Exploring the neural correlates of touch and pain in women with provoked vestibulodynia
Group differences in touch and pain thresholds—and their neural correlates—were studied in women with provoked vestibulodynia (PVD; N = 15), a common subtype of vulvodynia (chronic vulvar pain), and pain-free control women (N = 15). Results from quantitative sensory testing and self-report measures indicated that, as compared with control participants, women with PVD exhibited allodynia (ie, pain in response to a normally nonpainful stimulus) and hyperalgesia (ie, an increased response to a normally painful stimulus) at vulvar and nonvulvar sites. In addition, brain imaging analyses demonstrated reduced differe...
Source: Pain - April 23, 2020 Category: Anesthesiology Tags: Research Paper Source Type: research

Trigeminal neuralgia associated with a solitary pontine lesion: clinical and neuroimaging definition of a new syndrome
In conclusion, SPL-TN patients have identical clinical features to TN but have a single pontine lesion not in keeping with MS and are refractory to surgical management. (Source: Pain)
Source: Pain - April 23, 2020 Category: Anesthesiology Tags: Research Paper Source Type: research

Hypnosis for pain in pediatric oncology: relevant and effective or an intervention of the past?
No abstract available (Source: Pain)
Source: Pain - April 23, 2020 Category: Anesthesiology Tags: Topical Review Source Type: research

The circadian clock at the intercept of sleep and pain
No abstract available (Source: Pain)
Source: Pain - April 23, 2020 Category: Anesthesiology Tags: Topical Review Source Type: research

Managing patients with chronic pain during the COVID-19 outbreak: considerations for the rapid introduction of remotely supported (eHealth) pain management services
No abstract available (Source: Pain)
Source: Pain - April 23, 2020 Category: Anesthesiology Tags: Topical Review Source Type: research

Neck pain and headache after whiplash injury: a systematic review and meta-analysis
Neck pain and headache are 2 of the most common complications of whiplash injury. Therefore, we performed a systematic literature search on PubMed and Embase for publications reporting on the prevalence of neck pain and headache after whiplash injury. The literature search identified 2709 citations of which 44 contained relevant original data. Of these, 27 studies provided data for the quantitative analysis. For non–population-based studies, the present meta-analysis showed that a pooled relative frequency of neck pain was 84% confidence interval (68%-95%) and a pooled relative frequency of headache was 60% (46%-73%)...
Source: Pain - April 23, 2020 Category: Anesthesiology Tags: Systematic Review and Meta-Analysis Source Type: research

In Memoriam: Ronald Melzack
No abstract available (Source: Pain)
Source: Pain - April 23, 2020 Category: Anesthesiology Tags: Obituary Source Type: research

Reply to Boland and Bennett
No abstract available (Source: Pain)
Source: Pain - March 26, 2020 Category: Anesthesiology Tags: Correspondence Source Type: research

Pain, opioids, and survival in patients with cancer
No abstract available (Source: Pain)
Source: Pain - March 26, 2020 Category: Anesthesiology Tags: Correspondence Source Type: research

Marked sexual dimorphism in neuroendocrine mechanisms for the exacerbation of paclitaxel-induced painful peripheral neuropathy by stress
This study provides evidence that neuroendocrine stress axis activity has a marked, sexually dimorphic, effect on paclitaxel-induced painful CIPN. (Source: Pain)
Source: Pain - March 26, 2020 Category: Anesthesiology Tags: Research Paper Source Type: research

Temporal instability of salience network activity in migraine with aura
This study aims to investigate whether intranetwork dynamic functional connectivity and causal interactions of the salience network is altered in the interictal term of migraine. Thirty-two healthy controls, 37 migraineurs without aura, and 20 migraineurs with aura were recruited. Participants underwent a T1-weighted scan and resting-state fMRI protocol inside a 1.5T MR scanner. We obtained average spatial maps of resting-state networks using group independent component analysis, which yielded subject-specific time series through a dual regression approach. Salience network regions of interest (bilateral insulae and prefro...
Source: Pain - March 26, 2020 Category: Anesthesiology Tags: Research Paper Source Type: research

Activation of µ-δ opioid receptor heteromers inhibits neuropathic pain behavior in rodents
We examined the effects of spinal nerve injury on µ-δ heteromer expression in dorsal root ganglion (DRG) neurons and the effects of a µ-δ heteromer–targeting agonist, CYM51010, on neuropathic pain behavior in rats and mice. An L5 spinal nerve ligation (SNL) in rats significantly decreased µ-δ heteromer expression in L5 DRG but increased heteromer levels in uninjured L4 DRG. Importantly, in SNL rats, subcutaneous injection of CYM51010 inhibited mechanical hypersensitivity in a dose-related manner (EC50: 1.09 mg/kg) and also reversed heat hyperalgesia and attenuated ongoing pain (2 m...
Source: Pain - March 26, 2020 Category: Anesthesiology Tags: Research Paper Source Type: research

Dexpramipexole blocks Nav1.8 sodium channels and provides analgesia in multiple nociceptive and neuropathic pain models
Selective targeting of sodium channel subtypes Nav1.7, Nav1.8, and Nav1.9, preferentially expressed by peripheral nociceptors, represents a unique opportunity to develop analgesics devoid of central side effects. Several compounds that target Nav1.7 and Nav1.8 with different degrees of selectivity have been developed and are currently being tested in clinical trials for multiple pain indications. Among these chemicals, benzothiazole-like compounds emerged as potent sodium channel blockers. We evaluated the effects of dexpramipexole, a benzothiazole-bearing drug with pleiotypic neuroactive properties and a good safety profi...
Source: Pain - March 26, 2020 Category: Anesthesiology Tags: Research Paper Source Type: research

Sleep disturbance underlies the co-occurrence of trauma and pediatric chronic pain: a longitudinal examination
Epidemiological and cross-sectional studies have shown that post-traumatic stress disorder symptoms (PTSS) are common and impairing in youth with chronic pain. Yet, the co-occurrence of PTSS and pediatric chronic pain has not been examined longitudinally, which has limited understanding of theoretically proposed mechanisms (eg, sleep disturbance) underlying the PTSS-pain relationship over time. This longitudinal study aimed to fill this gap. Participants included 138 youth (Mage = 14.29, 75% girls) referred to a tertiary-level outpatient chronic pain program and one of their parents. At baseline, youth reported their pain ...
Source: Pain - March 26, 2020 Category: Anesthesiology Tags: Research Paper Source Type: research

Ethnic disparities in pain processing among healthy adults: μ-opioid receptor binding potential as a putative mechanism
This study sought to address this knowledge gap by examining differences in µ-selective agonist binding potential (BPND; [11C]-Carfentanil) between 27 non-Hispanic black (NHB) and 27 demographically similar, non-Hispanic white participants. Participants completed questionnaires and two 90-minute high-resolution research tomograph positron emission tomography (PET) imaging sessions. During PET imaging, a capsaicin or control cream was applied to individuals' arms, and pain ratings were collected. Bonferroni-corrected PET volumes of interest analyses revealed significantly greater [11C]-Carfentanil BPND among NHB parti...
Source: Pain - March 26, 2020 Category: Anesthesiology Tags: Research Paper Source Type: research

Complex regional pain syndrome patient immunoglobulin M has pronociceptive effects in the skin and spinal cord of tibia fracture mice
It has been proposed that complex regional pain syndrome (CRPS) is a post-traumatic autoimmune disease. Previously, we observed that B cells are required for the full expression of CRPS-like changes in a mouse tibia fracture model and that serum immunoglobulin M (IgM) antibodies from fracture mice have pronociceptive effects in muMT fracture mice lacking B cells. The current study evaluated the pronociceptive effects of injecting CRPS patient serum or antibodies into muMT fracture mice by measuring hind paw allodynia and unweighting changes. Complex regional pain syndrome serum binding was measured against autoantigens pre...
Source: Pain - March 26, 2020 Category: Anesthesiology Tags: Research Paper Source Type: research

Longitudinal prevalence and determinants of pain in multiple sclerosis: results from the German National Multiple Sclerosis Cohort study
Pain is frequent in multiple sclerosis (MS) and includes different types, with neuropathic pain (NP) being most closely related to MS pathology. However, prevalence estimates vary largely, and causal relationships between pain and biopsychosocial factors in MS are largely unknown. Longitudinal studies might help to clarify the prevalence and determinants of pain in MS. To this end, we analyzed data from 410 patients with newly diagnosed clinically isolated syndrome or relapsing-remitting MS participating in the prospective multicenter German National MS Cohort Study (NationMS) at baseline and after 4 years. Pain was assess...
Source: Pain - March 26, 2020 Category: Anesthesiology Tags: Research Paper Source Type: research

Functional and anatomical deficits in visceral nociception with age: a mechanism of silent appendicitis in the elderly?
The ability to sense visceral pain during appendicitis is diminished with age leading to delay in seeking health care and poorer clinical outcomes. To understand the mechanistic basis of this phenomenon, we examined visceral nociception in aged mouse and human tissue. Inflamed and noninflamed appendixes were collected from consenting patients undergoing surgery for the treatment of appendicitis or bowel cancer. Supernatants were generated by incubating samples in buffer and used to stimulate multiunit activity in intestinal preparations, or single-unit activity from teased fibres in colonic preparations, of young and old m...
Source: Pain - March 26, 2020 Category: Anesthesiology Tags: Research Paper Source Type: research

Nicotinamide adenine dinucleotide phosphate oxidase 2–derived reactive oxygen species contribute to long-term potentiation of C-fiber-evoked field potentials in spinal dorsal horn and persistent mirror-image pain following high-frequency stimulus of the sciatic nerve
This study provided electrophysiological and behavioral evidence that NOX2-derived ROS in the spinal cord contributed to persistent mirror-image pain by enhancing the synaptic transmission, which was mediated by increasing presynaptic glutamate release and activation of NMDA receptor and NF-κB in the spinal dorsal horn. (Source: Pain)
Source: Pain - March 26, 2020 Category: Anesthesiology Tags: Research Paper Source Type: research

Personal, biomechanical, psychosocial, and organizational risk factors for carpal tunnel syndrome: a structural equation modeling approach
This longitudinal study aimed at exploring the direct and indirect relationships between organizational, psychosocial, biomechanical, and personal factors and carpal tunnel syndrome (CTS) in French workers. Between 2002 and 2005, 3710 workers were included in the Cosali cohort. Between 2007 and 2010, 1611 workers were re-examined using the same standardized clinical protocol. Subjects free from CTS at baseline were studied (804 men and 563 women). We used structural equation models to examine the relationships between incident CTS cases and organizational (machine-paced work or work pace dependent on customers' demand), ps...
Source: Pain - March 26, 2020 Category: Anesthesiology Tags: Research Paper Source Type: research

Correlates and motivations of prescription opioid use among adolescents 12 to 17 years of age in the United States
We examined whether rates of opioid use, including opioid misuse and opioid use disorder among 12 to 17 year olds in the United States, differ according to sociodemographic factors, physical and mental health, and substance use characteristics using data from the 2015 and 2016 National Survey on Drug Use and Health. We also examined motivations for opioid misuse. The study included 27,857 participants. Black, non-Hispanic adolescents were more likely to both use and misuse opioids as compared to white, non-Hispanic adolescents, a clear difference from previous studies. The main motivation for misuse by adolescents was reli...
Source: Pain - March 26, 2020 Category: Anesthesiology Tags: Research Paper Source Type: research

Hub disruption in patients with chronic neck pain: a graph analytical approach
Chronic pain is known to alter the brain's network dynamics. These dynamics are often demonstrated by identifying alterations in the brain network topology. A common approach used for this purpose is graph theory. To date, little is known on how these potentially altered networks in chronic pain relate to the symptoms reported by these patients. Here, we applied a graph theoretical approach to identify network changes in patients suffering from chronic neck pain, a group that is often neglected in chronic pain research. Participants with chronic traumatic and nontraumatic neck pain were compared to healthy pain-free contro...
Source: Pain - March 26, 2020 Category: Anesthesiology Tags: Research Paper Source Type: research

New procedure of high-frequency repetitive transcranial magnetic stimulation for central neuropathic pain: a placebo-controlled randomized crossover study
Repetitive transcranial magnetic stimulation (rTMS) is a procedure increasingly used to treat patients with central neuropathic pain, but its efficacy is still under debate. Patients with medically refractory chronic central neuropathic pain were included in 2 randomized phases (active/sham), separated by a wash-out period of 8 weeks. Each phase consisted of 4 consecutive rTMS sessions and a final evaluation session, all separated from one another by 3 weeks. High-frequency (20 Hz) rTMS was delivered over the primary motor cortex (M1) contralateral to the patient's pain using a neuronavigated robotic system. Patients and c...
Source: Pain - March 26, 2020 Category: Anesthesiology Tags: Research Paper Source Type: research

Measuring and reporting adverse events in clinical trials of psychological treatments for chronic pain
No abstract available (Source: Pain)
Source: Pain - March 26, 2020 Category: Anesthesiology Tags: Topical Review Source Type: research

Regular dosing compared with as-needed dosing of opioids for management of chronic cancer pain: systematic review and meta-analysis
Opioids are the recommended form of analgesia for patients with persistent cancer pain, and regular dosing “by the clock” is advocated in many international guidelines on cancer pain management. The development of sustained-release opioid preparations has made regular dosing easier for patients. However, patients report that the intensity and impact of their cancer pain varies considerably day to day, and many try to find a trade-off between acceptable pain control and impact of cognitive (and other) adverse effects on daily activities. In acute care settings, (eg, postoperative) as-needed dosing and other opio...
Source: Pain - March 26, 2020 Category: Anesthesiology Tags: Systematic Review and Meta-Analysis Source Type: research

What is usual care for low back pain? A systematic review of health care provided to patients with low back pain in family practice and emergency departments
International clinical practice guidelines for low back pain (LBP) contain consistent recommendations including universal provision of information and advice to remain active, discouraging routine referral for imaging, and limited prescription of opioids. This systematic review describes usual care provided by first-contact physicians to patients with LBP. Studies that reported the assessments and care provided to people with LBP in family practice and emergency departments (EDs) from January 2000 to May 2019 were identified by searches of PubMed, EMBASE, and CINAHL. Study quality was assessed with reference to representat...
Source: Pain - March 26, 2020 Category: Anesthesiology Tags: Systematic Review and Meta-Analysis Source Type: research

A systematic review and meta-analysis of pregabalin preclinical studies
Despite large efforts to test analgesics in animal models, only a handful of new pain drugs have shown efficacy in patients. Here, we report a systematic review and meta-analysis of preclinical studies of the commercially successful drug pregabalin. Our primary objective was to describe design characteristics and outcomes of studies testing the efficacy of pregabalin in behavioral models of pain. Secondarily, we examined the relationship between design characteristics and effect sizes. We queried MEDLINE, Embase, and BIOSIS to identify all animal studies testing the efficacy of pregabalin published before January 2018 and ...
Source: Pain - March 26, 2020 Category: Anesthesiology Tags: Systematic Review and Meta-Analysis Source Type: research

Are weather conditions associated with chronic musculoskeletal pain? Review of results and methodologies
Many people believe that weather influences chronic musculoskeletal pain. Previous studies on this association are narratively reviewed, with particular focus on comparing methodologies and summarising study findings in light of study quality. We searched 5 databases (Medline, Embase, Web of Science, PsycINFO, and Scopus) for observational studies on the association between weather variables and self-reported musculoskeletal pain severity. Of 4707 located articles, 43 were eligible for inclusion. The majority (67%) found some association between pain and a weather variable. Temperature, atmospheric pressure, relative humid...
Source: Pain - March 26, 2020 Category: Anesthesiology Tags: Narrative Review Source Type: research

“First do no harm”: why don't we measure adverse events routinely in psychological treatment trials for people with chronic pain?
No abstract available (Source: Pain)
Source: Pain - March 26, 2020 Category: Anesthesiology Tags: Commentary Source Type: research

Primary care for low back pain: we don't know the half of it
No abstract available (Source: Pain)
Source: Pain - March 26, 2020 Category: Anesthesiology Tags: Commentary Source Type: research

Graded chronic pain scale revised: mild, bothersome, and high-impact chronic pain
Drawing on advances in chronic pain metrics, a simplified Graded Chronic Pain Scale-Revised was developed to differentiate mild, bothersome, and high-impact chronic pain. Graded Chronic Pain Scale-Revised was validated among adult enrollees of 2 health plans (N = 2021). In this population, the prevalence of chronic pain (pain present most or every day, prior 3 months) was 40.5%: 15.4% with mild chronic pain (lower pain intensity and interference); 10.1% bothersome chronic pain (moderate to severe pain intensity with lower interference with life activities); and 15.0% high-impact chronic pain (sustained pain-related activit...
Source: Pain - February 19, 2020 Category: Anesthesiology Tags: Research Paper Source Type: research

Chronic noncancer pain is not associated with accelerated brain aging as assessed by structural magnetic resonance imaging in patients treated in specialized outpatient clinics
This study provided no evidence for the hypothesis that chronic pain is associated with accelerated brain aging (Welch t test, P = 0.74, Cohen's d = 0.061). A Bayesian independent-samples t test indicated moderate evidence in favor of the null hypothesis (BF01 = 4.875, ie, group means were equal). Our results provide indirect support for recent models of pain-related changes of brain structure, brain function, and cognitive functions. These models postulate network-specific maladaptive plasticity, rather than widespread or global neural degeneration. (Source: Pain)
Source: Pain - February 19, 2020 Category: Anesthesiology Tags: Research Paper Source Type: research

Brain signatures of threat–safety discrimination in adolescent chronic pain
In this study, 91 adolescents (10-24 years; 78 females) including 30 chronic pain patients with high pain-related distress, 29 chronic pain patients with low pain-related distress, and 32 healthy peers without chronic pain completed a developmentally appropriate T–S learning paradigm. We measured self-reported fear, psychophysiology (skin conductance response), and functional magnetic resonance imaging responses (N = 72 after functional magnetic resonance imaging exclusions). After controlling for age and anxiety symptoms, patients with high pain-related distress showed altered self-reported fear and frontolimbic act...
Source: Pain - February 19, 2020 Category: Anesthesiology Tags: Research Paper Source Type: research

A functional polymorphism in the ATP-Binding Cassette B1 transporter predicts pharmacologic response to combination of nortriptyline and morphine in neuropathic pain patients
In this study, the treatment effects of nortriptyline and morphine were tested for an association with genetic markers relevant to pain pathways. Treatment effects were determined for single and combination therapies. A total of 24 functional single nucleotide polymorphisms were tested within the gene loci of mu-opioid receptor (OPRM1) gene locus, ATP-Binding Cassette B1 Transporter (ABCB1), Cytochrome P450 gene family (CYP2C19 and CYP2D6), catecholamine inactivator Catechol-O-Methyl Transferase (COMT), and serotonin receptor 2A (HTR2A). Genotyping was performed in a population of neuropathic pain patients who previously p...
Source: Pain - February 19, 2020 Category: Anesthesiology Tags: Research Paper Source Type: research

Selective modulation of tonic aversive qualities of neuropathic pain by morphine in the central nucleus of the amygdala requires endogenous opioid signaling in the anterior cingulate cortex
The amygdala is a key subcortical region believed to contribute to emotional components of pain. As opioid receptors are found in both the central (CeA) and basolateral (BLA) nuclei of the amygdala, we investigated the effects of morphine microinjection on evoked pain responses, pain-motivated behaviors, dopamine release in the nucleus accumbens (NAc), and descending modulation in rats with left-side spinal nerve ligation (SNL). Morphine administered into the right or left CeA had no effect on nerve injury–induced tactile allodynia or mechanical hyperalgesia. Right, but not left, CeA morphine produced conditioned pla...
Source: Pain - February 19, 2020 Category: Anesthesiology Tags: Research Paper Source Type: research

Implications of the putamen in pain and motor deficits in complex regional pain syndrome
Complex regional pain syndrome (CRPS) develops after-limb injury, with persistent pain and deficits in movement frequently co-occurring. The striatum is critical for mediating multiple mechanisms that are often aberrant in CRPS, which includes sensory and pain processing, motor function, and goal-directed behaviors associated with movement. Yet, much remains unknown with regards to the morphological and functional properties of the striatum and its subregions in this disease. Thus, we investigated 20 patients (15 female, age 58 ± 9 years, right-handed) diagnosed with chronic (6+ months of pain duration) CRPS in the ...
Source: Pain - February 19, 2020 Category: Anesthesiology Tags: Research Paper Source Type: research

Evaluating the efficacy of an attention modification program for patients with fibromyalgia: a randomized controlled trial
Persons with chronic musculoskeletal pain may be hypervigilant for pain-related cues which, paradoxically, may be maintaining their pain. Several randomized controlled trials have assessed whether a modified dot-probe protocol (ie, attention bias modification [ABM]) reduces chronic pain- and pain-related symptoms in persons with several diagnoses, including fibromyalgia. Scalability and economic efficiency potentiates the appeal of ABM protocols; however, research results have been mixed, with only some studies evidencing significant symptom gains from ABM and some evidencing gains for the control group. The current random...
Source: Pain - February 19, 2020 Category: Anesthesiology Tags: Research Paper Source Type: research

Diabetic polyneuropathy and pain, prevalence, and patient characteristics: a cross-sectional questionnaire study of 5,514 patients with recently diagnosed type 2 diabetes
Most studies of diabetic polyneuropathy (DPN) and painful DPN are conducted in persons with longstanding diabetes. This cross-sectional study aimed to estimate the prevalence of DPN and painful DPN, important risk factors, and the association with mental health in recently diagnosed type 2 diabetes. A total of 5514 (82%) patients (median diabetes duration 4.6 years) enrolled in the Danish Centre for Strategic Research in Type 2 Diabetes cohort responded to a detailed questionnaire on neuropathy and pain. A score ≥4 on the MNSI questionnaire determined possible DPN, whereas pain presence in both feet together with a scor...
Source: Pain - February 19, 2020 Category: Anesthesiology Tags: Research Paper Source Type: research

Rapid identification and clinical indices of fear-avoidance in youth with chronic pain
This study describes the development and psychometric examination of the FOPQC-SF, a short form of the original measure. We selected 10 items for the short form that best represented the content and 2-factor (fear and avoidance) structure of the original measure from a cohort of 613 youth (Mage = 14.7 years) with chronic pain. Next, confirmatory factor analyses from a second sample of 526 youth (Mage = 14.7 years) with chronic pain who completed the FOPQC-SF supported the original 2-factor model but indicated that one item should be moved to the avoidance subscale. The FOPQC-SF demonstrates strong internal consistency and ...
Source: Pain - February 19, 2020 Category: Anesthesiology Tags: Research Paper Source Type: research

Offset analgesia: somatotopic endogenous pain modulation in migraine
The complex mechanisms underlying migraine are not entirely understood. It has been suggested that descending endogenous pain modulation is an important contributing factor, although research is controversial. A frequently used method to quantify the inhibitory pain modulation system is offset analgesia (OA), defined as a disproportionally large decrease in pain perception in response to a small decrease of painful stimulation. The aim of this study is to evaluate the OA response in patients with migraine and healthy controls, measured at the forehead (trigeminal, V1) and forearm (extratrigeminal). Patients with episodic m...
Source: Pain - February 19, 2020 Category: Anesthesiology Tags: Research Paper Source Type: research

Biomarkers for predicting central neuropathic pain occurrence and severity after spinal cord injury: results of a long-term longitudinal study
Central neuropathic pain (CNP) after spinal cord injury (SCI) is debilitating and immensely impacts the individual. Central neuropathic pain is relatively resistant to treatment administered after it develops, perhaps owing to irreversible pathological processes. Although preemptive treatment may overcome this shortcoming, its administration necessitates screening patients with clinically relevant biomarkers that could predict CNP early post-SCI. The aim was to search for such biomarkers by measuring pronociceptive and for the first time, antinociceptive indices early post-SCI. Participants were 47 patients with acute SCI ...
Source: Pain - February 19, 2020 Category: Anesthesiology Tags: Research Paper Source Type: research

Wnt signaling contributes to withdrawal symptoms from opioid receptor activation induced by morphine exposure or chronic inflammation
Preventing and treating opioid dependence and withdrawal is a major clinical challenge, and the underlying mechanisms of opioid dependence and withdrawal remain elusive. We hypothesized that prolonged morphine exposure or chronic inflammation-induced μ-opioid receptor activity serves as a severe stress that elicits neuronal alterations and recapitulates events during development. Here, we report that Wnt signaling, which is important in developmental processes of the nervous system, plays a critical role in withdrawal symptoms from opioid receptor activation in mice. Repeated exposures of morphine or peripheral inflamma...
Source: Pain - February 19, 2020 Category: Anesthesiology Tags: Research Paper Source Type: research

Avoid or engage? Outcomes of graded exposure in youth with chronic pain using a sequential replicated single-case randomized design
Pain-related fear is typically associated with avoidance behavior and pain-related disability in youth with chronic pain. Youth with elevated pain-related fear have attenuated treatment responses; thus, targeted treatment is highly warranted. Evidence supporting graded in vivo exposure treatment (GET) for adults with chronic pain is considerable, but just emerging for youth. The current investigation represents the first sequential replicated and randomized single-case experimental phase design with multiple measures evaluating GET for youth with chronic pain, entitled GET Living. A cohort of 27 youth (81% female) with mix...
Source: Pain - February 19, 2020 Category: Anesthesiology Tags: Research Paper Source Type: research

Reducing the use of opioids by patients with chronic pain: an effectiveness study with long-term follow-up
This study addresses the problem of long-term opioid use by chronic pain patients. The study involved a secondary analysis of unanalyzed data from a published study of 2 versions of cognitive-behavioural therapy-based interdisciplinary treatment for chronic pain. In this study, we examined whether the use of opioids by 140 chronic pain patients could be ceased sustainably over 12 months after participation in the comprehensive interdisciplinary pain management program aimed at enhancing pain self-management. On admission to the treatment, there were no significant differences between those patients taking or not taking opi...
Source: Pain - February 19, 2020 Category: Anesthesiology Tags: Clinical Note Source Type: research

Pain behavior without pain sensation: an epileptic syndrome of “symbolism for pain”?
“Asymbolia for pain” has shown the potentiality of diseased insular networks to dissociate sensory from affective-behavioral dimensions of pain, resulting in the lack of appropriate motor and affective responses despite preserved sensory aspect of pain. Here, we describe 4 patients with an inverse phenomenon of asymbolia for pain, namely an isolated “symbolism for pain” triggered by epileptic seizures, characterized by pain behavior without declarative pain sensation despite fully preserved contact and vigilance. Stereoelectroencephalography demonstrated in each case focal seizure discharges within ...
Source: Pain - February 19, 2020 Category: Anesthesiology Tags: Clinical Note Source Type: research

Pain, opioid therapy, and survival: a needed discussion
No abstract available (Source: Pain)
Source: Pain - February 19, 2020 Category: Anesthesiology Tags: Topical Review Source Type: research

Neuromodulation: more than a placebo effect?
No abstract available (Source: Pain)
Source: Pain - February 19, 2020 Category: Anesthesiology Tags: Topical Review Source Type: research

Evaluating the impact of gabapentinoids on sleep health in patients with chronic neuropathic pain: a systematic review and meta-analysis
The objective of this systematic review and meta-analysis was to assess the relationship between GB therapy dose and duration on sleep quality, daytime somnolence, and intensity of pain in patients with NP. Subgroup comparisons were planned for high- vs low-dose GBs, where 300 mg per day or more of pregabalin was used to classify high-dose therapy. Trial data were segregated by duration less than 6 weeks and 6 weeks or greater. Twenty randomized controlled trials were included. Primary outcome measures included pain-related sleep interference and incidence of daytime somnolence. Secondary outcomes included daily pain score...
Source: Pain - February 19, 2020 Category: Anesthesiology Tags: Systematic Review and Meta-Analysis Source Type: research

Alterations in pronociceptive and antinociceptive mechanisms in patients with low back pain: a systematic review with meta-analysis
Altered pronociceptive and antinociceptive mechanisms are often implicated in painful conditions and have been increasingly studied over the past decade. For some painful conditions, alterations are well-established, but in populations with low back pain (LBP), there remains considerable debate whether these mechanisms are altered. The present systematic review aimed to address this issue by identifying studies assessing conditioned pain modulation (CPM) and/or temporal summation of pain (TSP) in patients with LBP, comparing with either a healthy control group or using a method with reference data available. Qualitative sy...
Source: Pain - February 19, 2020 Category: Anesthesiology Tags: Systematic Review and Meta-Analysis Source Type: research

Pain, aging, and the brain: new pieces to a complex puzzle
No abstract available (Source: Pain)
Source: Pain - February 19, 2020 Category: Anesthesiology Tags: Commentary Source Type: research