Noradrenaline, Serotonin, GABA, and Glycine in Cerebrospinal Fluid during Labor Pain: A Cross-Sectional Prospective Study.

Pornpan Chalermkitpanit,Atikun Thonnagith,Somrat Charuluxananan,Phatthanaphol Engsusophon,Sittisak Honsawek

doi:10.1155/2017/2752658

Noradrenaline, Serotonin, GABA, and Glycine in Cerebrospinal Fluid during Labor Pain: A Cross-Sectional Prospective Study.

Pornpan Chalermkitpanit, Atikun Thonnagith + Show 3 more

Open Access

https://doi.org/10.1155/2017/2752658

Copy DOI

Abstract

Background and Aims The inhibitory pathways that play a role in spinal modulation include local interneurons and descending control. Clinical data regarding the role of these pathways in acute pain is lacking. Accordingly, the aim of this study was to evaluate cerebrospinal fluid (CSF) levels of noradrenaline, serotonin, gamma-aminobutyric acid (GABA), and glycine in parturients with labor pain compared to those without labor pain. Methods One hundred term uncomplicated pregnant women receiving spinal anesthesia for cesarean section were enrolled in this prospective cross-sectional study. CSF noradrenaline, serotonin, GABA, and glycine levels were analyzed by enzyme-linked immunosorbent assay. Labor pain score was assessed by numerical rating scale. Results Median CSF serotonin concentration in parturients with labor pain was significantly lower than in those without pain (p < 0.001). Median CSF glycine level in the labor pain group was significantly higher than in the control group (p < 0.001). There were no significant differences in median CSF level of noradrenaline or GABA between parturients with and without labor pain. Subsequent analysis showed labor pain scores to be negatively correlated with CSF serotonin (r = −0.217, p = 0.04) but positively correlated with CSF glycine (r = 0.415, p < 0.001). Conclusion CSF serotonin and glycine were significantly correlated with labor pain scores. These findings suggest that the serotonergic and glycinergic systems may play a role in spinal modulation of visceral pain.

Highlights

Noxious stimuli from the periphery are modulated in the dorsal horn of the spinal cord before signals are transmitted to the thalamus and the cortex, and the perception of pain develops
This study demonstrated the effect of descending inhibitory control and spinal cord interneurons on pain modulation during active labor in an acute pain setting
There was an inverse correlation between cerebrospinal fluid (CSF) serotonin level and labor pain score (NRS)

Summary

Introduction

Noxious stimuli from the periphery are modulated in the dorsal horn of the spinal cord before signals are transmitted to the thalamus and the cortex, and the perception of pain develops. The two major pathways that attenuate nociceptive input in the dorsal horn consist of local control from inhibitory interneurons and the descending inhibitory system from the supraspinal level. The inhibitory pathways that play a role in spinal modulation include local interneurons and descending control. The aim of this study was to evaluate cerebrospinal fluid (CSF) levels of noradrenaline, serotonin, gamma-aminobutyric acid (GABA), and glycine in parturients with labor pain compared to those without labor pain. Median CSF serotonin concentration in parturients with labor pain was significantly lower than in those without pain (p < 0.001). CSF serotonin and glycine were significantly correlated with labor pain scores These findings suggest that the serotonergic and glycinergic systems may play a role in spinal modulation of visceral pain

Objectives

Methods

Results

Conclusion