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Chronic pain, chronic stress and depression: coincidence or consequence?
G Blackburn-Munro1, R E Blackburn-Munro
1Laboratory of Neuroendocrinology, Department of Biomedical Sciences, University of Edinburgh, Hugh Robson Building, George Square, Edinburgh, EH8 9XD, UK.
Journal of Neuroendocrinology
|November 28, 2001
Summary
Chronic pain and depression may be linked through stress-induced hypothalamo-pituitary-adrenal (HPA) axis dysfunction. Targeting the HPA axis could offer new treatments for these debilitating conditions.
Area of Science:
- Neuroscience
- Endocrinology
- Psychiatry
Background:
- Chronic pain and depression are prevalent, debilitating conditions often resistant to current treatments.
- Both conditions exhibit comorbidity in human patients.
- Animal models show chronic pain activates the hypothalamo-pituitary-adrenal (HPA) axis, similar to inescapable stress, which induces depressive-like symptoms.
Purpose of the Study:
- To explore the potential role of HPA axis dysfunction in the co-occurrence of chronic pain and depression.
- To propose a unified etiological framework for these linked conditions.
Main Methods:
- Review of existing literature on HPA axis function in chronic pain and depression models.
- Analysis of stressor-induced HPA axis activation and its consequences.
Main Results:
- Chronic pain acts as an inescapable stressor, activating the HPA axis.
- Inescapable stress is known to induce depressive-like symptoms in animal models.
- HPA axis dysfunction is implicated in the pathophysiology of both chronic pain and depression.
Conclusions:
- The HPA axis is a potential common pathway linking chronic pain and depression.
- Dysregulation of the HPA axis may underlie the comorbidity of these disorders.
- Targeting the HPA axis presents a promising strategy for developing novel pharmacotherapies for both conditions.
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