| Anxiety increases acid-induced esophageal hyperalgesia. | |
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MedLine Citation:
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PMID: 20841561 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Abhishek Sharma; Lukas Van Oudenhove; Peter Paine; Lloyd Gregory; Qasim Aziz |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Date: 2010-09-14 |
Journal Detail:
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Title: Psychosomatic medicine Volume: 72 ISSN: 1534-7796 ISO Abbreviation: Psychosom Med Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-10-06 Completed Date: 2010-11-05 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0376505 Medline TA: Psychosom Med Country: United States |
Other Details:
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Languages: eng Pagination: 802-9 Citation Subset: IM |
Affiliation:
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Salford Royal NHS Foundation Trust, Salford, United Kingdom. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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//Cancer Research UK; //Medical Research Council |
| Chemical | |
Reg. No./Substance:
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7647-01-0/Hydrochloric Acid |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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