p>}},
  author       = {{Bjurström, Martin F. and Blennow, Kaj and Zetterberg, Henrik and Bodelsson, Mikael and Waldén, Markus and Dietz, Nicholas and Hall, Sara and Hansson, Oskar and Irwin, Michael R. and Mattsson-Carlgren, Niklas}},
  issn         = {{2471-2531}},
  keywords     = {{Central nervous system; Central sensitization; Cerebrospinal fluid; Monoamines; Osteoarthritis; Pain}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{988--988}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Pain Reports}},
  title        = {{Central nervous system monoaminergic activity in hip osteoarthritis patients with disabling pain : associations with pain severity and central sensitization}},
  url          = {{http://dx.doi.org/10.1097/PR9.0000000000000988}},
  doi          = {{10.1097/PR9.0000000000000988}},
  volume       = {{7}},
  year         = {{2022}},
}