Weather change and pain: a behavioral animal study of the influences of simulated meteorological changes on chronic pain

Environmental factors and their impact on chronic pain development and maintenance

It is more than recognized and accepted that the environment affects the physiological responses of all living things, from bacteria to superior vertebrates, constituting an important factor in the evolution of all species. Environmental influences range from natural processes such as sunlight, seasons of the year, and rest to complex processes like stress and other mood disorders, infections, and air pollution, being all of them influenced by how each creature deals with them. In this chapter, it will be discussed how some of the environmental elements affect directly or indirectly neuropathic pain, a type of chronic pain caused by a lesion or disease of the somatosensory nervous system. For that, it was considered the edge of knowledge in translational research, thus including data from human and experimental animals as well as the applicability of such findings.

Pain and Weather associations - Action Mechanisms; Personalized profiling

It is a well-known hypothesis that weather can influence human health, including pain sensation. The primary meteorological factors are atmospheric pressure, wind, humidity, precipitation, and temperature, which vary from the climate and seasons, but the parameters of space weather (e.g., geomagnetic and cosmic ray activities) also may affect our body condition. Despite a significant number of experimental studies, reviews, and meta-analyses concerning the potential role of weather in pain sensitivity, the findings are heterogeneous and lack consensus. Therefore, rather than attempting a comprehensive analysis of the entire literature on the effects of weather on different pain types, this study highlights the potential action mechanisms of the meteorological factors, and the possible causes of the controversial results. The few data available about the individual evaluations are discussed in detail to reveal the significance of the personalized analysis of the possible relationships between the most available weather parameters and the pain scores. The use of special algorithms may enable the individual integration of different data for a precise outcome concerning the link between pain sensitivity and weather parameters. It is presumed that despite the high level of interindividual differences in response to meteorological parameters, the patients can be clustered in different groups based on their sensitivity to the weather parameters with a possible disparate treatment design. This information may help patients to control their daily activities and aid physicians to plan more valuable management for patients with pain states when the weather conditions change.

To tolerate weather and to tolerate pain: two sides of the same coin? The Tromsø Study 7

ABSTRACT

It is a common belief that weather affects pain. Therefore, we hypothesized that weather can affect pain tolerance. This study used data from over 18,000 subjects aged 40 years or older from the general population, who participated in the Tromsø Study 7. They underwent a one-time assessment of cuff algometry pressure pain tolerance (PPT) and cold pain tolerance (CPT), tested with a cold pressor test. The results showed a clear seasonal variation in CPT. The rate of withdrawal in the cold pressor test was up to 75% higher in months in the warmer parts of the year compared with January 2016. There was no seasonal variation in PPT. The study not only found a nonrandom short-term variation in PPT but also indications of such a variation in CPT. The intrinsic timescale of this short-term variation in PPT was 5.1 days (95% % confidence interval 4.0-7.2), which is similar to the observed timescales of meteorological variables. Pressure pain tolerance and CPT correlated with meteorological variables, and these correlations changed over time. Finally, temperature and barometric pressure predicted future values of PPT. These findings suggest that weather has a causal and dynamic effect on pain tolerance, which supports the common belief that weather affects pain.

Passive Way of Measuring QOL/Well-Being Levels Using Smartphone Log

Research on mental health states involves paying increasing attention to changes in daily life. Researchers have attempted to understand such daily changes by relying on self-reporting through frequent assessment using devices (smartphones); however, they are mostly focused on a single aspect of mental health. Assessing the mental health of a person from various perspectives may help in the primary prevention of mental illness and the comprehensive measurement of mental health. In this study, we used users' smartphone logs to build a model to estimate whether the scores on three types of questionnaires related to quality of life and well-being would increase compared to the previous week (fluctuation model) and whether they would be higher compared to the average for that user (interval model). Sixteen participants completed three questionnaires once per week, and their smartphone logs were recorded over the same period. Based on the results, estimation models were built, and the F-score ranged from 0.739 to 0.818. We also analyzed the features that the estimation model emphasized. Information related to “physical activity,” such as acceleration and tilt of the smartphone, and “environment,” such as atmospheric pressure and illumination, were given more weight in the estimation than information related to “cyber activity,” such as usage of smartphone applications. In particular, in the Positive and Negative Affect Schedule (PANAS), 9 out of 10 top features in the fluctuation model and 7 out of 10 top features in the interval model were related to activities in the physical world, suggesting that short-term mood may be particularly heavily influenced by subjective activities in the human physical world.

Effects of short- and long-term exposure to air pollution and meteorological factors on Meniere's disease

The association between air pollutants and Meniere’s disease has not been explored. The present study investigated the relationship between meteorological factors and air pollutants on Meniere’s disease. Participants, aged ≥ 40 years, of the Korean National Health Insurance Service-Health Screening Cohort were included in this study. The 7725 patients with Meniere’s disease were matched with 30,900 control participants. The moving average meteorological and air pollution data of the previous 7 days, 1 month, 3 months, and 6 months before the onset of Meniere’s disease were compared between the Meniere’s disease and control groups using conditional logistic regression analyses. Additional analyses were conducted according to age, sex, income, and residential area. Temperature range; ambient atmospheric pressure; sunshine duration; and levels of SO₂, NO₂, O₃, CO, and PM₁₀ for 1 month and 6 months were associated with Meniere’s disease. Adjusted ORs (odds ratios with 95% confidence interval [CI]) for 1 and 6 months of O₃ concentration were 1.29 (95% CI 1.23–1.35) and 1.31 (95% CI 1.22–1.42), respectively; that for the 1 and 6 months of CO concentration were 3.34 (95% CI 2.39–4.68) and 4.19 (95% CI 2.79–6.30), respectively. Subgroup analyses indicated a steady relationship of O₃ and CO concentrations with Meniere’s disease. Meteorological factors and air pollutants were associated with the rate of Meniere’s disease. In particular, CO and O₃ concentrations were positively related to the occurrence of Meniere’s disease.

Blame it on the weather? The association between pain in fibromyalgia, relative humidity, temperature and barometric pressure

Self-reported pain levels in patients with fibromyalgia may change according to weather conditions. Previous studies suggest that low barometric pressure (BMP) is significantly related to increased pain, but that the contribution of changes in BMP has limited clinical relevance. The present study examined whether BMP influenced variability in perceived stress, and if stress levels moderated or mediated the relationship between BMP and pain. Forty-eight patients with fibromyalgia enrolled in a randomized controlled trail (RCT) reported pain and emotional state three times daily with mobile phone messages for a 30-consecutive day period prior to the start of the treatment in the RCT. The patients were unaware that weather data were collected simultaneously with pain and emotional reports. The results showed that lower BMP and increased humidity were significantly associated with increased pain intensity and pain unpleasantness, but only BMP was associated with stress levels. Stress levels moderated the impact of lower BMP on pain intensity significantly, where higher stress was associated with higher pain. Significant individual differences were present shown by a sub-group of patients (n = 8) who reacted opposite compared to the majority of patients (n = 40) with increased pain reports to an increase in BMP. In sum, lower BMP was associated with increased pain and stress levels in the majority of the patients, and stress moderated the relationship between BMP and pain at the group-level. Significant individual differences in response to changes in BMP were present, and the relation between weather and pain may be of clinical relevance at the individual level.

Lowering barometric pressure induces neuronal activation in the superior vestibular nucleus in mice

Weather changes accompanied by decreases in barometric pressure are suggested to trigger meteoropathy, i.e., weather-related pain. We previously reported that neuropathic pain-related behavior in rats is aggravated by lowering barometric pressure, and that this effect is abolished by inner ear lesions. These results suggest that mechanisms that increase vestibular neuronal activity may parallel those that contribute to meteoropathy generation. However, it remains unknown whether changes in barometric pressure activate vestibular neuronal activity. To address this issue, we used expression of c-Fos protein as a marker for neural activation. Male and female mice were placed in a climatic chamber, and the barometric pressure was lowered by 40 hPa, from 1013 hPa, for 50 min (LP stimulation). The total number of c-Fos-positive cells in the vestibular nuclei was counted bilaterally after LP stimulation. We also video-recorded mouse behaviors and calculated the total activity score during the LP stimulation. LP stimulation resulted in significant c-Fos expression in the superior vestibular nucleus (SuVe) of male and female mice. There was no effect of LP stimulation on the total activity score. These data show that distinct neurons in the SuVe respond to LP stimulation. Similar mechanisms may contribute to the generation of meteoropathy in humans.

Effects of cold temperatures on the excitability of rat trigeminal ganglion neurons that are not for cold sensing

Aside from a small population of primary afferent neurons for sensing cold, which generate sensations of innocuous and noxious cold, it is generally believed that cold temperatures suppress the excitability of primary afferent neurons not responsible for cold sensing. These not-for-cold-sensing neurons include the majority of non-nociceptive and nociceptive afferent neurons. In this study we have found that the not-for-cold-sensing neurons of rat trigeminal ganglia (TG) change their excitability in several ways at cooling temperatures. In nearly 70% of not-for-cold-sensing TG neurons, a cooling temperature of 15°C increases their membrane excitability. We regard these neurons as cold-active neurons. For the remaining 30% of not-for-cold-sensing TG neurons, the cooling temperature of 15°C either has no effect (cold-ineffective neurons) or suppress their membrane excitability (cold-suppressive neurons). For cold-active neurons, the cold temperature of 15°C increases their excitability as is evidenced by increases in action potential (AP) firing numbers and/or the reduction in AP rheobase when these neurons are depolarized electrically. The cold temperature of 15°C significantly inhibits M-currents and increases membrane input resistance of cold-active neurons. Retigabine, an M-current activator, abolishes the effect of cold temperatures on AP firing, but not the effect of cold temperature on AP rheobase levels. The inhibition of M-currents and the increases of membrane input resistance are likely two mechanisms by which cooling temperatures increase the excitability of not-for-cold-sensing TG neurons. This article is part of the special article series "Pain".

The Weather and Ménière's Disease: A Longitudinal Analysis in the UK

HYPOTHESIS

Changes in the weather influence symptom severity in Ménière's disease (MD).

BACKGROUND

MD is an unpredictable condition that significantly impacts on quality of life. It is suggested that fluctuations in the weather, especially atmospheric pressure may influence the symptoms of MD. However, to date, limited research has investigated the impact of the weather on MD.

METHODS

In a longitudinal study, a mobile phone application collected data from 397 individuals (277 females and 120 males with an average age of 50 yr) from the UK reporting consultant-diagnosed MD. Daily symptoms (vertigo, aural fullness, tinnitus, hearing loss, and attack prevalence) and GPS locations were collected; these data were linked with Met Office weather data (including atmospheric pressure, humidity, temperature, visibility, and wind speed).

RESULTS

Symptom severity and attack prevalence were reduced on days when atmospheric pressure was higher. When atmospheric pressure was below 1,013 hectopascals, the risk of an attack was 1.30 (95% confidence interval: 1.10, 1.54); when the humidity was above 90%, the risk of an attack was 1.26 (95% confidence interval 1.06, 1.49).

CONCLUSION

This study provides the strongest evidence to date that changes in atmospheric pressure and humidity are associated with symptom exacerbation in MD. Improving our understanding of the role of weather and other environmental triggers in Ménière's may reduce the uncertainty associated with living with this condition, significantly contributing to improved quality of life.

Thermal sensitivity of voltage-gated Na+ channels and A-type K+ channels contributes to somatosensory neuron excitability at cooling temperatures

Cooling temperatures may modify action potential firing properties to alter sensory modalities. Herein, we investigated how cooling temperatures modify action potential firing properties in two groups of rat dorsal root ganglion (DRG) neurons, tetrodotoxin-sensitive (TTXs) Na(+) channel-expressing neurons and tetrodotoxin-resistant (TTXr) Na(+) channel-expressing neurons. We found that multiple action potential firing in response to membrane depolarization was suppressed in TTXs neurons but maintained or facilitated in TTXr neurons at cooling temperatures. We showed that cooling temperatures strongly inhibited A-type K(+) currents (IA) and TTXs Na(+) channels but had fewer inhibitory effects on TTXr Na(+) channels and non-inactivating K(+) currents (IK). We demonstrated that the sensitivity of A-type K(+) channels and voltage-gated Na(+) channels to cooling temperatures and their interplay determine somatosensory neuron excitability at cooling temperatures. Our results provide a putative mechanism by which cooling temperatures modify different sensory modalities including pain.

Possible effects of changes in the meteorological state over semi-arid areas on the general well-being of weather-sensitive patients

BACKGROUND

The influence of the changes in atmospheric states, typical for areas close to big deserts, on general well-being of hypertensive persons was analyzed.

METHODS

Under test was the group of 20 hypertensive weather-sensitive patients; their blood pressure, pulse rate and appearance of 4 symptoms of discomfort sensations: arthritic pain, unjustified anxiety, severe headache and inexplicable tiredness- were registered. Symptoms are classified in ICD-9 code (780-790) and scored on a 4-point scale. Results were defined as positive (no departure from the range of normal values) or problematic; the daily number of the latter results was collected under the name "pathological reactions" NPR if at least two of these 7 checked symptoms (of one patient) were outside the normal range. Comparison of the current weather conditions with their means, questioning of patients and repeated examinations are used to gain information. The data was analyzed employing the SAS statistical software. Pearson and Spearman correlations were used, applied on the best and worst days, when a minimum and a maximum of pathological changes NPR in the patients' well-being were observed. The statistical significance was p < 0.05 in all cases.

RESULTS

~1500 medical observations and verbal statements were registered in the Primary Care Clinic (Be'er-Sheva, Israel) during 2001-2002. No meaning correlation was found between NPR and absolute values of temperature, humidity and atmospheric pressure. Variations in wind speed WS and direction were expressed in blood pressure changes and in exacerbation of discomfort of various degrees. Unfavorable conditions correspond to days with dominant desert air streams and to high WS, when NPR reaches 85.7%; during the days with prevalent sea breeze NPR was ≤22.9%. The role of wind direction in NPR occurrence is prevalent when WS > 4 m·s-1. The Spearman test gives higher correlation than Pearson test (ρ ~ 0.14, p < 0.03 against ρ ~ 0.1, p < 0.04).

CONCLUSIONS

NPR is more affected by the air streams than by absolute values of meteorological parameters. The method of this study might give to family doctors some additional tools to predict deterioration in general feelings of chronic patients and could be related to other health problems influenced by the meteorological environment.

Chronic pain and weather conditions in patients suffering from temporomandibular disorders: a pilot study

OBJECTIVES

Patients with temporomandibular disorders (TMDs) often report increased pain in response to changes in weather conditions. Nevertheless, scientific evidence supporting this relationship is scarce. The aim of this study was to assess a potential relationship between pain intensity and meteorological factors, through a newly developed, portable device, in patients affected by chronic masticatory muscle pain.

METHODS

Seven female subjects were diagnosed with myofascial pain of the masticatory muscles, according to RDC/TMD criteria, were recruited, and participated in the study. Each patient was provided with a portable data logger that recorded and stored weather variables (atmospheric pressure, air humidity, temperature) every 15 min. Patients were asked to record the level of perceived pain on an electronic visual analogue scale (VAS) every hour. The relationship between meteorological variables and pain scores was investigated using separate generalized least squares regression models with a correlation structure estimated via autoregressive integrated moving average models.

RESULTS

Individual VAS trajectories in the study period were different. The effect of meteorological factors on VAS scores was statistically significant in five subjects, with at least one main effect and/or one two-way interaction between meteorological variables being significant.

CONCLUSIONS

The analyses suggest the existence of different interindividual responses to climatic changes. However, the identified putative role of meteorological variables and of their two-way interactions suggests that further investigations on larger samples may be useful to assess the research question under examination.

Pop hole use by hens with different keel fracture status monitored throughout the laying period

The aim of this work was to study the effect of keel fractures on the extent to which free-range hens access the range through pop holes. Over two consecutive laying periods (two production years) a total of 1100 individual birds from one half of a house, divided into four separated flocks, were caught at 25, 35, 45, 55 and 65 weeks, palpated to assess the prevalence and severity of keel fractures and tagged with RFID transponders. Their use of pop holes was subsequently monitored in some cases from week 25 to end of lay at 68 to 70 weeks. At regular intervals (every 10 weeks), the tagged birds were re-caught to assess changes in keel fracture prevalence and severity. The average percentage of birds with fractured keels at 25, 35, 45, 55, 65 and at end of lay (68 to 70 weeks of age) was 5.5, 25.5, 49, 63, 66.5 and 78.5, respectively, across both production years. The effect of keel score on pop hole use was modelled statistically, adjusting for weather conditions and age of the birds. There were significant effects of most of the weather variables recorded, as well as age of the bird, on use of pop holes and also a significant effect of keel score. Higher keel scores resulted in a reduction in pop hole use. A significant statistical interaction between keel score and ambient temperature revealed an accelerated reduction in use as the temperature decreased and keel score increased. It is concluded that the occurrence of keel fractures may affect the birds' ability or willingness to utilise the outdoor range provided by free-range housing systems, thereby reducing the potential welfare advantages of this type of housing.

The rate and magnitude of atmospheric pressure change that aggravate pain-related behavior of nerve injured rats

Complaints of patients with chronic pain may increase when the weather changes. The exact mechanism for weather change-induced pain has not been clarified. We have previously demonstrated that artificially lowering barometric pressure (LP) intensifies pain-related behaviors in rats with neuropathic pain [chronic constriction injury (CCI) and spinal nerve ligation (SNL)]. In the present study, we examined the rate and magnitude of LP that aggravates neuropathic pain. We measured pain-related behaviors [number of paw lifts to von Frey hair (VFH) stimulation] in awake rats after SNL or CCI surgery, and found that rates of decompression ≥5 hPa/h and ≥10 hPa/h and magnitudes of decompression ≥5 hPa and ≥10 hPa augmented pain-related behaviors in SNL and CCI rats, respectively. These results indicate that LP within the range of natural weather patterns augments neuropathic pain in rats, and that SNL rats are more sensitive to LP than CCI rats.

The inner ear is involved in the aggravation of nociceptive behavior induced by lowering barometric pressure of nerve injured rats

Patients suffering from neuropathic pain often complain of pain aggravation when the weather is changing. The exact mechanism for weather change-induced pain has not been clarified. We have previously demonstrated that experimentally lowering barometric pressure (LP) intensifies pain-related behaviors in rats with chronic constriction injury (CCI). In the present experiment we examined whether this pain aggravating effect of LP exposure in nerve injured rats is still present after lesioning of the inner ear. We used both CCI and spinal nerve ligation (SNL) models for this study. We injected into the middle ear sodium arsanilate solution (100mg/ml, 50microl/ear), which is known to degenerate vestibular hair cells, under anesthesia the day before surgery. Rats were exposed to LP (27hPa decrease over 8min) 7-9 days after CCI or 5-8 days after SNL surgery, and pain-related behavior (number of paw lifts induced by von Frey hair stimuli) was measured. When the inner ear lesioned SNL or CCI rats were exposed to LP, they showed no augmentation of pain-related behavior. On the other hand, the pain aggravating effect of a temperature decrease (from 24 to 17 degrees C) was maintained in both SNL and CCI rats. These results suggest that the barometric sensor/sensing system influencing nociceptive behavior during LP in rats is located in the inner ear.

Biometeorological effects on worker absenteeism

The effects of six biometeorological variables (temperature, precipitation, air pressure, humidity, wind speed, and snow) on plant-wide worker absenteeism rates were investigated using 4 years of daily absence data (n=889). After holding constant temporal variables (years, season, and day of week), and then other biometeorological variables, all but one of the variables under consideration were uniquely and significantly related to absenteeism: temperature (r(partial)=-0.17***), precipitation (r(partial)=0.12***), air pressure (r(partial)=-0.09**), wind speed (r(partial)=0.11*), and snow (r(partial)=0.30***). Humidity (r(partial)=-00, ns) was not uniquely correlated. The adjusted R(2) of .29 (full R=0.55) for the entire model was also significant, illustrating the importance of these exogenous, meteorological variables in developing a prediction model of plant-wide absenteeism.