title: Low-grade inflammation may moderate the effect of behavioral treatment for chronic pain in adults.
abstract: The purpose of the present pilot study was to explore the moderating role of basal inflammation on the effects of behavioral pain treatment in 41 patients with long-standing pain. Baseline pro-inflammatory status moderated behavioral treatment outcomes: higher pre-treatment levels of Tumor Necrosis Factor (TNF)-α and Interleukin (IL)-6 were related to less improvement in pain intensity, psychological inflexibility and in mental health-related quality of life. The treatment outcomes improved in the subgroup that had low levels of pro-inflammatory cytokines at baseline, while the subjects with higher pro-inflammatory status did not. Altogether, results indicate that low-grade inflammation may influence the behavioral treatment outcomes and provide a possible explanation of the heterogeneity in treatment response.
authors.affiliation: Psychology Division, Department of Clinical Neuroscience, Karolinska Institutet, Nobels väg 9, 171 65, Solna, Stockholm, Sweden. julie.lasselin@ki.se.|Stress Research Institute, Stockholm University, Frescati Hagväg 16A, 106 91, Stockholm, Sweden. julie.lasselin@ki.se.|Institute of Medical Psychology and Behavioral Immunobiology, Universitätsklinikum Essen, Hufelandstr. 55, 45122, Essen, Germany. julie.lasselin@ki.se.
authors.forename: Julie
authors.identifier: 0000-0001-8323-0714
authors.initials: J
authors.lastname: Lasselin
authors.affiliation: Psychology Division, Department of Clinical Neuroscience, Karolinska Institutet, Nobels väg 9, 171 65, Solna, Stockholm, Sweden.|Behavior Medicine Pain Treatment Service, Karolinska University Hospital, 171 76, Stockholm, Sweden.
authors.forename: Mike K
authors.initials: MK
authors.lastname: Kemani
authors.affiliation: Psychology Division, Department of Clinical Neuroscience, Karolinska Institutet, Nobels väg 9, 171 65, Solna, Stockholm, Sweden.|Behavior Medicine Pain Treatment Service, Karolinska University Hospital, 171 76, Stockholm, Sweden.
authors.forename: Marie
authors.initials: M
authors.lastname: Kanstrup
authors.affiliation: Psychology Division, Department of Clinical Neuroscience, Karolinska Institutet, Nobels väg 9, 171 65, Solna, Stockholm, Sweden.|Department of Physiology and Pharmacology, Karolinska Institutet, 171 77, Solna, Stockholm, Sweden.
authors.forename: Gunnar L
authors.initials: GL
authors.lastname: Olsson
authors.affiliation: Psychology Division, Department of Clinical Neuroscience, Karolinska Institutet, Nobels väg 9, 171 65, Solna, Stockholm, Sweden.|Stress Research Institute, Stockholm University, Frescati Hagväg 16A, 106 91, Stockholm, Sweden.|Osher Center for Integrative Medicine, Karolinska Institutet, Scheeles väg 1, 171 65, Solna, Stockholm, Sweden.
authors.forename: John
authors.initials: J
authors.lastname: Axelsson
authors.affiliation: Stress Research Institute, Stockholm University, Frescati Hagväg 16A, 106 91, Stockholm, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Andreasson
authors.affiliation: Psychology Division, Department of Clinical Neuroscience, Karolinska Institutet, Nobels väg 9, 171 65, Solna, Stockholm, Sweden.|Stress Research Institute, Stockholm University, Frescati Hagväg 16A, 106 91, Stockholm, Sweden.|Osher Center for Integrative Medicine, Karolinska Institutet, Scheeles väg 1, 171 65, Solna, Stockholm, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Lekander
authors.affiliation: Psychology Division, Department of Clinical Neuroscience, Karolinska Institutet, Nobels väg 9, 171 65, Solna, Stockholm, Sweden.|Behavior Medicine Pain Treatment Service, Karolinska University Hospital, 171 76, Stockholm, Sweden.
authors.forename: Rikard K
authors.initials: RK
authors.lastname: Wicksell
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D059350:Chronic Pain / Q000378:metabolism* / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000378:metabolism*; D015850:Interleukin-6 / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D059408:Pain Management; D010865:Pilot Projects; D011788:Quality of Life; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: C508600:IL6 protein, human; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha
keywords: Chronic low-grade inflammation; Chronic pain; Cognitive behavioral therapy (CBT); Cytokines; Psychological inflexibility; Treatment responders