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71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21.06. - 24.06.2020

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The endogenous neuropeptide calcitonin gene-related peptide after spontaneous subarachnoid haemorrhage – a psychoactive prognostic serum biomarker for pain

Das endogene Neuropeptid Calcitonin gene-related peptide nach spontaner Subarachnoidalblutung – ein psychoaktiver prognostischer Biomarker im Serum für Schmerz

Meeting Abstract

Suche in Medline nach

  • presenting/speaker Elisabeth Bründl - Universitätsklinikum Regensburg, Klinik und Poliklinik für Neurochirurgie, Regensburg, Deutschland
  • Martin Proescholdt - Universitätsklinikum Regensburg, Klinik und Poliklinik für Neurochirurgie, Regensburg, Deutschland
  • Eva-Maria Störr - Universitätsklinikum Regensburg, Klinik und Poliklinik für Neurochirurgie, Regensburg, Deutschland
  • Petra Schödel - Universitätsklinikum Regensburg, Klinik und Poliklinik für Neurochirurgie, Regensburg, Deutschland
  • Sylvia Bele - Universitätsklinikum Regensburg, Klinik und Poliklinik für Neurochirurgie, Regensburg, Deutschland
  • Julius Höhne - Universitätsklinikum Regensburg, Klinik und Poliklinik für Neurochirurgie, Regensburg, Deutschland
  • Florian Zeman - Universitätsklinikum Regensburg, Zentrum für Klinische Studien, Regensburg, Deutschland
  • Alexander Brawanski - Universitätsklinikum Regensburg, Klinik und Poliklinik für Neurochirurgie, Regensburg, Deutschland
  • Nils Ole Schmidt - Universitätsklinikum Regensburg, Klinik und Poliklinik für Neurochirurgie, Regensburg, Deutschland
  • Karl-Michael Schebesch - Universitätsklinikum Regensburg, Klinik und Poliklinik für Neurochirurgie, Regensburg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. sine loco [digital], 21.-24.06.2020. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocV229

doi: 10.3205/20dgnc226, urn:nbn:de:0183-20dgnc2261

Veröffentlicht: 26. Juni 2020

© 2020 Bründl et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: The pronociceptive neuromediator calcitonin gene-related peptide (CGRP) is associated with pain transmission and modulation. After spontaneous subarachnoid hemorrhage (sSAH), the vasodilatory CGRP is excessively released into cerebrospinal fluid (CSF) and serum and modulates psycho-behavioral function. In CSF, the hypersecretion of CGRP subacutely after good-grade sSAH was significantly correlated with an impaired health-related quality of life (hrQoL). Now, we prospectively analyzed the treatment-specific differences in the secretion of endogenous CGRP into plasma after good-grade sSAH and its impact on hrQoL.

Methods: 26 consecutive patients (f:m=13:8; mean age 50.6 years) with good-grade sSAH were enrolled (drop out n=5): n=9 underwent endovascular aneurysm occlusion, n=6 microsurgery, and n=6 patients with perimesencephalic SAH received standardized intensive medical care. No patient developed any serious vasospasm-related ischemic or hemorrhagic complications. Plasma was drawn daily from day 1-10, at 3 weeks, and at the 6-month follow-up (FU). CGRP levels were determined with competitive enzyme immunoassay in duplicate serum samples. All patients underwent neuropsychological self-report assessment [36-Item Short Form Health Survey (SF-36) and ICD-10-Symptom-Rating questionnaire (ISR)] after the onset of sSAH (t1: day 11-35) and at the FU (t2).

Results: During the first 10 days, the mean CGRP levels in serum (.470 ± .10 ng/ml) were significantly lower than the previously analyzed mean CGRP values in CSF (.662 ± .173; p=.0001). The mean serum CGRP levels within the first 10 days did not differ significantly from the values at 3 weeks (p=.145). At 6 months, the mean serum CGRP value (.429 ± .119 ng/ml) was significantly lower compared to 3 weeks (p=.0001) and compared to the first 10 days (p=.026). Higher mean serum CGRP levels at 3 weeks (p=.0001) and at 6 months (p=.0242) correlated with a significantly poorer performance in the SF-36 item pain, and, at 3 weeks, with a higher ISR symptom burden regarding somatoform syndrome (p=.0310) at t2.

Conclusion: Our study reveals the first insight into the serum levels of endogenous CGRP in good-grade sSAH patients with regard to hrQoL. In plasma, upregulated CGRP levels at 3 weeks and 6 months seem to be associated with a poorer mid-term hrQoL in terms of pain. In migraineurs, CGRP receptor antagonists have proven clinical efficacy. Our findings corroborate the potential capacity of CGRP in pain processing.