Cardiovascular responses to an acute psychological stressor are associated with the cortisol awakening response in individuals with chronic neck pain.
Cardiovascular responses to an acute psychological stressor are associated with the cortisol awakening response in individuals with chronic neck pain.
复制标题
慢性颈部疼痛患者的心血管对急性心理应激源的反应与皮质醇觉醒反应有关。
DOI：
10.1016/j.physbeh.2015.02.010
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发表时间：
2015
影响因子：
2.9
通讯作者：
Maluf,KatrinaS
中科院分区：
文献类型：
--
作者：
Shahidi,Bahar;Sannes,Timothy;Laudenslager,Mark;Maluf,KatrinaS
下丘脑-垂体-肾上腺轴（HPA轴）的失调在经历慢性心理应激的个体以及慢性疼痛的个体中是常见的。在慢性应激源（如疼痛）存在下皮质醇可用性的变化可能会影响交感-肾上腺-髓质（SAM）系统，该系统有助于心血管对应激的反应，并且在疼痛存在下也表现出改变的反应性。本研究的目的是探讨HPA活动在皮质醇觉醒反应和心血管反应在暴露于一个急性心理应激的个人慢性neck pain.MethodsArea下的唾液皮质醇觉醒反应的曲线（AUC）之间的关系进行了评估，在41个人与慢性颈部疼痛，年龄在19-80岁（22名男性，23名女性）。斜率代表的平均动脉压和心率的变化在基线安静的坐姿条件下，低压力条件下的精神集中，高压力条件下的精神集中与社会评估的威胁相结合，计算每个人的心血管反应性的指数急性应激。心血管反应回归皮质醇觉醒AUC和疼痛持续时间，调整年龄和sex.ResultsGreater平均动脉压（β=-0.33，p = 0.02）和心率反应（β=-0.41，p = 0.007）的急性心理应激与皮质醇觉醒反应较低调整年龄和性别后。慢性疼痛持续时间较短的个体在实验室压力刺激期间平均动脉压也有较大幅度的增加（β=-0.39，p = 0.01），但疼痛持续时间和心率变化之间没有关系（p= 0.25）结论慢性颈痛持续时间较短的个体，对急性心理应激表现出较高的心血管反应性，皮质醇唤醒反应较低。这些结果与慢性疼痛存在下两个主要压力系统的时间依赖性适应一致。
IntroductionDysregulation of the hypothalamic–pituitary–adrenal axis (HPA-axis) is common in individuals who experience chronic psychological stress, as well as individuals with chronic pain. Changes in cortisol availability in the presence of a chronic stressor such as pain may influence the sympathetic–adrenal–medullary (SAM) system, which contributes to cardiovascular responses to stress and also exhibits altered responsiveness in the presence of pain. The purpose of this study was to investigate the relationship between HPA activity during the cortisol awakening response and cardiovascular reactivity during exposure to an acute psychological stressor in individuals with chronic neck pain.MethodsArea under the curve (AUC) of the salivary cortisol awakening response was assessed in 41 individuals with chronic neck pain aged 19–80 years (22 men, 23 women). Slopes representing the change in mean arterial pressure and heart rate during a baseline quiet sitting condition, a low stress condition with mental concentration, and a high stress condition combining mental concentration with social evaluative threat were calculated for each individual as an index of cardiovascular responsiveness to the acute stressor. Cardiovascular responses were regressed on cortisol awakening AUC and pain duration, adjusting for age and sex.ResultsGreater mean arterial pressure (β= − 0.33,p= 0.02) and heart rate responses (β= − 0.41,p= 0.007) to the acute psychological stressor were associated with lower cortisol awakening responses after adjusting for age and sex. Individuals with a shorter duration of chronic pain also demonstrated a larger increase in mean arterial pressure during the laboratory stressor (β= − 0.39,p= 0.01), but there was no relationship between pain duration and changes in heart rate (p= 0.25).ConclusionsIndividuals with a shorter duration of chronic neck pain who demonstrate heightened cardiovascular responsiveness to an acute psychological stressor also exhibit lower cortisol awakening response. These results are consistent with time-dependent adaptations across the two major stress systems in the presence of chronic pain.