Impact of Transforaminal Epidural Steroid Injection in Lumbar Disc Prolpse on Micro RNA-155 Serum Level
Status:
Recruiting
Trial end date:
2023-06-01
Target enrollment:
Participant gender:
Summary
Chronic pain could be considered a brain disease as it can affect multiple aspects of brain
function, chemistry, neural networks and structure. Pain is associated with impaired
cognitive function (1). Around 45-50% of these patients report cognitive deficits such as
forgetfulness (23.4%), minor accidents (23.1%), difficulty finishing tasks (20.5%), and
difficulty maintaining attention (18.7%) (2,3). Many studies emphasized an impairment in the
cognitive tests assessing executive functioning, attention abilities, processing speed, and
memory in patients with chronic pain (4,5). Studies of community-dwelling older adults found
that pain, particularly widespread or severe pain, was associated with mobility Limitations
in physical performance (e.g., walking speed, stair climbing, and activities of daily living)
(6-9) in individuals with chronic pain and correspond to the pain level (10,11). Finally,
both pain and impaired cognition affect mobility status in older adults, and mobility is
affected to a greater extent when both are present (12).
Recent data indicate that miR-155 has a typical multifunctional miRNA and plays a crucial
role in various physiological and pathological processes such as immunity, inflammation,
cognitive dysfunction and neuropathies (13). The available experimental evidence indicating
that miR-155 is up-regulated in neuropathies allows us to include this miRNA in the list of
genes of paramount importance in chronic low back pain diagnosis and prognosis. Exogenous
molecular control in vivo of miR-155 expression could open up new ways to restore cognitive
outcome or attenuate the pain intensity (14).
No study searched the role of intervention (epidural steroid injection) on cognitive function
reserve, whether it is a better substitution or not for the conservative medical treatment.
Since exogenous steroid is a part of epidural injection, the systemic effect of a single dose
of steroids does not affect cognitive function, giving superiority to the intervention
modality on the conservative medical therapy approach (15).
Aim of the work This work aims to study the impact of transforaminal epidural steroid
injection in lumbar disc prolapse on pain intensity and cognitive function in relation to
Micro RNA-155 serum level.