期刊
JOURNAL OF CLINICAL MEDICINE
卷 11, 期 9, 页码 -出版社
MDPI
DOI: 10.3390/jcm11092285
关键词
psychological inflexibility; pain interference; cytokine; inflammation; chronic pain; ACT
资金
- Swedish Research Council [2017-00489]
- Swedish Society of Medicine [SLS-691251]
- Sweden-America Foundation
- Fulbright Sweden
- Heart-Lung Foundation [20190110]
- AFA Insurance [140350]
- Stockholm County Council ALF
- Medical Unit Medical Psychology at the Karolinska University Hospital
- Swedish Research Council [2017-00489] Funding Source: Swedish Research Council
This study found that multimodal therapy significantly improved pain interference and psychological inflexibility in chronic pain patients, but did not have a significant effect on pain intensity. The levels of inflammatory cytokines in the blood plasma did not change during the treatment, but higher baseline inflammation levels were associated with less improvement in psychological inflexibility.
Background: The medical and scientific communities struggle to understand chronic pain and find effective treatments. Multimodal approaches are encouraging but show significant individual differences. Methods: Seventy-eight persons (56 women) with chronic pain received Acceptance and Commitment Therapy and provided blood samples before and after treatment. The participants completed surveys with the blood sampling. Blood plasma was analyzed for IL-6 and TNF-alpha levels with the Olink Inflammation Panel (Olink Bioscience Uppsala, Sweden). The treatment effects and moderating effects of low-grade inflammation on changes in outcomes were analyzed using linear mixed models. Results: Pain interference (p < 0.001) and psychological inflexibility (p < 0.001) improved significantly during treatment, but pain intensity did not (p = 0.078). Cytokine levels did not change over the course of the treatment (IL-6/TNF-alpha p = 0.086/0.672). Mean baseline levels of IL-6 and TNF-alpha moderated improvement in psychological inflexibility during the course of treatment (p = 0.044), but cytokine levels did not moderate changes in pain interference (p = 0.205) or pain intensity (p = 0.536). Conclusions: Higher baseline inflammation levels were related to less improvement in psychological inflexibility. Low-grade inflammation may be one factor underlying the variability in behavioral treatment in chronic pain.
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