Abstract
Study design:
Cross-sectional, observational and longitudinal.
Objectives:
The aim of the study was to analyze the relationship between pain intensity, plasma lipids and severity of spinal cord injuries in patients with paraplegia (n=11), tetraplegia (n=16) and polytrauma (n=15). We concentrated on the hospitalization period immediately following injury.
Methods:
Pain intensity was assessed on a visual analog scale immediately after patients were transported to hospital, again 14 days after injury and before discharge from hospital. Blood samples were also obtained at these same times. We measured following biochemical parameters: total protein, albumin, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, glycemia, and C-reactive protein. Data were analyzed with respect to type of injury, state of unconsciousness immediately after injury, hemorrhage, measure of liability (self-inflicted injuries vs casualties), cause of the accident and pre-injury cholesterol levels.
Results:
On the day of injury, pain intensity correlated positively with HDL cholesterol (r=0.48, P=0.04); on the day of discharge from hospital, pain intensity correlated positively with blood glucose levels (r=0.67, P=0.0002). Diagnostic subgroups did not differ either in pain intensity or in pain dynamics during hospitalization. Total cholesterol level was lowest in patients with polytrauma. In all patients, the lowest total cholesterol level was observed immediately after injury. HDL cholesterol was highest after injury.
Conclusion:
After spinal cord injury, lower total cholesterol levels reflected more serious trauma intensity and HDL cholesterol predicted more intensive pain. Subjects responsible for their own injuries suffered less intensive pain than those who were not responsible for their injuries.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Krikava K, Kalla K, Yamamotová A, Rokyta R . Blood serum changes in patients with pain during bone fractures and acute pancreatitis. Neuroendocrinol Lett 2004; 25: 62–69.
Rokyta R, Yamamotová A, Sulc R, Trefil L, Racek J, Treska V . Assessment of biochemical markers in patients with pain of vascular origin. Clin Exp Med 2008; 8: 199–206.
Jensen MP, Hoffman AJ, Cardenas DD . Chronic pain in individuals with spinal cord injury: a survey and longitudinal study. Spinal Cord 2005; 43: 704–712.
Engelberg H . Low serum cholesterol and suicide. Lancet 1992; 339: 727–729.
Florkowski A, Gruszczynski W, Wawrzyniak Z . Selected biochemical parameters of blood serum in soldiers committing self-mutilation. Mil Med 2001; 166: 375–377.
Orbach I, Mikulincer M, King R, Cohen D, Stein D . Thresholds and tolerance of physical pain in suicidal and nonsuicidal adolescents. J Consult Clin Psychol 1997; 65: 646–652.
Anderson DK, Beattie M, Blesch A, Bresnahan J, Bunge M, Dietrich D et al. Recommended guidelines for studies of human subjects with spinal cord injury. Spinal Cord 2005; 43: 453–458.
Campagnolo DI, Bartlett JA, Chatterton R, Keller SE . Adrenal and pituitary hormone patterns after spinal cord injury. Am J Phys Med Rehabil 1999; 78: 361–366.
Schmid A, Halle M, Stutzle C, Konig D, Baumstark MW, Storch MJ et al. Lipoproteins and free plasma catecholamines in spinal cord injured men with different injury levels. Clin Physiol 2000; 20: 304–310.
Vidal J, Javierre C, Curia FJ, Garrido E, Lizarraga MA, Segura R . Long-term evolution of blood lipid profiles and glycemic levels in patients after spinal cord injury. Spinal Cord 2003; 41: 178–181.
Kamolz L-P, Andel H, Mittlböck M, Winter W, Haslik W, Meissl G, Frey M . Serum cholesterol and triglycerides: potential role in mortality prediction. Burns 2003; 29: 810–815.
Bakalar B, Zadak Z, Pachl J, Eidam M, Hyspler R, Crhova S . Hypocholesterolemia after multiple injuries is not caused by simple hemodilution. Rozhl Chir 2001; 80: 67–71.
Bakalar B, Hyspler R, Pachl J, Zadak Z . Changes in cholesterol and its precursors during the first days after major trauma. Wien Klin Wochenschr 2003; 115: 775–779.
Bauman WA, Spungen AM . Coronary heart disease in individuals with spinal cord injury: assessment of risk factors. Spinal Cord 2008; 46: 466–476.
de Groot S, Dallmeijer AJ, Post MW, Angenot EL, van den Berg-Emons RJ, van der Woude LH . Prospective analysis of lipid profiles in persons with a spinal cord injury during and 1 year after inpatient rehabilitation. Arch Phys Med Rehabil 2008; 89: 531–537.
Bauman WA, Adkins RH, Spungen AM, Herbert R, Schechter C, Smith D et al. Is immobilization associated with an abnormal lipoprotein profile? Observations from a diverse cohort. Spinal Cord 1999; 37: 485–493.
Armario A, Marti J, Gil M . The serum glucose response to acute stress is sensitive to the intensity of the stressor and to habituation. Psychoneuroendocrinology 1990; 15: 341–347.
Brad L, Cahusac PMB . Decreased sensitivity to self-inflicted pain. Pain 2006; 124: 134–139.
Bryant HU, Kuta CC, Story JA, Yim GK . Stress- and morphine-induced elevations of plasma and tissue cholesterol in mice: reversal by naltrexone. Biochem Pharmacol 1988; 37: 3777–3780.
Bryant HU, Story JA, Yim GK . Assessment of endogenous opioid mediation in stress-induced hypercholesterolemia in the rat. Psychosom Med 1988; 50: 576–585.
Acknowledgements
This study was founded by Research Goal MSM 0021620816.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Yamamotová, A., Šrámková, T. & Rokyta, R. Intensity of pain and biochemical changes in blood plasma in spinal cord trauma. Spinal Cord 48, 21–26 (2010). https://doi.org/10.1038/sc.2009.71
Received:
Revised:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/sc.2009.71
Keywords
This article is cited by
-
Upregulation of Inflammatory Mediators in a Model of Chronic Pain after Spinal Cord Injury
Neurochemical Research (2011)


