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Effects of CO Level on Pain, Sensory Function, and Subjective Health

30. dubna 2026 aktualizováno: Betül Taşpınar, Izmir Democracy University

Evaluation of the Effects of Carbon Monoxide (CO) Levels on Pain Threshold, Sensory Function, Anxiety, Depression, and Subjective Health Complaints

Carbon monoxide (CO) is a colorless and odorless gas that can enter the human body through environmental exposure and especially tobacco use. CO binds to hemoglobin with a much higher affinity than oxygen, thereby reducing oxygen transport to tissues. This condition may lead to various physiological and psychological effects, particularly on the nervous system.

In the literature, CO exposure has mainly been investigated in the context of acute poisoning cases and smoking-related effects. However, studies evaluating the effects of low-level and chronic CO exposure-more commonly encountered in the general population-on pain perception, sensory functions, and psychological status are limited.

Tobacco smoke is an important source of CO, and exhaled CO levels have been shown to be significantly higher in smokers and associated with various neurocognitive changes. Evidence suggests that CO exposure may influence anxiety, depression, attention, and cognitive functions. In addition, some studies indicate that CO may affect brain regions involved in pain perception and emotional regulation.

However, there is insufficient research examining the relationship between low-level carbon monoxide exposure and pain threshold, sensory functions, anxiety, depression, and subjective health complaints within the same study framework.

This study aims to evaluate the relationship between exhaled carbon monoxide (CO) levels and pain threshold, sensory functions, anxiety, depression, and subjective health complaints in healthy adults. By examining the multidimensional effects of low-level CO exposure, the study seeks to fill an important gap in the literature and provide a more comprehensive understanding of this issue.

Přehled studie

Detailní popis

Carbon monoxide (CO) is a colorless, odorless, and toxic gas that can adversely affect human health through both environmental and behavioral exposure pathways. In the literature, most studies on CO exposure have focused on acute poisoning cases and smoking cessation processes. In contrast, research addressing the physiological and psychological effects of chronic low-level CO exposure, which is more commonly encountered in the general population, remains limited.

According to the World Health Organization (WHO), tobacco use causes approximately 8 million deaths annually and represents a major public health concern. CO, one of the main components of tobacco smoke, binds to hemoglobin with a much higher affinity than oxygen, impairing oxygen transport to tissues and leading to systemic hypoxia. This condition has particularly pronounced effects on the central nervous system.

Studies on the neurological and psychiatric outcomes of CO exposure have reported that cognitive impairments, anxiety, and depressive symptoms are frequently observed following acute poisoning. Significant associations have also been demonstrated between the severity of poisoning and the level of depressive and anxious symptoms. In addition, voxel-based morphometry studies have reported that CO exposure may lead to reductions in gray matter volume in brain regions associated with pain perception and emotional regulation, such as the frontal lobe, cerebellum, and periaqueductal gray matter.

In studies involving smokers, exhaled CO levels have been shown to be significantly higher compared to non-smokers and positively correlated with daily cigarette consumption. Even at low carboxyhemoglobin levels, neurological effects such as visual perception impairments, attention deficits, learning difficulties, and reduced motor performance have been reported.

At the molecular level, CO is thought to induce oxidative stress and neuroinflammatory processes, potentially leading to neuronal damage. These mechanisms may influence pain perception, sensory functions, and emotional status. However, studies simultaneously evaluating the relationship between chronic low-level CO exposure and pain threshold, sensory function, anxiety, depression, and subjective health complaints are still insufficient.

In this context, the planned study aims to systematically and comprehensively evaluate the relationships between exhaled carbon monoxide (CO) levels and pain threshold, sensory functions, anxiety, depression, and subjective health complaints in healthy adults. The study is expected to fill an important gap in the literature by shedding light on the multidimensional effects of chronic low-level CO exposure and contributing novel insights to the scientific knowledge base.

Typ studie

Pozorovací

Zápis (Odhadovaný)

70

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní kontakt

  • Jméno: Betül Taşpınar, Professor
  • Telefonní číslo: +90 506 680 44 26

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

  • Dospělý
  • Starší dospělý

Přijímá zdravé dobrovolníky

Ano

Metoda odběru vzorků

Vzorek nepravděpodobnosti

Studijní populace

This study will include healthy adult participants aged 18-65 years with a history of regular smoking for at least the past 6 months. Participants will be free of respiratory, cardiovascular, neurological, and psychiatric diseases, and will not have any acute infection or recent surgery affecting respiratory muscles.

Popis

Inclusion Criteria:

  • Being between the ages of 18 and 65

Having a regular smoking history for the past 6 months

No history of respiratory, cardiovascular, or neurological/psychiatric diseases

No recent surgery or trauma that could affect respiratory muscles

Not having an acute infection (especially upper or lower respiratory tract infection)

Exclusion Criteria:

-

Having chronic respiratory diseases such as COPD or asthma

Having a history of cardiovascular disease

Having a diagnosed neurological or psychiatric disorder

Having a history of surgery or trauma affecting respiratory muscles within the last 3 months

Being pregnant or having a suspicion of pregnancy

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

Kohorty a intervence

Skupina / kohorta
Healthy Adults - CO Exposure
This cohort includes healthy adult participants. No intervention is applied. Participants will be assessed for exhaled carbon monoxide (CO) levels, pain threshold, sensory functions, anxiety, depression, and subjective health complaints. The study aims to investigate the association between low-level CO exposure and physiological and psychological outcomes.

Co je měření studie?

Primární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Exhaled Carbon Monoxide (CO) Level
Časové okno: June 2026- July 2026

Exhaled carbon monoxide levels will be measured using a Bedfont Smokerlyzer-piCO+ device. Participants will be instructed to take a deep breath, hold their breath for 15 seconds, and then exhale slowly and completely into the device mouthpiece. The measured CO values will be classified as follows:

0-6 ppm: non-smoker 7-10 ppm: light exposure 11-15 ppm: regular smoker 16-25 ppm: heavy smoker

25 ppm: very heavy smoker

June 2026- July 2026

Sekundární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Pain Threshold Measurement
Časové okno: June 2026- July 2026
Pressure pain thresholds will be assessed using an algometer, which is a validated and reliable tool for measuring muscle and soft tissue sensitivity. The device consists of a 1 cm diameter rubber-tipped metal probe attached to a pressure gauge measuring force in kilograms and pounds. Pressure pain thresholds will be measured bilaterally at the upper, middle, and lower portions of the trapezius muscle
June 2026- July 2026
Beck Anxiety Inventory (BAI)
Časové okno: June 2026- July 2026
Anxiety levels will be assessed using the Beck Anxiety Inventory, a 21-item self-report questionnaire. Each item will be scored between 0 and 3, with total scores ranging from 0 to 63. Higher scores will indicate greater anxiety severity.
June 2026- July 2026
Beck Depression Inventory (BDI)
Časové okno: June 2026- July 2026
Depressive symptoms will be evaluated using the Beck Depression Inventory, a 21-item self-report scale assessing cognitive, emotional, motivational, and somatic symptoms of depression. Each item will be scored from 0 to 3, with total scores ranging from 0 to 63. Higher scores will indicate more severe depressive symptoms.
June 2026- July 2026
Semmes-Weinstein Monofilament Test
Časové okno: June 2026- July 2026
Sensory function will be assessed using the Semmes-Weinstein monofilament test, a widely used method for evaluating light touch and pressure perception. Monofilaments ranging from 0.086 gm to 448 gm will be applied in ascending order. Testing will be performed from distal to proximal regions, including the anterior and posterior surfaces of all fingers. The smallest detectable monofilament will be recorded. When the filament bends, the applied force will be considered constant, and participants' perception will be recorded accordingly
June 2026- July 2026
Subjective Health Complaints Inventory
Časové okno: June 2026-July 2026
Physical and psychological health complaints will be assessed using the Subjective Health Complaints Inventory, a self-report questionnaire developed in Norway and widely used internationally. The scale consists of 29 items rated from 0 (none) to 3 (severe), covering symptoms experienced during the last 30 days. Total scores will range from 0 to 87, with higher scores indicating more complaints. The scale includes five subdomains: musculoskeletal, pseudoneurological, gastrointestinal, allergy, and flu-like symptoms.
June 2026-July 2026
Fagerström Test for Nicotine Dependence
Časové okno: June 2026- July 2026
Nicotine dependence will be assessed using the Fagerström Test for Nicotine Dependence, a 6-item self-report questionnaire. Total scores will range from 0 to 10. Based on the score, participants will be classified as very low, low, moderate, high, or very high dependence.
June 2026- July 2026

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia (Odhadovaný)

1. června 2026

Primární dokončení (Odhadovaný)

1. července 2026

Dokončení studie (Odhadovaný)

1. září 2026

Termíny zápisu do studia

První předloženo

30. dubna 2026

První předloženo, které splnilo kritéria kontroly kvality

30. dubna 2026

První zveřejněno (Aktuální)

7. května 2026

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Aktuální)

7. května 2026

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

30. dubna 2026

Naposledy ověřeno

1. dubna 2026

Více informací

Termíny související s touto studií

Plán pro data jednotlivých účastníků (IPD)

Plánujete sdílet data jednotlivých účastníků (IPD)?

NE

Popis plánu IPD

Individual participant data will not be shared due to privacy and confidentiality considerations. All data will be analyzed and reported in an aggregated and anonymized form to ensure participant protection.

Informace o lécích a zařízeních, studijní dokumenty

Studuje lékový produkt regulovaný americkým FDA

Ne

Studuje produkt zařízení regulovaný americkým úřadem FDA

Ne

Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .

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