Genetic predictors of recovery in low back and lumbar radicular pain
In this study, we assessed the correlation between 8 genetic polymorphisms (VDR, COL11, MMP1, MMP9, IL-1α, IL-1RN, OPRM1, COMT) and pain recovery in patients with low back pain (LBP) and lumbar radicular pain (LRP). In total, 296 patients with LBP or LRP were followed for 5 years. The patients underwent standardized clinical examination and completed pain and function questionnaires. Univariate linear regression associations with P values G in men was associated with better long-term pain recovery. In men, the OPRM1 rs1799971 explained 4.7% of the variance of pain intensity. We conclude that the MMP9 rs17576 and OPRM...
Source: Pain - July 26, 2017 Category: Anesthesiology Tags: Research Paper Source Type: research

Stratifying patients with peripheral neuropathic pain based on sensory profiles: algorithm and sample size recommendations
Abstract: In a recent cluster analysis, it has been shown that patients with peripheral neuropathic pain can be grouped into 3 sensory phenotypes based on quantitative sensory testing profiles, which are mainly characterized by either sensory loss, intact sensory function and mild thermal hyperalgesia and/or allodynia, or loss of thermal detection and mild mechanical hyperalgesia and/or allodynia. Here, we present an algorithm for allocation of individual patients to these subgroups. The algorithm is nondeterministic—ie, a patient can be sorted to more than one phenotype—and can separate patients with neuropath...
Source: Pain - July 26, 2017 Category: Anesthesiology Tags: Research Paper Source Type: research

The effect of a lay-led, group-based self-management program for patients with chronic pain: a randomized controlled trial of the Danish version of the Chronic Pain Self-Management Programme
Abstract: The Stanford Chronic Pain Self-Management Programme (CPSMP) consists of 6 2½-hour weekly workshops focusing on how to manage pain in daily life. The workshops are facilitated by 2 workshop leaders of whom at least 1 must suffer from a long-term pain condition. The program is highly structured and manualized. Only few controlled trials testing the effect of CPSMP exist. Enrolled in the study were 424 adults from 19 Danish municipalities, (72% women; age: 25-93 years) with pain of any etiology and great variation in pain history (0-50 yrs). Of these, 216 were randomized to a lay-led version of the CPSMP. The...
Source: Pain - July 26, 2017 Category: Anesthesiology Tags: Research Paper Source Type: research

A prospective, multisite, international validation of the Complex Regional Pain Syndrome Severity Score
Abstract: Clinical diagnosis of complex regional pain syndrome (CRPS) is a dichotomous (yes/no) categorization, a format necessary for clinical decision making. Such dichotomous diagnostic categories do not convey an individual's subtle gradations in the severity of the condition over time and have poor statistical power when used as an outcome measure in research. This prospective, international, multicenter study slightly modified and further evaluated the validity of the CRPS Severity Score (CSS), a continuous index of CRPS severity. Using a prospective design, medical evaluations were conducted in 156 patients with CRP...
Source: Pain - July 26, 2017 Category: Anesthesiology Tags: Research Paper Source Type: research

Activity rhythms and clinical correlates in fibromyalgia
Abstract: The primary aim of this study was to evaluate activity rhythms in fibromyalgia syndrome (FMS) and their association with FMS-related symptoms. We hypothesized that stronger and more consistent activity rhythms would be associated with reduced symptom severity and presentation in FMS. Two hundred ninety-two patients with FMS (mean age = 45.1 ± 11.1; 272 women) provided a 7-day actigraphy recording and responses to questionnaires addressing degree of pain, fatigue, mood, and physical impairment. Using a simple cosine model, we extracted Amplitude (activity range), Phi (time at maximum), Mesor (mean activity)...
Source: Pain - July 26, 2017 Category: Anesthesiology Tags: Research Paper Source Type: research

Altered neural responses to heat pain in drug-naive patients with Parkinson disease
This study indicates altered neural processing during the anticipation and receipt of experimental pain in drug-naive PD patients. It provides first evidence for a progressive decline in descending pain modulation in PD, which might be related to the high prevalence of pain in later stages of PD. (Source: Pain)
Source: Pain - July 26, 2017 Category: Anesthesiology Tags: Research Paper Source Type: research

Patient action: as means and end for chronic pain care
No abstract available (Source: Pain)
Source: Pain - July 26, 2017 Category: Anesthesiology Tags: Topical Review Source Type: research

Patient action as means and end of chronic pain care: risks and routes to meaningful action
No abstract available (Source: Pain)
Source: Pain - July 26, 2017 Category: Anesthesiology Tags: Commentary Source Type: research

In memoriam: Ulf Lindblom 1927 to 2017
No abstract available (Source: Pain)
Source: Pain - July 26, 2017 Category: Anesthesiology Tags: Obituary Source Type: research

Identifying patients with chronic widespread pain in primary care: Erratum.
No abstract available (Source: Pain)
Source: Pain - June 22, 2017 Category: Anesthesiology Tags: Erratum Source Type: research

Diagnostic accuracy of laser evoked potentials in diabetic neuropathy: Erratum.
No abstract available (Source: Pain)
Source: Pain - June 22, 2017 Category: Anesthesiology Tags: Erratum Source Type: research

Corrigendum to: Effectiveness of psychological interventions for chronic pain on health care use and work absence: systematic review and meta-analysis, by Pike et al. PAIN 2016;157: 777–785
No abstract available (Source: Pain)
Source: Pain - June 22, 2017 Category: Anesthesiology Tags: Correspondence Source Type: research

Assessment of physical function: considerations in chronic pain populations
No abstract available (Source: Pain)
Source: Pain - June 22, 2017 Category: Anesthesiology Tags: Correspondence Source Type: research

Reply
No abstract available (Source: Pain)
Source: Pain - June 22, 2017 Category: Anesthesiology Tags: Correspondence Source Type: research

Support for extended classification of pain states
No abstract available (Source: Pain)
Source: Pain - June 22, 2017 Category: Anesthesiology Tags: Correspondence Source Type: research

Sustained improvements in pain, mood, function and opioid use post interdisciplinary pain rehabilitation in patients weaned from high and low dose chronic opioid therapy
This study examined outcomes of patients weaned from opioids in an ICPRP from 2007 to 2012. Participants included 413 patients on high dose chronic opioid therapy (COT;>100 mg), 528 on low dose COT, and 516 not on opioids (NO). Outcomes were assessed at discharge, 6, and 12 months posttreatment through self-report and chart review. One thousand one hundred ninety-four participants completed treatment (81.95%); 86.74% of those on opioids were weaned. High doses were less likely to complete (78.45%) than NO participants (85.27%; P (Source: Pain)
Source: Pain - June 22, 2017 Category: Anesthesiology Tags: Clinical Note Source Type: research

Chronic pain patients' perspectives of medical cannabis
Abstract: Medical cannabis (MC) is used for a variety of conditions including chronic pain. The goal of this report was to provide an in-depth qualitative exploration of patient perspectives on the strengths and limitations of MC. Members of MC dispensaries (N = 984) in New England including two-thirds with a history of chronic pain completed an online survey. In response to “How effective is medical cannabis in treating your symptoms or conditions?,” with options of 0% “no relief” to 100% “complete relief,” the average was 74.6% ± 0.6. The average amount spent on MC each year was...
Source: Pain - June 22, 2017 Category: Anesthesiology Tags: Research Paper Source Type: research

Neuropathic pain after chronic nerve constriction may not correlate with chloride dysregulation in mouse trigeminal nucleus caudalis neurons
Abstract: Changes in chloride reversal potential in rat spinal cord neurons have previously been associated with persistent pain in nerve injury and inflammation models. These changes correlate with a decrease in the expression of the potassium chloride transporter, KCC2, and with increases in neuronal excitability. Here, we test the hypothesis that similar changes occur in mice with neuropathic pain induced by chronic constriction injury of the trigeminal infraorbital nerve (CCI-ION). This model allows us to distinguish an acute pain phase (3-5 days after injury) from a persistent pain phase (12-14 days after CCI-ION). Ch...
Source: Pain - June 22, 2017 Category: Anesthesiology Tags: Research Paper Source Type: research

Rab7—a novel redox target that modulates inflammatory pain processing
Abstract: Chronic pain is accompanied by production of reactive oxygen species (ROS) in various cells that are important for nociceptive processing. Recent data indicate that ROS can trigger specific redox-dependent signaling processes, but the molecular targets of ROS signaling in the nociceptive system remain largely elusive. Here, we performed a proteome screen for pain-dependent redox regulation using an OxICAT approach, thereby identifying the small GTPase Rab7 as a redox-modified target during inflammatory pain in mice. Prevention of Rab7 oxidation by replacement of the redox-sensing thiols modulates its GTPase activ...
Source: Pain - June 22, 2017 Category: Anesthesiology Tags: Research Paper Source Type: research

Musculoskeletal pain profile of obese individuals attending a multidisciplinary weight management service
Abstract: Obesity is associated with numerous chronic diseases, including musculoskeletal (MSK) pain, which affects on quality of life (QoL). There is, however, limited research providing a comprehensive MSK pain profile of an obese cohort. This retrospective study used a patient database at a national weight management service. After ethical approval, anonymized patient data were statistically analyzed to develop a pain profile, investigate relationships between pain, sleep, and function, and explore variables associated with having low back pain (LBP) and knee pain. Overall, 915 individuals attended the weight management...
Source: Pain - June 22, 2017 Category: Anesthesiology Tags: Research Paper Source Type: research

A role for neurokinin-1 receptor neurons in the rostral ventromedial medulla in the development of chronic postthoracotomy pain
Abstract: Thoracotomy results in chronic postoperative pain (CPTP) in half of the cases. Earlier findings in rat models of persistent post-surgical pain suggest that spinal pathways are critical for pain onset but not its maintenance. Descending systems from the brain stem modulate nociceptive transmission in the spinal cord and contribute to persistent pain, but their role in chronic postoperative pain has not been studied. Here, we ablated pronociceptive neurokinin-1 receptor (NK-1R)-expressing neurons in the rat rostral ventromedial medulla (RVM) to identify their role in CPTP. Cells were ablated by microinjection of th...
Source: Pain - June 22, 2017 Category: Anesthesiology Tags: Research Paper Source Type: research

Development and validation of the self-reported PROMIS pediatric pain behavior item bank and short form scale
In this study, youth with chronic pain associated with juvenile fibromyalgia, juvenile idiopathic arthritis, or sickle cell disease (ages 8-18 years) from 3 pediatric centers completed all 47 candidate items for development of the pain behavior item bank along with established measures of pain interference, depressive symptoms, fatigue, average pain intensity, and pain catastrophizing. Caregivers reported on sociodemographic information and health history. Psychometric properties of the pain behavior items were examined using an item response theory framework with confirmatory factor analysis and examination of differentia...
Source: Pain - June 22, 2017 Category: Anesthesiology Tags: Research Paper Source Type: research

Peripheral inflammatory pain sensitisation is independent of mast cell activation in male mice
Abstract: The immune and sensory systems are known for their close proximity and interaction. Indeed, in a variety of pain states, a myriad of different immune cells are activated and recruited, playing a key role in neuronal sensitisation. During inflammatory pain it is thought that mast cells (MC) are one of the immune cell types involved in this process, but so far the evidence outlining their direct effect on neuronal cells remains unclear. To clarify whether MC are involved in inflammatory pain states, we used a transgenic mouse line (Mctp5Cre-iDTR) in which MC could be depleted in an inducible manner by administratio...
Source: Pain - June 22, 2017 Category: Anesthesiology Tags: Research Paper Source Type: research

Targeting brain-derived neurotrophic factor in the medial thalamus for the treatment of central poststroke pain in a rodent model
Abstract: Approximately 7% to 10% of patients develop a chronic pain syndrome after stroke. This chronic pain condition is called central poststroke pain (CPSP). Recent studies have observed an abnormal increase in the secretion of brain-derived neurotrophic factor (BDNF) in spinal cord tissue after spinal cord injury. An animal model of CPSP was established by an intrathalamus injection of collagenase. Mechanical and thermal allodynia was induced after lesions of the thalamic ventral basal complex in rats. Four weeks after the injection, the number of neurons decreased, the number of astrocytes, microglia, and P2X4 recept...
Source: Pain - June 22, 2017 Category: Anesthesiology Tags: Research Paper Source Type: research

The pain course: a randomised controlled trial comparing a remote-delivered chronic pain management program when provided in online and workbook formats
This study compared a remote-delivered pain management program, the Pain Course, when delivered in online and workbook formats. Participants (n = 178) were randomised into 2 groups: (1) an Internet Group (n = 84) who were provided with secure accounts to the program in an online format; or (2) a Workbook Group (n = 94) who were mailed workbook versions of the program. The content of both programs was identical and comprised 5 core lessons, which participants were encouraged to work through over an 8-week period, according to a prescribed timetable. All participants were provided with weekly contact with a clinical psycholo...
Source: Pain - June 22, 2017 Category: Anesthesiology Tags: Research Paper Source Type: research

C-reactive protein and cold-pressor tolerance in the general population: the Tromsø Study
Abstract: The aim of this study was to examine whether increases in severity of subclinical inflammation, measured by high-sensitivity C-reactive protein (hs-CRP), increased experimental pain sensitivity, measured by cold-pressor tolerance, and to test whether this relationship is independent of chronic pain. A large population-based study from 2007 to 2008, the sixth Tromsø Study, provided data from 12,981 participants. For the present analysis, complete data for 10,274 participants (age: median 58 years) were available. The main outcome measure was cold-pressor tolerance, tested by placing the dominant hand in cir...
Source: Pain - June 22, 2017 Category: Anesthesiology Tags: Research Paper Source Type: research

Temporal summation and motor function modulation during repeated jaw movements in patients with temporomandibular disorder pain and healthy controls
This study evaluated changes in pain and movement patterns during repeated jaw movements in patients with painful temporomandibular joints (TMJ) compared with healthy controls. Twenty patients with TMD with TMJ pain, and an anterior disk displacement without reduction and 20 age- and gender-matched healthy volunteers were included. Participants performed 20 trials (4 × 5 sessions) of standardized and repeated mandibular movements, and scored the movement-associated pain intensity on 0 to 10 numeric rating scale in addition to measurements of jaw movements. Patients with TMJ pain reported higher baseline pain compared...
Source: Pain - June 22, 2017 Category: Anesthesiology Tags: Research Paper Source Type: research

Midazolam as an active placebo in 3 fentanyl-validated nociceptive pain models
Abstract: The use of inactive placebos in early translational trials of potentially analgesic compounds is discouraged because of the side-effect profiles of centrally acting analgesics. Therefore, benzodiazepines are used, although their use has not been validated in this context. Whether benzodiazepines confound the results of acute pain tests is unknown. Midazolam (0.06 mg/kg) as an active placebo was investigated in 3 nociceptive models that included contact heat, electrical pain, and pressure pain thresholds in 24 healthy volunteers. Fentanyl (1 μg/kg) served as an internal validator in this randomized, placebo (sa...
Source: Pain - June 22, 2017 Category: Anesthesiology Tags: Research Paper Source Type: research

Biomarker of extracellular matrix remodelling C1M and proinflammatory cytokine interleukin 6 are related to synovitis and pain in end-stage knee osteoarthritis patients
Abstract: Little is known about local and systemic biomarkers in relation to synovitis and pain in end-stage osteoarthritis (OA) patients. We investigated the associations between the novel extracellular matrix biomarker, C1M, and local and systemic interleukin 6 (IL-6) with synovitis and pain. Serum C1M, plasma, and synovial fluid IL-6 (p-IL-6, sf-IL-6) were measured in 104 end-stage knee OA patients. Contrast-enhanced magnetic resonance imaging was used to semiquantitatively assess an 11-point synovitis score; pain was assessed by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Neuropat...
Source: Pain - June 22, 2017 Category: Anesthesiology Tags: Research Paper Source Type: research

Neuropathic pain-induced enhancement of spontaneous and pain-evoked neuronal activity in the periaqueductal gray that is attenuated by gabapentin
Abstract: Neuropathic pain is a debilitating pathological condition that is poorly understood. Recent evidence suggests that abnormal central processing occurs during the development of neuropathic pain induced by the cancer chemotherapeutic agent, paclitaxel. Yet, it is unclear what role neurons in supraspinal pain network sites, such as the periaqueductal gray, play in altered behavioral sensitivity seen during chronic pain conditions. To elucidate these mechanisms, we studied the spontaneous and thermally evoked firing patterns of ventrolateral periaqueductal gray (vlPAG) neurons in awake-behaving rats treated with pacl...
Source: Pain - June 22, 2017 Category: Anesthesiology Tags: Research Paper Source Type: research

Parkinson disease and musculoskeletal pain: an 8-year population-based cohort study
This study showed that the PD may significantly increase the risk of developing MSP. The risk of developing MSP seems to be greatest for middle-aged male patients with PD. Clinicians should be more alert for MSP in patients with PD, and early intervention should be considered. (Source: Pain)
Source: Pain - June 22, 2017 Category: Anesthesiology Tags: Research Paper Source Type: research

Predictors and social consequences of daily pain expectancy among adults with chronic pain
Abstract: Previous research suggests that for people living with chronic pain, pain expectancy can undermine access to adaptive resources and functioning. We tested and replicated the unique effect of pain expectancy on subsequent pain through 2 daily diary studies. We also extended previous findings by examining cognitive and affective antecedents of pain expectancy and the consequences of pain expectancy for daily social enjoyment and stress. In study 1, 231 individuals with rheumatoid arthritis completed 30 end-of-day diaries. Results of multilevel structural equation model showed that controlling for today's pain, pain...
Source: Pain - June 22, 2017 Category: Anesthesiology Tags: Research Paper Source Type: research

The long-term reliability of static and dynamic quantitative sensory testing in healthy individuals
Abstract: Quantitative sensory tests (QSTs) have been increasingly used to investigate alterations in somatosensory function in a wide range of painful conditions. The interpretation of these findings is based on the assumption that the measures are stable and reproducible. To date, reliability of QST has been investigated for short test-retest intervals. The aim of this study was to investigate the long-term reliability of a multimodal QST assessment in healthy people, with testing conducted on 3 occasions over 4 months. Forty-two healthy people were enrolled in the study. Static and dynamic tests were performed, includin...
Source: Pain - June 22, 2017 Category: Anesthesiology Tags: Research Paper Source Type: research

Hyperalgesic priming (type II) induced by repeated opioid exposure: maintenance mechanisms
In this study, we evaluated the mechanisms involved in the maintenance of type II priming. Opioid receptor antagonist, naloxone, induced hyperalgesia in DAMGO-primed paws. When repeatedly injected, naloxone-induced hyperalgesia, and hyperalgesic priming, supporting the suggestion that maintenance of priming involves changes in MOR signaling. However, the knockdown of MOR with oligodeoxynucleotide antisense did not reverse priming. Mitogen-activated protein kinase and focal adhesion kinase, which are involved in the Src signaling pathway, previously implicated in type II priming, also inhibited the expression, but not maint...
Source: Pain - June 22, 2017 Category: Anesthesiology Tags: Research Paper Source Type: research

Gene-to-gene interactions regulate endogenous pain modulation in fibromyalgia patients and healthy controls—antagonistic effects between opioid and serotonin-related genes
In this study, we assessed the effects of 3 functional genetic polymorphisms on EIH in 130 patients with FM and 132 healthy controls. Subjects were genotyped regarding the mu-opioid receptor (OPRM1) gene (rs1799971), the serotonin transporter (5-HTT) gene (5-HTTLPR/rs25531), and the serotonin-1a receptor (5-HT1a) gene (rs6296). The patients with FM had increased pain sensitivity and reduced EIH compared with healthy controls. None of the polymorphisms had an effect on EIH on their own. We found significant gene-to-gene interactions between OPRM1 x 5-HTT and OPRM1 x 5-HT1a regarding activation of EIH, with no statistically ...
Source: Pain - June 22, 2017 Category: Anesthesiology Tags: Research Paper Source Type: research

Using magnetic resonance imaging to visualize the brain in chronic pain
No abstract available (Source: Pain)
Source: Pain - June 22, 2017 Category: Anesthesiology Tags: PAIN Pictured Source Type: research

Pain and cancer survival: a cognitive-affective model of symptom appraisal and the uncertain threat of disease recurrence
No abstract available (Source: Pain)
Source: Pain - June 22, 2017 Category: Anesthesiology Tags: Topical Review Source Type: research

Changing pain expectations: the role of social context and communication
No abstract available (Source: Pain)
Source: Pain - June 22, 2017 Category: Anesthesiology Tags: Commentary Source Type: research

In memoriam Donald D. Price: 1942 to 2016
No abstract available (Source: Pain)
Source: Pain - June 22, 2017 Category: Anesthesiology Tags: Obituary Source Type: research

Neuropathic pain phenotyping by international consensus (NeuroPPIC) for genetic studies: a NeuPSIG systematic review, Delphi survey, and expert panel recommendations: Erratum.
No abstract available (Source: Pain)
Source: Pain - May 24, 2017 Category: Anesthesiology Tags: Erratum Source Type: research

Growth hormone regulates the sensitization of developing peripheral nociceptors during cutaneous inflammation: Erratum.
No abstract available (Source: Pain)
Source: Pain - May 24, 2017 Category: Anesthesiology Tags: Erratum Source Type: research

Reply
No abstract available (Source: Pain)
Source: Pain - May 24, 2017 Category: Anesthesiology Tags: Correspondence Source Type: research

The effect of nothing? Time to abandon the concept of placebo
No abstract available (Source: Pain)
Source: Pain - May 24, 2017 Category: Anesthesiology Tags: Correspondence Source Type: research

Reply
No abstract available (Source: Pain)
Source: Pain - May 24, 2017 Category: Anesthesiology Tags: Correspondence Source Type: research

A conceptual framework for “updating the definition of pain”
No abstract available (Source: Pain)
Source: Pain - May 24, 2017 Category: Anesthesiology Tags: Correspondence Source Type: research

Reply
No abstract available (Source: Pain)
Source: Pain - May 24, 2017 Category: Anesthesiology Tags: Correspondence Source Type: research

Widespread effects of clinically unilateral focal nerve injuries
No abstract available (Source: Pain)
Source: Pain - May 24, 2017 Category: Anesthesiology Tags: Correspondence Source Type: research

Evaluating the impact of trigeminal neuralgia
Patients with idiopathic trigeminal neuralgia (TN) were categorised into 3 subtypes (n = 225). Group 1 (n = 155, 68.9%) had TN without concomitant pain, group 2 (n = 32, 14.2%) had TN with intermittent concomitant pain, and group 3 (n = 39, 16.9%) had TN with autonomic symptoms. We tested 2 hypotheses: (1) that different pain profiles would be associated with the different groups; (2) that the severe pain associated with TN would impact negatively on activities of daily living and thereby result in disability as defined by the World Health Organisation. A different pain profile was found across the groups. We obtained uneq...
Source: Pain - May 24, 2017 Category: Anesthesiology Tags: Clinical Note Source Type: research

Nerve injury–induced epigenetic silencing of opioid receptors controlled by DNMT3a in primary afferent neurons
Abstract: Opioids are the gold standard for pharmacological treatment of neuropathic pain, but their analgesic effects are unsatisfactory in part due to nerve injury–induced downregulation of opioid receptors in dorsal root ganglia (DRG) neurons. How nerve injury drives such downregulation remains elusive. DNA methyltransferase (DNMT)-triggered DNA methylation represses gene expression. We show here that blocking the nerve injury–induced increase in DRG DNMT3a (a de novo DNMT) rescued the expression of Oprm1 and Oprk1 mRNAs and their respective encoding mu-opioid receptor (MOR) and kappa-opioid receptor (KOR) p...
Source: Pain - May 24, 2017 Category: Anesthesiology Tags: Research Paper Source Type: research

Use of analgesics in young adults as a predictor of health care utilization and pain prevalence: Israel defense forces experience
In this study, we evaluated analgesics consumption patterns of regular Israel Defense Force soldiers. We have performed a historical cohort study of 665,137 young adults during active duty in 2002 to 2012. Analgesics were prescribed to 518,242 (78%) soldiers, mostly for musculoskeletal pain (69.3%), abdominal pain (12.7%), and headache (12.1%). Acute (1-14 days), subacute (15-90), and chronic (>90 days) analgesic use episodes were experienced by 396,987 (59.7%), 74,591 (11.2%), and 46,664 (7%) of the population. In a multivariate model, predictors for chronic analgesics use were as follows: low intelligence, service in ...
Source: Pain - May 24, 2017 Category: Anesthesiology Tags: Research Paper Source Type: research