RESUMO
Gabapentin (GBP) is an anti-convulsive drug often used as analgesic to control neuropathic pain. This study aimed at evaluating whether oral GBP treatment could improve nerve inflammation response after sciatic nerve constriction in association with selected pain and motor spontaneous behavior assessments in Wistar rats. We evaluated nerve myeloperoxidase (MPO) and inflammatory cytokines on the 5th day post-injury, time in which nerve inflammation is ongoing. In addition, the role of GBP on carrageenan-induced paw edema and peritoneal cell migration was analyzed. GBP was given by gavage at doses of 30, 60 and 120mg/kg, 60min prior to chronic constriction of the sciatic nerve (CCSN) and during 5 days post-injury, 12/12h. CCSN animals treated with saline were used as controls and for behavioral and inflammation assessments untreated sham-operated rats were also used. On the 5th day, GBP (60 and 120mg/kg) alleviated heat-induced hyperalgesia and significantly increased delta walking scores in CCSN animals, the latter suggesting excitatory effects rather than sedation. GBP (60mg/kg) significantly increased nerve MPO, TNF-α, and IL-1ß levels, comparing with the saline group. GBP (120mg/kg) reduced the anti-inflammatory cytokine IL-10 nerve levels compared with the CCSN saline group. Furthermore, GBP (60 and 120mg/kg) increased carrageenan-induced paw edema and peritoneal macrophage migration compared with the CCSN saline group. Altogether our findings suggest that GBP accentuates nerve and peripheral inflammatory response, however confirmed its analgesic effect likely due to an independent CNS-mediated mechanism, and raise some concerns about potential GBP inflammatory side effects in widespread clinical use.
Assuntos
Aminas/farmacologia , Analgésicos/farmacologia , Ácidos Cicloexanocarboxílicos/farmacologia , Edema/tratamento farmacológico , Neuralgia/tratamento farmacológico , Nervo Isquiático/efeitos dos fármacos , Ácido gama-Aminobutírico/farmacologia , Administração Oral , Aminas/administração & dosagem , Aminas/uso terapêutico , Analgésicos/administração & dosagem , Analgésicos/uso terapêutico , Animais , Movimento Celular , Constrição Patológica , Ácidos Cicloexanocarboxílicos/administração & dosagem , Ácidos Cicloexanocarboxílicos/uso terapêutico , Citocinas/metabolismo , Edema/imunologia , Gabapentina , Inflamação/tratamento farmacológico , Inflamação/imunologia , Masculino , Atividade Motora/efeitos dos fármacos , Neuralgia/imunologia , Neuralgia/fisiopatologia , Cavidade Peritoneal/citologia , Ratos , Ratos Wistar , Nervo Isquiático/imunologia , Nervo Isquiático/lesões , Ácido gama-Aminobutírico/administração & dosagem , Ácido gama-Aminobutírico/uso terapêuticoRESUMO
OBJECTIVE: Bipolar spectrum disorders are prevalent and frequently underdiagnosed and undertreated. This report describes the development and validation of the Brazilian version of the Mood Disorder Questionnaire, a screening instrument for bipolar spectrum disorders, in an adult psychiatric population. METHOD: A total of 114 consecutive patients attending an outpatient psychiatric clinic completed the Brazilian version of the Mood Disorder Questionnaire. A research psychiatrist, blind to the Mood Disorder Questionnaire results, interviewed patients by means of the mood module of the Structured Clinical Interview for DSM-IV ('gold standard'). RESULTS: The internal consistency of the Brazilian Mood Disorder Questionnaire, evaluated with Cronbach's alpha coefficient was 0.76 (95 percent CI; 0.69-0.92). Principal component analysis with varimax rotation indicated an 'irritability-racing thoughts' factor and 'energized-activity' factor, which explained 39.1 percent of variance. On the basis of the SCID, 69 (60.5 percent) individuals received a diagnosis of bipolar disorders. A Brazilian Mood Disorder Questionnaire screening score of 8 or more items yielded sensitivity of 0.91 (95 percent CI; 0.85-0.98), specificity of 0.70 (95 percent CI; 0.62-0.75), a positive predictive value of 0.82 (95 percent CI; 0.75-0.88) and a negative predictive value of 0.84 (95 percent CI; 0.77-0.90). CONCLUSION: The present data demonstrate that the Brazilian Mood Disorder Questionnaire is a valid instrument for the screening of bipolar disorders. The instrument needs to be validated in other settings (e.g., in general practice).
OBJETIVO: Transtornos do espectro bipolar são prevalentes e comumente subdiagnosticados e subtratados. O presente trabalho descreve o desenvolvimento e a validação da versão brasileira do questionário de transtornos do humor, um instrumento de rastreio para transtornos bipolares, em uma população psiquiátrica adulta. MÉTODO: 114 pacientes consecutivos de um ambulatório psiquiátrico completaram a versão brasileira do questionário de transtornos do humor. Um psiquiatra pesquisador, cego para os escores da versão brasileira do questionário de transtornos do humor, entrevistou os participantes por meio do módulo de transtornos do humor da entrevista clínica estruturada para o DSM-IV ("padrão-ouro"). RESULTADOS: A consistência interna da versão brasileira do questionário de transtornos do humor, avaliada por meio do coeficiente alfa de Cronbach, foi de 0,76 (IC 95 por cento; 0,69-0,92). Uma análise de componentes principais com rotação ortogonal indicou fator de "irritabilidade-pensamentos acelerados" e outro de "energia-atividade", que explicaram 39,1 por cento da variação dos escores. De acordo com o padrão-ouro, 69 (60,5 por cento) dos participantes tiveram um diagnóstico de transtornos bipolares. Um escore do questionário de transtornos do humor de 8 ou mais itens apresentou uma sensibilidade de 0,91 (IC 95 por cento; 0,85-0,98), especificidade de 0,70 (IC 95 por cento; 0,62-0,75), valor preditivo positivo de 0,82 (IC 95 por cento; 0,75-0,88) e valor preditivo negativo de 0,84 (IC 95 por cento; 0,77-0,90). CONCLUSÃO: Os resultados do presente estudo demonstram que a versão brasileira do questionário de transtornos do humor é um instrumento válido para o rastreio de transtornos bipolares. O instrumento necessita de validação em outros contextos (p.ex., serviços primários).
Assuntos
Adulto , Feminino , Humanos , Masculino , Programas de Rastreamento/métodos , Transtornos do Humor/diagnóstico , Vigilância da População , Inquéritos e Questionários , Instituições de Assistência Ambulatorial , Brasil , Idioma , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , TraduçõesRESUMO
OBJECTIVE: Bipolar spectrum disorders are prevalent and frequently underdiagnosed and undertreated. This report describes the development and validation of the Brazilian version of the Mood Disorder Questionnaire, a screening instrument for bipolar spectrum disorders, in an adult psychiatric population. METHOD: A total of 114 consecutive patients attending an outpatient psychiatric clinic completed the Brazilian version of the Mood Disorder Questionnaire. A research psychiatrist, blind to the Mood Disorder Questionnaire results, interviewed patients by means of the mood module of the Structured Clinical Interview for DSM-IV ('gold standard'). RESULTS: The internal consistency of the Brazilian Mood Disorder Questionnaire, evaluated with Cronbach's alpha coefficient was 0.76 (95% CI; 0.69-0.92). Principal component analysis with varimax rotation indicated an 'irritability-racing thoughts' factor and 'energized-activity' factor, which explained 39.1% of variance. On the basis of the SCID, 69 (60.5%) individuals received a diagnosis of bipolar disorders. A Brazilian Mood Disorder Questionnaire screening score of 8 or more items yielded sensitivity of 0.91 (95% CI; 0.85-0.98), specificity of 0.70 (95% CI; 0.62-0.75), a positive predictive value of 0.82 (95% CI; 0.75-0.88) and a negative predictive value of 0.84 (95% CI; 0.77-0.90). CONCLUSION: The present data demonstrate that the Brazilian Mood Disorder Questionnaire is a valid instrument for the screening of bipolar disorders. The instrument needs to be validated in other settings (e.g., in general practice).
RESUMO
OBJECTIVE: Bipolar spectrum disorders are prevalent and frequently underdiagnosed and undertreated. This report describes the development and validation of the Brazilian version of the Mood Disorder Questionnaire, a screening instrument for bipolar spectrum disorders, in an adult psychiatric population. METHOD: A total of 114 consecutive patients attending an outpatient psychiatric clinic completed the Brazilian version of the Mood Disorder Questionnaire. A research psychiatrist, blind to the Mood Disorder Questionnaire results, interviewed patients by means of the mood module of the Structured Clinical Interview for DSM-IV ('gold standard'). RESULTS: The internal consistency of the Brazilian Mood Disorder Questionnaire, evaluated with Cronbach's alpha coefficient was 0.76 (95% CI; 0.69-0.92). Principal component analysis with varimax rotation indicated an 'irritability-racing thoughts' factor and 'energized-activity' factor, which explained 39.1% of variance. On the basis of the SCID, 69 (60.5%) individuals received a diagnosis of bipolar disorders. A Brazilian Mood Disorder Questionnaire screening score of 8 or more items yielded sensitivity of 0.91 (95% CI; 0.85-0.98), specificity of 0.70 (95% CI; 0.62-0.75), a positive predictive value of 0.82 (95% CI; 0.75-0.88) and a negative predictive value of 0.84 (95% CI; 0.77-0.90). CONCLUSION: The present data demonstrate that the Brazilian Mood Disorder Questionnaire is a valid instrument for the screening of bipolar disorders. The instrument needs to be validated in other settings (e.g., in general practice).