Pain perception in schizophrenia: influence of neuropeptides, cognitive disorders, and negative symptoms

Małgorzata Urban-Kowalczyk,1 Justyna Pigońska,2 Janusz Śmigielski3 1Department of Affective and Psychotic Disorders, Medical University of Łódź, Łódź, Poland; 2Department of Neurology and Movement Disorders, Medical University of Łódź, Łódź, Poland; 3Depa...

Full description

Bibliographic Details
Main Authors: Urban-Kowalczyk M, Pigońska J, Śmigielski J
Format: Article
Language:English
Published: Dove Medical Press 2015-08-01
Series:Neuropsychiatric Disease and Treatment
Online Access:http://www.dovepress.com/pain-perception-in-schizophrenia-influence-ofnbspneuropeptides-cogniti-peer-reviewed-article-NDT
_version_ 1818424570576633856
author Urban-Kowalczyk M
Pigońska J
Śmigielski J
author_facet Urban-Kowalczyk M
Pigońska J
Śmigielski J
author_sort Urban-Kowalczyk M
collection DOAJ
description Małgorzata Urban-Kowalczyk,1 Justyna Pigońska,2 Janusz Śmigielski3 1Department of Affective and Psychotic Disorders, Medical University of Łódź, Łódź, Poland; 2Department of Neurology and Movement Disorders, Medical University of Łódź, Łódź, Poland; 3Department of Geriatrics, Healthy Ageing Research Centre (HARC), Medical University of Łódź, Łódź, Poland Objectives: The causes and nature of insensitivity to pain in schizophrenia remain unknown. The role of endorphins and the association of cognitive dysfunction and negative symptoms are postulated.Methods: In this study, 43 patients with schizophrenia, five first-degree relatives, and 34 healthy controls were examined. Participants’ plasma concentrations of substance P, β-endorphin, and calcitonin gene-related peptide (CGRP) were assessed. In patients, the Trail-Making Test, the Color Reading Interference Test (Stroop test), and the Positive and Negative Syndrome Scale Negative Syndrome subscale (PANSS N) test were performed. We also evaluated pain threshold using nociceptive reflex (RTIII) testing.Results: The mean β-endorphin concentration was about 20% higher in patients than in healthy controls (P<0.05). CGRP concentrations were significantly higher in patients than in controls (5.34 ng/mL versus 4.16 ng/mL; P<0.01). Subjects treated with antipsychotic polytherapy had higher concentrations of CGRP than did patients treated with second-generation antipsychotic monotherapy (5.92 ng/mL versus 5.02 ng/mL; P<0.05). There were no correlations between any biochemical parameters and Trail-Making Test, Stroop test, and PANSS N scores. There were no differences in RTIII among study groups. Strong negative correlation (P<0.001) was found between PANSS N scores and subjective pain threshold on the right lower limb.Conclusion: The insensitivity to pain in schizophrenia is a complex phenomenon that is probably not related to changes in nociceptive pathways. Increase in β-endorphin level may be related to this issue, but it is uncertain if such concentration ensures analgesic effect. It is unknown if patients with schizophrenia in fact experience less pain. Cognitive impairment and excess negative symptoms may strongly influence the patient’s expression of pain. Keywords: schizophrenia, endorphin, substance P, calcitonin gene-related peptide, working memory, negative symptoms
first_indexed 2024-12-14T14:00:09Z
format Article
id doaj.art-e6ba1436f29d48a2b304e84ef167c01a
institution Directory Open Access Journal
issn 1178-2021
language English
last_indexed 2024-12-14T14:00:09Z
publishDate 2015-08-01
publisher Dove Medical Press
record_format Article
series Neuropsychiatric Disease and Treatment
spelling doaj.art-e6ba1436f29d48a2b304e84ef167c01a2022-12-21T22:58:44ZengDove Medical PressNeuropsychiatric Disease and Treatment1178-20212015-08-012015default2023203123001Pain perception in schizophrenia: influence of neuropeptides, cognitive disorders, and negative symptomsUrban-Kowalczyk MPigońska JŚmigielski JMałgorzata Urban-Kowalczyk,1 Justyna Pigońska,2 Janusz Śmigielski3 1Department of Affective and Psychotic Disorders, Medical University of Łódź, Łódź, Poland; 2Department of Neurology and Movement Disorders, Medical University of Łódź, Łódź, Poland; 3Department of Geriatrics, Healthy Ageing Research Centre (HARC), Medical University of Łódź, Łódź, Poland Objectives: The causes and nature of insensitivity to pain in schizophrenia remain unknown. The role of endorphins and the association of cognitive dysfunction and negative symptoms are postulated.Methods: In this study, 43 patients with schizophrenia, five first-degree relatives, and 34 healthy controls were examined. Participants’ plasma concentrations of substance P, β-endorphin, and calcitonin gene-related peptide (CGRP) were assessed. In patients, the Trail-Making Test, the Color Reading Interference Test (Stroop test), and the Positive and Negative Syndrome Scale Negative Syndrome subscale (PANSS N) test were performed. We also evaluated pain threshold using nociceptive reflex (RTIII) testing.Results: The mean β-endorphin concentration was about 20% higher in patients than in healthy controls (P<0.05). CGRP concentrations were significantly higher in patients than in controls (5.34 ng/mL versus 4.16 ng/mL; P<0.01). Subjects treated with antipsychotic polytherapy had higher concentrations of CGRP than did patients treated with second-generation antipsychotic monotherapy (5.92 ng/mL versus 5.02 ng/mL; P<0.05). There were no correlations between any biochemical parameters and Trail-Making Test, Stroop test, and PANSS N scores. There were no differences in RTIII among study groups. Strong negative correlation (P<0.001) was found between PANSS N scores and subjective pain threshold on the right lower limb.Conclusion: The insensitivity to pain in schizophrenia is a complex phenomenon that is probably not related to changes in nociceptive pathways. Increase in β-endorphin level may be related to this issue, but it is uncertain if such concentration ensures analgesic effect. It is unknown if patients with schizophrenia in fact experience less pain. Cognitive impairment and excess negative symptoms may strongly influence the patient’s expression of pain. Keywords: schizophrenia, endorphin, substance P, calcitonin gene-related peptide, working memory, negative symptomshttp://www.dovepress.com/pain-perception-in-schizophrenia-influence-ofnbspneuropeptides-cogniti-peer-reviewed-article-NDT
spellingShingle Urban-Kowalczyk M
Pigońska J
Śmigielski J
Pain perception in schizophrenia: influence of neuropeptides, cognitive disorders, and negative symptoms
Neuropsychiatric Disease and Treatment
title Pain perception in schizophrenia: influence of neuropeptides, cognitive disorders, and negative symptoms
title_full Pain perception in schizophrenia: influence of neuropeptides, cognitive disorders, and negative symptoms
title_fullStr Pain perception in schizophrenia: influence of neuropeptides, cognitive disorders, and negative symptoms
title_full_unstemmed Pain perception in schizophrenia: influence of neuropeptides, cognitive disorders, and negative symptoms
title_short Pain perception in schizophrenia: influence of neuropeptides, cognitive disorders, and negative symptoms
title_sort pain perception in schizophrenia influence of nbsp neuropeptides cognitive disorders and negative symptoms
url http://www.dovepress.com/pain-perception-in-schizophrenia-influence-ofnbspneuropeptides-cogniti-peer-reviewed-article-NDT
work_keys_str_mv AT urbankowalczykm painperceptioninschizophreniainfluenceofnbspneuropeptidescognitivedisordersandnegativesymptoms
AT pigonskaj painperceptioninschizophreniainfluenceofnbspneuropeptidescognitivedisordersandnegativesymptoms
AT smigielskij painperceptioninschizophreniainfluenceofnbspneuropeptidescognitivedisordersandnegativesymptoms