Stress exacerbates pain in the everyday lives of women with fibromyalgia syndrome-The role of cortisol and alpha-amylase
Stress exacerbates pain in the everyday lives of women with fibromyalgia syndrome-The role of cortisol and alpha-amylase
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DOI：
10.1016/j.psyneuen.2015.09.018
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发表时间：
2016-01-01
影响因子：
3.7
通讯作者：
Nater, Urs M.
中科院分区：
文献类型：
--
作者：
Fischer, Susanne;Doerr, Johanna M.;Nater, Urs M.
目的：虽然纤维肌痛综合征（FMS）是一种慢性疾病，但其主要症状疼痛在一天内波动。压力经常被认为会加剧疼痛;然而，几乎没有任何证据表明这在日常生活中是否属实（或者，疼痛是否会导致压力水平增加）。使用生态有效的测量设计，我们测试了是否以及如何在FMS参与者的压力和疼痛交织在一起。我们还研究了两个主要的应激反应系统，下丘脑-垂体-肾上腺轴和自主神经系统，作为这种关系的潜在介质的作用。每天，32名FMS女性提供6个关于瞬时压力和疼痛水平的日记条目。在同一时间点收集唾液样本，以确定皮质醇和α-淀粉酶作为应激反应system.Results的指标：在给定的测量时间点较高的压力与较高的报告疼痛水平在随后的时间点（UC = 1.47，p < 0.001），但反之亦然（UC < 0.01，p = 0.179）。压力-疼痛的关系既不介导的瞬时皮质醇，也不是由α-淀粉酶，但是，瞬时皮质醇是独立相关的瞬时疼痛（UC = 0.27，p = 0.009）。结论：压力似乎是一个强大的加剧疼痛的因素，FMS患者在日常生活中所经历的。皮质醇可能参与FMS患者疼痛水平的昼夜波动。未来的研究应确定相关的日常压力与FMS的人，并仔细检查皮质醇疼痛关系的机制。(C)2015爱思唯尔有限公司版权所有。
Objective: Although flbromyalgia syndrome (FMS) is a chronic condition, its cardinal symptom pain is known to fluctuate over the day. Stress has often been claimed to exacerbate pain; however, there is barely any evidence on whether or not this is true on a day-to-day basis (and, alternatively, on whether pain leads to increased stress levels). Using an ecologically valid measurement design, we tested whether and how stress and pain are intertwined in participants with FMS. We additionally examined the role of the two major stress-responsive systems, the hypothalamic-pituitary-adrenal axis and the autonomic nervous system, as potential mediators of this relationship.Methods: An ambulatory assessment study was conducted over the course of 14 days. On each day, 32 females with FMS provided six diary entries on momentary stress and pain levels. Saliva samples were collected at the same time points to determine cortisol and alpha-amylase as indicators of stress-responsive systems.Results: Higher stress at a given measurement time point was associated with higher reported pain levels at the subsequent time point (UC = 1.47, p < 0.001), but not vice versa (UC < 0.01, p = 0.179). The stress-pain relationship was neither mediated by momentary cortisol nor by alpha-amylase; however, momentary cortisol was independently associated with momentary pain (UC = 0.27, p = 0.009).Conclusion: Stress seems to be a powerful exacerbating factor for pain as experienced by patients with FMS in their everyday lives. Cortisol may be involved in the diurnal fluctuation of pain levels in patients with FMS. Future studies should identify relevant daily stressors in persons with FMS and scrutinize the mechanisms underlying the cortisol-pain relationship. (C) 2015 Elsevier Ltd. All rights reserved.