Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, University of Alexandria, Egypt.
Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, University of Alexandria, Egypt.
J Clin Neurosci. 2024 Oct;128:110773. doi: 10.1016/j.jocn.2024.110773. Epub 2024 Aug 12.
Pain is the major cause of disability in disc induced lumbosacral radiculopathy (LSR) and is related to neurotrophins mainly brain derived neurotrophic factor (BDNF). However, to our knowledge evaluating serum BDNF in disc induced LSR has not been reported before. This study was done to investigate serum BDNF in LSR patients and its relation to pain severity and functional disability.
This case-control study included 40 disc induced LSR patients and 40 age and sex matched healthy subjects. All patients were subjected to neurological examination, electrophysiological evaluation, pain severity assessment using numerical rating scale (NRS) and functional disability assessment using Modified Oswestry Low Back Pain Disability Index (ODI) and Maine-Seattle Back Questionnaire (MSBQ). According to Douleur neuropathique 4 (DN4) questionnaire, patients were divided into those with neuropathic pain and those with non-neuropathic pain. Serum BDNF was measured by enzyme-linked immunosorbent assay in all participants.
Serum BDNF was significantly higher in LSR patients than in healthy controls (U=272.5, P<0.001). Moreover, serum BDNF was significantly higher in those with neuropathic pain compared to those with non-neuropathic pain (U=35, P=0.03). Serum BDNF had a significant positive correlation with NRS score among those with acute pain (r0.537, P=0.026), however there was no significant correlation among those with chronic pain. Furthermore, BDNF had no significant correlation with modified ODI and MSBQ.
Increased serum BDNF may be associated with neuropathic pain and acute pain severity in disc induced LSR. However, it may not be related to chronic pain severity or functional disability.
疼痛是椎间盘源性腰骶神经根病（LSR）导致残疾的主要原因，与神经营养因子（主要是脑源性神经营养因子，BDNF）有关。然而，据我们所知，评估椎间盘源性 LSR 患者的血清 BDNF 尚未见报道。本研究旨在探讨 LSR 患者血清 BDNF 及其与疼痛严重程度和功能障碍的关系。
本病例对照研究纳入 40 例椎间盘源性 LSR 患者和 40 例年龄和性别匹配的健康对照者。所有患者均接受神经学检查、电生理学评估、数字评分量表（NRS）评估疼痛严重程度和改良 Oswestry 下腰痛残疾指数（ODI）和缅因州西雅图腰痛问卷（MSBQ）评估功能障碍。根据 Douleur neuropathique 4（DN4）问卷，患者分为伴有神经病理性疼痛和不伴有神经病理性疼痛的患者。所有参与者均采用酶联免疫吸附试验测定血清 BDNF。
LSR 患者的血清 BDNF 明显高于健康对照组（U=272.5，P<0.001）。此外，伴有神经病理性疼痛的患者血清 BDNF 明显高于不伴有神经病理性疼痛的患者（U=35，P=0.03）。在急性疼痛患者中，血清 BDNF 与 NRS 评分呈显著正相关（r0.537，P=0.026），而在慢性疼痛患者中无显著相关性。此外，BDNF 与改良 ODI 和 MSBQ 无显著相关性。
血清 BDNF 升高可能与椎间盘源性 LSR 中的神经病理性疼痛和急性疼痛严重程度有关，但与慢性疼痛严重程度或功能障碍无关。
