Neuroinflammation and Central Sensitization in Chronic and Widespread Pain

Chronic pain is maintained in part by central sensitization, a phenomenon of synaptic plasticity, and increased neuronal responsiveness in central pain pathways after painful insults. Accumulating evidence suggests that central sensitization is also driven by neuroinflammation in the peripheral and central nervous system. A characteristic feature of neuroinflammation is the activation of glial cells, such as microglia and astrocytes, in the spinal cord and brain, leading to the release of proinflammatory cytokines and chemokines. Recent studies suggest that central cytokines and chemokines are powerful neuromodulators and play a sufficient role in inducing hyperalgesia and allodynia after central nervous system administration. Sustained increase of cytokines and chemokines in the central nervous system also promotes chronic widespread pain that affects multiple body sites. Thus, neuroinflammation drives widespread chronic painvia central sensitization. We also discuss sex-dependent glial/immune signaling in chronic pain and new therapeutic approaches that control neuroinflammation for the resolution of chronic pain.
Source: Anesthesiology - Category: Anesthesiology Source Type: research

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Publication date: Available online 6 September 2019Source: Anaesthesia &Intensive Care MedicineAuthor(s): G. Baranidharan, Ibrahim MohamedAbstractNeuropathic pain is a well-recognized chronic pain condition. This can have a significant impact in patients' quality of life. Neuromodulation is defined by the International Neuromodulation Society as ‘the therapeutic alteration of activity in the central or peripheral nervous system either electrically or pharmacologically’. Electrical stimulation can be performed at the motor cortex, deep brain, spinal cord, dorsal root ganglion, peripheral nerve and peripheral...
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
CONCLUSIONS: This study suggests that inhibitory effects of bPNS on bladder pain could be suppressed in subjects receiving benzodiazepine therapy, suggesting that potential clinical testing of pudendal nerve stimulation for the treatment of painful bladder syndromes may be confounded by the use of benzodiazepines. Clinical assessment of other forms of neuromodulation should also be screened for impacts of benzodiazepines. PMID: 31490256 [PubMed - as supplied by publisher]
Source: Anesthesia and Analgesia - Category: Anesthesiology Authors: Tags: Anesth Analg Source Type: research
This article reviews the current thought processes on mechanisms and modulators from a basic science and epidemiological perspective.
Source: Current Opinion in Anaesthesiology - Category: Anesthesiology Tags: REGIONAL ANESTHESIA: Edited by Nabil Elkassabany Source Type: research
ConclusionThe laparoscopic reverse technique is an alternative approach to face retrocervical or rectovaginal nodules infiltrating the anterior rectal wall. In this technique, the separation of the nodule from the rectal wall is performed at the end of the surgery and not at the beginning as performed within the traditional technique. This enables the surgeon to perform a more precise dissection of the endometriotic nodule from the rectal wall because of the increased mobility of the bowel. The wider range of movements serves as an ergonomic advantage for the subsequent dissection of the lesion from the rectum, allowi...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
Conclusion At first glance, the future prospects for the hospital industry’s surgery business look promising. Profit margins for most procedure lines remain solid, and an aging population will fuel growth in a broad array of surgical interventions. However, demographic trends are not the sole driver of surgery volumes—technological and competitive forces will also exert a significant influence on the future course of surgery. On the technology front, advances in biomedical engineering will create new surgical interventions while rendering existing surgical procedures obsolete. Technologi...
Source: MDDI - Category: Medical Devices Authors: Tags: Digital Health Source Type: news
CONCLUSION The study indicates that assessment of altered central pain processing using current QST is unlikely to identify patients at risk of FBSS and is therefore unlikely to inform clinical decisions.
Source: European Journal of Anaesthesiology - Category: Anesthesiology Tags: Diagnostic and prediction Source Type: research
ConclusionsIH is an under-recognized cause of seizure following the spinal or cranial surgery, lumbar puncture, or spinal anesthesia. Proposed mechanisms include traction on cortical structures, increased cerebral blood flow, and cortical irritation secondary to subdural hygromas.
Source: Neurocritical Care - Category: Neurology Source Type: research
AbstractPurpose of ReviewThe erector spinae plane block (ESPB), first described in 2016, offers the promise of becoming a safe, less invasive, and technically less demanding alternative to conventional thoracic regional anesthetic techniques including thoracic epidurals and traditional paravertebral blocks. Clinical and cadaveric studies suggest that ESPB acts on the ventral rami of spinal nerves in the paravertebral space via penetration of the intertransverse connection tissues and moreover achieves visceral analgesia via the rami communicantes and sympathetic chain.Recent FindingsThe block has garnered considerable appe...
Source: Current Pain and Headache Reports - Category: Neurology Source Type: research
This study, when complete, will be a monumental step-up for evidence-driven medicine in the rapidly growing field of neuromodulation,” said Andrea Trescot, the CMO of Stimwave and former President of the American Society of Interventional Pain Physicians (ASIPP). “Every other industry is expected to show efficacy through sham and placebo-controlled studies; the Tsunami study is growing the evidence that single-stage, wireless neurostimulators can offer more options to more pain patients.” Medtech's Response The opioid crisis has had a profound impact in the U.S. resulti...
Source: MDDI - Category: Medical Devices Authors: Tags: Digital Health Source Type: news
ConclusionLaparoscopic reverse technique is an alternative approach to face retrocervical or rectovaginal nodules infiltrating the anterior rectal wall.  In this technique, the separation of the nodule from the rectal wall is performed at the end of the surgery and not at the beginning as performed within the traditional technique. This enables the surgeon to perform a more precise dissection of the endometriotic nodule from the rectal wall because of the increased mobility of the bowel. The wider range of movements serves as an ergonomic advantage for the subsequent dissection of the lesion from the rectum, allowing ...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
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