Hypothalamic-Pituitary-Adrenocortical Axis Dysregulation in Acute Temporomandibular Disorder and Low Back Pain: A Marker for Chronicity?
Date
2006-07Author
Gatchel, Robert J.
Garofalo, John P.
Robinson, Richard C.
Metadata
Show full item recordAbstract
Dysregulation of the hypothalamic–pituitary–adrenocortical (HPA) axis is believed to be a
valid biological marker of stress. This study evaluating changes in patients with temporomandibular
disorders (TMD) and low back pain (LBP) to determine whether dysregulation
of this system represents a marker for chronicity. Salivary cortisol samples were collected
from 78 patients (TMD = 41, LBP = 37) upon waking up and 20 minutes later daily for 2
weeks. High-risk patients for chronic pain had different overall cortisol levels versus lowrisk
patients. High-risk patients exhibited greater variability in terms of cortisol secretion
compared with low-risk patients, F (1, 1,243) = 17.73, p < .000. These results provide evidence
of a neuroendocrine mechanism underlying a constellation of psychosocial risk
factors for chronic pain.