Theoretical reviewThe comorbidity of insomnia, chronic pain, and depression: Dopamine as a putative mechanism
Section snippets
Summary of studies simultaneously investigating insomnia, pain, and depression
Although relatively fewer studies have examined the triad of insomnia, chronic pain, and depression – or their symptoms – together in one model, there is growing support for the hypothesis that the three disorders are linked through common mechanisms. Wilson et al.18 examined comorbidities in a sample of chronic musculoskeletal pain patients and found that those diagnosed with depression were significantly more likely to have insomnia. Further, patients with both comorbidities reported greater
Mesolimbic DA and arousal
DA is a neurotransmitter from the catecholamine family that is considered to be a key neurobiological substrate of reward, and has traditionally been the target of pharmaceutical therapies for movement disorders, psychotic disorders, and to a lesser extent depression. Evidence also indicates, however, that DA is integral to the promotion and maintenance of arousal states (for reviews, see*29, 30).
Mesolimbic DA neurons originate in the ventral tegmental area and the substantia nigra pars
Conflicts of interest
None declared.
Acknowledgments
The authors would like to acknowledge funding support from NINDS/NINR grant T32 NS070201 (PHF) and R01 AR05487, R01 AR059410, R01 DE019731(MTS).
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