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Recombinant human growth hormone improves cognitive capacity in a pain patient exposed to chronic opioids
Author(s) -
RHODIN A.,
EHREN M.,
SKOTTHEIM B.,
GRÖNBLADH A.,
ORTIZNIETO F.,
RAININKO R.,
GORDH T.,
NYBERG F.
Publication year - 2014
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.12309
Subject(s) - medicine , chronic pain , recombinant dna , human growth hormone , growth hormone , cognition , anesthesia , intensive care medicine , hormone , pharmacology , physical therapy , psychiatry , biochemistry , chemistry , gene
During recent decades, the increasing use of opioids for chronic non‐cancer pain has raised concerns regarding tolerance, addiction, and importantly cognitive dysfunction. Current research suggests that the somatotrophic axis could play an important role in cognitive function. Administration of growth hormone ( GH ) to GH ‐deficient humans and experimental animals has been shown to result in significant improvements in cognitive capacity. In this report, a patient with cognitive disabilities resulting from chronic treatment with opioids for neuropathic pain received recombinant human growth hormone (rh GH ) replacement therapy. A 61‐year‐old man presented with severe cognitive dysfunction after long‐term methadone treatment for intercostal neuralgia and was diagnosed with GH insufficiency by GH releasing hormone‐arginine testing. The effect of rh GH replacement therapy on his cognitive capacity and quality of life was investigated. The hippocampal volume was measured using magnetic resonance imaging, and the ratios of the major metabolites were calculated using proton magnetic resonance spectroscopy. Cognitive testing revealed significant improvements in visuospatial cognitive function after rh GH . The hippocampal volume remained unchanged. In the right hippocampus, the N‐acetylaspartate/creatine ratio (reflecting nerve cell function) was initially low but increased significantly during rh GH treatment, as did subjective cognitive, physical and emotional functioning. This case report indicates that rh GH replacement therapy could improve cognitive behaviour and well‐being, as well as hippocampal metabolism and functioning in opioid‐treated patients with chronic pain. The idea that GH could affect brain function and repair disabilities induced by long‐term exposure to opioid analgesia is supported.