Correlation of low back pain caused by lumbar spinal stenosis and depression in women: a clinical study.

OBJECTIVE: Low back pain (LBP) due to spinal stenosis may be one of the most debilitating symptoms to decrease the quality of life. The cause and effect association of LBP and depression is vague. Pain may also be a somatization symptom of depression. This is more frequent in the female population. This clinical study was designed to evaluate the correlation between the level of back pain caused by lumbar spinal stenosis and depression in the female population. METHOD: The study included 50 consecutive female patients with spinal stenosis. The stenosis diagnosis is made by neurological examination and neuro-imaging. The study group was psychiatrically evaluated and grouped as those with and without depression. Visual analog scale (VAS), Oswestry disability index (ODI) and Hamilton Depression Scale (HDS) were utilized in initial evaluation of the group. RESULTS: Twenty-one patients with lumbar spinal stenosis had depression (DLS Group) and 29 did not (LSS Group). Mean HDS scores were 8.97 and 32.48 for Group LSS and Group DLS, respectively. There was a statistically significant difference between the VAS scores of the groups (the mean VAS scores were 5.6 and 7.6, for groups LSS and DLS, respectively). The mean ODI values for LSS (65.24 ± 4.58) and DLS (75.1 ± 6.7) groups were also significantly different. In Group DLS, there were positive correlations between ODI and VAS with HDS (p < 0.001). CONCLUSION: Our findings indicated a relationship between lumbar spinal stenosis associated pain levels and depression. However, the cause and result relationship still needs to be established yet.

Brain-derived neurotrophic factor (BDNF) changes in the serum of depressed women.

Neuroplastic processes are thought to be involved in the pathophysiology of many psychiatric disorders, including major depression. It has been hypothesized that the brain-derived neurotrophic factor (BNDF), a key factor in neuroplasticity, is associated with depressive disorders. Our study evaluated the pre- and post-treatment levels of BDNF in a group of depressed patients and compared them with healthy controls. In order to exclude the effects of gender on neuroplasticity, our study group was restricted to women exclusively and consisted of 20 depressive patients and 20 healthy controls, with similar age and educational level distribution. Blood samples were collected before the treatment and on the sixth week of the treatment with 10 mg S-citalopram. The pre-treatment BDNF levels of the depressed patients were found to be lower than those of the healthy subjects. During the sixth week, the BDNF levels of depressive patients were significantly higher than the pre-treatment levels but similar to those of control subjects. These findings suggest that BDNF level may be an important factor in the etiopathogenesis of depression and may have a role in the action mechanism of antidepressant drugs.