The onset of treatment with the antidepressant desipramine is critical for the emotional consequences of neuropathic pain

In this study, we evaluated the efficacy of the tricyclic antidepressant desipramine (DMI, a noradrenaline reuptake inhibitor) in preventing or relieving the noradrenergic impairment induced by neuropathic pain. The treatment started before or after the onset of the anxiodepressive phenotype (“early or late treatment”) in adult rats subjected to chronic sciatic constriction. Electrophysiological and western blotting assays showed LC dysfunction (increased bursting activity, alpha2-adrenoceptor sensitivity, tyrosine hydroxylase, and noradrenaline transporter expression) in chronic constriction injury at long term. These noradrenergic changes were concomitant to the progression of anxiety and despair-like features. Desipramine induced efficient analgesia, and it counteracted the despair-like behavior in chronic constriction injury-DMI animals, reducing the burst rate and tyrosine hydroxylase expression. Surprisingly, “early” DMI treatment did not modify pain-induced anxiety, and it dampened pain aversion, although these phenomena were abolished when the treatment commenced after noradrenaline impairment had been established. Hence, DMI seems to produce different outcomes depending when the treatment commences, indicating that the balance between the benefits and adverse effects of DMI therapy may shift as neuropathy progresses.
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research

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Ruona E Abstract Purpose: To study the use of Vibroacoustic treatment and an added self-care intervention for improving the functioning and ability to work of patients with chronic pain and potential comorbid depressive and anxious symptoms.Materials and methods: A mixed methods study with four single cases. Participants received bi-weekly Vibroacoustic practitioner-led treatment sessions for five weeks, followed by a one-month washout period without treatments. Then, participants conducted four self-care vibroacoustic sessions per week for five weeks, followed by another month-long washout period. Participants ke...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
Conclusions: Six commonly used anxiety scales demonstrate similar responsiveness, and estimated MIDs can be used to gauge anxiety change in clinical research and practice.
Source: Medical Care - Category: Health Management Tags: Original Articles Source Type: research
Conclusions: Turkish version of Back Beliefs Questionnaire is a valid and reliable questionnaire that can be used to evaluate beliefs about pain in patients with chronic low back pain. IMPLICATIONS FOR REHABILITATION Negative attitudes and beliefs about low back pain cause patients to avoid engaging in physical activities and consequently lead to disability. The Back Belief Questionnaire can be used to evaluate these negative attitudes and beliefs to determine whether the patient will suffer from a disability in the future. Informations obtained with the Back Belief Questionnaire can be used to train the susceptible patien...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
Conclusion: The European Portuguese version of the FDI has very good internal consistency, good test-retest reliability, and construct validity when used in a sample of community adolescents with chronic pain. Implications for rehabilitation One of the most widely instruments used to assess functional disability is the Functional Disability Inventory (FDI), which in its original version has good psychometric properties and is recommended by the Pediatric Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials; However, the FDI has not been translated yet into European Portuguese language and its psychome...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
Once you begin to dip your toes into psychological therapies, it doesn’t take long before you begin to see TLAs all over the place. So today I’m going to post on two things: some of the TLAs, and why or how we might consider using these approaches in pain rehabilitation. The first one is CBT, or cognitive behavioural therapy. CBT grew out of two movements: behaviour therapy (Skinner and the pigeons, rats and all that behaviour modification stuff), and cognitive therapy (Ellis and Beck and the “cognitive triad” – more on this later). When the two approaches to therapy are combined, we have c...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: ACT - Acceptance & Commitment Therapy Clinical reasoning Cognitive behavioral therapy Coping strategies Interdisciplinary teams Occupational therapy Physiotherapy Professional topics Psychology Research Science in practice Source Type: blogs
CONCLUSIONS: The authors' findings provide insight regarding the mechanisms of spinal cord stimulation failure that resulted in total removal of the implanted system. The relationship between spinal cord stimulation failure and certain psychiatric disorders, such as PTSD, depression, and anxiety, is highlighted. Ultimately, this work may shed light on potential avenues to reduce morbidity and improve patient outcomes. PMID: 31585414 [PubMed - as supplied by publisher]
Source: Journal of Neurosurgery.Spine - Category: Neurosurgery Authors: Tags: J Neurosurg Spine Source Type: research
Tobacco smoking is associated with adverse health effects, and its relationship to pain is complex. The longitudinal effect of smoking on patients attending a tertiary pain management center is not well established. Using the Collaborative Health Outcomes Information Registry of patients attending the Stanford Pain Management Center from 2013 to 2017, we conducted a propensity-weighted analysis to determine independent effects of smoking on patients with chronic pain. We adjusted for covariates including age, sex, body mass index, depression and anxiety history, ethnicity, alcohol use, marital status, disability, and educa...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
CONCLUSIONS: People with migraine who discontinue acute prescription medication have a high level of unmet treatment need. The majority cannot work or function normally with headaches, with 646/1719 (37.6%) of discontinued users reporting 5 or more headache days per month. PMID: 31544244 [PubMed - as supplied by publisher]
Source: Headache - Category: Neurology Authors: Tags: Headache Source Type: research
Pediatric chronic pain is associated with risk of impact across social, emotional, and behavioral domains at child and family levels.30,52,67 Extant literature highlights psychosocial factors that can foster resilience and others that underlie vulnerability for poor pain coping and disability. Resilience factors, such as pain acceptance and psychosocial adjustment, have been found to promote the use of adaptive pain coping strategies within this population.14 Greater child and parent pain catastrophizing, clinically significant internalizing symptoms (e.g., anxiety, depression), and maladaptive parent responses (e.g., over...
Source: The Journal of Pain - Category: Materials Science Authors: Tags: Original Reports Source Type: research
ConclusionsStrongly believing that thinking about pain helps you solve problems or cope with pain (positive metacognition), or that it is harmful and uncontrollable (negative metacognition), can increase the amount you worry or ruminate as pain increases. This is associated with increased pain catastrophizing. Identifying and modifying these unhelpful pain metacognitions may improve treatments for pain catastrophizing and thereby chronic pain generally.
Source: European Journal of Pain - Category: Anesthesiology Authors: Tags: ORIGINAL ARTICLE Source Type: research
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