Autonomically-mediated decrease in microvascular blood flow due to mental stress and pain in sickle cell disease: A...

Area of Science:

• Vascular Physiology
• Neuroimmunology
• Complementary and Alternative Medicine

Background:

• Pain and vaso-occlusive crises (VOC) are significant complications of sickle cell disease (SCD), causing physical and psychosocial impairment.
• The triggers for VOC and the variability in pain frequency in SCD are not fully understood.
• Autonomically-mediated vascular function is affected by pain and emotional stressors in individuals with SCD.

Purpose of the Study:

• To summarize the physiological effects of pain and emotional stressors on vascular function in SCD.
• To review the impact of hypnosis on microvascular blood flow in SCD patients.
• To identify autonomically-mediated vascular responses as a potential intervention target in SCD.

Main Methods:

• Review of recent studies from the authors' vascular physiology laboratory.
• Assessment of microvascular responses to laboratory stressors in individuals with SCD.
• Pilot study evaluating the effects of hypnosis on microvascular blood flow.

Main Results:

• Individuals with SCD exhibit significant neurally mediated vascular reactivity to pain, pain-related fear, and mental stress.
• Pilot data suggest that hypnosis can attenuate harmful microvascular responses to pain.
• Autonomic vascular dysfunction is exacerbated by pain and mental stress in SCD.

Conclusions:

• Autonomically-mediated vascular responses to pain and mental stress are a critical target for SCD interventions.
• Cognitive and neuromodulatory interventions like hypnosis are physiologically justified for SCD management.
• Integrative treatments may prevent the enhancement of autonomic vascular dysfunction in SCD.