Role of dehydroepiandrosterone and cortisol in nociceptive sensitivity to thermal pain in anorexia nervosa and healthy women.

OBJECTIVES Anorexia nervosa (AN) patients represent a natural model of relationship between changed hormonal level and pain perception due to lower level of sex hormones and consistently described increased pain threshold. As the adrenal stress steroid hormones (cortisol and DHEA) are known to be also changed in AN (and share a common precursor), our study was aimed to analyze the association between these hormones and pain perception in AN patients and control healthy women. METHODS The pain threshold latencies to radiant heat stimuli were measured in 20 DSM-IV diagnosed patients with AN and in 21 healthy women. Blood samples were collected in the morning hours and analyses of the plasma levels of dehydroepiandrosterone (DHEA), its conjugated sulfate ester (DHEA-S) and cortisol were implemented. RESULTS Thermal pain threshold was higher in AN than in healthy women and correlated negatively with the level of DHEA and positively with cortisol/DHEA(S) ratio. No significant correlation between thermal pain and hormones was found in healthy women. If both groups were pooled together, the rest pain threshold correlated negatively with DHEA-S (r=-0.42, p=0.008). CONCLUSION We showed for the first time that sensitivity to thermal pain in women is dependent on DHEA-S and on cortisol/DHEA(S) ratio in patients with AN.

[1]  A. Beitz,et al.  Intrathecal injection of the neurosteroid, DHEAS, produces mechanical allodynia in mice: involvement of spinal sigma‐1 and GABAA receptors , 2009, British journal of pharmacology.

[2]  A. Klibanski,et al.  Adrenal glucocorticoid and androgen precursor dissociation in anorexia nervosa. , 2009, The Journal of clinical endocrinology and metabolism.

[3]  O. Wolkowitz,et al.  Neurobiological and neuropsychiatric effects of dehydroepiandrosterone (DHEA) and DHEA sulfate (DHEAS) , 2009, Frontiers in Neuroendocrinology.

[4]  B. Arnetz,et al.  Stress biomarkers' associations to pain in the neck, shoulder and back in healthy media workers: 12-month prospective follow-up , 2008, European Spine Journal.

[5]  A. Mensah-Nyagan,et al.  Biochemical and functional evidence for the control of pain mechanisms by dehydroepiandrosterone endogenously synthesized in the spinal cord , 2008, FASEB journal : official publication of the Federation of American Societies for Experimental Biology.

[6]  M. al’Absi,et al.  Influence of naltrexone administration on dehydroepiandrosterone sulfate levels in male and female participants , 2007, Biological Psychology.

[7]  C. Grillon,et al.  Cortisol and DHEA-S are associated with startle potentiation during aversive conditioning in humans , 2006, Psychopharmacology.

[8]  P. Martelletti,et al.  Salivary cortisol, dehydroepiandrosteronesulphate (DHEA–S) and testosterone in women with chronic migraine , 2006, The Journal of Headache and Pain.

[9]  R. Uher,et al.  Elevated pain threshold in eating disorders: physiological and psychological factors. , 2005, Journal of psychiatric research.

[10]  F. Hucklebridge,et al.  The diurnal patterns of the adrenal steroids cortisol and dehydroepiandrosterone (DHEA) in relation to awakening , 2005, Psychoneuroendocrinology.

[11]  Shu-Cheng Chen,et al.  Competitive Inhibition of the Capsaicin Receptor-Mediated Current by Dehydroepiandrosterone in Rat Dorsal Root Ganglion Neurons , 2004, Journal of Pharmacology and Experimental Therapeutics.

[12]  Abraham Weizman,et al.  Elevation of the cortisol/dehydroepiandrosterone ratio in schizophrenia patients , 2004, European Neuropsychopharmacology.

[13]  Ann Rasmusson,et al.  Relationships among plasma dehydroepiandrosterone sulfate and cortisol levels, symptoms of dissociation, and objective performance in humans exposed to acute stress. , 2004, Archives of general psychiatry.

[14]  M. Roo,et al.  Dehydroepiandrosterone Potentiates Native Ionotropic ATP Receptors Containing the P2X2 Subunit in Rat Sensory Neurones , 2003, The Journal of physiology.

[15]  H. Ueda,et al.  Neurosteroid-induced hyperalgesia through a histamine release is inhibited by progesterone and p,p′-DDE, an endocrine disrupting chemical , 2003, Neurochemistry International.

[16]  I. Eli,et al.  Pain perception in patients with schizophrenia. , 2002, The Journal of nervous and mental disease.

[17]  A. Young,et al.  Elevation of the cortisol-dehydroepiandrosterone ratio in drug-free depressed patients. , 2002, The American journal of psychiatry.

[18]  S. Mellon,et al.  Neurosteroids: biochemistry and clinical significance , 2002, Trends in Endocrinology & Metabolism.

[19]  Mario Maj,et al.  Plasma Levels of Neuroactive Steroids Are Increased in Untreated Women With Anorexia Nervosa or Bulimia Nervosa , 2001, Psychosomatic medicine.

[20]  E. Baulieu,et al.  Dehydroepiandrosterone sulfate and dehydroepiandrosterone: neuroactive neurosteroids , 2000 .

[21]  O. Wolf,et al.  Actions of dehydroepiandrosterone and its sulfate in the central nervous system: effects on cognition and emotion in animals and humans , 1999, Brain Research Reviews.

[22]  P. Dessein,et al.  Hyposecretion of adrenal androgens and the relation of serum adrenal steroids, serotonin and insulin-like growth factor-1 to clinical features in women with fibromyalgia , 1999, PAIN.

[23]  M. Zwaan,et al.  Relationship between thresholds to thermally and to mechanically induced pain in patients with eating disorders and healthy subjects , 1996, Pain.

[24]  S. Lautenbacher,et al.  Pain perception in psychiatric disorders: a review of the literature. , 1994, Journal of psychiatric research.

[25]  K. Pirke,et al.  Pain sensitivity in anorexia nervosa and bulimia nervosa , 1991, Biological Psychiatry.