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Dahlgren D, Borg K, Melin E. Post-polio syndrome - somatosensory dysfunction and its relation to pain: a pilot study with quantitative sensory testing. J Rehabil Med 2024; 56:jrm26192. [PMID: 38915293 PMCID: PMC11218677 DOI: 10.2340/jrm.v56.26192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 05/17/2024] [Indexed: 06/26/2024] Open
Abstract
OBJECTIVE To explore and characterize somatosensory dysfunction in patients with post-polio syndrome and chronic pain, by conducting examinations with Quantitative Sensory Testing. DESIGN A cross-sectional, descriptive, pilot study conducted during 1 month. SUBJECTS/PATIENTS Six patients with previously established post-polio syndrome and related chronic pain. METHODS All subjects underwent a neurological examination including neuromuscular function, bedside sensory testing, a thorough pain anamnesis, and pain drawing. Screening for neuropathic pain was done with 2 questionnaires. A comprehensive Quantitative Sensory Testing battery was conducted with z-score transformation of obtained data, enabling comparison with published reference values and the creation of sensory profiles, as well as comparison between the study site (more polio affected extremity) and internal control site (less affected extremity) for each patient. RESULTS Derived sensory profiles showed signs of increased prevalence of sensory aberrations compared with reference values, especially Mechanical Pain Thresholds, with significant deviation from reference data in 5 out of 6 patients. No obvious differences in sensory functions were seen between study sites and internal control sites. CONCLUSION Post-polio syndrome may be correlated with a mechanical hyperalgesia/allodynia and might be correlated to a somatosensory dysfunction. With lack of evident side-to-side differences, the possibility of a generalized dysfunction in the somatosensory system might be considered.
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Affiliation(s)
- Daniel Dahlgren
- Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden
| | - Kristian Borg
- Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden; Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Eva Melin
- Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden; Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden.
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On AY, Latifoglou E, Çınar E, Tanıgör G. Prevalence and Severity of Central Sensitization in Post-Polio Syndrome: Associations with Clinical Measures and Quality of Life. Ann Indian Acad Neurol 2024; 27:282-288. [PMID: 38907687 PMCID: PMC11232829 DOI: 10.4103/aian.aian_1040_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 05/23/2024] [Accepted: 06/02/2024] [Indexed: 06/24/2024] Open
Abstract
OBJECTIVES To investigate the presence and severity of central sensitization (CS) and its associations with clinical measures and quality of life (QoL) in individuals with a history of paralytic poliomyelitis with and without post-polio syndrome (PPS). METHODS In this cross-sectional study, we included 98 individuals with a history of poliomyelitis, in whom 82 (83.6%) met the criteria of PPS. We used CS Inventory (CSI) to evaluate the presence and severity of CS. We evaluated the severity of fatigue, pain, polio-related impairments, and QoL using a Numerical Rating Scale in addition to Fatigue Severity Scale, Self-reported Impairments in Persons with late effects of Polio rating scale (SIPP), and Nottingham Health Profile (NHP). RESULTS CS was present in 52.4% of patients with PPS, of which 63% are classified as severe to extreme. Those with CS reported more severe symptoms, more polio-related impairments, and worse QoL than those without CS. Severity of CS showed significant positive correlations with severity of fatigue, pain, SIPP, and NHP scales in those with PPS. CSI did not indicate CS in any of those without PPS. CONCLUSION CS was present in more than half of the individuals with PPS and correlated with more severe pain, fatigue, and more polio-related impairments, in addition to poorer QoL. These findings suggest that CS may contribute to the clinical picture in a subgroup of individuals with PPS. Thus, identification and appropriate management of CS patients may potentially help alleviate their symptoms and improve their QoL.
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Affiliation(s)
- Arzu Y On
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Emre Latifoglou
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Ece Çınar
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Göksel Tanıgör
- Department of Internal Sciences, Faculty of Medicine, İzmir University of Economics, İzmir, Turkey
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Attal N, Martinez V, Bouhassira D. Potential for increased prevalence of neuropathic pain after the COVID-19 pandemic. Pain Rep 2021; 6:e884. [PMID: 33537521 PMCID: PMC7850724 DOI: 10.1097/pr9.0000000000000884] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/02/2020] [Accepted: 11/07/2020] [Indexed: 12/25/2022] Open
Abstract
Although coronavirus disease 2019 (COVID-19) most commonly manifests with acute respiratory symptoms, one very common symptom of COVID-19 is pain. As COVID-19 often causes peripheral or central neurological complications, it is anticipated that a number of the chronic pain complications of COVID-19 will be neuropathic. This review first examines the most common viral infections responsible for neurological complications including neuropathic pain. These encompass herpes zoster, HIV, poliovirus, enteroviruses, and several tropical viruses. Neurological complications of COVID-19 including in particular Guillain-Barré syndrome, myelitis, and stroke are reviewed with regards to their potential risk of chronic neuropathic pain. Prospective longitudinal cohorts of patients should be implemented to evaluate the exact risk of neuropathic pain after COVID-19.
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Affiliation(s)
- Nadine Attal
- INSERM U 987, CETD, Hôpital Ambroise Paré, APHP, Boulogne-Billancourt, France
| | - Valéria Martinez
- INSERM U 987, CETD, Hôpital Ambroise Paré, APHP, Boulogne-Billancourt, France
- Université Versailles Saint Quentin, Versailles, France
- Department of Anesthesiology and Pain Unit, Hôpital Raymond Poincaré, APHP, Garches, France
| | - Didier Bouhassira
- INSERM U 987, CETD, Hôpital Ambroise Paré, APHP, Boulogne-Billancourt, France
- Université Versailles Saint Quentin, Versailles, France
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Naqvi AA, Naqvi SBS, Zehra F, Verma AK, Usmani S, Badar S, Ahmad R, Ahmad N. Estimation of the Direct Cost of Poliomyelitis Rehabilitation Treatment to Pakistani Patients: A 53-Year Retrospective Study. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2018; 16:871-888. [PMID: 30128833 DOI: 10.1007/s40258-018-0422-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Pakistan is one of the last few countries in which poliomyelitis is endemic. Evidence indicates that out-of-pocket expenditures are a barrier to polio rehabilitation treatment, yet there are no reported figures related to the financial burden of this disease on patients in a recently polio-endemic country. OBJECTIVE This study investigated direct costs attributed to rehabilitation treatment of poliomyelitis among Pakistani patients and reported its duration along with the socioeconomic status of poliomyelitis survivors. CONCLUSION The cost of poliomyelitis rehabilitation in Pakistan is high; it has an economic effect on the lives of patients and their families. Despite good education, polio survivors in Pakistan appear to have low socioeconomic status, lower chances of employment and marriage, as well as fewer children. Further research is recommended to explore the burden of disease on society, i.e., indirect costs and suffering.
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Affiliation(s)
- Atta Abbas Naqvi
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, 31441, Saudi Arabia.
| | | | - Fatima Zehra
- Applied Economics Research Centre, University of Karachi, Karachi, 75270, Pakistan
| | - Ashutosh Kumar Verma
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Minden, 11800, Penang, Malaysia
| | - Saman Usmani
- Institute of Pharmaceutical Sciences, Jinnah Sindh Medical University, Karachi, 75510, Pakistan
| | - Sehrish Badar
- Faculty of Pharmacy, Hamdard University, Madinatul Hikmah, Karachi, 74600, Pakistan
| | - Rizwan Ahmad
- Natural Products and Alternative Medicines, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, 31441, Saudi Arabia
| | - Niyaz Ahmad
- Department of Pharmaceutics, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, 31441, Saudi Arabia
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Chen SX, Wang SK, Yao PW, Liao GJ, Na XD, Li YY, Zeng WA, Liu XG, Zang Y. Early CALP2 expression and microglial activation are potential inducers of spinal IL-6 up-regulation and bilateral pain following motor nerve injury. J Neurochem 2018; 145:154-169. [DOI: 10.1111/jnc.14317] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 01/28/2018] [Accepted: 01/30/2018] [Indexed: 12/21/2022]
Affiliation(s)
- Shao-Xia Chen
- Pain Research Center and Department of Physiology; Zhongshan Medical School of Sun Yat-Sen University; Guangzhou China
- Department of Anesthesiology; Cancer Center, Sun Yat-Sen University; State Key Laboratory of Oncology in South China; Collaborative, Innovation Center for Cancer Medicine; Guangzhou China
| | - Shao-Kun Wang
- Pain Research Center and Department of Physiology; Zhongshan Medical School of Sun Yat-Sen University; Guangzhou China
| | - Pei-Wen Yao
- Pain Research Center and Department of Physiology; Zhongshan Medical School of Sun Yat-Sen University; Guangzhou China
| | - Guang-Jie Liao
- Pain Research Center and Department of Physiology; Zhongshan Medical School of Sun Yat-Sen University; Guangzhou China
| | - Xiao-Dong Na
- Pain Research Center and Department of Physiology; Zhongshan Medical School of Sun Yat-Sen University; Guangzhou China
- Department of Pathophysiology; Zhongshan Medical School of Sun Yat-Sen University; Guangzhou China
| | - Yong-Yong Li
- Pain Research Center and Department of Physiology; Zhongshan Medical School of Sun Yat-Sen University; Guangzhou China
| | - Wei-an Zeng
- Department of Anesthesiology; Cancer Center, Sun Yat-Sen University; State Key Laboratory of Oncology in South China; Collaborative, Innovation Center for Cancer Medicine; Guangzhou China
| | - Xian-Guo Liu
- Pain Research Center and Department of Physiology; Zhongshan Medical School of Sun Yat-Sen University; Guangzhou China
| | - Ying Zang
- Pain Research Center and Department of Physiology; Zhongshan Medical School of Sun Yat-Sen University; Guangzhou China
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Norrefalk JR, Borg K. The Functional Barometer - An analysis of a self-assessment questionnaire with ICF-coding regarding functional/activity limitations and quality of life due to pain - Differences in age gender and origin of pain. Scand J Pain 2017; 17:16-21. [PMID: 28850368 DOI: 10.1016/j.sjpain.2017.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 06/11/2017] [Indexed: 11/18/2022]
Abstract
Long standing non-malignant pain leads to a variety of limitations which can be assessed by means of the self-assessment questionnaire Functional Barometer. It is designed to assess the extent and limitations in function, activity and decreased quality-of-life and is adapted to the International Classification of Functioning and Health. AIM To investigate the outcome and differences in age, gender and origin of pain in patients with long-standing non-malignant pain regarding the subjective experience of functional-, activity- and quality-of-life limitations. METHOD 300 patients with a median duration of pain of 49 months referred to a Pain Management Centre filled out the Functional Barometer questionnaire, adapted to the International Classification of Functioning and Health. RESULTS 66% patients were women and 34% were men. Seventy-five percent were in working age, 18-64 years. The duration before being referred to a pain specialist was over 4 years and 65% reported pain from more than three origins. Significant differences in functioning, activity and quality-of-life were found in comparing gender, age and origin of pain. Men more often reported physiological limitations while women more often reported psychological limitations of functioning, activity and quality-of-life. The most important were that men more often had difficulties in walking and climbing stairs, while women reported problems with concentration, stress and psychological demands, family relations and contact with friends. CONCLUSION The significant differences regarding functioning, activity and quality-of-life between women and men as age and origin of pain must be taken into account when tailoring individual treatment and rehabilitation programmes.
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Affiliation(s)
- Jan-Rickard Norrefalk
- Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
| | - Kristian Borg
- Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden
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Bertolasi L, Danese A, Monaco S, Turri M, Borg K, Werhagen L. Polio Patients in Northern Italy, a 50 Year Follow-up. Open Neurol J 2016; 10:77-82. [PMID: 27651845 PMCID: PMC5012079 DOI: 10.2174/1874205x01610010077] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Revised: 05/24/2016] [Accepted: 06/09/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Poliomyelitis was before the immunization an important medical problem. Nowadays polio prior patients (PP) suffer from polio sequelae or have developed post-polio-syndrome (PPS) with increasing paresis, pain and fatigue. OBJECTIVES To analyze the medical situation 50 years after acute polio. The degree of paresis was compared between the recovery 1952-1961 and 2012.The prevalence of patients fulfilling the criteria for PPS was estimated. METHOD The study was performed in Italy. Included were PP with rehabilitation after acute polio 1952-1961 and in 2012. During the years PP underwent yearly evaluation. A thorough neurological examination was performed in 2012. A telephone interview with questions concerning pain, paresis, fatigue, walking aids and concomitant diseases was performed in 2012. The patients were divided in two groups, if they fulfilled the criteria for PPS or not. RESULTS Included were 67(94%) patients receiving rehabilitation after acute poliomyelitis and 2012. 78% were walkers, half of the PPS used wheelchair. Eight out of ten suffered from pain. Four out of ten fulfilled the PPS criteria. Pain was slightly more common in PPS. CONCLUSION Female gender, fatigue and wheelchair dependency were significantly more common in PPS while pain was common in both groups.
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Affiliation(s)
- L. Bertolasi
- Section of Neurology, Department of Neurological, Neurophysiological, Morphological and Motor Sciences, University of Verona, Verona, Italy
| | - A Danese
- Section of Neurology, Department of Neurological, Neurophysiological, Morphological and Motor Sciences, University of Verona, Verona, Italy
| | - S Monaco
- Section of Neurology, Department of Neurological, Neurophysiological, Morphological and Motor Sciences, University of Verona, Verona, Italy
| | - M Turri
- Section of Neurology, Department of Neurological, Neurophysiological, Morphological and Motor Sciences, University of Verona, Verona, Italy
| | - K Borg
- Division of Rehabilitation Medicine, Department of Clinical Sciences, Karolinska Institut at Danderyds Hospital, Stockholm, Sweden
| | - L Werhagen
- Division of Rehabilitation Medicine, Department of Clinical Sciences, Karolinska Institut at Danderyds Hospital, Stockholm, Sweden
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Werhagen L, Borg K. Survey of young patients with polio and a foreign background at a Swedish post-polio outpatient clinic. Neurol Sci 2016; 37:1597-601. [DOI: 10.1007/s10072-016-2629-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 06/03/2016] [Indexed: 11/28/2022]
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Flansbjer UB, Brogårdh C, Horstmann V, Lexell J. Men With Late Effects of Polio Decline More Than Women in Lower Limb Muscle Strength: A 4-Year Longitudinal Study. PM R 2015; 7:1127-1136. [DOI: 10.1016/j.pmrj.2015.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 03/20/2015] [Accepted: 05/01/2015] [Indexed: 12/26/2022]
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Bridgens R. Does a subgroup of postpolio patients need different management? Disabil Health J 2015; 8:305-8. [PMID: 25899845 DOI: 10.1016/j.dhjo.2015.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 12/10/2014] [Accepted: 02/13/2015] [Indexed: 10/23/2022]
Abstract
Throughout the 30 years of postpolio syndrome (PPS) research, there have been many puzzling anomalies in the data and not enough information to make sense of them. It is therefore welcome that Winberg et al have examined physical activity in relation to life satisfaction, sex and age. They hypothesized that activity would decrease with age and found the opposite. This result is not so surprising as Ostlund et al found that vitality was associated with older age and that younger age was associated with more pain, increasing physical fatigue, decreasing sleep quality and reducing activity. This commentary will examine past postpolio research with unexpected results in order to describe a subgroup of patients who may be more susceptible to overusing muscles and have particular exercise and activity needs.
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Affiliation(s)
- Ruth Bridgens
- 66 High Street, Marshfield, Chippenham, Wiltshire SN 14 8LP, UK.
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Review of secondary health conditions in postpolio syndrome: prevalence and effects of aging. Am J Phys Med Rehabil 2015; 94:139-45. [PMID: 25122095 DOI: 10.1097/phm.0000000000000166] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study sought to better understand the prevalence and the severity of secondary health conditions in individuals with postpolio syndrome (PPS) as well as the association between these conditions and aging. DESIGN A scoping literature review was conducted searching electronic databases for studies published from 1986 to 2011. The scoping review provided information regarding the prevalence and associations of secondary health conditions in PPS with age or other duration-related variables. RESULTS The findings indicate that (1) individuals with PPS experience a number of serious secondary health conditions; (2) the most common conditions or symptoms are fatigue, pain, respiratory and sleep complaints, and increased risk for falls; (3) reports of the associations between the frequency or the severity of conditions and age-related factors are variable, perhaps because of methodological inconsistencies between studies; and (4) there is a marked lack of longitudinal research examining the natural course of health conditions in people aging with PPS. CONCLUSIONS Longitudinal research is needed to understand the course of health conditions and the impact of multiple secondary conditions in people aging with PPS. Efforts are also needed to develop and test the efficacy of interventions to prevent these secondary health conditions or reduce their negative impact.
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Melin E, Sohrabian A, Rönnelid J, Borg K. Normal serum levels of immune complexes in postpolio patients. RESULTS IN IMMUNOLOGY 2014; 4:54-7. [PMID: 25009767 PMCID: PMC4085341 DOI: 10.1016/j.rinim.2014.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 06/09/2014] [Accepted: 06/13/2014] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The pathophysiology of the postpolio syndrome is not fully understood. Increased cytokine levels in cerebrospinal fluid and peripheral blood indicate a systemic inflammatory process. Decreased cytokine levels and the clinical effect of intravenous immunoglobulin treatment further indicate an inflammatory/immunological pathogenesis. The aim of the present study was to evaluate whether an autoimmune process follows the initial infection, by means of analyzing immune complexes. PATIENTS AND METHODS Circulating immune complexes were analyzed from blood samples of 20 postpolio patients and 95 healthy controls. To compensate for differences in age between patients and controls, a sub-analysis was performed using only the 30 oldest controls. Tumor necrosis factor-inducing properties of polyethylene glycol-precipitated immune complexes were compared between the postpolio patients and 10 healthy controls. RESULTS When comparing levels in postpolio patients to the whole control group, including the 30 oldest investigated, there were no statistically significant differences. No difference was found in tumor necrosis factor levels induced by immune complexes when comparing patients and controls. CONCLUSIONS There was no increase in circulating immune complex or in tumor necrosis factor-inducing effects of circulating immune complex between postpolio patients and healthy controls, indicating that the postpolio syndrome is not due to an autoimmune reaction.
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Affiliation(s)
- Eva Melin
- Division of Rehabilitation Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden
| | - Azita Sohrabian
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Johan Rönnelid
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Kristian Borg
- Division of Rehabilitation Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden
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Tamburin S, Borg K, Caro XJ, Jann S, Clark AJ, Magrinelli F, Sobue G, Werhagen L, Zanette G, Koike H, Späth PJ, Vincent A, Goebel A. Immunoglobulin g for the treatment of chronic pain: report of an expert workshop. PAIN MEDICINE 2014; 15:1072-82. [PMID: 24422915 DOI: 10.1111/pme.12319] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND The treatment of chronic pain is still unsatisfactory. Despite the availability of different drugs, most patients with chronic pain do not receive satisfactory pain relief or report side effects. Converging evidence implicates involvement of the immune system in the pathogenesis of different types of nociceptive and neuropathic chronic pain. DESIGN At a workshop in Liverpool, UK (October 2012), experts presented evidence suggesting immunological involvement in chronic pain and recent data supporting the concept that the established immune-modulating drug, polyvalent immunoglobulin G (IgG), either given intravenously (IVIg) or subcutaneously (SCIg), may reduce pain in some peripheral neuropathies and a range of other pain disorders. Workshop's attendees discussed the practicalities of using IVIg and SCIg in these disorders, including indications, cost-effectiveness, and side effects. RESULTS IgG may reduce pain in a range of nociceptive and neuropathic chronic pain conditions, including diabetes mellitus, Sjögren's syndrome, fibromyalgia, complex regional pain syndrome, post-polio syndrome, and pain secondary to pathological autoantibodies. CONCLUSIONS IgG is a promising treatment in several chronic pain conditions. IgG is a relatively safe therapeutic strategy, with uncommon and mild side effects but high costs. Randomized, controlled trials and predictive tests are needed to better support the use of IgG for refractory chronic pain.
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Affiliation(s)
- Stefano Tamburin
- Department of Neurological and Movement Sciences, University of Verona, Verona, Verona, Italy
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Yelnik AP, Andriantsifanetra C, Bradai N, Sportouch P, Beaudreuil J, Dizien O. Poliomyelitis sequels in France and the clinical and social needs of survivors: a retrospective study of 200 patients. Ann Phys Rehabil Med 2013; 56:542-50. [PMID: 24120581 DOI: 10.1016/j.rehab.2013.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 08/06/2013] [Accepted: 08/07/2013] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Polio survivors in France are estimated at 50,000. This study aimed at describing their needs from their clinical and vocational conditions. METHOD A retrospective study of our physical and rehabilitation medicine (PRM) consultation activity. RESULTS One hundred and fifteen women/85 men, with a mean age of 51years±14.3 (17 to 82). Paralysis involved only one lower limb in 108 patients, the two lower limbs in 56 patients and only one upper limb in 4. At the time of the first consultation 137 patients had experienced functional worsening. The complaints were pain (105 subjects), fatigue (59) and new paresis (58). Only 25% had retired. Post-polio syndrome criteria were present in 46 subjects (23%). Patients who had contracted poliomyelitis in France (56%) differed from the other subjects with regard to age (58.4 versus 41.5), professional status and frequency of PPS (30.9% versus 12.6%). CONCLUSION These polio survivors were not particularly aged and they had often experienced functional worsening. The evolution of their disease shall represent a public health issue over the decades to come.
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Affiliation(s)
- A P Yelnik
- Service de médecine physique et de réadaptation, université Paris Diderot, UMR 8194 Paris Descartes, AP-HP, groupe hospitalier St.-Louis-Lariboisière-F.-Widal, 200, rue du Faubourg-Saint-Denis, 75010 Paris, France.
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Kumru H, Portell E, Marti M, Albu S, Tormos JM, Vidal J, Valls-Sole J. Mechanical and thermal hyperalgesia in patients with poliomyelitis. Clin Neurophysiol 2013; 124:1431-8. [DOI: 10.1016/j.clinph.2013.01.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Revised: 12/28/2012] [Accepted: 01/01/2013] [Indexed: 11/15/2022]
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Zespół post-polio: Część I. „Dziedzictwo” zapomnianej choroby, wyzwanie dla lekarzy i pacjentów. Neurol Neurochir Pol 2012; 46:357-71. [DOI: 10.5114/ninp.2012.30269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Jensen MP, Alschuler KN, Smith AE, Verrall AM, Goetz MC, Molton IR. Pain and Fatigue in Persons With Postpolio Syndrome: Independent Effects on Functioning. Arch Phys Med Rehabil 2011; 92:1796-801. [DOI: 10.1016/j.apmr.2011.06.019] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Revised: 05/30/2011] [Accepted: 06/20/2011] [Indexed: 01/22/2023]
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