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Endogenous inhibition of pain and spinal nociception in women with premenstrual dysphoric disorder

PURPOSE: Premenstrual dysphoric disorder (PMDD) is characterized by severe affective and physical symptoms, such as increased pain, during the late-luteal phase of the menstrual cycle. The mechanisms underlying hyperalgesia in women with PMDD have yet to be identified, and supraspinal pain modulatio...

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Autores principales: Palit, Shreela, Bartley, Emily J, Kuhn, Bethany L, Kerr, Kara L, DelVentura, Jennifer L, Terry, Ellen L, Rhudy, Jamie L
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4755473/
https://www.ncbi.nlm.nih.gov/pubmed/26929663
http://dx.doi.org/10.2147/JPR.S97109
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author Palit, Shreela
Bartley, Emily J
Kuhn, Bethany L
Kerr, Kara L
DelVentura, Jennifer L
Terry, Ellen L
Rhudy, Jamie L
author_facet Palit, Shreela
Bartley, Emily J
Kuhn, Bethany L
Kerr, Kara L
DelVentura, Jennifer L
Terry, Ellen L
Rhudy, Jamie L
author_sort Palit, Shreela
collection PubMed
description PURPOSE: Premenstrual dysphoric disorder (PMDD) is characterized by severe affective and physical symptoms, such as increased pain, during the late-luteal phase of the menstrual cycle. The mechanisms underlying hyperalgesia in women with PMDD have yet to be identified, and supraspinal pain modulation has yet to be examined in this population. The present study assessed endogenous pain inhibitory processing by examining conditioned pain modulation (CPM, a painful conditioning stimulus inhibiting pain evoked by a test stimulus at a distal body site) of pain and the nociceptive flexion reflex (NFR, a spinally-mediated withdrawal reflex) during the mid-follicular, ovulatory, and late-luteal phases of the menstrual cycle. METHODS: Participants were regularly-cycling women (14 without PMDD; 14 with PMDD). CPM was assessed by delivering electrocutaneous test stimuli to the sural nerve before, during, and after a painful conditioning ischemia task. Participants rated their pain to electrocutaneous stimuli, and NFR magnitudes were measured. A linear mixed model analysis was used to assess the influence of group and menstrual phase on CPM. RESULTS: Compared with controls, women with PMDD experienced greater pain during the late-luteal phase and enhanced spinal nociception during the ovulation phase, both of which were independent of CPM. Both groups showed CPM inhibition of pain that did not differ by menstrual phase. Only women with PMDD evidenced CPM inhibition of NFR. CONCLUSION: Endogenous modulation of pain and spinal nociception is not disrupted in women with PMDD. Additionally, greater NFR magnitudes during ovulation in PMDD may be due to tonically-engaged descending mechanisms that facilitate spinal nociception, leading to enhanced pain during the premenstrual phase.
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spelling pubmed-47554732016-02-29 Endogenous inhibition of pain and spinal nociception in women with premenstrual dysphoric disorder Palit, Shreela Bartley, Emily J Kuhn, Bethany L Kerr, Kara L DelVentura, Jennifer L Terry, Ellen L Rhudy, Jamie L J Pain Res Original Research PURPOSE: Premenstrual dysphoric disorder (PMDD) is characterized by severe affective and physical symptoms, such as increased pain, during the late-luteal phase of the menstrual cycle. The mechanisms underlying hyperalgesia in women with PMDD have yet to be identified, and supraspinal pain modulation has yet to be examined in this population. The present study assessed endogenous pain inhibitory processing by examining conditioned pain modulation (CPM, a painful conditioning stimulus inhibiting pain evoked by a test stimulus at a distal body site) of pain and the nociceptive flexion reflex (NFR, a spinally-mediated withdrawal reflex) during the mid-follicular, ovulatory, and late-luteal phases of the menstrual cycle. METHODS: Participants were regularly-cycling women (14 without PMDD; 14 with PMDD). CPM was assessed by delivering electrocutaneous test stimuli to the sural nerve before, during, and after a painful conditioning ischemia task. Participants rated their pain to electrocutaneous stimuli, and NFR magnitudes were measured. A linear mixed model analysis was used to assess the influence of group and menstrual phase on CPM. RESULTS: Compared with controls, women with PMDD experienced greater pain during the late-luteal phase and enhanced spinal nociception during the ovulation phase, both of which were independent of CPM. Both groups showed CPM inhibition of pain that did not differ by menstrual phase. Only women with PMDD evidenced CPM inhibition of NFR. CONCLUSION: Endogenous modulation of pain and spinal nociception is not disrupted in women with PMDD. Additionally, greater NFR magnitudes during ovulation in PMDD may be due to tonically-engaged descending mechanisms that facilitate spinal nociception, leading to enhanced pain during the premenstrual phase. Dove Medical Press 2016-02-11 /pmc/articles/PMC4755473/ /pubmed/26929663 http://dx.doi.org/10.2147/JPR.S97109 Text en © 2016 Palit et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Palit, Shreela
Bartley, Emily J
Kuhn, Bethany L
Kerr, Kara L
DelVentura, Jennifer L
Terry, Ellen L
Rhudy, Jamie L
Endogenous inhibition of pain and spinal nociception in women with premenstrual dysphoric disorder
title Endogenous inhibition of pain and spinal nociception in women with premenstrual dysphoric disorder
title_full Endogenous inhibition of pain and spinal nociception in women with premenstrual dysphoric disorder
title_fullStr Endogenous inhibition of pain and spinal nociception in women with premenstrual dysphoric disorder
title_full_unstemmed Endogenous inhibition of pain and spinal nociception in women with premenstrual dysphoric disorder
title_short Endogenous inhibition of pain and spinal nociception in women with premenstrual dysphoric disorder
title_sort endogenous inhibition of pain and spinal nociception in women with premenstrual dysphoric disorder
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4755473/
https://www.ncbi.nlm.nih.gov/pubmed/26929663
http://dx.doi.org/10.2147/JPR.S97109
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