Brian Poeschla - Academia.edu (original) (raw)

Papers by Brian Poeschla

The Clinical Journal of Pain, 2016

Hypothalamic-pituitary-adrenal (HPA) axis dysregulation is associated with chronic pain. Studying... more Hypothalamic-pituitary-adrenal (HPA) axis dysregulation is associated with chronic pain. Studying pain sensitivity and the HPA axis could elucidate the role of stress in chronic pain development, which might be influenced by familial factors, including genes. Associations between pain sensitivity and salivary cortisol and familial confounding in these associations were examined in 88 female, community-based twin pairs (75% monozygotic, mean age 29▒y). Cortisol was assessed after 0.25▒mg dexamethasone, recovery from 0.25▒mg dexamethasone, and after 0.5▒mg dexamethasone. Cold pressor task pain ratings were obtained at threshold and at tolerance. Conditioned pain modulation (CPM) was examined using thermal heat as the testing stimulus and hot water as the conditioning stimulus. Generalized estimating equation models were used and adjusted for baseline pain rating, age, and other relevant covariates. After controlling for baseline cortisol, greater cortisol suppression following dexamethasone administration and lower recovery cortisol levels were associated with higher pain ratings at tolerance during the cold pressor task (B&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s=-2.42 to -17.82; P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s=0.031 to&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001) as well as with reduced CPM (B&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s=-0.92 to -1.68; P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s=0.003 to 0.046). Interestingly, familial confounding was evident in the cold pressor task and CPM during recovery from dexamethasone administration, but not immediately following dexamethasone administration. These findings contribute to understanding possible mechanisms underlying chronic pain by demonstrating that HPA axis response to negative feedback is related to pain sensitivity.

The American journal of physiology

To investigate the dependence of the satiating action of cholecystokinin on serotonergic function... more To investigate the dependence of the satiating action of cholecystokinin on serotonergic function in rats, we examined the effects of systemic pretreatment with serotonin (5-HT) antagonists of varying selectivity for 5-HT receptor subtypes on suppression of food intake induced by systemic administration of cholecystokinin octapeptide (CCK-8). Mianserin, a 5-HT1C/2-selective antagonist, significantly attenuated the satiating action of CCK-8. Ketanserin, a 5-HT2 antagonist, and three 5-HT3 antagonists, MDL-72222, ICS 205-930, and ondansetron, however, had no effect on the satiating action of CCK-8. These results demonstrate that the satiating action of exogenous CCK depends on activation of 5-HT1 (probably 5-HT1C) receptors and that activation of 5-HT2 or 5-HT3 receptors is not required.

Journal of psychosomatic research, 2015

Pain is a complex phenomenon influenced by context and person-specific factors. Affective dimensi... more Pain is a complex phenomenon influenced by context and person-specific factors. Affective dimensions of pain involve both enduring personality traits and fleeting emotional states. We examined how personality traits and emotional states are linked with clinical and evoked pain in a twin sample. 99 female twin pairs were evaluated for clinical and evoked pain using the McGill Pain Questionnaire (MPQ) and dolorimetry, and completed the 120-item International Personality Item Pool (IPIP), the Positive and Negative Affect Scale (PANAS), and ratings of stress and mood. Using a co-twin control design we examined a) the relationship of personality traits and emotional states with clinical and evoked pain and b) whether genetics and common environment (i.e. familial factors) may account for the associations. Neuroticism was associated with the sensory component of the MPQ; this relationship was not confounded by familial factors. None of the emotional state measures was associated with the ...

Pharmacology Biochemistry and Behavior, 1992

The 5-HTIA agonist 8-OH-DPAT attenuates the satiating action of cholecystokinin. PHARMACOL BIOCHE... more The 5-HTIA agonist 8-OH-DPAT attenuates the satiating action of cholecystokinin. PHARMACOL BIOCHEM BEHAV 42(3) 541-543, 1992.-To investigate the dependence of the satiating action of cholecystokinin (CCK) on serotonergic action at central 5-HT receptors, we examined the effect of systemic pretreatment with 8-OH-DPAT (a 5-HT~A agonist that decreases central 5-HT synthesis and release via an action at somatodendritic autoreceptors in the brainstem raphe) on the suppression of food intake induced by systemic administration of cholecystokinin octapeptide (CKK-8). 8-OH-DPAT significantly attenuated the satiating action of CKK-8.

Journal of Hospice & Palliative Nursing, 2009

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General Hospital Psychiatry, 2011

The increasing use of serotonergic agents, alone and in combination, across multiple disciplines,... more The increasing use of serotonergic agents, alone and in combination, across multiple disciplines, makes it likely that the prevalence of serotonin syndrome will rise. Caution should be used, especially in the elderly, to avoid unnecessary and potentially harmful polypharmacy. We describe a case of serotonin syndrome in a 79-year-old man taking mirtazapine, venlafaxine and quetiapine. As this case illustrates, serotonin syndrome can be caused by combinations of direct serotonin agonists (e.g., serotonergic antidepressants) and indirect serotonin agonists (e.g., atypical antipsychotics).

Burns, 2011

Self-immolation remains a significant contemporary problem. Its epidemiology and causes, and the ... more Self-immolation remains a significant contemporary problem. Its epidemiology and causes, and the intervention strategies these suggest vary significantly between higher- and lower-income countries. We summarize what is known about suicide by self-immolation in terms of its demographic and psychiatric risk factors, causes, local patterns and means employed, and points of possible intervention. We reviewed the literature for all published papers on self-immolation between 1973 and 2010. Epidemiologic and psychiatric risk factors and aspects of method, locale and timing of self-immolation were compared between higher- and lower-income countries. In higher-income countries self-immolation tends to be rare and the majority of self-immolation patients are male. In lower-income countries, the incidence of self-immolation is much higher, and the majority of patients are female. Self-immolation was more frequently associated with a history of mental illness or substance abuse history in higher-income countries than in lower-income countries. Reports in the literature of self-immolation divide most informatively into two groups according to the higher- or lower-income of the societies affected. This classification is not arbitrary, as it correlates with other measures of development, and the epidemiologic patterns revealed show distinct differences, suggesting differing causes and intervention strategies. Analytical studies are needed to distinguish associations from underlying causes and identify efficient points of intervention.

Annals of Behavioral Medicine, 2014

Background There is a dearth of knowledge about the link between cortisol and pain sensitivity. P... more Background There is a dearth of knowledge about the link between cortisol and pain sensitivity. Purpose We examined the association of salivary cortisol with indices of cold pain sensitivity in 198 female twins and explored the role of familial confounding. Methods Three-day saliva samples were collected for cortisol levels and a cold pressor test was used to collect pain ratings and time to threshold and tolerance. Linear regression modeling with generalized estimating equations examined the overall and within-pair associations. Results Lower diurnal variation of cortisol was associated with higher pain ratings at threshold (p=0.02) and tolerance (p<0.01). The relationship of diurnal variation with pain ratings at threshold and tolerance was minimally influenced by familial factors (i.e., genetics and common environment). Conclusions Understanding the genetic and non-genetic mechanisms underlying the link between HPA axis dysregulation and pain sensitivity may help to prevent chronic pain development and maintenance.

Annals of Behavioral Medicine, 2013

Background The etiology of chronic fatigue syndrome (CFS) remains unknown. Personality traits inf... more Background The etiology of chronic fatigue syndrome (CFS) remains unknown. Personality traits influence well-being and may play a role in CFS and unexplained chronic fatigue. Purpose This study aimed to examine the association of emotional instability and extraversion with chronic fatigue and CFS in a genetically informative sample. Methods We evaluated 245 twin pairs for two definitions of chronic fatigue. They completed the Neuroticism and Extraversion subscales of the NEO Five Factor Inventory. Using a co-twin control design, we examined the association between personality and chronic fatigue. Results Higher emotional instability was associated with both definitions of chronic fatigue and was confounded by shared genetics. Lower extraversion was also associated with both definitions of fatigue, but was not confounded by familial factors. Conclusions Both emotional instability and extraversion are related to chronic fatigue and CFS. Whereas emotional instability and chronic fatigue are linked by shared genetic mechanisms, the relationship with extraversion may be causal and bidirectional.

Annals of Behavioral Medicine, 2011

Background Systemic inflammation and pain sensitivity may contribute to the development and maint... more Background Systemic inflammation and pain sensitivity may contribute to the development and maintenance of chronic pain conditions. Purpose We examined the relationship between systemic inflammation as measured by C-reactive protein (CRP) and cold pain sensitivity in 198 female twins from the University of Washington Twin Registry. We also explored the potential role of familial factors in this relationship. Methods Linear regression modeling with generalized estimating equations examined the overall and within-pair associations.

Pain Medicine, 2015

Objective. The relationship between sleep quality and pain has been studied in populations with c... more Objective. The relationship between sleep quality and pain has been studied in populations with chronic pain and in nonclinical populations using experimental paradigms. Little is known about the familial contributions to this relationship. This study examines self-reported sleep quality and pain in a nonclinical sample and to explore familial (i.e., shared genetic and common family environment) confounding in those relationships.