Back to Journals » Neuropsychiatric Disease and Treatment » Volume 11

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

Authors Urban-Kowalczyk M, Pigońska J, Śmigielski J

Received 30 April 2015

Accepted for publication 20 May 2015

Published 6 August 2015 Volume 2015:11 Pages 2023—2031

DOI https://doi.org/10.2147/NDT.S87666

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Ryouhei Ishii

Peer reviewer comments 2

Editor who approved publication: Dr Roger Pinder

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

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]

 

Other articles by this author:

Comparison of beta-endorphin and CGRP levels before and after treatment for severe schizophrenia

Urban-Kowalczyk M, Śmigielski J, Strzelecki D

Neuropsychiatric Disease and Treatment 2016, 12:863-868

Published Date: 15 April 2016

Neuropsychiatric symptoms and celiac disease

Urban-Kowalczyk M, Śmigielski J, Gmitrowicz A

Neuropsychiatric Disease and Treatment 2014, 10:1961-1964

Published Date: 14 October 2014

Readers of this article also read:

Emerging and future therapies for hemophilia

Carr ME, Tortella BJ

Journal of Blood Medicine 2015, 6:245-255

Published Date: 3 September 2015

Green synthesis of water-soluble nontoxic polymeric nanocomposites containing silver nanoparticles

Prozorova GF, Pozdnyakov AS, Kuznetsova NP, Korzhova SA, Emel’yanov AI, Ermakova TG, Fadeeva TV, Sosedova LM

International Journal of Nanomedicine 2014, 9:1883-1889

Published Date: 16 April 2014

Methacrylic-based nanogels for the pH-sensitive delivery of 5-Fluorouracil in the colon

Ashwanikumar N, Kumar NA, Nair SA, Kumar GS

International Journal of Nanomedicine 2012, 7:5769-5779

Published Date: 15 November 2012

Cross-linked acrylic hydrogel for the controlled delivery of hydrophobic drugs in cancer therapy

Deepa G, Thulasidasan AK, Anto RJ, Pillai JJ, Kumar GS

International Journal of Nanomedicine 2012, 7:4077-4088

Published Date: 27 July 2012

Crystallization after intravitreal ganciclovir injection

Pitipol Choopong, Nattaporn Tesavibul, Nattawut Rodanant

Clinical Ophthalmology 2010, 4:709-711

Published Date: 14 July 2010