Document Detail


Anxiety increases acid-induced esophageal hyperalgesia.
MedLine Citation:
PMID:  20841561     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Anxiety at the time of gastrointestinal injury or inflammation increases the risk of developing visceral hyperalgesia. Distal esophageal acidification induces hyperalgesia in the non-acid exposed proximal esophagus, due to the sensitization of spinal dorsal horn neurones. The objective was to determine whether anxiety influences acid-induced hyperalgesia. METHODS: A total of 19 healthy volunteers (n = 12 females; age, 22-57 years; mean, 35.7 years) completed a 10-minute mood induction paradigm (anxiety or neutral) with autonomic monitoring (visit 1). On visits 2 and 3, pain thresholds to electrical stimulation, in milliamperes (mA), were determined in the proximal esophagus and foot (control) before and after a 30-minute infusion of 0.15 M of hydrochloric acid. During esophageal acid infusion, the subjects randomly received anxiety or neutral mood induction with autonomic monitoring, in a crossover design. Anxiety and pain ratings were recorded pre and post infusion. RESULTS: Visit 1: Anxiety induction increased anxiety scores (p < .001), mean arterial pressure (p < .001), and cardiac sympathetic index (p = .007), and reduced parasympathetic measures (cardiac vagal tone [p = .05] and cardiac sensitivity to baroreflex [p = .006)]). Visit 2: Anxiety induction conferred greater acid-induced hyperalgesia compared with neutral (-4.9 mA versus 2.7 mA, p = .009, analysis of covariance). No differences in autonomic measures were found during acid infusion with anxiety or neutral mood induction. CONCLUSIONS: Anxiety induction increases acid-induced esophageal hyperalgesia; anxiety, thus, facilitates central sensitization in the esophagus. Our studies provide a new model for studying the effects of anxiety on esophageal hyperalgesia and may allow testing of therapeutic strategies to reduce this effect.
Authors:
Abhishek Sharma; Lukas Van Oudenhove; Peter Paine; Lloyd Gregory; Qasim Aziz
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-09-14
Journal Detail:
Title:  Psychosomatic medicine     Volume:  72     ISSN:  1534-7796     ISO Abbreviation:  Psychosom Med     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-06     Completed Date:  2010-11-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376505     Medline TA:  Psychosom Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  802-9     Citation Subset:  IM    
Affiliation:
Salford Royal NHS Foundation Trust, Salford, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Adult
Affect / drug effects,  physiology
Anxiety / complications,  epidemiology*
Autonomic Nervous System / drug effects,  physiology
Baroreflex / drug effects,  physiology
Cross-Over Studies
Esophageal Diseases / chemically induced*,  diagnosis,  etiology
Esophagus / drug effects*,  innervation*
Female
Gastroesophageal Reflux
Humans
Hydrochloric Acid / administration & dosage,  pharmacology*
Hydrogen-Ion Concentration
Hyperalgesia / chemically induced*,  diagnosis,  etiology
Male
Middle Aged
Pain / chemically induced*,  diagnosis
Pain Measurement
Pain Threshold / drug effects,  physiology
Grant Support
ID/Acronym/Agency:
//Cancer Research UK; //Medical Research Council
Chemical
Reg. No./Substance:
7647-01-0/Hydrochloric Acid

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