Almay Béla G L, Johansson Folke, Von Knorring Lars, Terenius Lars, Wahlstrom Agneta
Department of Neurology, University of Umeå, Umeå, Sweden Department of Psychiatry, University of Umeå, Umeå, Sweden Department of Pharmacology, University of Uppsala, Uppsala Sweden.
Pain. 1978 Aug;5(2):153-162. doi: 10.1016/0304-3959(78)90037-4.
A series of 37 patients with chronic pain was investigated with regard to neurologic and psychiatric variables. Twenty of the patients were classified as having mainly organic (= somatogenic) pain syndromes while 17 patients were rather suffering from psychogenic pain syndromes. Samples of lumbar cerebrospinal fluid (CSF) were obtained from the patients and analyzed for the presence of opiate receptor-active material, here called endorphins. Patients classified as having mainly organic pain syndromes were found to have significantly lower endorphin levels than patients with predominantly psychogenic pain syndromes. In the total group of patients as well as in the two subgroups, there was a significant correlation between CSF endorphin levels and the depth of depressive symptomatology as reported by the patients. On the other hand, there was no correlation between CSF endorphin levels and extent of anxiety or motor retardation. It is concluded that CSF endorphins reflect central processes involved in chronic pain syndromes.
对37例慢性疼痛患者进行了神经学和精神学变量方面的调查。其中20例患者被归类为主要患有器质性（=躯体源性）疼痛综合征，而17例患者则患有心因性疼痛综合征。从患者身上采集腰椎脑脊液样本，分析其中是否存在阿片受体活性物质，即内啡肽。结果发现，主要患有器质性疼痛综合征的患者，其内啡肽水平显著低于主要患有心因性疼痛综合征的患者。在整个患者组以及两个亚组中，脑脊液内啡肽水平与患者报告的抑郁症状严重程度之间存在显著相关性。另一方面，脑脊液内啡肽水平与焦虑程度或运动迟缓之间没有相关性。结论是脑脊液内啡肽反映了慢性疼痛综合征所涉及的中枢过程。
