Bruendl, Elisabeth and Proescholdt, Martin and Stoerr, Eva-Maria and Schoedel, Petra and Bele, Sylvia and Zeman, Florian and Hohenberger, Christoph and Kieninger, Martin and Schmidt, Nils Ole and Schebesch, Karl-Michael (2022) The endogenous neuropeptide calcitonin gene-related peptide after spontaneous subarachnoid hemorrhage-A potential psychoactive prognostic serum biomarker of pain-associated neuropsychological symptoms. FRONTIERS IN NEUROLOGY, 13: 889213. ISSN 1664-2295,
Full text not available from this repository. (Request a copy)Abstract
BackgroundThe pronociceptive neuromediator calcitonin gene-related peptide (CGRP) is associated with pain transmission and modulation. After spontaneous subarachnoid hemorrhage (sSAH), the vasodilatory CGRP is excessively released into cerebrospinal fluid (CSF) and serum and modulates psycho-behavioral function. In CSF, the hypersecretion of CGRP subacutely after good-grade sSAH was significantly correlated with an impaired health-related quality of life (hrQoL). Now, we prospectively analyzed the treatment-specific differences in the secretion of endogenous CGRP into serum after good-grade sSAH and its impact on hrQoL. MethodsTwenty-six consecutive patients (f:m = 13:8; mean age 50.6 years) with good-grade sSAH were enrolled (drop out n = 5): n = 9 underwent endovascular aneurysm occlusion, n = 6 microsurgery, and n = 6 patients with perimesencephalic SAH received standardized intensive medical care. Plasma was drawn daily from day 1 to 10, at 3 weeks, and at the 6-month follow-up (FU). CGRP levels were determined with competitive enzyme immunoassay in duplicate serum samples. All patients underwent neuropsychological self-report assessment after the onset of sSAH (t(1): day 11-35) and at the FU (t(2)). ResultsDuring the first 10 days, the mean CGRP levels in serum (0.470 +/- 0.10 ng/ml) were significantly lower than the previously analyzed mean CGRP values in CSF (0.662 +/- 0.173; p = 0.0001). The mean serum CGRP levels within the first 10 days did not differ significantly from the values at 3 weeks (p = 0.304). At 6 months, the mean serum CGRP value (0.429 +/- 0.121 ng/ml) was significantly lower compared to 3 weeks (p = 0.010) and compared to the first 10 days (p = 0.026). Higher mean serum CGRP levels at 3 weeks (p = 0.001) and at 6 months (p = 0.005) correlated with a significantly poorer performance in the item pain, and, at 3 weeks, with a higher symptom burden regarding somatoform syndrome (p = 0.001) at t(2). ConclusionOur study reveals the first insight into the serum levels of endogenous CGRP in good-grade sSAH patients with regard to hrQoL. In serum, upregulated CGRP levels at 3 weeks and 6 months seem to be associated with a poorer mid-term hrQoL in terms of pain. In migraineurs, CGRP receptor antagonists have proven clinical efficacy. Our findings corroborate the potential capacity of CGRP in pain processing.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | QUALITY-OF-LIFE; CGRP; HEADACHE; OUTCOMES; MIGRAINE; TIME; biomarker; calcitonin gene-related peptide (CGRP); cognitive impairment; health-related quality of life (hrQoL); neuropeptide; pain; somatoform syndrome; spontaneous subarachnoid hemorrhage |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Neurochirurgie Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 07 Nov 2023 10:13 |
| Last Modified: | 07 Nov 2023 10:13 |
| URI: | https://pred.uni-regensburg.de/id/eprint/56666 |
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