Hypothalamic–pituitary–adrenal axis function in patients with complex regional pain syndrome type 1
| Autor: | Ryun S. Ahn, Jai Y. Park |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Male
Hypothalamo-Hypophyseal System medicine.medical_specialty Saliva Cortisol awakening response Hydrocortisone Endocrinology Diabetes and Metabolism Hypothalamus Pituitary-Adrenal System Dexamethasone Young Adult Endocrinology Oral administration Internal medicine medicine Humans Young adult Biological Psychiatry Endocrine and Autonomic Systems medicine.disease Pathophysiology Reflex Sympathetic Dystrophy Psychiatry and Mental health medicine.anatomical_structure Complex regional pain syndrome Female Pituitary-Adrenal Function Tests Psychology Hypothalamic–pituitary–adrenal axis medicine.drug |
| Zdroj: | Psychoneuroendocrinology. 37:1557-1568 |
| ISSN: | 0306-4530 |
| Popis: | An exaggerated inflammatory process is considered an important pathophysiological feature of complex regional pain syndrome type 1 (CRPS-1). The hypothalamic-pituitary-adrenal (HPA) axis serves as a negative feedback mechanism for inflammatory processes. The present study examined the HPA axis function in patients with CRPS-1 by a determination of cortisol concentrations in saliva. Three sets of saliva samples were sequentially collected from 24 patients with CRPS-1 during medication (on-Med), 72 h after stopping medication (off-Med) and 8h after the oral administration of 1mg dexamethasone. One set of saliva samples was collected from healthy controls. The cortisol awakening response (CAR) and diurnal cortisol decline (DCD) were used as indices for HPA axis function. Cortisol levels during the post-awakening period in patients were increased following withdrawal of medications. The CAR during the off-Med condition was disappeared after administration of dexamethasone. Among the examined CRPS-related numerical variables, the frequency of spontaneous pain attacks showed relationships with the indices of HPA axis function. After classifying the patients into two subgroups, we observed that the CAR and DCD in patient who had a relatively high frequency of spontaneous pain attacks (subgroup 5 ≤) were lower and less steep than those in patient who had a relatively low frequency of spontaneous pain attacks (subgroup 0-4) for the on- and off-Med conditions. The CAR and DCD in subgroup 5 ≤ during their off-Med condition were comparable to those in controls. These results suggest that the increase in frequency of spontaneous pain attacks is associated with a reduced CAR and flattened DCD in patients CRPS-1. |
| Databáze: | OpenAIRE |
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