Updates in the Treatment of Post-Stroke Pain

AbstractPurpose of ReviewTo provide an overview of the current treatment strategies for common subtypes of post-stroke pain.Recent FindingsThere is growing research interest in non-pharmacological treatment approaches for chronic pain, including neurostimulation as well as lifestyle and psychosocial interventions. Newer pharmacotherapy research includes cannabinoids and NMDA-receptor antagonists as well as bee venom. Persistent post-stroke headache is an increasingly appreciated entity, though the role of novel chronic migraine treatments for post-stroke headache is not known.SummaryOverall, most treatment approaches to post-stroke pain lack high-quality evidence. Stroke survivors are in need of effective treatments based on methodologically sound evidence. To address the interplay of clinical and psychosocial factors that contribute to post-stroke pain, it may be reasonable to adopt a multimodal treatment strategy incorporating both lifestyle interventions and conventional therapies.
Source: Current Neurology and Neuroscience Reports - Category: Neuroscience Source Type: research

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Abstract Purinergic signaling was proposed in 1972, after it was demonstrated that adenosine 5'-triphosphate (ATP) was a transmitter in nonadrenergic, noncholinergic inhibitory nerves supplying the guinea-pig taenia coli. Later, ATP was identified as an excitatory cotransmitter in sympathetic and parasympathetic nerves, and it is now apparent that ATP acts as a cotransmitter in most, if not all, nerves in both the peripheral nervous system and central nervous system (CNS). ATP acts as a short-term signaling molecule in neurotransmission, neuromodulation, and neurosecretion. It also has potent, long-term (trophic) ...
Source: Mol Biol Cell - Category: Molecular Biology Authors: Tags: Methods Mol Biol Source Type: research
Abstract The pituitary adenylate cyclase-activating polypeptide (PACAP)-selective PAC1 receptor (PAC1R, ADCYAP1R1) is a member of the vasoactive intestinal peptide (VIP)/secretin/glucagon family of G protein-coupled receptors (GPCRs). PAC1R has been shown to play crucial roles in the central and peripheral nervous systems. The activation of PAC1R initiates diverse downstream signal transduction pathways, including adenylyl cyclase, phospholipase C, MEK/ERK and Akt pathways that regulate a number of physiological systems to maintain functional homeostasis. Accordingly, at times of tissue injury or insult, PACAP/PAC...
Source: Current Topics in Medicinal Chemistry - Category: Chemistry Authors: Tags: Curr Top Med Chem Source Type: research
Publication date: Available online 24 June 2019Source: The LancetAuthor(s): Maigeng Zhou, Haidong Wang, Xinying Zeng, Peng Yin, Jun Zhu, Wanqing Chen, Xiaohong Li, Lijun Wang, Limin Wang, Yunning Liu, Jiangmei Liu, Mei Zhang, Jinlei Qi, Shicheng Yu, Ashkan Afshin, Emmanuela Gakidou, Scott Glenn, Varsha Sarah Krish, Molly Katherine Miller-Petrie, W Cliff Mountjoy-VenningSummaryBackgroundPublic health is a priority for the Chinese Government. Evidence-based decision making for health at the province level in China, which is home to a fifth of the global population, is of paramount importance. This analysis uses data from the...
Source: The Lancet - Category: General Medicine Source Type: research
Abstract Background: Chronic migraine with medication overuse headache (CM-MOH) is the most common type of chronic migraine, and it increases risk of stroke and white matter lesions. These pathologic changes could induce cognitive decline. However, the alteration of cognitive function in CM-MOH patients is not established. Therefore, we took this study to reveal the cognitive performances in CM-MOH. Methods: This cross-sectional study was conducted between December 2015 and January 2017. Patients were divided into CM-MOH, CMwoMOH (chronic migraine without medication overuse), and MO (migraine without aura) gr...
Source: Pain Research and Management - Category: Anesthesiology Authors: Tags: Pain Res Manag Source Type: research
DiscussionAs detailed above, the “elements” in both a classical and a contemporary sense have effects on our mental health and are potentially modifiable aspects that can be harnessed as therapeutic interventions. The most robust interventional evidence currently available shows tentative support for several use of the elements via horticultural and nature-exposure therapy, green exercise/physical activity, sauna and heat therapy, balneotherapy, and breathing exercises. It should be noted that, in many cases, these interventions were not studied in definitive diagnosed psychiatric disorders and thus it is prema...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
Conclusion The aim of this paper was to examine whether military tDCS use can be efficacious and ethical in military settings. Our assessment is that tDCS offers a number of cognitive, motor, and perceptual enhancement opportunities which could provide value in military situations like training and operations. There is potential scope for use in a number of key areas that directly affect practical battlefield advantage and survivability, such as deceptive capabilities, risk-taking, threat detection, perception, and physiological improvement. Additionally, tDCS has the potential to improve command and control decision maki...
Source: Frontiers in Human Neuroscience - Category: Neuroscience Source Type: research
Conclusion and Perspectives Since their cloning 20 years ago, the physiological importance of TREK-1 channels has continued to grow (Figure 3). Today, TREK-1 channels have been shown to be important and their presence is essential in a number of physiopathological processes. Their involvement in these different processes demonstrate the necessity to design pharmacological modulators, activators or inhibitors, of these channels to correct any TREK-1-related dysfunctions. Despites a number of studies and many molecule screenings, only few putative new drugs were identified. The activators belonging to the ML and BL series ...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Conclusions: Pre-injury psychiatric and pre-injury headache/migraine symptoms are risk factors for worse functional and post-concussive outcomes at 3- and 6-months post-mTBI. mTBI patients presenting to acute care should be evaluated for psychiatric and headache/migraine history, with lower thresholds for providing TBI education/resources, surveillance, and follow-up/referrals. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT01565551. Introduction Traumatic brain injury (TBI) remains a significant cause of morbidity and mortality worldwide. In 2013 ~2.8 million TBI cases were recorded annually i...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Ryan R. Kelly1,2†, Lindsay T. McDonald1,2†, Nathaniel R. Jensen1,2, Sara J. Sidles1,2 and Amanda C. LaRue1,2* 1Research Services, Ralph H. Johnson VA Medical Center, Charleston, SC, United States 2Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, United States The significant biochemical and physiological effects of psychological stress are beginning to be recognized as exacerbating common diseases, including osteoporosis. This review discusses the current evidence for psychological stress-associated mental health disorders as risk factors for os...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
Medication side-effects can seem unbearable at times: dry mouth, nausea, dizziness, constipation. Certain prescriptions can also increase our risks for developing chronic conditions like thyroid disease and diabetes. Three years ago, I decided that the pills’ side-effects weren’t worth the relief they brought, so I slowly weaned off all my medication. I then plummeted into a severe depression that ended up taking a far greater toll on my health than the nuisance of my drugs. You may be justifiably concerned about how your mood stabilizer and antidepressant are altering your biochemistry, but also consider the g...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Depression General Medications Antidepressant Cognitive Decline Diabetes Mood Stabilizer Source Type: blogs
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