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Li B, Cao Y, Yuan H, Yu Z, Miao S, Yang C, Gong Z, Xie W, Li C, Bai W, Tang W, Zhao D, Yu S. The crucial role of locus coeruleus noradrenergic neurons in the interaction between acute sleep disturbance and headache. J Headache Pain 2024; 25:31. [PMID: 38443795 PMCID: PMC10913606 DOI: 10.1186/s10194-024-01714-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/07/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Both epidemiological and clinical studies have indicated that headache and sleep disturbances share a complex relationship. Although headache and sleep share common neurophysiological and anatomical foundations, the mechanism underlying their interaction remains poorly understood. The structures of the diencephalon and brainstem, particularly the locus coeruleus (LC), are the primary sites where the sleep and headache pathways intersect. To better understand the intricate nature of the relationship between headache and sleep, our study focused on investigating the role and function of noradrenergic neurons in the LC during acute headache and acute sleep disturbance. METHOD To explore the relationship between acute headache and acute sleep disturbance, we primarily employed nitroglycerin (NTG)-induced migraine-like headache and acute sleep deprivation (ASD) models. Initially, we conducted experiments to confirm that ASD enhances headache and that acute headache can lead to acute sleep disturbance. Subsequently, we examined the separate roles of the LC in sleep and headache. We observed the effects of drug-induced activation and inhibition and chemogenetic manipulation of LC noradrenergic neurons on ASD-induced headache facilitation and acute headache-related sleep disturbance. This approach enabled us to demonstrate the bidirectional function of LC noradrenergic neurons. RESULTS Our findings indicate that ASD facilitated the development of NTG-induced migraine-like headache, while acute headache affected sleep quality. Furthermore, activating the LC reduced the headache threshold and increased sleep latency, whereas inhibiting the LC had the opposite effect. Additional investigations demonstrated that activating LC noradrenergic neurons further intensified pain facilitation from ASD, while inhibiting these neurons reduced this pain facilitation. Moreover, activating LC noradrenergic neurons exacerbated the impact of acute headache on sleep quality, while inhibiting them alleviated this influence. CONCLUSION The LC serves as a significant anatomical and functional region in the interaction between acute sleep disturbance and acute headache. The involvement of LC noradrenergic neurons is pivotal in facilitating headache triggered by ASD and influencing the effects of headache on sleep quality.
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Affiliation(s)
- Bozhi Li
- Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing, 100853, People's Republic of China
- Neurology Institute of Chinese PLA General Hospital, the First Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing, 100853, People's Republic of China
| | - Ya Cao
- Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing, 100853, People's Republic of China
- Neurology Institute of Chinese PLA General Hospital, the First Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing, 100853, People's Republic of China
- Medical School of Chinese PLA, Beijing, 100853, People's Republic of China
| | - Huijuan Yuan
- Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing, 100853, People's Republic of China
- Neurology Institute of Chinese PLA General Hospital, the First Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing, 100853, People's Republic of China
- School of Medicine, Nankai University, Tianjin, China
| | - Zhe Yu
- Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing, 100853, People's Republic of China
| | - Shuai Miao
- Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing, 100853, People's Republic of China
- Neurology Institute of Chinese PLA General Hospital, the First Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing, 100853, People's Republic of China
| | - Chunxiao Yang
- Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing, 100853, People's Republic of China
- Neurology Institute of Chinese PLA General Hospital, the First Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing, 100853, People's Republic of China
- School of Medicine, Nankai University, Tianjin, China
| | - Zihua Gong
- Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing, 100853, People's Republic of China
- Neurology Institute of Chinese PLA General Hospital, the First Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing, 100853, People's Republic of China
- Medical School of Chinese PLA, Beijing, 100853, People's Republic of China
| | - Wei Xie
- Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing, 100853, People's Republic of China
| | - Chenhao Li
- Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing, 100853, People's Republic of China
- Neurology Institute of Chinese PLA General Hospital, the First Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing, 100853, People's Republic of China
- Medical School of Chinese PLA, Beijing, 100853, People's Republic of China
| | - Wenhao Bai
- Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing, 100853, People's Republic of China
- Neurology Institute of Chinese PLA General Hospital, the First Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing, 100853, People's Republic of China
| | - Wenjing Tang
- Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing, 100853, People's Republic of China
- Neurology Institute of Chinese PLA General Hospital, the First Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing, 100853, People's Republic of China
| | - Dengfa Zhao
- Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing, 100853, People's Republic of China
- Neurology Institute of Chinese PLA General Hospital, the First Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing, 100853, People's Republic of China
| | - Shengyuan Yu
- Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing, 100853, People's Republic of China.
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Feige B, Benz F, Dressle RJ, Riemann D. Insomnia and REM sleep instability. J Sleep Res 2023; 32:e14032. [PMID: 37679882 DOI: 10.1111/jsr.14032] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 08/14/2023] [Indexed: 09/09/2023]
Abstract
In this narrative review, we give an overview of the concept of rapid eye movement sleep instability and its reported implications in the context of insomnia. The term rapid eye movement sleep instability was coined to describe the observation of a modified rapid eye movement quality in insomnia, characterized by an increased tendency of perceiving rapid eye movement sleep as wake, a small but consistent rapid eye movement sleep reduction and an increased rapid eye movement sleep arousal index. Current research highlights relationships that are transdiagnostic in nature, corresponding to the known interaction of insomnia with many psychiatric disorders, and showing relationships to chronic stress and anxiety disorders.
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Affiliation(s)
- Bernd Feige
- Department of Psychiatry and Psychotherapy, Section of Clinical Psychology and Psychophysiology, Medical Center - University of Freiburg, Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Fee Benz
- Department of Psychiatry and Psychotherapy, Section of Clinical Psychology and Psychophysiology, Medical Center - University of Freiburg, Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Raphael J Dressle
- Department of Psychiatry and Psychotherapy, Section of Clinical Psychology and Psychophysiology, Medical Center - University of Freiburg, Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Section of Clinical Psychology and Psychophysiology, Medical Center - University of Freiburg, Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
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3
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Su N, Cai P, Dou Z, Yin X, Xu H, He J, Li Z, Li C. Brain nuclei and neural circuits in neuropathic pain and brain modulation mechanisms of acupuncture: a review on animal-based experimental research. Front Neurosci 2023; 17:1243231. [PMID: 37712096 PMCID: PMC10498311 DOI: 10.3389/fnins.2023.1243231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/14/2023] [Indexed: 09/16/2023] Open
Abstract
Neuropathic pain (NP) is known to be associated with abnormal changes in specific brain regions, but the complex neural network behind it is vast and complex and lacks a systematic summary. With the help of various animal models of NP, a literature search on NP brain regions and circuits revealed that the related brain nuclei included the periaqueductal gray (PAG), lateral habenula (LHb), medial prefrontal cortex (mPFC), and anterior cingulate cortex (ACC); the related brain circuits included the PAG-LHb and mPFC-ACC. Moreover, acupuncture and injurious information can affect different brain regions and influence brain functions via multiple aspects to play an analgesic role and improve synaptic plasticity by regulating the morphology and structure of brain synapses and the expression of synapse-related proteins; maintain the balance of excitatory and inhibitory neurons by regulating the secretion of glutamate, γ-aminobutyric acid, 5-hydroxytryptamine, and other neurotransmitters and receptors in the brain tissues; inhibit the overactivation of glial cells and reduce the release of pro-inflammatory mediators such as interleukins to reduce neuroinflammation in brain regions; maintain homeostasis of glucose metabolism and regulate the metabolic connections in the brain; and play a role in analgesia through the mediation of signaling pathways and signal transduction molecules. These factors help to deepen the understanding of NP brain circuits and the brain mechanisms of acupuncture analgesia.
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Affiliation(s)
- Na Su
- First Clinical Medicine College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Pingping Cai
- Department of Traditional Chinese Medicine, Shandong Provincial Hospital, Jinan, China
| | - Zhiqiang Dou
- College of Acupuncture and Moxibustion and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xiaoxue Yin
- Department of Science and Education, Shandong Academy of Chinese Medicine, Jinan, China
| | - Hongmin Xu
- Department of Gynecology, Laiwu Hospital of Traditional Chinese, Jinan, China
| | - Jing He
- First Clinical Medicine College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Zhaofeng Li
- College of Acupuncture and Moxibustion and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
- International Office, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Changzhong Li
- Department of Obstetrics and Gynecology, Shenzhen Hospital, Peking University, Shenzhen, China
- Department of Gynecology, Shandong Provincial Hospital, Jinan, China
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4
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Duo L, Yu X, Hu R, Duan X, Zhou J, Wang K. Sleep disorders in chronic pain and its neurochemical mechanisms: a narrative review. Front Psychiatry 2023; 14:1157790. [PMID: 37324825 PMCID: PMC10267346 DOI: 10.3389/fpsyt.2023.1157790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/15/2023] [Indexed: 06/17/2023] Open
Abstract
Chronic pain (CP) is a prevalent problem, and more than half of patients with CP have sleep disorders. CP comorbidity with sleep disorders imposes immense suffering and seriously affects the patient's quality of life, which is a challenging issue encountered by clinicians. Although the reciprocal interactions between pain and sleep have been studied to some degree, there is still a lack of awareness and comprehensive description of CP comorbidity with sleep disorders. In this narrative review article, we summarize the current knowledge about the present estimates of the prevalence of comorbid sleep disorders in CP patients, sleep detection methods, sleep characterization in CP, and the effect of sleep disorders on CP and current therapies. We also summarize current knowledge of the neurochemical mechanisms of CP comorbidity with sleep disorders. In conclusion, insufficient attention has been paid to the role of sleep disorders in CP patients, and CP patients should be screened for sleep disorders in the clinic. Special attention should be given to a possible risk of drug-drug interaction when using two types of drugs targeting pain and sleep simultaneously. The current insight into the neurobiological mechanisms underlying CP comorbidity with sleep disorders is still rather limited.
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Ito H, Navratilova E, Vagnerova B, Watanabe M, Kopruszinski C, Moreira de Souza LH, Yue X, Ikegami D, Moutal A, Patwardhan A, Khanna R, Yamazaki M, Guerrero M, Rosen H, Roberts E, Neugebauer V, Dodick DW, Porreca F. Chronic pain recruits hypothalamic dynorphin/kappa opioid receptor signalling to promote wakefulness and vigilance. Brain 2023; 146:1186-1199. [PMID: 35485490 PMCID: PMC10169443 DOI: 10.1093/brain/awac153] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/08/2022] [Accepted: 03/31/2022] [Indexed: 11/13/2022] Open
Abstract
Increased vigilance in settings of potential threats or in states of vulnerability related to pain is important for survival. Pain disrupts sleep and conversely, sleep disruption enhances pain, but the underlying mechanisms remain unknown. Chronic pain engages brain stress circuits and increases secretion of dynorphin, an endogenous ligand of the kappa opioid receptor (KOR). We therefore hypothesized that hypothalamic dynorphin/KOR signalling may be a previously unknown mechanism that is recruited in pathological conditions requiring increased vigilance. We investigated the role of KOR in wakefulness, non-rapid eye movement (NREM) sleep and rapid eye movement (REM) sleep in freely moving naïve mice and in mice with neuropathic pain induced by partial sciatic nerve ligation using EEG/EMG recordings. Systemic continuous administration of U69,593, a KOR agonist, over 5 days through an osmotic minipump decreased the amount of NREM and REM sleep and increased sleep fragmentation in naïve mice throughout the light-dark sleep cycle. We used KORcre mice to selectively express a Gi-coupled designer receptor activated by designer drugs (Gi-DREADD) in KORcre neurons of the hypothalamic paraventricular nucleus, a key node of the hypothalamic-pituitary-adrenal stress response. Sustained activation of Gi-DREADD with clozapine-N-oxide delivered in drinking water over 4 days, disrupted sleep in these mice in a similar way as systemic U69,593. Mice with chronic neuropathic pain also showed disrupted NREM and total sleep that was normalized by systemic administration of two structurally different KOR antagonists, norbinaltorphimine and NMRA-140, currently in phase II clinical development, or by CRISPR/Cas9 editing of paraventricular nucleus KOR, consistent with endogenous KOR activation disrupting sleep in chronic pain. Unexpectedly, REM sleep was diminished by either systemic KOR antagonist or by CRISPR/Cas9 editing of paraventricular nucleus KOR in sham-operated mice. Our findings reveal previously unknown physiological and pathophysiological roles of dynorphin/KOR in eliciting arousal. Physiologically, dynorphin/KOR signalling affects transitions between sleep stages that promote REM sleep. Furthermore, while KOR antagonists do not promote somnolence in the absence of pain, they normalized disrupted sleep in chronic pain, revealing a pathophysiological role of KOR signalling that is selectively recruited to promote vigilance, increasing chances of survival. Notably, while this mechanism is likely beneficial in the short-term, disruption of the homeostatic need for sleep over longer periods may become maladaptive resulting in sustained pain chronicity. A novel approach for treatment of chronic pain may thus result from normalization of chronic pain-related sleep disruption by KOR antagonism.
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Affiliation(s)
- Hisakatsu Ito
- Department of Pharmacology, University of Arizona, Tucson, USA
- Department of Anesthesiology, University of Toyama, Toyama, Japan
| | - Edita Navratilova
- Department of Pharmacology, University of Arizona, Tucson, USA
- Department of Collaborative Research, Mayo Clinic, Scottsdale, USA
| | | | - Moe Watanabe
- Department of Pharmacology, University of Arizona, Tucson, USA
| | | | | | - Xu Yue
- Department of Pharmacology, University of Arizona, Tucson, USA
| | - Daigo Ikegami
- Department of Pharmacology, University of Arizona, Tucson, USA
| | - Aubin Moutal
- Department of Pharmacology, University of Arizona, Tucson, USA
| | - Amol Patwardhan
- Department of Pharmacology, University of Arizona, Tucson, USA
| | - Rajesh Khanna
- Department of Pharmacology, University of Arizona, Tucson, USA
| | | | - Miguel Guerrero
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, USA
| | - Hugh Rosen
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, USA
| | - Ed Roberts
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, USA
| | - Volker Neugebauer
- Department of Pharmacology and Neuroscience and Garrison Institute on Aging, Texas Tech University Health Sciences Center, Lubbock, USA
| | | | - Frank Porreca
- Department of Pharmacology, University of Arizona, Tucson, USA
- Department of Collaborative Research, Mayo Clinic, Scottsdale, USA
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6
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Donertas-Ayaz B, Caudle RM. Locus coeruleus-noradrenergic modulation of trigeminal pain: Implications for trigeminal neuralgia and psychiatric comorbidities. NEUROBIOLOGY OF PAIN (CAMBRIDGE, MASS.) 2023; 13:100124. [PMID: 36974102 PMCID: PMC10038791 DOI: 10.1016/j.ynpai.2023.100124] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 03/15/2023] [Accepted: 03/15/2023] [Indexed: 03/29/2023]
Abstract
Trigeminal neuralgia is the most common neuropathic pain involving the craniofacial region. Due to the complex pathophysiology, it is therapeutically difficult to manage. Noradrenaline plays an essential role in the modulation of arousal, attention, cognitive function, stress, and pain. The locus coeruleus, the largest source of noradrenaline in the brain, is involved in the sensory and emotional processing of pain. This review summarizes the knowledge about the involvement of noradrenaline in acute and chronic trigeminal pain conditions and how the activity of the locus coeruleus noradrenergic neurons changes in response to acute and chronic pain conditions and how these changes might be involved in pain-related comorbidities including anxiety, depression, and sleep disturbance.
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Affiliation(s)
| | - Robert M. Caudle
- Corresponding author at: Department of Oral and Maxillofacial Surgery, University of Florida College of Dentistry, PO Box 100416, 1395 Center Drive, Gainesville, FL 32610, United States.
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Chen Y, Li Q, Li X, Liu H, Li P, Hai R, Guo Y, Wang S, Wang K, Du C. Amylin regulates testosterone levels via steroidogenesis-related enzymes in the central nervous system of male mice. Neuropeptides 2022; 96:102288. [PMID: 36279616 DOI: 10.1016/j.npep.2022.102288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 10/14/2022]
Abstract
Amylin is a peripheral satiation signal polypeptide co-secreted with insulin by pancreatic β-cells in response to nutrient ingestion. Amylin participates in the eating-inhibitory effect and regulates energy metabolism by acting on the central nervous system (CNS). However, the role of amylin in regulating the biosynthesis of steroid hormones, such as testosterone, through the hypothalamic-pituitary-gonadal axis (HPG) remains unexplored. However, only limited evidence is available on the involvement of amylin in steroid synthesis, we hypothesize that amylin regulates testosterone levels via steroidogenesis-related enzymes in the CNS. In this study, we elucidated the effect of intraperitoneal injection of amylin on the protein expression of steroidogenesis-related enzymes, including 3β-hydroxysteroid dehydrogenase (3β-HSD), cytochrome P450 17A1 (CYP17A1), and steroidogenic acute regulatory protein (StAR), and phospho-extracellular signal-regulated kinase (pERK). Additionally, the effect of amylin on testosterone levels in male mice was examined. Our results suggested that 3β-HSD and CYP17A1 neurons were widely expressed in the CNS of male mice, whereas StAR neurons were mainly expressed in the zona incerta (ZI) and locus coeruleus (LC) regions. Intraperitoneal injection of amylin significantly reduced (p < 0.01) the expression of 3β-HSD, CYP17A1, and StAR in ZI and other areas near the third ventricle (3 V) but increased (p < 0.01) pERK expression, brain testosterone levels, serum FSH, serum LH, and decreased (p < 0.01) serum testosterone levels in mice. In conclusion, amylin regulates testosterone levels via steroidogenesis-related enzymes in the central nervous system of male mice.
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Affiliation(s)
- Yujie Chen
- Vocational and Technical College, Inner Mongolia Agricultural University, Baotou 014109, China
| | - Qiang Li
- College of Veterinary Medicine, Inner Mongolia Agricultural University, Hohhot 010018, China
| | - Xiaojing Li
- College of Horticulture and Plant Protection, Inner Mongolia Agricultural University, Hohhot 010018, China
| | - Haodong Liu
- College of Veterinary Medicine, Inner Mongolia Agricultural University, Hohhot 010018, China
| | - Penghui Li
- College of Veterinary Medicine, Inner Mongolia Agricultural University, Hohhot 010018, China
| | - Rihan Hai
- Vocational and Technical College, Inner Mongolia Agricultural University, Baotou 014109, China
| | - Yongqing Guo
- Vocational and Technical College, Inner Mongolia Agricultural University, Baotou 014109, China
| | - Siwei Wang
- Institute of Cereal and Oil Crops, Hebei Academy of Agricultural and Forestry Sciences, Shijiazhuang 050000, China; Key Laboratory of Crop Cultivation Physiology and Green Production in Hebei Province, Shijiazhuang 050000, China
| | - Kun Wang
- Institute of Cereal and Oil Crops, Hebei Academy of Agricultural and Forestry Sciences, Shijiazhuang 050000, China; Key Laboratory of Crop Cultivation Physiology and Green Production in Hebei Province, Shijiazhuang 050000, China
| | - Chenguang Du
- Vocational and Technical College, Inner Mongolia Agricultural University, Baotou 014109, China; College of Veterinary Medicine, Inner Mongolia Agricultural University, Hohhot 010018, China.
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Li MT, Robinson CL, Ruan QZ, Surapaneni S, Southerland W. The Influence of Sleep Disturbance on Chronic Pain. Curr Pain Headache Rep 2022; 26:795-804. [PMID: 36190680 DOI: 10.1007/s11916-022-01074-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2022] [Indexed: 12/01/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to present an overview of common sleep disturbance pathologies and their impact on chronic pain, while examining various factors that are implicit in the relationship between sleep disturbance and chronic pain, including neurobiochemistry, anatomy, and systemic mediators, and reviewing recent and landmark literature. RECENT FINDINGS Earlier literature reviews and studies have introduced the bidirectional relationship between sleep disturbance and chronic pain; that is, impaired sleep may worsen chronic pain, and chronic pain causes sleep disturbance. However, more recent reviews and studies seem to show a more associative, rather than causative relationship. There have been recent studies that attempt to determine mechanisms that link sleep disturbance and chronic pain; the results of these studies were more varied, ultimately concluding that there may be a separate, yet-to-be discovered mechanism that shows the causative relationship between sleep disturbance and pain. There are several neurotransmitters that are involved in the mediation of chronic pain and sleep disturbance as separate entities, and some studies have shown that there may be mechanisms that govern both chronic pain and sleep disturbance as a single unit. Other neuroendocrine substances also serve to mediate chronic pain and sleep disturbance. All these substances are found to be associated with various sleep disorders and are also associated with chronic pain symptoms as well. Inflammation plays a role in chronic pain and sleep disturbance, with an increase in inflammatory substances and mediators associated with an increase or worsening in chronic pain symptoms and sleep disorders. The HPA axis plays a role in chronic pain and sleep disorders, influencing pain and sleep pathways through stress response, inflammation, and maintenance of homeostasis. There are several variables that influence both chronic pain and sleep disturbance, and more research into these variables may further our understanding into the complex pathways governing the influence of sleep disturbance on pain, and ultimately to improve treatment for this issue.
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Affiliation(s)
- Michael T Li
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - Christopher Louis Robinson
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Qing Zhao Ruan
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Sindhuja Surapaneni
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Warren Southerland
- Department of Anesthesia, The Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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Berisha A, Shutkind K, Borniger JC. Sleep Disruption and Cancer: Chicken or the Egg? Front Neurosci 2022; 16:856235. [PMID: 35663547 PMCID: PMC9160986 DOI: 10.3389/fnins.2022.856235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 04/05/2022] [Indexed: 11/13/2022] Open
Abstract
Sleep is a nearly ubiquitous phenomenon across the phylogenetic tree, highlighting its essential role in ensuring fitness across evolutionary time. Consequently, chronic disruption of the duration, timing, or structure of sleep can cause widespread problems in multiple physiological systems, including those that regulate energy balance, immune function, and cognitive capacity, among others. Many, if not all these systems, become altered throughout the course of cancer initiation, growth, metastatic spread, treatment, and recurrence. Recent work has demonstrated how changes in sleep influence the development of chronic diseases, including cancer, in both humans and animal models. A common finding is that for some cancers (e.g., breast), chronic disruption of sleep/wake states prior to disease onset is associated with an increased risk for cancer development. Additionally, sleep disruption after cancer initiation is often associated with worse outcomes. Recently, evidence suggesting that cancer itself can affect neuronal circuits controlling sleep and wakefulness has accumulated. Patients with cancer often report difficulty falling asleep, difficulty staying asleep, and severe fatigue, during and even years after treatment. In addition to the psychological stress associated with cancer, cancer itself may alter sleep homeostasis through changes to host physiology and via currently undefined mechanisms. Moreover, cancer treatments (e.g., chemotherapy, radiation, hormonal, and surgical) may further worsen sleep problems through complex biological processes yet to be fully understood. This results in a "chicken or the egg" phenomenon, where it is unclear whether sleep disruption promotes cancer or cancer reciprocally disrupts sleep. This review will discuss existing evidence for both hypotheses and present a framework through which the interactions between sleep and cancer can be dissociated and causally investigated.
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Affiliation(s)
- Adrian Berisha
- Cold Spring Harbor Laboratory, Cold Spring Harbor, NY, United States
| | - Kyle Shutkind
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
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Ito H, Tsuneki H, Sasaoka T, Toyooka N, Matsuo M, Yamazaki M. Suvorexant and mirtazapine improve chronic pain-related changes in parameters of sleep and voluntary physical performance in mice with sciatic nerve ligation. PLoS One 2022; 17:e0264386. [PMID: 35213655 PMCID: PMC8880854 DOI: 10.1371/journal.pone.0264386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 02/09/2022] [Indexed: 11/19/2022] Open
Abstract
Both chronic pain and sleep disorders are associated with a reduction in the quality of life. They can be both a cause and a consequence of each other, and should therefore be simultaneously treated. However, optimal treatments for chronic pain-related sleep disorders are not well established. Here, we aimed to investigate the effects of suvorexant, a novel sleep drug, and mirtazapine, a noradrenergic and specific serotonergic antidepressant, on pain-related changes in sleep parameters in a preclinical chronic pain mice model, by partial sciatic nerve ligation. We evaluated the quantity, duration, and depth of sleep by analyzing the electroencephalogram and voluntary activity by counting the number of wheel rotations to determine various symptoms of sleep disorders, including reduced total sleep time, fragmentation, low quality, and impaired activity in the daytime. Suvorexant and mirtazapine normalized the reduction in sleep time and fragmented sleep, further regaining the sleep depth at sleep onset in the chronic pain state in nerve-ligated mice. Mirtazapine also increased the percentage of rapid eye movement sleep in mice. Suvorexant decreased voluntary activity, which was prolonged after administration; however, mirtazapine did not decrease it. Although the effects of suvorexant and mirtazapine on sleep and activity are different, both suvorexant and mirtazapine could be potential therapeutic agents for chronic pain-related sleep disorders.
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Affiliation(s)
- Hisakatsu Ito
- Department of Anesthesiology, University of Toyama, Toyama, Japan
- * E-mail:
| | - Hiroshi Tsuneki
- Department of Clinical Pharmacology, University of Toyama, Toyama, Japan
| | - Toshiyasu Sasaoka
- Department of Clinical Pharmacology, University of Toyama, Toyama, Japan
| | - Naoki Toyooka
- Faculty of Engineering, University of Toyama, Toyama, Japan
| | - Mitsuhiro Matsuo
- Department of Anesthesiology, University of Toyama, Toyama, Japan
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Analysis of the effects of a tricyclic antidepressant on secondary sleep disturbance induced by chronic pain in a preclinical model. PLoS One 2020; 15:e0243325. [PMID: 33270791 PMCID: PMC7714178 DOI: 10.1371/journal.pone.0243325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 11/18/2020] [Indexed: 11/28/2022] Open
Abstract
Chronic pain and sleep have a bidirectional relationship that promotes a vicious circle making chronic pain more difficult to treat. Therefore, pain and sleep should be treated simultaneously. In our previous study, we suggested that hyperactivation of ascending serotonergic neurons could cause secondary sleep disturbance in chronic pain. This study aimed to demonstrate the effects of a tricyclic antidepressant (amitriptyline) and a selective 5-hydroxy-tryptamine 2A (5-HT2A) antagonist (MDL 100907) that adjust serotonergic transmission, on secondary sleep disturbance induced in a preclinical chronic pain model. We produced a chronic neuropathic pain model by partial sciatic nerve ligation in mice, analyzed their electroencephalogram (EEG) and electromyogram (EMG) using the SleepSign software, and evaluated the sleep condition of the pain model mice after administration of amitriptyline or MDL 100907. Amitriptyline improved thermal hyperalgesia and the amount of sleep, especially non-REM sleep. Time change of normalized power density of δ wave in the nerve ligation group with amitriptyline administration showed a normal pattern that was similar to sham mice. In addition, MDL 100907 normalized sleep condition similar to amitriptyline, without improvement in pain threshold. In conclusion, amitriptyline could improve sleep quantity and quality impaired by chronic pain. 5-HT2A receptor antagonism could partially contribute to this sleep improvement, but is not associated with pain relief.
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12
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Broncel A, Bocian R, Kłos-Wojtczak P, Konopacki J. Effects of locus coeruleus activation and inactivation on hippocampal formation theta rhythm in anesthetized rats. Brain Res Bull 2020; 162:180-190. [DOI: 10.1016/j.brainresbull.2020.05.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 04/23/2020] [Accepted: 05/12/2020] [Indexed: 02/05/2023]
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13
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Ahmadi-Soleimani SM, Mianbandi V, Azizi H, Azhdari-Zarmehri H, Ghaemi-Jandabi M, Abbasi-Mazar A, Mohajer Y, Darana SP. Coregulation of sleep-pain physiological interplay by orexin system: An unprecedented review. Behav Brain Res 2020; 391:112650. [DOI: 10.1016/j.bbr.2020.112650] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 02/28/2020] [Accepted: 04/08/2020] [Indexed: 12/14/2022]
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Abstract
Introduction to Diabetic Neuropathy podcast recording (MP4 55526 kb).
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Affiliation(s)
- Uazman Alam
- Department of Diabetes and Endocrinology, Liverpool University Hospital NHS Foundation Trust, Liverpool, UK.
- Department of Eye and Vision Sciences, and the Pain Research Institute, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK.
- Division of Endocrinology, Diabetes and Gastroenterology, University of Manchester, Manchester, UK.
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15
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Sleep deficiency and chronic pain: potential underlying mechanisms and clinical implications. Neuropsychopharmacology 2020; 45:205-216. [PMID: 31207606 PMCID: PMC6879497 DOI: 10.1038/s41386-019-0439-z] [Citation(s) in RCA: 217] [Impact Index Per Article: 54.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 05/10/2019] [Accepted: 06/05/2019] [Indexed: 11/09/2022]
Abstract
Pain can be both a cause and a consequence of sleep deficiency. This bidirectional relationship between sleep and pain has important implications for clinical management of patients, but also for chronic pain prevention and public health more broadly. The review that follows will provide an overview of the neurobiological evidence of mechanisms thought to be involved in the modulation of pain by sleep deficiency, including the opioid, monoaminergic, orexinergic, immune, melatonin, and endocannabinoid systems; the hypothalamus-pituitary-adrenal axis; and adenosine and nitric oxide signaling. In addition, it will provide a broad overview of pharmacological and non-pharmacological approaches for the management of chronic pain comorbid with sleep disturbances and for the management of postoperative pain, as well as discuss the effects of sleep-disturbing medications on pain amplification.
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Takahashi M, Matsudaira K, Shimazu A. Disabling low back pain associated with night shift duration: sleep problems as a potentiator. Am J Ind Med 2015; 58:1300-10. [PMID: 26122920 DOI: 10.1002/ajim.22493] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2015] [Indexed: 01/28/2023]
Abstract
BACKGROUND We investigated how night shift duration and sleep problems were jointly associated with disabling low back pain (LBP) among workers in different occupations. METHODS An online-survey was conducted regarding work schedules, disabling LBP, sleep problems, and other relevant factors in 5,008 workers who were randomly selected from a market research panel. Multiple logistic regression analyses determined the joint associations of night shift duration (0 [permanent day shift], <8, 8-9.9, 10-15.9, ≥16 hr) and sleep problems (no, yes) with disabling LBP adjusted for potential confounders. RESULTS A night shift ≥16 hr was associated with a significant increase in the likelihood of disabling LBP. The magnitude of this association was elevated when participants perceived sleep problems including both sleep duration and quality. CONCLUSION Associations between extended night shifts and disabling LBP became stronger in the presence of short or poor quality sleep.
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Affiliation(s)
- Masaya Takahashi
- National Institute of Occupational Safety and Health, Tama-ku, Kawasaki, Japan
| | - Ko Matsudaira
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Clinical Research Center for Occupational Musculoskeletal Disorders, Kanto Rosai Hospital, Nakahara-ku, Kawasaki, Japan
| | - Akihito Shimazu
- Department of Mental Health, The University of Tokyo, Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
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Zhang J, Luo H, Pace E, Li L, Liu B. Psychophysical and neural correlates of noised-induced tinnitus in animals: Intra- and inter-auditory and non-auditory brain structure studies. Hear Res 2015; 334:7-19. [PMID: 26299842 DOI: 10.1016/j.heares.2015.08.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 08/04/2015] [Accepted: 08/17/2015] [Indexed: 12/19/2022]
Abstract
Tinnitus, a ringing in the ear or head without an external sound source, is a prevalent health problem. It is often associated with a number of limbic-associated disorders such as anxiety, sleep disturbance, and emotional distress. Thus, to investigate tinnitus, it is important to consider both auditory and non-auditory brain structures. This paper summarizes the psychophysical, immunocytochemical and electrophysiological evidence found in rats or hamsters with behavioral evidence of tinnitus. Behaviorally, we tested for tinnitus using a conditioned suppression/avoidance paradigm, gap detection acoustic reflex behavioral paradigm, and our newly developed conditioned licking suppression paradigm. Our new tinnitus behavioral paradigm requires relatively short baseline training, examines frequency specification of tinnitus perception, and achieves sensitive tinnitus testing at an individual level. To test for tinnitus-related anxiety and cognitive impairment, we used the elevated plus maze and Morris water maze. Our results showed that not all animals with tinnitus demonstrate anxiety and cognitive impairment. Immunocytochemically, we found that animals with tinnitus manifested increased Fos-like immunoreactivity (FLI) in both auditory and non-auditory structures. The manner in which FLI appeared suggests that lower brainstem structures may be involved in acute tinnitus whereas the midbrain and cortex are involved in more chronic tinnitus. Meanwhile, animals with tinnitus also manifested increased FLI in non-auditory brain structures that are involved in autonomic reactions, stress, arousal and attention. Electrophysiologically, we found that rats with tinnitus developed increased spontaneous firing in the auditory cortex (AC) and amygdala (AMG), as well as intra- and inter-AC and AMG neurosynchrony, which demonstrate that tinnitus may be actively produced and maintained by the interactions between the AC and AMG.
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Affiliation(s)
- Jinsheng Zhang
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University, School of Medicine, 4201 Saint Antoine, Detroit, MI 48201, USA; Department of Communication Sciences & Disorders, Wayne State University, College of Liberal Arts & Sciences, 60 Farnsworth St., Detroit, MI 48202, USA.
| | - Hao Luo
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University, School of Medicine, 4201 Saint Antoine, Detroit, MI 48201, USA
| | - Edward Pace
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University, School of Medicine, 4201 Saint Antoine, Detroit, MI 48201, USA
| | - Liang Li
- Department of Psychology, McGovern Institute for Brain Research at PKU, Key Laboratory on Machine Perception (Ministry of Education), Peking University, Beijing, 100080, China
| | - Bin Liu
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University, School of Medicine, 4201 Saint Antoine, Detroit, MI 48201, USA
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