PMID- 25551477
OWN - NLM
STAT- MEDLINE
DCOM- 20160701
LR  - 20180816
IS  - 1536-5409 (Electronic)
IS  - 0749-8047 (Linking)
VI  - 31
IP  - 11
DP  - 2015 Nov
TI  - Clinical Value of Serum Neuroplasticity Mediators in Identifying the Central 
      Sensitivity Syndrome in Patients With Chronic Pain With and Without Structural 
      Pathology.
PG  - 959-67
LID - 10.1097/AJP.0000000000000194 [doi]
AB  - BACKGROUND AND OBJECTIVES: Central sensitivity syndrome (CSS) encompasses 
      disorders with overlapping symptoms in a spectrum of structural pathology from 
      persistent somatic nociception (eg, osteoarthritis) to absence of tissue injury 
      such as in fibromyalgia, chronic tension-type headache, and myofascial pain 
      syndrome. Likewise, the spectrum of the neuroplasticity mediators associated with 
      CSS might present a pattern of clinical utility. METHODS: We studied the 
      brain-derived neurotrophic factor (BDNF), tumor necrosis factor-alpha (TNF-alpha), and 
      interleukins 6 (IL-6) and IL-10 in female patients with CSS absent of structural 
      pathology (chronic tension-type headache [n=30], myofascial pain syndrome [n=29], 
      fibromyalgia [n=22]); with CSS due to persistent somatic/visceral nociception 
      (osteoarthritis [n=27] and endometriosis [n=32]); and in pain-free controls 
      (n=37). RESULTS: Patients with CSS absent of structural pathology presented 
      higher serum TNF-alpha (28.61+/-12.74 pg/mL) and BDNF (49.87+/-31.86 ng/mL) than those 
      with persistent somatic/visceral nociception (TNF-alpha=17.35+/-7.38 pg/mL; 
      BDNF=20.44+/-8.30 ng/mL) and controls (TNF-alpha=21.41+/-5.74 pg/mL, BDNF=14.09+/-11.80 
      ng/mL). Moreover, CSS patients absent of structural pathology presented lower IL 
      levels. Receiver operator characteristics analysis showed the ability of BDNF to 
      screen CSS (irrespective of the presence of structural pathology) from controls 
      (cutoff=13.31 ng/mL, area under the curve [AUC]=0.86, sensitivity=95.06%, 
      specificity=56.76%); and its ability to identify persistent nociception in CSS 
      patients when experiencing moderate-severe depressive symptoms (AUC=0.81; 
      cutoff=42.83 ng/mL, sensitivity=56.80%, specificity=100%). When the level of pain 
      measured on the visual analog scale was <5 and moderate-severe depressive 
      symptoms were observed TNF-alpha discriminated structural pathology in the chronic 
      pain conditions (AUC=0.97; cutoff=22.11 pg/mL, sensitivity=90%, 
      specificity=91.3%). CONCLUSION: Neuroplasticity mediators could play a role as 
      screening tools for pain clinicians, and as validation of the complex and diffuse 
      symptoms of these patients.
FAU - Deitos, Alicia
AU  - Deitos A
AD  - *Post-Graduate Program in Medical Sciences, School of Medicine, Universidade 
      Federal do Rio Grande do Sul (UFRGS) daggerLaboratory of Pain and Neuromodulation 
      double daggerPostgraduate Program in Health and Human development, La Salle Universitary 
      Center, Canoas  section signPhysical Medicine and Rehabilitation Service daggerdaggerPain Treatment and 
      Palliative Care Service, Hospital de Clinicas de Porto Alegre (HCPA) 
      **Pharmacology Department, Instituto de Ciencias Basicas da Saude double daggerdouble daggerPain and 
      Anesthesia at Department of Surgery in Medical School at Universidade Federal do 
      Rio Grande do Sul (UFRGS), Porto Alegre, Brazil  parallelSpaulding Neuromodulation 
      Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown 
      Departments of  paragraph signPhysical Medicine and Rehabilitation #Neurology, Harvard Medical 
      School, Boston, MA.
FAU - Dussan-Sarria, Jairo A
AU  - Dussan-Sarria JA
FAU - Souza, Andressa de
AU  - Souza Ad
FAU - Medeiros, Liciane
AU  - Medeiros L
FAU - Tarrago, Maria da Graca
AU  - Tarrago Mda G
FAU - Sehn, Francislea
AU  - Sehn F
FAU - Chassot, Monica
AU  - Chassot M
FAU - Zanette, Simone
AU  - Zanette S
FAU - Schwertner, Andre
AU  - Schwertner A
FAU - Fregni, Felipe
AU  - Fregni F
FAU - Torres, Iraci L S
AU  - Torres IL
FAU - Caumo, Wolnei
AU  - Caumo W
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Clin J Pain
JT  - The Clinical journal of pain
JID - 8507389
RN  - 0 (Brain-Derived Neurotrophic Factor)
RN  - 0 (IL10 protein, human)
RN  - 0 (IL6 protein, human)
RN  - 0 (Interleukin-6)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - 130068-27-8 (Interleukin-10)
RN  - 7171WSG8A2 (BDNF protein, human)
SB  - IM
MH  - Adult
MH  - Brain-Derived Neurotrophic Factor/*blood
MH  - Chronic Pain/*blood/*etiology/psychology
MH  - Cross-Sectional Studies
MH  - Depression/blood
MH  - Endometriosis/blood
MH  - Female
MH  - Fibromyalgia/blood
MH  - Humans
MH  - Interleukin-10/*blood
MH  - Interleukin-6/*blood
MH  - Middle Aged
MH  - Myofascial Pain Syndromes/blood
MH  - Neuronal Plasticity
MH  - Osteoarthritis/blood
MH  - ROC Curve
MH  - Retrospective Studies
MH  - Sensitivity and Specificity
MH  - Tension-Type Headache/blood
MH  - Tumor Necrosis Factor-alpha/*blood
EDAT- 2015/01/01 06:00
MHDA- 2016/07/02 06:00
CRDT- 2015/01/01 06:00
PHST- 2015/01/01 06:00 [entrez]
PHST- 2015/01/01 06:00 [pubmed]
PHST- 2016/07/02 06:00 [medline]
AID - 10.1097/AJP.0000000000000194 [doi]
PST - ppublish
SO  - Clin J Pain. 2015 Nov;31(11):959-67. doi: 10.1097/AJP.0000000000000194.