A two-component model of hair cortisol concentration in fibromyalgia: Independent effects of pain chronicity and severity.

BACKGROUND: Fibromyalgia (FM) is a chronic pain disorder of unknown aetiopathogenesis, in which the role of activity of the hypothalamic-pituitary-adrenal (HPA) axis is not clearly established. METHODS: This study analysed the modulatory effects of disease chronicity and severity on cortisol levels. Hair cortisol concentrations (HCC) and clinical evaluation data (pain severity, impact of FM on daily activities, depression, anxiety, fatigue and insomnia) were collected from 47 female patients with FM and 36 healthy women (HW). RESULTS: The results showed that disease chronicity, with a negative effect, and symptom severity, with a positive effect, were independent predictors of HCC. Patients with a shorter disease duration had higher HCC than patients with a longer disease duration and healthy participants. Furthermore, patients with greater symptom severity had higher HCC than those patients with lower clinical severity and healthy participants. While disease chronicity in FM was associated with a decrease in HCC, clinical severity increased HCC. CONCLUSIONS: These results support the existence of a dysfunction in the regulation of the HPA axis in FM and its possible contribution to chronic pain development. SIGNIFICANCE: This is the first study to assess hair cortisol concentrations in a specific sample of patients with fibromyalgia (FM). This method is especially useful for the assessment of long-term regular cortisol excretion. Results showed a two-component model for explaining cortisol levels: disease chronicity, with a negative effect, and symptom severity, with a positive effect. This suggests that severe pain/stress evokes higher cortisol levels at earlier stages of FM, while in the longer term a decrease in cortisol levels was observed.

Asymmetries in reciprocal baroreflex mechanisms and chronic pain severity: Focusing on irritable bowel syndrome.

BACKGROUND: Objective measures of pain severity remain ill defined, although its accurate measurement is critical. Reciprocal baroreflex mechanisms of blood pressure (BP) control were found to impact differently on pain regulation, and thus their asymmetry was hypothesized to also connect to chronic pain duration and severity. METHODS: Seventy-eight female patients with irritable bowel syndrome (IBS) and 27 healthy women were assessed for IBS severity and chronicity, negative affect, and various measures of resting autonomic function including BP, heart rate and its variability (HRV), baroreceptor-sensitivity to activations and inhibitions, gains of brady- and tachy-cardiac baro-responses, gains of BP falls/rises, and BP start points for these spontaneous baroreflexes. KEY RESULTS: IBS directly and indirectly (through increased negative affect) was associated with asymmetry between baroreceptor activations/inhibitions compared to symmetrical baroreflex reciprocity in the healthy women. In the IBS group, independently of specific IBS symptoms, pain chronicity was associated with (i) decreased BP falls coupled with either (a) decreased tachycardia associated with lower disease severity (earlier "pain resilience" mechanism), or (b) decreased bradycardia associated with higher disease severity (later "pain decompensation" mechanism), or (ii) increased BP start point for baroreceptor activations coupled with either (a) BP increase (delayed "pain adaptation" mechanism) or (b) affect-related HRV decrease (delayed "pain aggravation" mechanism). CONCLUSION AND INFERENCES: We anticipate the findings to be a starting point for validating these autonomic metrics of pain suffering and pain coping mechanisms in other chronic pain syndromes to suggest them as biomarkers of its severity and duration for profiling and correct management of chronic pain patients.

Neurodevelopment and phenotype-modulating functions of S100B protein: a pilot study.

The importance of certain neurotrophic proteins found in maternal blood and milk for breastfed infants has remained ambiguous. This study was conducted to present evidence of the impact of an induced deficit of active S100B protein on neonate development. Newborn mice from two groups of mothers, immunized or sham-immunized against S100B, were subjected to various behavioral tests, and the development of their morphological characteristics was recorded from birth until weaning. Morphological problems, including weight gain and fur coating, a delay in the maturation of neurobehavioral systems and a deficit in neuromotor functions, including visual abilities, somato-sensory and posture reactions, muscular strength, locomotion, and fear/orienting processes, were observed in pups of immunized mothers. The S100B protein of external or internal origin in infants may be considered to be a specific factor that determines neuro- and morphological development and a risk-avoidance ('homeward-bent' or fearful) phenotype. The suppression of activity of the S100B protein results in a slower neonatal development and the formation of a risk-tolerant (fearless) phenotype of the offspring. This study thus considers the mechanism of neuroplastic regulation on the extent of sensation-seeking or risk-taking (homeless-like or fearless) and sensation- or risk-avoidance (home-bound or fearful) features in individual phenotypes.

[Gender differences in emotion regulation in response to texts with violent content].

We investigated gender differences in emotion regulation depending on the cognitive disclosure of negative emotive content of 3 different texts after their presentations. For the purposes of the study we varied order between (i) completing of special checklists, created for specification of emotive and arousing attributes of the text contents and (ii) readings of autonomic activity. Results suggested that completing of the checklists increased engagement in processing of the most arousing text's content in men, while no effect was found in women, who were proposed to be engaged in content processing already during the text presentation. Results of the present study are discussed in the context of the recent findings on the emotional regulation.

[Cardiovascular reactivity to emotional texts in subjects with low and high level of psychoticism].

The article presents the results of comparative study of groups of subjects with low and high level of psychoticism. Heart rate, heart rate responses to inspiratory and expiratory Valsalva maneuvers, and blood pressure were measured before and after presentation of the texts with validated negative content in groups of subjects with low and high psychoticism scores. It was hypothesized that subjects with high level of psychoticism would be less engaged in the processing of negative contents of the texts and their physiological reactivity (physiological resources submitted for support of cognitive processing) would be less pronounced compared to subjects with low level of psychoticism. Significant main effect of psychoticism was obtained for changes in heart rate to expiratory Valsalva maneuver after presentations of the texts. Significant interaction effects of gender and psychoticism were obtained for systolic blood pressure. Other cardiovascular variables were not sensitive to the level of psychoticism. These effects of psychoticism were independent of other individual traits, such as neuroticism, extraversion, lie (social desirability), anger, trait anxiety and depression.

[Brain bioelectrical activities in heroin addicts during early abstinence period]. / Bioélektricheskaia aktivnist' mozga u bol'nykh geroinovoi narkomaniei v rannie sroki abstinentsii.

Standard 19-channel EEG registration was performed in 30 heroin addicts (mean age 21.7 +/- 2.8 years, daily heroin abusing duration--12.2 +/- 8.0 months, heroin dose per day--0.42 +/- 0.29 g, abstinence duration--12.3 +/- 8.1 days). Qualitative EEG changes, being observed in more than 70% of the cases, included low voltage of background activity with depression of alpha rhythm and increase in beta activity; large amount of low amplitude waves in central regions; low reactivity to stimulation. The patients with daily heroin doses more than 0.5 g demonstrated slowing of alpha rhythm in comparison to those with lower doses (8.9 +/- 0.8 Hz vs 10.3 +/- 2.0 Hz, p < 0.05). In follow-up study, obvious or even complete normalization of the EEG was observed in most of the cases during the first months of abstinence.

[Premorbid psychological status in heroin abusers: impact of treatment compliance]. / Vliianie premorbidnogo psikhologicheskogo statusa zloupotrebliaiushchikh geroinom lits na ikh otnoshenie k lecheniiu.

UNLABELLED: Heroin abusers who performed two "prefrontal" psychological tests (WCST and Delayed Alternation test--DIAT) with unusual amount of perseverative responses, reached i.v. doses of 0.5-1.0 g of heroin per day during the first year of heroin intake and continued out-patient treatment after discharge from hospital. Patients with "ideal" performance on two tests injected 0.1-0.3 g of heroin per day during the first year of heroin intake and stopped treatment after discharge, sometimes returned for treatment after several months of remission because of relapse. The latter patient group had lower verbal intelligence in comparison with education-matched normal controls. Percent of normal controls who made unusually many perseverative responses on WCST was the same as in the patient group (chi 2 = 5.5, p = 0.24). CONCLUSIONS: a) Performance of WCST and partially DAT can characterise of premorbid psychological status in heroin abusers; b) premorbid dysfunction of prefrontal cortex that mediates perseverative responses to WCST and DAT may contribute to drug abusing severity; c) low verbal intelligence may poorly influence treatment compliance in heroin abusers.

[Neuropsychological deficit in chronic heroin abusers]. / Neiropsikhologicheskii defitsit pri khronicheskoi narkotizatsii geroinom.

Neurological consequences of chronic heroin exposure are poorly known. 38 male patients with current heroin abuse or dependence were examined in withdrawal period that lasted more than 10 days, and were compared with 19 healthy controls. Wisconsin Card Sorting Test (WCST), "Delayed Alternation" Test (DAT), "Tower of London" Test (TLT), Russian version of WAIS (1995) were used. Patients were medicated and medication status was evaluated by psychomotor speed level. Patients with the duration of daily heroin abuse more than 1.5 years performed significantly less effectively TLT solutions as compared with the healthy controls (after Bonferroni correction, p = 0001). Patients with shorter duration of daily heroin abuse had a trend to perform TLT solutions poorer as compared to healthy controls and better than group with longer duration (after Bonferroni correction, p = 0.07 and 0.08). Three groups did not differ by WCST and DAT significantly, and general intelligence was in normal range in three groups. Multiple regression analysis confirmed significant influence of daily heroin abuse duration on TLT performance efficiency in our population (beta = -0.426, p < 0.05) without effect of age, education, IQ, dosage of heroin per day, withdrawal duration and current medication status (psychomotor speed level). Perseverative responses on DAT were significantly related to daily heroin dosages before treatment (beta = 0.405, p < 0.05) and negatively correlated with the withdrawal duration. These data give grounds to suppose, that chronic heroin exposure impairs planning functions of prefrontal cortex (TLT), that can be explained by cumulative neuronal damages of prefrontal cortex and VTA dopamine neurons. That was demonstrated in experimental and morphological studies of opiate addicts who died after opiate overdose. Large doses of heroin can induce more extensive functional impairment with possible involvement of orbit frontal cortex. The latter deficit may be partially reversible during short-term withdrawal.

[The humoral immunity characteristics of women with neurotic depressions]. / Osobennosti gumoral'nogo immuniteta u zhenshchin s nevroticheskimi depressiiami.

The levels of autoantibodies and their anti-idiotypes to proteins of nervous tissue (S100b, GFAP, MP65 and nerve growth factor) were studied in 85 women of 18-48 years of age with psychogenic neurotic depressions. It was found that the changes of the levels of autoantibodies to the proteins of nervous tissue correspond to various somatoautonomic manifestations and correlate with severity of depression, its typological variations and duration of the disease. The data obtained show a close relationship between nervous and immune systems that was expressed by some parallelism of the dynamics of the changes of both neurotic depressive symptoms and serum immunoreactivity to neuroantigens.