Interacting influences of gender and chronic pain status on parasympathetically mediated heart rate variability in adolescents and young adults

Abstract: Considerable research links chronic pain to autonomic nervous system (ANS) dysfunction, specifically low heart rate variability (HRV) mediated by reduced parasympathetic activity. However, little is known about factors that influence ANS function in chronic pain. The ANS is the primary pathway for brain–gut communication, making it of particular interest in gastrointestinal disorders, such as irritable bowel syndrome, characterized by functional abdominal pain (FAP). We evaluated the relation of sex, pain severity, and psychological stress to ANS function in adolescents/young adults from a database of pediatric FAP and control participants enrolled 8 years earlier in a prospective study of pain. At follow-up in adolescence/young adulthood (Mean age = 19.46, SD = 3.48), we classified participants as Pain-Remit (n = 130), Pain-Persist (n = 96), and pain-free controls (n = 123). We recorded electrocardiogram data at rest and during laboratory stressors. Results demonstrated significantly lower HRV in Pain-Persist females compared with Pain-Remit females, female controls, and all males regardless of pain category. Spectral analysis of electrocardiogram showed that Pain-Persist females had reduced power in the high frequency domain of cardiac activity, ie, reduced parasympathetic “braking” of sympathetic activity, both at rest and during stress. Pain-Remit females exhibited levels of autonomic imbalance intermediate between those of females with persist...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research

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A 48-year-old kidney transplant recipient was admitted to our hospital with nausea, polyuria, diffuse paresthesia, and muscle weakness of all extremities. His past medical history was remarkable for renal transplantation with impaired graft function (baseline glomerular filtration rate approximately 20 ml/min per 1.73 m2) and parathyroidectomy due to an uncontrolled hyperparathyroidism. An electrocardiogram showed pronounced concave ST-segment elevations in leads II, III, and aVF suspicious of an acute ST elevation myocardial infarction as well as ascending elevations deriving from a deep S wave especially in leads V1 &nda...
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Nephrology Image Source Type: research
A 46-year-old woman with a history of sickle cell disease and associated predialysis stage V chronic kidney disease (CKD) with secondary hyperparathyroidism presented with fever, severe extremity pain, and perioral numbness. On examination, she had a prominent Chvostek ’s sign, carpopedal spasm, hyperactive tendon reflexes, and a nontender mass in the left lobe of her thyroid gland. She was not on bisphosphonates or calcimimetics and had not been taking her prescribed calcitriol for 2 weeks.
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Make Your Diagnosis Source Type: research
The objective of this presentation is to explore historical, scientific, interventional, and other differences between the two paradigms, so that innovators, researchers, practitioners, policy-makers, patients, end-users, and others can gain clarity with respect to both the explicit and implicit assumptions associated with brain advancement agendas of any kind. Over the course of three decades, a series of brain-centric, evolution-inspired insights have been articulated with increasing refinement, as principles of allostasis (Sterling and Eyer, 1988; Sterling, 2004, 2012, 2014). Allostasis recognizes that the role of the ...
Source: Frontiers in Human Neuroscience - Category: Neuroscience Source Type: research
Conclusion: Characteristics and nonverbal behaviors of experimenters/clinicians contribute to the elicitation and modulation of pain, placebo, and nocebo effects.IntroductionThe present qualitative review investigated whether the characteristics or nonverbal behavior (NB) of the person administrating painful stimulation affected pain or placebo/nocebo effects in the research participant. The placebo effect is a psychobiological response that may occur following the application of active and inactive interventions (1). Applying an inactive medication paired with positive information about its analgesic effects can reduce pa...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
Ryan R. Kelly1,2†, Lindsay T. McDonald1,2†, Nathaniel R. Jensen1,2, Sara J. Sidles1,2 and Amanda C. LaRue1,2* 1Research Services, Ralph H. Johnson VA Medical Center, Charleston, SC, United States 2Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, United States The significant biochemical and physiological effects of psychological stress are beginning to be recognized as exacerbating common diseases, including osteoporosis. This review discusses the current evidence for psychological stress-associated mental health disorders as risk factors for os...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
In conclusion, the studies presented in the current review demonstrate that CBD has the potential to limit delta-9-THC-induced cognitive impairment and improve cognitive function in various pathological conditions. Human studies suggest that CBD may have a protective role in delta-9-THC-induced cognitive impairments; however, there is limited human evidence for CBD treatment effects in pathological states (e.g. schizophrenia). In short, they found that CBD may help alleviate the negative impact of a person with schizophrenia from taking cannabis, both in the psychotic and cognitive symptoms associated with schizophrenia. T...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Alternative and Nutritional Supplements Disorders General Research Treatment cannabidiol Cannabis cbd cbd oil Marijuana THC Source Type: blogs
This article reviews the acute neural transmission of pain, pruritus, and nausea symptoms, which can begin in the periphery and/or viscera. The subsequent multiple pathways in the central nervous system that become involved in the processing of these symptoms are also discussed. The authors describe human brain imaging studies that have revealed consistent cortical and subcortical networks  activated by these symptoms, including sensory, limbic, and associative regions. In particular, the authors discuss information revealed by the studies regarding the primary somatosensory cortex, secondary somatosensory cortex, ant...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Current Issue Neurologic Systems and Symptoms Neurology Pain Review central processing nausea pruritus Source Type: research
Conclusions &InferencesBased on rodent studies, one may speculate that chronically activated stress signaling pathways in IBS maintain a pro‐inflammatory state in the periphery. Alternatively, primed monocytes may migrate to the brain during stress, inducing regional neuroinflammatory changes in salience regions involved in the modulation of visceral sensitivity. Results show a difference in correlation between PBMC gene expression levels and salience network connectivity in patients with IBS vs. HCs. Inflammatory genes (IL6 and APOL2) are positively correlated with connectivity within salience network in IBS patien...
Source: Neurogastroenterology and Motility - Category: Gastroenterology Authors: Tags: ORIGINAL ARTICLE Source Type: research
“Buprenorphine is a kappa receptor antagonist. For these reasons, buprenorphine might be unique in its ability to treat chronic pain and possibly OIH.” The opioid crisis has been fueled by the use of opioids to treat chronic pain.  Practice patterns have changed, but doctors are still criticized for their roles in the overuse of opioids.  I’ve sat through community ‘heroin forums’ (sometimes on stage) as sheriffs, politicians, and ‘recovered addicts’ firmly pointed fingers at health professionals.  I, meanwhile, kept my finger under the table, but had the t...
Source: Suboxone Talk Zone - Category: Addiction Authors: Tags: Acute Pain Buprenorphine Chronic pain Suboxone treatment buprenorphine treats chronic pain chronic pain treatment opioid induced hyperalgesia opioid pain relief pain vs. addiction Source Type: blogs
Authors: Brierley S Abstract The gastrointestinal tract is unique in that it is innervated by several distinct populations of neurons, whose cell bodies are either intrinsic (enteric, viscerofugal) or extrinsic (sympathetic, sensory afferents) to the wall of the gut. We are usually completely unaware of the continuous, complicated orchestra of functions that these neurons conduct. However, for patients with Inflammatory Bowel Disease (IBD) or functional gastrointestinal disorders, such as Functional Dyspepsia (FD) and Irritable Bowel Syndrome (IBS) altered gastrointestinal motility, discomfort and pain are common, ...
Source: Advances in Experimental Medicine and Biology - Category: Research Tags: Adv Exp Med Biol Source Type: research
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