BDNF and serum S100B levels according the spectrum of structural pathology in chronic pain patients

Abstract

Central sensitivity syndrome (CSS) consists of adaptive pathophysiological changes associated with neuroplasticity in some chronic pain disorders. It could be grouped in two main conceptual conditions: one includes those chronic pain patients without overt structural pathology such as fibromyalgia, and the other subgroup includes conditions with recognizable structural abnormalities, both somatic (osteoarthritis) and visceral (endometriosis). In order to understand the role of neuromodulators in CCS we aim to determine whether brain-derived neurotrophic factor (BDNF) and S100B are associated to specific chronic pain disorders. Serum BDNF and S100B were measured in chronic pain women with different diagnosis: 88 with osteoarthritis, 36 with endometriosis, 117 with fibromyalgia, 33 with chronic tension type headache and in 41 healthy controls. ANCOVA analysis followed by heteroscedasticity-consistent covariance matrix was performed to evaluate BDNF and S100B levels, adjusted for depression severity, pain levels and use of analgesics according different pathologies. Serum BDNF concentrations were higher and not different in patients with fibromyalgia and headache, the CSS group without structural pathology. In contrast, the concentrations of S100B were higher in patients with osteoarthritis and endometriosis, in comparison to controls, fibromyalgia and tensional headache patients. This study supports the hypothesis that BDNF and S100B neuromodulators present different serum levels according to the background disease associated to the chronic pain. These have the potential to be studied as markers of active disease or treatment evolution.

Mapping of predictors of the disengagement of the descending inhibitory pain modulation system in fibromyalgia: an exploratory study

“…2,3,45 Thus, changes in serum BDNF can indicate a dysfunction of the central nervous system, given the growing literature showing a lower serum BDNF in patients with major depression, whereas in fibromyalgia, its levels are high. 46,47 These differences suggest that the serum BDNF indicates that a neuroplasticity process underpins the pathophysiological mechanisms of each of the two conditions, which is over-activated in chronic pain. However, we need parsimony in the interpretation of these results, and more data are required to conclude that the generation of BDNF is a compensatory mechanism related to the physiopathology of fibromyalgia.…”

The Brief Measure of Emotional Preoperative Stress (B-MEPS) as a new predictive tool for postoperative pain: A prospective observational cohort study

“…One explanation could be associated to the acute and transient nature of emotional preoperative stress, in comparison to chronic pain situations where these neuromodulators had a pattern of elevation [21].…”

Hyper-connectivity between the left motor cortex and prefrontal cortex is associated with the severity of dysfunction of the descending pain modulatory system in fibromyalgia

“…Central sensitization in chronic pain is usually linked with insufficient descending inhibition signaling and amplification of afferent signals. These neuroplastic changes are involved in allodynia, hyperalgesia, expanded receptive field, prolonged electrophysiological discharge, and neuronal hyperexcitability [19, 62]. Remarkably, this study’s increase in cortical connectivity was associated with a lack of DPMS adaptability, which may suggest an increase in excitatory synaptic signaling and a disinhibited state when taking the above mentioned into account.…”