ABSTRACT
Immunoreactive substance P was determined in lumbar CSF of 35 healthy volunteers and 60 patients with chronic pain syndromes of at least 6 months duration. No significant relationships were found between substance P levels and age, sex or body height. Substance P levels were lower in chronic pain patients, with either neurogenic (n = 23) or idiopathic pain (n = 37) syndromes, than in the healthy volunteers. Substance P levels were especially low in patients with neurogenic pain with lesions involving the extremities and in those with polyneuropathy, while patients with central pain or pain of the head or face had higher values. Substance P levels were related to depressive symptomatology as determined by means of visual analogue scales and to stable personality traits as determined by means of the Karolinska Scales of Personality (KSP). The most consistent (and inverse) relationship was found between substance P levels and the symptom 'inner tension' and between substance P levels and the personality trait 'psychic anxiety.'
Subject(s)
Pain, Intractable/cerebrospinal fluid , Pain/cerebrospinal fluid , Substance P/cerebrospinal fluid , Adult , Aged , Chronic Disease , Depression/cerebrospinal fluid , Female , Humans , Male , Middle Aged , Nervous System Diseases/complications , Pain/etiology , Pain/psychology , Pain, Intractable/psychology , Personality Inventory , SyndromeABSTRACT
In a series of 90 patients with chronic pain syndromes of psychogenic and organic etiology, the concentrations of fraction I endorphins in cerebrospinal fluid were investigated. A significant circannual variation in the concentrations of endorphins was found, with the highest concentrations in January-February and the lowest concentrations in July-August. There was no corresponding seasonal variation with regard to age, sex, bodylength, possible etiology of the pain syndrome self-rated pain levels, or experimental pain measures. Circannual difference in the intensity of symptoms in chronic pain syndromes and in affective disorders have been described in the literature. The present results suggest an association between these observations, giving further support for functional importance of endorphins in chronic pain.
Subject(s)
Endorphins/cerebrospinal fluid , Pain/cerebrospinal fluid , Seasons , Adult , Aged , Chronic Disease , Female , Humans , Male , Middle AgedABSTRACT
Seventy-two patients suffering from chronic pain were treated with high frequency transcutaneous electrical nerve stimulation (hi-TNS). Significant predictors for a positive result were pains of neurogenic origin and pains located mainly in the extremities. CSF endorphin levels were determined for 22 patients with organic pain and the group with positive results from the treatment had somewhat (but not significantly) lower levels of fraction I endorphins. Age, sex or reported severity of pain had no predictive value.
