Beta-Endorphin as a Biomarker in the Treatment of Chronic Pain with Non-Invasive Brain Stimulation: A Systematic Scoping Review

Abstract

A scoping review to synthesize evidence and assess articles describing the use of beta-endorphins as a pain biomarker in chronic pain patients treated with non-invasive brain stimulation techniques was systematically performed with respect to the study quality, the technique employed and the results. Independent reviewers determined if the article met the study criteria at each stage for it to be included. Content analysis was applied and summarized. The results are described in a narrative form grouped by pain condition, type of intervention, stimulation protocol, outcome measures and main results. A total of 67 of 73 references were excluded, and 6 identified studies met the inclusion criteria. The study design, sample size, stimulation type, session protocol and the main findings of each study were extracted. The studies in this scoping review ranged from unsatisfactory to good based on the adopted criteria, with no study achieving an excellent rating. There is limited evidence on the dosage of beta-endorphin in chronic pain conditions during treatment with NIBS. Based on this literature, evidence suggests that BE may not only be useful for acute and persistent pain, but also for a variety of chronic pain states in which opioids are not effective.

Is There Hope for Chronic Pain Patients?

“…Walking, running, bicycling, swimming and other exercises can decrease chemokine production and either cure or diminish chronic pain [19,21]. Blood endorphin levels are increased in chronic pain [22], and can be increased even more with exercise. Endorphins may be involved in modulating chronic pain.…”

Efek Tindakan Transcranial Magnetic Stimulation (TMS) terhadap Derajat Nyeri dan Kadar Beta-Endorfin Serum pada Pasien Nyeri Kanker Payudara

“…Betaendorfin adalah suatu opioid endogen yang tidak hanya memiliki efek analgesik seperti morfin, tetapi juga 18 sampai 33 kali lebih poten dibandingkan morfin. 19 Studi oleh Ahmed et al didapatkan bahwa 17 dari 27 pasien dengan nyeri phantom kronik yang diberikan stimulasi TMS setelah 5 hari berturut-turut memiliki efek pereda nyeri yang lama setidaknya setelah 2 bulan setelah intervensi TMS terakhir dibandingkan dengan pasien yang mendapatkan stimulasi plasebo. Selain itu, disebutkan juga bahwa beta-endorfin serum meningkat secara signifikan pada pasien yang diberi stimulasi TMS, sedangkan tidak didapatkan perubahan beta-endorfin serum pada pasien yang mendapatkan stimulasi plasebo.…”

Terapi Murottal Meningkatkan Hormon Β -Endorfin dan Menurunkan Tekanan Darah Lansia

“…Hormon β-endorfin dapat menghambat respon inflamasi epitel endometrium dan sel stroma melalui reseptor δ opioid, mengatasi penyakit akut, nyeri persisten, dan berbagai kondisi nyeri kronis dimana opioid tidak efektif (Cui et al, 2021;De Assis et al, 2021). Hal ini didukung dalam penelitian yang mengidentifikasi β-Endorfin pre-post perlakuan medis didapatkan hasil nyeri nosiseptif empiris terjadi pada pasien yang menjalani operasi kecil dengan hipnoanestesi dan tidak ada perubahan yang signifikan pada kadar β-endorfin sebelum dan sesudah hipnoanestesi (Amri et al, 2023).…”