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Bilika P, Aivatzidis I, Kaloudis K, Gkotzamanis R, Ruscheweyh R, Kapreli E. Pain Sensitivity Questionnaire: Cross-cultural adaptation and validation of the Greek version. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2024; 29:e2113. [PMID: 39076064 DOI: 10.1002/pri.2113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 06/01/2024] [Accepted: 07/15/2024] [Indexed: 07/31/2024]
Abstract
INTRODUCTION The Pain Sensitivity Questionnaire (PSQ) was developed to assess general pain sensitivity. OBJECTIVE This study aimed to validate the Greek version of PSQ. METHODS The questionnaire was translated into Greek (PSQ-GR) and piloted in a small sample of patients with chronic pain (n = 35). A total of 146 chronic pain patients and healthy volunteers completed the PSQ-GR, the Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS) and Central Sensitization Inventory (CSI). To evaluate the test-retest reliability, 36 volunteers completed the PSQ-GR twice over 7 ± 2 days. RESULTS Internal consistency was excellent (Cronbach's alpha 0.90-0.96) for PSQ-total, PSQ-minor, and PSQ-moderate. The Intraclass Correlation Coefficient was estimated at 0.90-0.96 for PSQ-total, PSQ-minor and PSQ-moderate and the SEM was 0.59-0.90 for PSQ-total, PSQ-minor and PSQ-moderate approximately. The smallest detectable change was 0.48 for PSQ-total, 0.47 for PSQ-minor and 0.44 for PSQ-moderate. Positive and significant correlations were observed between PSQ-GR and HADS (r = 0.38, p < 0.01), PCS (r = 0.41, p < 0.01) and CSI (r = 0.30, p < 0.01). Statistically significant differences in PSQ-GR scores were identified between the healthy volunteers and the chronic pain patients. CONCLUSION The PSQ-GR is a reliable and valid tool that can assess pain sensitivity in healthy individuals and chronic musculoskeletal pain patients.
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Affiliation(s)
- Paraskevi Bilika
- Clinical Exercise Physiology and Rehabilitation Research Laboratory, Department of Physiotherapy, School of Health Sciences, University of Thessaly, Lamia, Greece
| | - Ioannis Aivatzidis
- Clinical Exercise Physiology and Rehabilitation Research Laboratory, Department of Physiotherapy, School of Health Sciences, University of Thessaly, Lamia, Greece
| | - Konstantinos Kaloudis
- Clinical Exercise Physiology and Rehabilitation Research Laboratory, Department of Physiotherapy, School of Health Sciences, University of Thessaly, Lamia, Greece
| | - Rafail Gkotzamanis
- Clinical Exercise Physiology and Rehabilitation Research Laboratory, Department of Physiotherapy, School of Health Sciences, University of Thessaly, Lamia, Greece
| | - Ruth Ruscheweyh
- Department of Neurology Ludwig Maximilians, University of Munich, Munich, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Technical University of Munich, Munich, Germany
| | - Eleni Kapreli
- Clinical Exercise Physiology and Rehabilitation Research Laboratory, Department of Physiotherapy, School of Health Sciences, University of Thessaly, Lamia, Greece
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Smits RJH, van der Wal SEI, van Boekel RLM, Timmerman H, Bronkhorst EM, Abrar D, Vissers KCP, Blaney Davidson EN, Steegers MAH. Sex Differences in Pain Sensitivity in a Dutch Cohort: Cross-Sectional and Web-Based Multidimensional Study. J Med Internet Res 2024; 26:e53926. [PMID: 39121479 DOI: 10.2196/53926] [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: 11/02/2023] [Revised: 04/19/2024] [Accepted: 06/12/2024] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND Sex is an important factor influencing the development and treatment of chronic pain, but the extent of its influence is still unclear. Other demographic factors as well as nonpharmacological interventions might influence pain sensitivity differently in men and women. OBJECTIVE In this study, we aimed to investigate the influence of sex and other demographic, lifestyle, behavioral, clinical, and environmental factors on pain sensitivity in the Dutch population. Different films were used to investigate how they would impact pain sensitivity and what influence sex and other variables have on the effect of this simple intervention. METHODS We performed a study consisting of 2 parts: (1) a cross-sectional research to investigate pain sensitivity differences between men and women and the influence of other demographic variables on the pain sensitivity in a Dutch cohort and (2) an internet intervention study to determine whether a short film could skew pain sensitivity. RESULTS All respondents filled in a web-based demographic questionnaire and were randomized into 4 groups. The control group filled in the Pain Sensitivity Questionnaire without watching a preliminary film. A cross-sectional analysis was performed in the control group (n=1746). The other 3 groups watched short films: one group watched a film with scenes of nature (n=2650), another group watched a film on laughing people (n=2735), and the last group watched a film on physically painful events (n=2708). Immediately after the film viewing, participants were directed to the Pain Sensitivity Questionnaire to measure their pain sensitivity. The Pain Sensitivity Questionnaire score was stated as a mean per question on the numeric rating scale from 0-1. The cross-sectional study revealed no significant differences between men and women but showed male-female differences in the Pain Sensitivity Questionnaire when specific background factors were present. Watching a short film had a positive impact on the pain sensitivity of the respondents who had chronic pain, with a higher effect observed in female respondents. CONCLUSIONS Scientists performing pain research need to account for factors that can influence the outcome of their study and be aware that these factors can be sex-dependent, and pain sensitivity should be analyzed accordingly. Even relatively small interventions such as watching a film can impact pain sensitivity, especially in respondents with current chronic pain. This effect can vary as well when different background factors are present. Our findings warrant further explorations of the possibilities that simple interventions bring for patients in personalized medicine. TRIAL REGISTRATION Landelijk Trial Register NTR-new NL8182; https://onderzoekmetmensen.nl/en/trial/29537.
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Affiliation(s)
- Rachel J H Smits
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud university medical center, Nijmegen, Netherlands
| | - Selina E I van der Wal
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud university medical center, Nijmegen, Netherlands
| | - Regina L M van Boekel
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud university medical center, Nijmegen, Netherlands
| | - Hans Timmerman
- Department of Anesthesiology, Pain Center, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Ewald M Bronkhorst
- Department for Health Evidence, Radboud university medical center, Nijmegen, Netherlands
| | - Diana Abrar
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud university medical center, Nijmegen, Netherlands
| | - Kris C P Vissers
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud university medical center, Nijmegen, Netherlands
| | | | - Monique A H Steegers
- Department of Anesthesiology, Amsterdam University Medical Center, location VU Medical Center, Amsterdam, Netherlands
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Bazancir-Apaydin Z, Sari F. Psychometric properties of the Turkish version of Central Sensitization Inventory-9 in patients with chronic musculoskeletal pain. Int J Rehabil Res 2024; 47:122-128. [PMID: 38470712 DOI: 10.1097/mrr.0000000000000617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
The aim of the study was to assess the psychometric properties of the Turkish version of Central Sensitization Inventory-9 (CSI-9) in patients with chronic musculoskeletal pain. The methodological study included 92 patients with chronic musculoskeletal pain. The original version of the CSI-9 was translated and culturally adapted into Turkish. The internal consistency and test-retest reliability were evaluated with Cronbach's α and the intraclass correlation coefficient (ICC), respectively. The assessment of reproducibility was conducted with the standard error of measurement (SEM) and minimal detectable difference (MDD) values. Convergent validity was explored by correlation analysis between the CSI-9 and Central Sensitization Inventory (CSI-25), Brief Pain Inventory (BPI), and European Quality of Life Survey-5 Dimensions (EQ-5D). The structural validity was assessed with factor analysis. Floor and ceiling effects were also analyzed. We found a very good internal consistency (Cronbach's α of 0.83) and excellent test-retest reliability (ICC of 0.96) of the Turkish CSI-9. The SEM demonstrated a range between 0.19 and 1.12, and the MDD was observed to vary from 1.17 to 1.35. The CSI-9 correlated significantly with the CSI-25 ( r = 0.77, P < 0.001), the pain severity subscale of the BPI ( r = 0.41 to 0.53, P < 0.001), the pain interference subscale of the BPI ( r = 0.21 to 0.58, P = 0.02 to P < 0.001), the EQ-5D ( r = 0.24 to 0.48, P < 0.05), and the EQ-5D visual analog scale ( r = -0.41, P < 0.001). One factor was identified within the CSI-9. Our data suggest that the Turkish CSI-9 is reliable and valid outcome measure for assessing CS in patients with chronic musculoskeletal pain.
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Affiliation(s)
- Zilan Bazancir-Apaydin
- Department of Physiotherapy and Rehabilitation, Ankara Medipol University Faculty of Health Science, Ankara
| | - Fulden Sari
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bingol University, Bingöl, Turkey
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Gräper PJ, Hartvigsen J, Scafoglieri A, Clark JR, van Trijffel E, Hallegraeff JM. Sensory profiles and their role in the persistence of central sensitization symptoms in low back pain. A prospective cohort study. Physiother Theory Pract 2024:1-10. [PMID: 38466052 DOI: 10.1080/09593985.2024.2326592] [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: 05/16/2023] [Accepted: 02/28/2024] [Indexed: 03/12/2024]
Abstract
INTRODUCTION Acute lower back pain can lead to neuroplastic changes in the central nervous system, and symptoms of central sensitization after 12 weeks. While sensory sensitivity has been shown to predict symptoms of central sensitization, trait sensory profiles may be prognostic in the persistence of central sensitization symptoms in low back pain over time. OBJECTIVE To examine sensory profiles as prognostic symptoms of central sensitization in people with acute low back pain. METHODS A longitudinal type 2 prognostic factor research study was performed according to the PROGRESS framework. Baseline and 12-week follow-up measures were taken using the Adolescent/Adult Sensory Profile and the Central Sensitization Inventory measures. Study participants were consecutively included from primary care physiotherapy practices. Univariable, and multivariable regression analyses were performed to adjust sensory profiles based on previous history of low back pain, baseline Central Sensitization Inventory scores, level of pain, disability, age, and duration of low back pain. RESULTS After adjustment, the sensory profiles of Low Registration B = 0.44, 95%CI (0.18, 0.70), Sensation Seeking B = 0.38, 95%CI (0.19, 0.57), Sensory Sensitive B = 0.49, 95%CI (0.25, 0.74), Sensation Avoiding B = 0.40, 95% CI (0.15, 0.65) was significantly associated with the persistence of central sensitization symptoms (N = 103). CONCLUSION Sensory profiles may predict symptoms of central sensitization after 12 weeks in people with acute low back pain.
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Affiliation(s)
- Pieter J Gräper
- Faculty of Physical Education and Physiotherapy, Department of Physiotherapy, Human Physiology and Anatomy, Experimental Anatomy research group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jan Hartvigsen
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Aldo Scafoglieri
- Faculty of Physical Education and Physiotherapy, Department of Physiotherapy, Human Physiology and Anatomy, Experimental Anatomy research group, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Master Education, SOMT University of Physiotherapy, Amersfoort, The Netherlands
| | - Jacqueline R Clark
- Faculty of Physical Education and Physiotherapy, Department of Physiotherapy, Human Physiology and Anatomy, Experimental Anatomy research group, Vrije Universiteit Brussel, Brussels, Belgium
- Pains & Brains, Omokoroa, New Zealand
| | | | - Joannes M Hallegraeff
- Faculty of Physical Education and Physiotherapy, Department of Physiotherapy, Human Physiology and Anatomy, Experimental Anatomy research group, Vrije Universiteit Brussel, Brussels, Belgium
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Alqarni A, Khan F, Alabasi U, Ruscheweyh R. Translation, cross-cultural adaptation, and measurement properties of the Arabic version of the pain sensitivity questionnaire. FRONTIERS IN PAIN RESEARCH 2024; 5:1339449. [PMID: 38380375 PMCID: PMC10877041 DOI: 10.3389/fpain.2024.1339449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/23/2024] [Indexed: 02/22/2024] Open
Abstract
Background The Pain Sensitivity Questionnaire (PSQ) is a reliable and valid self-reported tool for the assessment of pain sensitivity in clinical practice. The PSQ has been translated, validated, and cross-culturally adapted into multiple languages. However, a validated Arabic version of the PSQ is not available. Thus, this study aims to translate, validate, and cross-culturally adapt the English version of the PSQ into the Arabic language. Methods and materials The English version of the PSQ was translated and culturally adapted into Arabic following international guidelines. The psychometric properties of the final version of the PSQ-Arabic (PSQ-A) were tested among 119 patients with different persistent musculoskeletal (MSK) pain. Findings The Cronbach's α for the PSQ-A-total, PSQ-A-moderate, and PSQ-C-minor were 0.81, 0.79, and 0.76, respectively. The means for the PSQ-A-total, PSQ-A-moderate, and PSQ-C-minor scores were 5.07 (±1.28), 5.64 (±2.07), and 4.50 (±0.50). The test-retest reliability measured with the interclass correlation coefficient for 68 subjects was 0.80 for the PSQ-A-total, 0.74 for the PSQ-A-moderate, and 0.77 for the PSQ-A-minor. The PSQ-A-total and the PSQ-A-minor showed positive significant correlations with pain catastrophizing scale (PCS) (r = 0.15, 0.17); P ≤ 0.05), respectively. The PSQ-A-total, PSQ-A-moderate, and PSQ-A-minor showed positive significant correlations with the Brief Pain Inventory (BPI)-pain scores (r = 0.47, 0.43, 0.45; P ≤ 0.01), respectively and with the BPI-pain interference scores (r = 0.37, 0.33, 0.34; P ≤ 0.01), respectively. Conclusions This study shows that the PSQ-A is a reliable and valid tool to assess individuals with pain sensitivity in Arabic populations. Further studies are recommended to examine the concurrent validity of the PSQ-A against experimental pain sensitivity measures.
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Affiliation(s)
- Abdullah Alqarni
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Fayaz Khan
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Umar Alabasi
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ruth Ruscheweyh
- Department of Neurology, University of Munich, Munich, Germany
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Freund-Azaria A, Bart O, Regev R, Bar-Shalita T. Breastfeeding-related Pain, Sensory Over-responsiveness, and Exclusive Breastfeeding at 6 Months: A Prospective Cohort Study. Womens Health Issues 2024; 34:80-89. [PMID: 37940508 DOI: 10.1016/j.whi.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 09/18/2023] [Accepted: 09/27/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Exclusive breastfeeding (EBF) is recommended for the first 6 months of life, yet EBF rates at 6 months (T3) in most developed countries are low. Painful and nonpainful sensory stimuli processing is linked, and while pain has been suggested to restrict breastfeeding, its coupling with sensory over-responsiveness (SOR) in relation to breastfeeding has not yet been reported. OBJECTIVE We aimed to explore whether breastfeeding-related pain, SOR, and general pain sensitivity predict nonexclusive breastfeeding (NEBF) at T3. STUDY DESIGN In this prospective study, participants were recruited at 2 days postpartum (enrollment). For the assessment of breastfeeding-related pain, participants completed the visual analogue scale and the Short-Form McGill Pain Questionnaire at enrollment, and at 6 weeks after birth. At T3, they completed the Pain Sensitivity Questionnaire and the Sensory Responsiveness Questionnaire-Intensity Scale and then provided information about their breastfeeding status. Participants were divided into two groups accordingly: EBF and NEBF. RESULTS A total of 164 participants were reached at T3: EBF (n = 105) and NEBF (n = 59). The incidence of SOR was significantly higher among NEBF compared with EBF participants (25.4% vs. 11.4%; p = .020). Between enrollment and 6 weeks after birth, 72.3% of the EBF participants had reported a ≥30% pain reduction, compared with 44.8% of the NEBF participants (p = .001). Logistic regression modeling revealed that both breastfeeding-related pain reduction and SOR predicted NEBF at T3 (p < .001), indicating a 3.2 times (p = .001) and 2.5 times (p = .041) odds ratio for NEBF, respectively. CONCLUSIONS SOR and sustained breastfeeding-related pain predict NEBF at T3 and may emerge as substantial breastfeeding barriers.
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Affiliation(s)
- Adi Freund-Azaria
- Faculty of Medicine, Occupational Therapy Department, School of Health Professions, Tel-Aviv University, Ramat Aviv, Tel Aviv, Israel; Department of Neonatology, Meir Medical Center, Kfar-Saba, Israel
| | - Orit Bart
- Faculty of Medicine, Occupational Therapy Department, School of Health Professions, Tel-Aviv University, Ramat Aviv, Tel Aviv, Israel
| | - Rivka Regev
- Clalit Health Organization and Neonatal Follow-up Clinic, Meir Medical Center, Kfar-Saba, Israel
| | - Tami Bar-Shalita
- Faculty of Medicine, Occupational Therapy Department, School of Health Professions, Tel-Aviv University, Ramat Aviv, Tel Aviv, Israel.
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Meeker TJ, Kim HJ, Tulloch IK, Keaser ML, Seminowicz DA, Dorsey SG. Secondary analysis: heat and self-report pain sensitivity associate with biological sex and racialized sociocultural group but may not be mediated by anxiety or pain catastrophizing. Pain Rep 2024; 9:e1133. [PMID: 38283650 PMCID: PMC10811695 DOI: 10.1097/pr9.0000000000001133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 10/10/2023] [Accepted: 10/24/2023] [Indexed: 01/30/2024] Open
Abstract
Introduction Previous studies have demonstrated associations between sex and racialized group on pain sensitivity and tolerance. We analyzed the association of sex and racialized group on heat pain sensitivity, sensibility to painful suprathreshold mechanical pain (STMP), and pain sensitivity questionnaire (PSQ). We hypothesized that anxiety and pain catastrophizing reported by racialized minority groups and women would mediate enhanced pain sensitivity. Our secondary aim was to evaluate validity of the PSQ in a diverse population. Methods Using quantitative sensory testing for painful heat, STMP (forces: 64, 128, 256, and 512 mN), and PSQ, we evaluated pain sensitivity in 134 healthy participants [34 (18 women) Asian, 25 (13 women) Black, and 75 (41 women) White]. We used general linear and linear mixed models to analyze outcomes. We assessed mediation of state and trait anxiety and pain catastrophizing on pain sensitivity. Results Racialized minority status was associated with greater heat pain sensitivity (F = 7.63; P = 0.00074) and PSQ scores (F = 15.45; P = 9.84 × 10-7) but not associated with STMP (F = 1.50; P = 0.23). Female sex was associated with greater heat pain sensitivity (F = 4.9; P = 0.029) and lower PSQ (F = 9.50; P = 0.0025) but not associated with STMP (F = 0.0018; P = 0.97). Neither anxiety nor pain catastrophizing mediated associations between sex or racialized group with heat pain threshold or PSQ. Differential experience of individual items (F = 19.87; P = 3.28 × 10-8) limited PSQ face validity in racialized minorities. Conclusion Consistent with previous research, sensitivity to painful heat was associated with racialized minority status and female sex. By contrast, there was no significant effect of racialized minority status or female sex on STMP. Some PSQ items are inapplicable to participants from racialized minority groups.
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Affiliation(s)
- Timothy J. Meeker
- Department of Biology, Morgan State University, Baltimore, MD, USA
- Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, MD, USA
| | - Hee Jun Kim
- Community of Acute and Chronic Care, The George Washington University, Washington, DC, USA
| | - Ingrid K. Tulloch
- Department of Psychology, Morgan State University, Baltimore, MD, USA
| | - Michael L. Keaser
- Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, MD, USA
| | - David A. Seminowicz
- Department of Medical Biophysics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada
| | - Susan G. Dorsey
- Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, MD, USA
- Department of Pain and Translational Symptom Sciences, University of Maryland School of Nursing, Baltimore, MD, USA
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Zhao H, Ran S, Gan K, Du Y, Li W. Pain sensitivity and quality of life of patients with burning mouth syndrome: a preliminary study in a Chinese population. BMC Oral Health 2023; 23:951. [PMID: 38041054 PMCID: PMC10693025 DOI: 10.1186/s12903-023-03689-2] [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: 10/11/2023] [Accepted: 11/21/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Burning mouth syndrome (BMS) is an oral-facial pain disorder involving the central and peripheral nervous systems, but the evidence for altered pain sensitivity remains inconclusive. The aim of this study was to investigate pain sensitivity and oral health-related quality of life (OHRQoL) in patients with BMS and to assess the relationship between them. METHODS Fifty Chinese patients with BMS (57.82 ± 11.2 years) and fifty age- and gender-matched healthy subjects (55.64 ± 10.1 years) participated in the study. The Pain Sensitivity Questionnaire (PSQ) was used to assess participants' pain sensitivity. The Oral Health Impact Profile (OHIP-14) was used to evaluate participants' OHRQoL. RESULTS The PSQ total score (p = 0.009), the PSQ minor score (p = 0.003) and the OHIP-14 score (p<0.05) of patients with BMS were significantly higher than those of the healthy subjects. Simple linear regression showed that the PSQ minor score was significantly associated with the OHIP-14 score in patients with BMS (β = 0.338, p = 0.016). CONCLUSION Patients with BMS have higher pain sensitivity than healthy subjects. Reducing pain sensitivity might help to improve the quality of life of patients with BMS.
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Affiliation(s)
- Hongsen Zhao
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450052, China.
| | - Shujun Ran
- National Clinical Research Center for Oral Diseases, Shanghai, China
| | - Kang Gan
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450052, China
| | - Yajing Du
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450052, China
| | - Wenlu Li
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450052, China
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Flasbeck V, Matthiessen A, Alabowitz A, Rusu AC, Brüne M. Is your pain my pain? A study exploring the relation between pain sensitivity, pain thresholds and empathy for somatic and psychological pain. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2023; 62:748-761. [PMID: 37605326 DOI: 10.1111/bjc.12436] [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: 04/27/2023] [Revised: 07/14/2023] [Accepted: 08/06/2023] [Indexed: 08/23/2023]
Abstract
OBJECTIVES Research has shown that empathy for both somatic and psychological pain recruits affective components of the so-called pain matrix, a set of brain regions that is activated during the perception of somatic pain. In addition, the subjective evaluation of experimentally induced somatic pain is related to empathy for somatic pain. In contrast, it is unclear whether or not the subjective sensitivity to somatic pain impacts on empathy for psychological pain. METHODS In the present study, 55 healthy participants conducted a pain-pressure-test (PPT) and a cold-pressor test (CPT) in order to assess pain thresholds, pain tolerance and evaluation of pain during the task. They further conducted the social interaction empathy task (SIET), which investigates empathy for somatic as well as psychological pain. All participants completed the interpersonal-reactivity index (IRI) and the pain-sensitivity questionnaire (PSQ). RESULTS Participants who are in general more sensitive to somatic pain, as indicated by high-PSQ scores, showed higher empathy, that is, higher pain ratings, for both somatic and psychological painful situations observed in others as compared to those with low-PSQ scores. High-PSQ scores and high pain and unpleasantness ratings during the CPT were correlated with empathy for pain (both pain conditions), whereas pain thresholds (PPT) and pain tolerance thresholds (CPT) did not correlate with empathy. The IRI subscore 'personal distress' correlated with psychological pain ratings. CONCLUSIONS Thus, empathy for both somatic and psychological pain were related to the subjective evaluation of somatic pain and general pain sensitivity.
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Affiliation(s)
- Vera Flasbeck
- Division of Social Neuropsychiatry and Evolutionary Medicine, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital Bochum, Ruhr University Bochum, Bochum, Germany
| | - Annegret Matthiessen
- Division of Social Neuropsychiatry and Evolutionary Medicine, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital Bochum, Ruhr University Bochum, Bochum, Germany
- Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr University Bochum, Bochum, Germany
| | - Anne Alabowitz
- Division of Social Neuropsychiatry and Evolutionary Medicine, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital Bochum, Ruhr University Bochum, Bochum, Germany
- Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr University Bochum, Bochum, Germany
| | - Adina Carmen Rusu
- Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr University Bochum, Bochum, Germany
| | - Martin Brüne
- Division of Social Neuropsychiatry and Evolutionary Medicine, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital Bochum, Ruhr University Bochum, Bochum, Germany
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Lau KKL, Kwan KYH, Cheung JPY, Law KKP, Cheung KMC. Impact of mental health components on the development of back pain in young adults with adolescent idiopathic scoliosis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023; 32:3970-3978. [PMID: 37665408 DOI: 10.1007/s00586-023-07908-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 08/11/2023] [Accepted: 08/16/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Back pain occurs commonly in adults and is multifactorial in nature. This study aimed to assess the prevalence and intensity of back pain during young adulthood in subjects with adolescent idiopathic scoliosis (AIS), as well as factors that may be associated with its prognosis. METHODS Subjects with AIS aged 20-39 treated conservatively were included in this study. Patient-reported outcome measures in adulthood involved episodes of back pain, and scales of self-image, depression, anxiety, and stress. Additionally, pain, self-image, and mental health scores were retrieved at the first clinic consultation. Occurrence of back pain was defined as a numeric pain rating scale ≥ 6. RESULTS 101 participants were enrolled. The prevalence of back pain in the lifetime, past 12 months, past 6 months, past 1 month, past 7 days, and past 24 h were 37%, 35%, 31%, 27%, 23%, and 20%, respectively. Male, self-image, and depression were significant associated factors for the development of back pain at all time points. Furthermore, the analyses of the initial presentation of participants have shown that participants with back pain in adulthood were characterised by poor self-image and mental health during their adolescence. CONCLUSION The present study addressed the natural history of back pain in young adults with conservatively treated AIS. Psychological makeup has been shown to constitute the development of back pain and is strongly hinted as an early sign of having back pain in adulthood among subjects with AIS.
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Affiliation(s)
- Kenney Ki Lee Lau
- Department of Orthopaedics and Traumatology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Kenny Yat Hong Kwan
- Department of Orthopaedics and Traumatology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Jason Pui Yin Cheung
- Department of Orthopaedics and Traumatology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Karlen Ka Pui Law
- Department of Orthopaedics and Traumatology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Kenneth Man Chee Cheung
- Department of Orthopaedics and Traumatology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
- Department of Orthopaedics and Traumatology, The University of Hong Kong Shenzhen Hospital, Shenzhen, China.
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11
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Scribante A, Pellegrini M, Pulicari F, Ghizzoni M, Modugno FP, Spadari F. Pain Assessment in Oral Medicine through Its Different Dimensions: A Comprehensive Review. Dent J (Basel) 2023; 11:246. [PMID: 37999011 PMCID: PMC10670171 DOI: 10.3390/dj11110246] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/14/2023] [Accepted: 10/20/2023] [Indexed: 11/25/2023] Open
Abstract
Orofacial pain is a complex experience made up of different features and involving various aspects of life. It has demonstrated a connection, especially when chronic, with conditions such as anxiety, depression, and sleep disorders, through paths that still have not been completely clarified. A deep understanding of orofacial pain and its impact on an individual's life is critical for planning accurate diagnostic and therapeutic approaches. This review seeks to provide a comprehensive overview of the components constituting the pain experience, its implications in an individual's life, the different tools for multidimensional pain assessment, and the specific applications for each tool. A comprehensive review was performed using the PubMed, Scopus, and Web of Science electronic databases. Ninety-five studies, including observational studies, clinical trials, case-control studies, and case reports, were included and analyzed in this review. Orofacial pain assessment exploits several methods, ranging from clinical evaluation to rating scales, questionnaires, and daily diaries. The choice of the correct instrument requires an evaluation of the type of pain experienced, of the patient's characteristics and abilities to complete particular tasks, and finally, of the assessment tool features.
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Affiliation(s)
- Andrea Scribante
- Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (M.G.); (F.P.M.)
| | - Matteo Pellegrini
- Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (F.P.); (F.S.)
| | - Federica Pulicari
- Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (F.P.); (F.S.)
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122 Milan, Italy
| | - Martina Ghizzoni
- Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (M.G.); (F.P.M.)
| | - Francesco Paolo Modugno
- Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (M.G.); (F.P.M.)
| | - Francesco Spadari
- Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (F.P.); (F.S.)
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122 Milan, Italy
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12
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Moshkovsky R, Golan N, Aviel Gadot E, Bar A, Achiron A, Fischer N, Spierer O. Pain control and subconjunctival haemorrhage after intravitreal injection using cooled anaesthetic eyedrops and antiseptics: A prospective, double-blind, randomized controlled trial. Acta Ophthalmol 2023. [PMID: 37853924 DOI: 10.1111/aos.15798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 09/21/2023] [Accepted: 10/09/2023] [Indexed: 10/20/2023]
Abstract
PURPOSE To evaluate whether cooled anaesthetic eyedrops and antiseptics alleviate pain and minimise subconjunctival haemorrhage following intravitreal injection. METHODS A prospective, double-masked, randomised controlled trial of 100 participants receiving either cooled (n = 50) or room temperature (n = 50) topical anaesthetic eyedrops and antiseptics before receiving an injection of bevacizumab. Baseline tolerability was estimated using a self-reported pain sensitivity questionnaire. RESULTS Overall tolerability was comparable between the study group and the control group (0.75 ± 0.13 vs. 0.74 ± 0.14, respectively, p = 0.99). Subconjunctival haemorrhage incidence was similar in both groups (80% vs. 86%, respectively, p = 0.113), as was subconjunctival haemorrhage size (2.75 ± 5.51 mm2 vs. 5.53 ± 10.72 mm2 , respectively, p = 0.11). Sub-group analysis demonstrated that the participants taking daily ocular eyedrops who received cooled anaesthetic eyedrops and antiseptics reported less pain at 10 min and less burning sensation at 24 h compared with matched controls (0.67 ± 1.50 vs. 2.50 ± 3.03, respectively, p = 0.040 and 0.00 ± 0.00 vs. 1.44 ± 2.96, respectively, p = 0.045). Participants who received cooled eyedrops and did not use antithrombotic therapy had smaller-sized subconjunctival haemorrhages compared with matched controls (1.55 ± 1.87 mm2 vs. 8.29 ± 14.61 mm2 , respectively, p = 0.038). Participants with hypertension who received cooled eyedrops had smaller-sized subconjunctival haemorrhage compared with matched controls (2.33 ± 4.99 mm2 vs. 6.89 ± 12.41 mm2 , respectively, p = 0.045). CONCLUSION The benefit of using cooled anaesthetic eyedrops and antiseptics to alleviate pain and minimise subconjunctival haemorrhage following intravitreal injection was not proven in the general population. It may be beneficial in part for some patients, such as those who regularly use eyedrops, patients with hypertension or those not on antithrombotic therapy.
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Affiliation(s)
- Ran Moshkovsky
- Department of Ophthalmology, Wolfson Medical Center, Holon, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nili Golan
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Ophthalmology, Rabin Medical Center, Petah-Tikva, Israel
| | - Einat Aviel Gadot
- The Faculty of Exact Sciences, Bar Ilan University, Ramat Gan, Israel
| | - Asaf Bar
- Department of Ophthalmology, Wolfson Medical Center, Holon, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Asaf Achiron
- Department of Ophthalmology, Tel Aviv Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Naomi Fischer
- Department of Ophthalmology, Wolfson Medical Center, Holon, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Oriel Spierer
- Department of Ophthalmology, Wolfson Medical Center, Holon, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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13
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Nosch DS, Käser E, Bracher T, Joos RE. Age-Related Changes in Corneal Sensitivity. Cornea 2023; 42:1257-1262. [PMID: 36730377 DOI: 10.1097/ico.0000000000003183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 09/12/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE The aim of this prospective cross-sectional cohort study was to clinically test whether corneal sensation decreases with age, based on subject feedback (psychophysical method), and whether it correlates with general pain perception. METHODS Subjects were recruited from 2 equally large age groups: group A (18-30 years) and group B (50-70 years; n = 45 per group). The inclusion criteria were healthy eyes, Ocular Surface Disease Index ≤13, and no contact lens wear. Corneal sensitivity threshold (CST) measurements were performed twice during each of the 2 visits, with the aid of the new Swiss liquid jet esthesiometer for corneal sensitivity (SLACS) and Cochet-Bonnet (CB) esthesiometer. A general pain sensitivity score was obtained from all participants. RESULTS Ninety subjects completed the study (n = 45 per age group, average age in group A: 24.2 ± 2.94 years, group B: 58.5 ± 5.71 years). Statistically higher CSTs for age group B were only observed for SLACS (mean difference: 1.58 dB, P < 0.001). No correlation was observed between the pain score and the CSTs obtained with either esthesiometry method (r = 0.11, P = 0.25 for liquid jet and r=-0.076, P = 0.61 CB). CONCLUSIONS A statistically significant decrease in corneal sensitivity was observed for the older age group with SLACS in this study, with CB however only a trend in the same direction was noted. General pain perception was not found to correlate with ocular surface sensation.
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Affiliation(s)
- Daniela S Nosch
- Institute of Optometry, School of Engineering, University of Applied Sciences and Arts Northwestern Switzerland (FHNW), Olten, Switzerland
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14
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Liu S, Liu S, Gu D, Zhao X, Zhang H, Deng C, Gu Y. Exploring the Effect of Pain Sensitive Questionnaire on Guiding Intravenous Analgesia After Cesarean Section: A Randomised Double Blind Controlled Trial. J Pain Res 2023; 16:3185-3196. [PMID: 37744183 PMCID: PMC10516306 DOI: 10.2147/jpr.s412131] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 09/08/2023] [Indexed: 09/26/2023] Open
Abstract
Objective This study investigates the effect of the Pain Sensitivity Questionnaire (PSQ) in guiding patient controlled intravenous analgesia (PCIA) on postoperative analgesia in women undergoing cesarean section. Methods A total of 160 women who were to undergo a cesarean section under combined spinal and epidural anaesthesia were included in this study. Women with a preoperative PSQ <4 were randomly divided into a low pain-sensitive control group (LC group), and a low pain-sensitive observation group (LO group), and women with preoperative PSQ >6 were randomly divided into a high pain-sensitive control group (HC group) and a high pain-sensitive observation group (HO group). After the surgery, patients received the pump butorphanol concentration was 3.5 µg·kg-1·h-1 in the LC and HC groups, 3.0 µg·kg-1·h-1 in the LO group and 4.0 µg·kg-1·h-1 in the HO group.To compare the analgesic effects of postoperative PCIA and postoperative recovery in women. Results Wound pain and uterine contraction pain VAS scores at rest and activity were significantly lower in the LC group than in the LO group at 4 and 8 h postoperatively (P<0.05). Similarly, wound pain and uterine contraction pain VAS scores at rest and activity were significantly lower in the HO group than in the HC group at 8, 12, and 24 h postoperatively (P<0.05). The Ramsay scores were significantly higher in the LC than in the LO groups at 4, 8, 12, 24, and 48 h postoperatively (P<0.05), but there was no statistically significant difference between the Ramsay scores in the HC group and the HO group. There was no statistical difference in any of the post-operative recoveries (P>0.05). Conclusion Compared to the weight-based postoperative PCIA, the PSQ-based postoperative PCIA has better analgesic effects and can improve maternal satisfaction with postoperative analgesia.
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Affiliation(s)
- Shuxin Liu
- Department of Anesthesiology, First Affiliated Hospital, Shihezi University, Shihezi, People’s Republic of China
| | - Siqi Liu
- Department of Anesthesiology, First Affiliated Hospital, Shihezi University, Shihezi, People’s Republic of China
| | - Dengfeng Gu
- Department of Anesthesiology, First Affiliated Hospital, Shihezi University, Shihezi, People’s Republic of China
| | - Xiaona Zhao
- Department of Obstetrics, First Affiliated Hospital, Shihezi University, Shihezi, People’s Republic of China
| | - Hong Zhang
- Department of Anesthesiology, First Affiliated Hospital, Shihezi University, Shihezi, People’s Republic of China
| | - Chao Deng
- Department of Anesthesiology, First Affiliated Hospital, Shihezi University, Shihezi, People’s Republic of China
| | - Yajuan Gu
- Department of Obstetrics, First Affiliated Hospital, Shihezi University, Shihezi, People’s Republic of China
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15
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Rutter-Locher Z, Arumalla N, Norton S, Taams LS, Kirkham BW, Bannister K. A systematic review and meta-analysis of questionnaires to screen for pain sensitisation and neuropathic like pain in inflammatory arthritis. Semin Arthritis Rheum 2023; 61:152207. [PMID: 37163841 DOI: 10.1016/j.semarthrit.2023.152207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/28/2023] [Accepted: 04/19/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND Targeted pain relief is a major unmet medical need for patients with inflammatory arthritis (IA), where approximately 40% of patients experience persistent pain. Self-reported questionnaires which report on pain sensitivity and neuropathic like pain may provide an insight into certain pain types to guide targeted treatment. OBJECTIVE In this systematic review and meta-analysis we evaluated self-reported pain sensitivity and neuropathic like pain in subjects with IA, as defined by questionnaires. METHODS MEDLINE, Embase, Web of Science, PsycINFO and google scholar were searched for publications and conference abstracts, reporting on pain sensitivity and neuropathic pain using painDETECT, DN4, LANSS, CSI, PSQ and McGill pain questionnaire in adult patients with IA. Risk of bias was assessed using National Institute of Health Quality Assessment Tool. Meta-analysis according to individual questionnaire criteria, was undertaken. RESULTS 63 studies (38 full text and 25 conference abstracts) were included in the review, reporting on a total of 13,035 patients. On meta-analysis, prevalence of pain sensitivity/neuropathic like pain in IA was 36% (95% CI 31-41%) according to painDETECT, 31% (95% CI 26-37%) according to the DN4, 40% (95% CI 32-49%) according to the LANSS and 42% (95% CI 34-51%) according to the CSI. On meta-regression, prevalence of pain sensitivity/neuropathic pain in RA was significantly lower than SpA (p = 0.01) and PsA (p = 0.002) using the painDETECT questionnaire. Across all questionnaires, pain sensitivity and neuropathic like pain were significantly associated with worse pain severity, disease activity, disability, quality of life and anxiety and depression measures. Studies reporting on whether neuropathic like pain is a predictor of treatment outcome were inconsistent. CONCLUSION Pain sensitivity and neuropathic like pain contribute to pain perception in up to 42% of patients with IA. Despite substantial heterogeneity between studies on meta-analysis, this review highlights the large proportion of patients with IA who may experience pain due to underlying mechanisms other than, or in addition to, synovial inflammation.
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Affiliation(s)
- Zoe Rutter-Locher
- Rheumatology Department, Guy's and St Thomas' NHS Foundation Trust, London, UK.
| | - Nikita Arumalla
- Rheumatology Department, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Sam Norton
- Department of Psychology, Health Psychology Section, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Leonie S Taams
- Centre for Inflammation Biology and Cancer Immunology (CIBCI), Department of Inflammation Biology, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Bruce W Kirkham
- Rheumatology Department, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Kirsty Bannister
- Institute of Psychiatry, Psychology and Neuroscience, Wolfson CARD, Guy's Campus, King's College London, London SE1 1UL, UK
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16
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Adams GR, Gandhi W, Harrison R, van Reekum CM, Wood-Anderson D, Gilron I, Salomons TV. Do "central sensitization" questionnaires reflect measures of nociceptive sensitization or psychological constructs? A systematic review and meta-analyses. Pain 2023; 164:1222-1239. [PMID: 36729810 DOI: 10.1097/j.pain.0000000000002830] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 10/21/2022] [Indexed: 02/03/2023]
Abstract
ABSTRACT Central sensitization (CS) is defined as an increased nociceptive responsiveness due to sensitization of neurons in the central nervous system, usually the result of prolonged nociceptive input or a disease state associated with noxious inputs (eg, polyarthritis). The concept of CS has recently been adopted in clinical assessments of chronic pain, but its diagnosis in humans may now include a wide range of hypervigilant responses. The purpose of this review is to ascertain whether self-report questionnaires linked with CS are associated with enhanced nociceptive responses or whether they measure sensitivity in a broader sense (ie, emotional responses). According to our published, PROSPERO-registered review protocol (CRD42021208731), a predefined search of studies that involve the Central Sensitization Inventory (CSI) or Pain Sensitivity Questionnaire (PSQ), correlated with either nociceptive sensory tests or emotional hypervigilance was conducted on MEDLINE, PsycINFO, and Web of Science. Correlations between the CSI or PSQ with our primary outcomes were extracted and meta-analysed. A review of 66 studies totalling 13,284 participants found that the CSI (but not the PSQ) strongly correlated with psychological constructs: depression, anxiety, stress, pain catastrophising, sleep, and kinesiophobia. The CSI and PSQ showed weak or no correlations with experimental measures of nociceptive sensitivity: pain thresholds, temporal summation, or conditioned pain modulation. The PSQ did, however, correlate strongly with phasic heat and tonic cold pain tests. The studies reviewed did not provide sufficient evidence that self-report measures reflect a canonical understanding of CS. The CSI more closely reflects psychological hypervigilance than increased responsiveness of nociceptive neurons.
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Affiliation(s)
- Greig R Adams
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Wiebke Gandhi
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Richard Harrison
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Carien M van Reekum
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | | | - Ian Gilron
- Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON, Canada
| | - Tim V Salomons
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
- Department of Psychology, Queen's University, Kingston, ON, Canada
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17
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Ruf SP, Hetterich L, Mazurak N, Rometsch C, Jurjut AM, Ott S, Herrmann-Werner A, Zipfel S, Stengel A. Mirror Therapy in Patients with Somatoform Pain Disorders-A Pilot Study. Behav Sci (Basel) 2023; 13:bs13050432. [PMID: 37232669 DOI: 10.3390/bs13050432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/12/2023] [Accepted: 05/18/2023] [Indexed: 05/27/2023] Open
Abstract
Patients with chronic pain report reduced quality of life and high symptom burden while often responding insufficiently to treatment options. Mirror therapy has been proven to be effective in treating phantom limb pain and other conditions such as CRPS. This study was designed to investigate the efficacy of mirror therapy in patients with somatoform pain disorders on symptom severity and associated physiological parameters. Fifteen patients with persistent somatoform pain disorder (F45.40) or chronic pain disorder with somatic and psychological factors (F45.41) participated and received four weeks of tablet-based mirror therapy. Symptom severity was measured with established questionnaires, and their thermal detection, pain thresholds, and heart rate variability (HRV) were also assessed. After mirror therapy, pain intensity was reduced (z = -2.878, p = 0.004), and pain thresholds for cold stimuli were also diminished, i.e., the subjects became more sensitive to cold stimuli (z = -2.040, p = 0.041). In addition, a reduction of absolute power in the low-frequency band of HRV (t(13) = 2.536, p = 0.025) was detected. These findings indicate that this intervention may reduce pain intensity and modulate associated physiological parameters. As these results are limited by several factors, e.g., a small sample size and no control group, they should be validated in further studies investigating this novel intervention in these patients.
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Affiliation(s)
- Steffen Philipp Ruf
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076 Tübingen, Germany
| | - Larissa Hetterich
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076 Tübingen, Germany
| | - Nazar Mazurak
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076 Tübingen, Germany
| | - Caroline Rometsch
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076 Tübingen, Germany
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134 Firenze, Italy
| | - Anna-Maria Jurjut
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076 Tübingen, Germany
| | - Stephan Ott
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076 Tübingen, Germany
- Institute of Occupational, Social and Environmental Medicine with Outpatient Clinic, Friedrich-Alexander-Universität Erlangen-Nürnberg, Henkestr. 9-11, 91054 Erlangen, Germany
| | - Anne Herrmann-Werner
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076 Tübingen, Germany
- TIME (Tübingen Institute for Medical Education), Medical Faculty Tübingen, Elfriede-Aulhorn-Str. 10, 72076 Tübingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076 Tübingen, Germany
| | - Andreas Stengel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076 Tübingen, Germany
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 12203 Berlin, Germany
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18
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Timm A, Schmidt-Wilcke T, Blenk S, Studer B. Altered social decision making in patients with chronic pain. Psychol Med 2023; 53:2466-2475. [PMID: 34736548 PMCID: PMC10123842 DOI: 10.1017/s0033291721004359] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 09/10/2021] [Accepted: 10/06/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Chronic pain affects up to 20% of the population, impairs quality of life and reduces social participation. Previous research reported that pain-related perceived injustice covaries with these negative consequences. The current study probed whether chronic pain patients responded more strongly to disadvantageous social inequity than healthy individuals. METHODS We administered the Ultimatum Game, a neuroeconomic social exchange game, where a sum of money is split between two players to a large sample of patients with chronic pain disorder with somatic and psychological factors (n = 102) and healthy controls (n = 101). Anonymised, and in truth experimentally controlled, co-players proposed a split, and our participants either accepted or rejected these offers. RESULTS Chronic pain patients were hypersensitive to disadvantageous inequity and punished their co-players for proposed unequal splits more often than healthy controls. Furthermore, this systematic shift in social decision making was independent of patients' performance on tests of executive functions and risk-sensitive (non-social) decision making . CONCLUSIONS Our findings indicate that chronic pain is associated with anomalies in social decision making (compared to healthy controls) and hypersensitivity to social inequity that is likely to negatively impact social partaking and thereby the quality of life.
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Affiliation(s)
- Alicja Timm
- Medical Faculty, Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- Department of Neurology, Mauritius Hospital Meerbusch, Meerbusch, Germany
| | - Tobias Schmidt-Wilcke
- Medical Faculty, Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- Department of Neurology, Mauritius Hospital Meerbusch, Meerbusch, Germany
| | - Sandra Blenk
- Centre for Pain Medicine, St.Vinzenz Hospital Düsseldorf, Düsseldorf, Germany
| | - Bettina Studer
- Medical Faculty, Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- Department of Neurology, Mauritius Hospital Meerbusch, Meerbusch, Germany
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19
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Segelcke D, van der Burgt M, Kappert C, Schmidt Garcia D, Sondermann JR, Bigalke S, Pradier B, Gomez-Varela D, Zahn PK, Schmidt M, Pogatzki-Zahn EM. Phenotype- and species-specific skin proteomic signatures for incision-induced pain in humans and mice. Br J Anaesth 2023; 130:331-342. [PMID: 36609060 DOI: 10.1016/j.bja.2022.10.040] [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: 05/24/2022] [Revised: 10/24/2022] [Accepted: 10/24/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Acute pain after surgery is common and often leads to chronic post-surgical pain, but neither treatment nor prevention is currently sufficient. We hypothesised that specific protein networks (protein-protein interactions) are relevant for pain after surgery in humans and mice. METHODS Standardised surgical incisions were performed in male human volunteers and male mice. Quantitative and qualitative sensory phenotyping were combined with unbiased quantitative mass spectrometry-based proteomics and protein network theory. The primary outcomes were skin protein signature changes in humans and phenotype-specific protein-protein interaction analysis 24 h after incision. Secondary outcomes were interspecies comparison of protein regulation as well as protein-protein interactions after incision and validation of selected proteins in human skin by immunofluorescence. RESULTS Skin biopsies in 21 human volunteers revealed 119/1569 regulated proteins 24 h after incision. Protein-protein interaction analysis delineated remarkable differences between subjects with small (low responders, n=12) and large incision-related hyperalgesic areas (high responders, n=7), a phenotype most predictive of developing chronic post-surgical pain. Whereas low responders predominantly showed an anti-inflammatory protein signature, high responders exhibited signatures associated with a distinct proteolytic environment and persistent inflammation. Compared to humans, skin biopsies in mice habored even more regulated proteins (435/1871) 24 h after incision with limited overlap between species as assessed by proteome dynamics and PPI. Immunohistochemistry confirmed the expression of high priority candidates in human skin biopsies. CONCLUSIONS Proteome profiling of human skin after incision revealed protein-protein interactions correlated with pain and hyperalgesia, which may be of potential significance for preventing chronic post-surgical pain. Importantly, protein-protein interactions were differentially modulated in mice compared to humans opening new avenues for successful translational research.
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Affiliation(s)
- Daniel Segelcke
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, Muenster, Germany
| | - Max van der Burgt
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, Muenster, Germany
| | - Christin Kappert
- Max Planck Institute for Multidisciplinary Sciences, City Campus, Goettingen, Germany
| | | | - Julia R Sondermann
- Division of Pharmacology and Toxicology, Department of Pharmaceutical Sciences, University of Vienna, Vienna, Austria
| | - Stephan Bigalke
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, Muenster, Germany; Clinic for Anaesthesiology, Intensive and Pain Medicine, Ruhr-University Bochum, BG-University Hospital Bergmannsheil gGmbH, Bochum, Germany
| | - Bruno Pradier
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, Muenster, Germany
| | - David Gomez-Varela
- Division of Pharmacology and Toxicology, Department of Pharmaceutical Sciences, University of Vienna, Vienna, Austria
| | - Peter K Zahn
- Clinic for Anaesthesiology, Intensive and Pain Medicine, Ruhr-University Bochum, BG-University Hospital Bergmannsheil gGmbH, Bochum, Germany
| | - Manuela Schmidt
- Division of Pharmacology and Toxicology, Department of Pharmaceutical Sciences, University of Vienna, Vienna, Austria.
| | - Esther M Pogatzki-Zahn
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, Muenster, Germany.
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Rudolph KS, Cloutier M, Stackhouse S. Pain inhibition-the unintended benefit of electrically elicited muscle strengthening contractions. BMC Musculoskelet Disord 2023; 24:131. [PMID: 36803339 PMCID: PMC9938574 DOI: 10.1186/s12891-023-06243-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 02/15/2023] [Indexed: 02/20/2023] Open
Abstract
BACKGROUND Neuromuscular electrical stimulation (NMES) is effective in muscle strengthening after orthopedic injury particularly when muscle activation failure is present, but the associated pain can be a barrier. Pain itself can produce a pain inhibitory response called Conditioned Pain Modulation (CPM). CPM is often used in research studies to assess the state of the pain processing system. However, the inhibitory response of CPM could make NMES more tolerable to patients and could improve functional outcomes in people with pain. This study compares the pain-inhibitory effect of NMES compared to volitional contractions and noxious electrical stimulation (NxES). METHODS Healthy participants, 18-30 years of age experienced 3 conditions: 10 NMES contractions, 10 bursts of NxES on the patella, and 10 volitional contractions on the right knee. Pressure pain thresholds (PPT) were measured before and after each condition in both knees and the middle finger. Pain was reported on an 11-point VAS. Repeated measures ANOVAs with 2 factors: site and time were performed for each condition followed by post-hoc paired t-tests, with Bonferroni correction. RESULTS Pain ratings were higher in the NxES condition compared to NMES (p = .000). No differences in PPTs prior to each condition were observed but PPTs were significantly higher in the right and left knees after the NMES contractions (p = .000, p = .013, respectively) and after the NxES (p = .006, P-.006, respectively). Pain during NMES and NxES did not correlate with pain inhibition (p > .05). Self-reported pain sensitivity correlated with pain during NxES. CONCLUSION NxES and NMES produced higher PPTs in both knees but not in the finger, suggesting that the mechanisms responsible for the reduction in pain are located in the spinal cord and local tissues. Pain reduction was elicited during the NxES and NMES conditions regardless of the self-reported pain ratings. When NMES is used for muscle strengthening significant pain reduction can also occur, which is an unintended benefit of the intervention that could improve functional outcomes in patients.
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Affiliation(s)
- Katherine S. Rudolph
- grid.266826.e0000 0000 9216 5478Department of Physical Therapy, University of New England, 716 Stevens Ave., Portland, ME 04103 USA
| | - Matthew Cloutier
- grid.266826.e0000 0000 9216 5478College of Osteopathic Medicine, University of New England, 11 Hills Beach Road, Biddeford, ME 04005 USA
| | - Scott Stackhouse
- grid.266826.e0000 0000 9216 5478Department of Physical Therapy, University of New England, 716 Stevens Ave., Portland, ME 04103 USA
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21
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Fu Q, Han M, Mu Y, Hao L, Lu L, Huang X, Li J, Kang F. Does the pain sensitivity questionnaire correlate with tourniquet pain in patients undergoing ankle surgery? Front Surg 2023; 10:1102319. [PMID: 36923376 PMCID: PMC10009183 DOI: 10.3389/fsurg.2023.1102319] [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: 11/18/2022] [Accepted: 02/06/2023] [Indexed: 03/02/2023] Open
Abstract
Background Tourniquet pain is the most prominent problem in ankle surgery, and there is no proper method to predict it. It was reported that pain sensitivity questionnaires could evaluate the pain sensitivity of subjects. Its potential to predict tourniquet pain in ankle surgery is constructive and meaningful. Methods One hundred and twenty patients undergoing ankle surgery were included in this study. The pain sensitivity questionnaire (PSQ) and self-rating anxiety scale (SAS) were completed before the operation. The methods included an ultrasound-guided popliteal sciatic, a femoral nerve block, and a proximal thigh tourniquet. The pressure of the tourniquet was set according to the systolic blood pressure (SBP + 100 mmHg). A visual analogue scale (VAS) was used to assess the tourniquet pain. Also, the onset time of tourniquet pain ≥4 VAS units was recorded. Results The PSQ-total and PSQ-minor scores were significantly correlated with the onset time when the tourniquet pain ≥4 VAS units (r = -0.763, r = -0.731, P < 0.001). The PSQ-total score <6.5 group gave significantly lower ratings for items 3, 4, 14, and 16 in the PSQ survey compared to the PSQ-total score ≥6.5 group (P < 0.05). Patients with high pain sensitivity have a higher need for analgesic drugs (P < 0.001). PSQ-total score ≥6.5 (OR = 185.8, 95% CI = 39.8-1,437.6, P < 0.001), sex (male, OR = 0.11, 95% CI = 0.018-0.488, P < 0.05), and age (OR = 0.92, 95% CI = 0.842-0.995, P < 0.05) were risk factors for reporting a tourniquet pain ≥4 VAS units within 30 min. Conclusion The PSQ score is found to be correlated with intraoperative tourniquet pain. In addition, sex and age also affect the time of having intraoperative tourniquet pain.
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Affiliation(s)
- Qiuyue Fu
- Department of Anesthesiology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, Anhui, China
| | - Mingming Han
- Department of Anesthesiology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, Anhui, China
| | - Yuyang Mu
- Department of Anesthesiology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, Anhui, China
| | - Lina Hao
- Department of Anesthesiology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, Anhui, China
| | - Liang Lu
- Department of Hand and Foot Surgery, The First Affiliated Hospital of University of Science and Technology of China, Hefei, Anhui, China
| | - Xiang Huang
- Department of Anesthesiology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, Anhui, China
| | - Juan Li
- Department of Anesthesiology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, Anhui, China
| | - Fang Kang
- Department of Anesthesiology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, Anhui, China
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22
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Granados-Santiago M, Martín-Núñez J, Heredia-Ciuró A, Ortiz-Rubio A, Calvache-Mateo A, López-López L, Valenza MC. Cross-sectional study of pain-related variables before and during the COVID-19 pandemic in patients with COPD. Pain Manag Nurs 2022; 23:737-741. [PMID: 35725544 PMCID: PMC9135743 DOI: 10.1016/j.pmn.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 05/05/2022] [Accepted: 05/23/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND The impact of the COVID-19 pandemic influences of COPD patients. The worsening of their health status may contribute to a higher pain prevalence. AIM The aim of this study was to analyze the pain-related variables before and during the COVID-19 pandemic in patients with chronic obstructive pulmonary disease. METHODS In this cross-sectional case-control study, stable patients with chronic obstructive pulmonary disease without a COVID-19 diagnosis were evaluated before and during the pandemic. The main outcomes were the pronociceptive pain profile (general pain sensitivity, pain intensity, pain interference, and pressure pain sensitivity) and the psychological vulnerability (perceived health status, anxiety, and depression). RESULTS Our results showed that patients with chronic obstructive pulmonary disease during COVID-19 pandemic experienced higher general pain sensitivity and intensity with statistical differences in pain interference (p < .001), being the overall perceived health status lower than before the pandemic (p < .05). CONCLUSIONS We concluded that patients with chronic obstructive pulmonary disease during the COVID-19 pandemic showed a rise the pronociceptive pain profile accompanied by increased psychological vulnerability.
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Affiliation(s)
| | - Javier Martín-Núñez
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Alejandro Heredia-Ciuró
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Araceli Ortiz-Rubio
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Andrés Calvache-Mateo
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Laura López-López
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain,Address correspondence to Laura López López, Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Av. De la Ilustración, 60, 18016 Granada, Spain
| | - Marie Carmen Valenza
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain
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23
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Favaretto E, Gögele M, Bedani F, Hicks AA, Erfurth A, Perugi G, Pramstaller PP, Melotti R. Pain sensitivity is modulated by affective temperament: Results from the population-based CHRIS Affective Disorder (CHRIS-AD) study. J Affect Disord 2022; 316:209-216. [PMID: 35952933 DOI: 10.1016/j.jad.2022.08.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/06/2022] [Accepted: 08/06/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Nociceptive pain modulation is related to psychological and psychiatric conditions. Evidence from clinical studies backs innate temperaments as potential precursors of mood symptoms and disorders, and pain sensitivity. Our study examines the modulation effect of affective temperaments on pain sensitivity in a general population adult sample, accounting for possible intervening mood symptoms, lifetime anxiety and depression, and pain treatments. METHODS The sample is part of the CHRIS-AD study, Italy. Primary outcomes were the pain sensitivity questionnaire PSQ-total intensity score and the experimental pressure pain threshold (PPT). Affective temperaments were evaluated with the TEMPS-M. Lifetime depression, anxiety, current mood disorders, and treatments were self-reported via rating-scales. Directed acyclic graphs theory guided linear and mixed linear regression model analyses. RESULTS Among 3804 participants (aged 18-65; response rate 78.4 %, females 53.3 %, mean age 38.4 years) for any given temperament, both the PSQ-total and the PPT were associated with temperament. The TEMPS-M four cyclothymic-related temperaments aligned on the pain-sensitive pole and the hyperthymic on the pain-resilient pole. The inclusion of current or lifetime mood symptoms, or pain drug use, as possible intervening pathways only partly diluted these associations, with stronger evidence for an effect of trait anxiety. LIMITATIONS The main limitations were the lack of experimental measures of suprathreshold pain intensity perception, and detailed information on affective disorders in the study population. CONCLUSIONS These findings support the hypothesis of a biological dichotomous diathesis of affective temperaments towards pain sensitivity; hyperthymic suggesting protection, whereas cyclothymic suggesting predisposition.
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Affiliation(s)
| | - Martin Gögele
- Institute for Biomedicine (affiliated to the University of Lübeck, Lübeck, Germany), Eurac Research, Bolzano, Italy
| | - Fulvio Bedani
- Department of Psychiatry, General Hospital, Bressanone, Italy
| | - Andrew A Hicks
- Institute for Biomedicine (affiliated to the University of Lübeck, Lübeck, Germany), Eurac Research, Bolzano, Italy
| | - Andreas Erfurth
- Klinik Hietzing, Department of Psychiatry and Psychotherapeutic Medicine, Vienna, Austria
| | - Giulio Perugi
- Section of Psychiatry, Department of Experimental and Clinic Medicine, University of Pisa, Pisa, Italy
| | - Peter P Pramstaller
- Institute for Biomedicine (affiliated to the University of Lübeck, Lübeck, Germany), Eurac Research, Bolzano, Italy; Department of Neurology, General Central Hospital, Bolzano, Italy
| | - Roberto Melotti
- Institute for Biomedicine (affiliated to the University of Lübeck, Lübeck, Germany), Eurac Research, Bolzano, Italy
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24
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Pain Management and Rehabilitation for Central Sensitization in Temporomandibular Disorders: A Comprehensive Review. Int J Mol Sci 2022; 23:ijms232012164. [PMID: 36293017 PMCID: PMC9602546 DOI: 10.3390/ijms232012164] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/07/2022] [Accepted: 10/09/2022] [Indexed: 11/24/2022] Open
Abstract
Temporomandibular disorders (TMD) are a group of musculoskeletal diseases affecting masticatory muscles and temporomandibular joints (TMJ). In this context, the chronic TMD could be considered as a condition with chronic primary orofacial pain, presenting as myofascial TMD pain or TMJ arthralgia. In this context, myogenous TMD may present overlapping features with other disorders, such as fibromyalgia and primary headaches, characterized by chronic primary pain related to dysfunction of the central nervous system (CNS), probably through the central sensitization. This phenomenon could be defined as an amplified response of the CNS to sensory stimuli and peripheral nociceptive, characterized by hyperexcitability in the dorsal horn neurons in the spinal cord, which ascend through the spinothalamic tract. The main objectives of the management of TMD patients are: decreasing pain, increasing TMJ function, and reducing the reflex masticatory muscle spasm/pain. The first-line treatments are physical therapy, pharmacological drugs, occlusal splints, laser therapy, extracorporeal shockwave therapy, transcutaneous electrical nerve stimulation, and oxygen–ozone therapy. Although all these therapeutic approaches were shown to have a positive impact on the central sensitization of TMD pain, there is still no agreement on this topic in the scientific literature. Thus, in this comprehensive review, we aimed at evaluating the evidence on pain management and rehabilitation for the central sensitization in TMD patients.
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25
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Suzuki K, Suzuki S, Shiina T, Kobayashi S, Hirata K. Central Sensitization in Migraine: A Narrative Review. J Pain Res 2022; 15:2673-2682. [PMID: 36101891 PMCID: PMC9464439 DOI: 10.2147/jpr.s329280] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/16/2022] [Indexed: 11/23/2022] Open
Abstract
Central sensitization (CS) is an increase in the responsiveness of nociceptive neurons in the central nervous system to their normal afferent input. As a result, even minor irritation can induce severe pain, leading to the chronicity and severity of various diseases, such as neurological disorders. CS is associated with migraine, which is a major neurological disorder that inflicts a high disability in daily life. Specifically, CS is thought to be involved in the pathogenesis of cutaneous allodynia as well as chronification of migraine. In this article, we reviewed the association between CS and migraine, including pathophysiological aspects and evidence from clinical studies. We suggest that appropriate screening and management of CS in migraine could further improve the quality of life of migraine patients.
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Affiliation(s)
- Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | - Shiho Suzuki
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | - Tomohiko Shiina
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | - Saro Kobayashi
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | - Koichi Hirata
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
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26
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Fontanillas P, Kless A, Bothmer J, Tung JY. Genome-wide association study of pain sensitivity assessed by questionnaire and the cold pressor test. Pain 2022; 163:1763-1776. [PMID: 34924555 PMCID: PMC9393798 DOI: 10.1097/j.pain.0000000000002568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 11/24/2021] [Accepted: 11/29/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT We deployed an online pain sensitivity questionnaire (PSQ) and an at-home version of the cold pressor test (CPT) in a large genotyped cohort. We performed genome-wide association studies on the PSQ score (25,321 participants) and CPT duration (6853). We identified one new genome-wide significant locus associated with the PSQ score, which was located in the TSSC1 (also known as EIPR1 ) gene (rs58194899, OR = 0.950 [0.933-0.967], P -value = 1.9 × 10 -8 ). Although high pain sensitivity measured by both PSQ and CPT was associated with individual history of chronic and acute pains, genetic correlation analyses surprisingly suggested an opposite direction: PSQ score was inversely genetically correlated with neck and shoulder pain ( rg = -0.71), rheumatoid arthritis (-0.68), and osteoarthritis (-0.38), and with known risk factors, such as the length of working week (-0.65), smoking (-0.36), or extreme BMI (-0.23). Gene-based analysis followed by pathway analysis showed that genome-wide association studies results were enriched for genes expressed in the brain and involved in neuronal development and glutamatergic synapse signaling pathways. Finally, we confirmed that females with red hair were more sensitive to pain and found that genetic variation in the MC1R gene was associated with an increase in self-perceived pain sensitivity as assessed by the PSQ.
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Affiliation(s)
| | - Achim Kless
- Grünenthal Innovation, Grünenthal GmbH, Aachen, Germany. Kless is now with the Neuroscience Genetics, Eli Lilly and Company, United Kingdom
| | | | - John Bothmer
- Grünenthal Innovation, Grünenthal GmbH, Aachen, Germany. Kless is now with the Neuroscience Genetics, Eli Lilly and Company, United Kingdom
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27
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Efraim Kaufman A, Weissman-Fogel I, Rosenthal MZ, Kaplan Neeman R, Bar-Shalita T. Opening a window into the riddle of misophonia, sensory over-responsiveness, and pain. Front Neurosci 2022; 16:907585. [PMID: 35992931 PMCID: PMC9381840 DOI: 10.3389/fnins.2022.907585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Misophonia and sensory over-responsiveness (SOR) share physiological and psychological symptoms. While individuals with SOR demonstrate pain perception alterations, these were not explored in misophonia. Methods This exploratory study comprised thirty healthy adults with (n = 15; based on the Misophonia Questionnaire) and without misophonia. The Sensory Responsiveness Questionnaire (SRQ) was used for evaluating sensory responsiveness. In addition, psychophysical tests were applied for quantification of: (i) stimulus-response function of painful stimuli, (ii) the individual perceived pain intensity, (iii) pain modulation efficiency, (iv) auditory intensity discrimination capability, and (v) painful and unpleasantness responses to six ecological daily sounds using the Battery of Aversiveness to Sounds (BAS). Results Individuals with misophonia reported higher scores in the SRQ-Aversive (p = 0.022) and SRQ-Hedonic (p = 0.029) scales as well as in auditory (p = 0.042) and smell (p = 0.006) sub-scales, indicating higher sensory responsiveness. Yet they were not identified with the SOR type of sensory modulation dysfunction. Groups did not differ in the pain psychophysical tests, and in auditory discrimination test scores (p > 0.05). However, in the misophonia group the BAS evoked higher pain intensity (p = 0.046) and unpleasantness (p <0.001) ratings in the apple biting sound, and higher unpleasantness rating in the scraping a dish sound (p = 0.007), compared to the comparison group. Conclusion Findings indicate increased sensory responsiveness in individuals with misophonia, yet not defined as SOR. Thus, this suggests that misophonia and SOR are two distinct conditions, differing in their behavioral responses to painful and non-painful stimuli.
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Affiliation(s)
- Adi Efraim Kaufman
- Department of Occupational Therapy, School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Irit Weissman-Fogel
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - M. Zachary Rosenthal
- Department of Psychiatry and Behavioral Sciences, Center for Misophonia and Emotion Regulation, Duke University Medical Center, Durham, NC, United States
| | - Ricky Kaplan Neeman
- Department of Communication Disorders, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tami Bar-Shalita
- Department of Occupational Therapy, School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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28
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Simon E, Zsidó AN, Birkás B, Csathó Á. Pain catastrophizing, pain sensitivity and fear of pain are associated with early life environmental unpredictability: a path model approach. BMC Psychol 2022; 10:97. [PMID: 35399087 PMCID: PMC8996610 DOI: 10.1186/s40359-022-00800-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 03/30/2022] [Indexed: 11/25/2022] Open
Abstract
Background Socioeconomic disadvantages in the childhood environment might strongly influence beliefs and behavior characterizing the adult years. When children experience unpredictable and adverse situations, they develop an unpredictability schema with the core belief that situations are unpredictable. Methods In two studies, we examined the association of childhood socioeconomic disadvantages with self-reported pain sensitivity, pain catastrophizing, and pain-related fear. Multidimensional survey measures were used to assess environmental conditions experienced in childhood. In addition, participants completed the Pain Catastrophizing Scale, Pain Sensitivity Questionnaire, Body Awareness Questionnaire, Unpredictability Schema Questionnaire, and Fear of Pain Questionnaire. In Study 1 (N = 252), in separate models, we examined pain sensitivity and pain catastrophizing of a community sample of pain-free young individuals in association with their childhood experiences. In Study 2 (N = 293), in a new sample, but with a wider age range, we examined the association of early life socioeconomic disadvantages with pain-related fear. In both studies, the predictions were tested with Structural Equation Modeling. Our models constituted a path from childhood socioeconomic status and household unpredictability to pain variables via the factors of family resources, unpredictability schemas, and body awareness. Results and conclusions The findings converged on the conclusion that individuals experiencing disadvantageous early life conditions tended to have an elevated level of pain catastrophizing, higher perceived sensitivity to pain, and higher level of pain-related fear. These associations were mediated by an unpredictability schema and body awareness. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-022-00800-0.
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Affiliation(s)
- Eszter Simon
- Department of Behavioral Sciences, Medical School, University of Pécs, Szigeti str. 12, 7624, Pécs, Hungary
| | - András N Zsidó
- Institute of Psychology, University of Pécs, Pécs, Ifjúság str. 6, 7624, Pécs, Hungary
| | - Béla Birkás
- Department of Behavioral Sciences, Medical School, University of Pécs, Szigeti str. 12, 7624, Pécs, Hungary
| | - Árpád Csathó
- Department of Behavioral Sciences, Medical School, University of Pécs, Szigeti str. 12, 7624, Pécs, Hungary.
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29
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Samuelly-Leichtag G, Eisenberg E, Zohar Y, Andraous M, Eran A, Sviri GE, Keynan O. Mechanism Underlying Painful Radiculopathy in Patients with Lumbar Disc Herniation. Eur J Pain 2022; 26:1269-1281. [PMID: 35357731 PMCID: PMC10083974 DOI: 10.1002/ejp.1947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 03/22/2022] [Accepted: 03/27/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Painful lumbar radiculopathy is a neuropathic pain condition, commonly attributed to nerve root inflammation/compression by disc herniation. The present exploratory study searched for associations between pain intensity and inflammatory markers, herniated disc size, infection, psychological factors and pain modulation in patients with confirmed painful lumbar radiculopathy scheduled for spine surgery. METHODS Prior to surgery, 53 patients underwent the following evaluation: pain intensity measured on a 0-10 numeric rating scale (NRS) and the Short-Form McGill Pain Questionnaire; sensory testing (modified DFNS protocol); pain processing including temporal summation and conditioned pain modulation (CPM); neurological examination; psychological assessment including Spielberger's Anxiety Inventory, Pain Sensitivity Questionnaire and the Pain Catastrophizing Scale. Pro-inflammatory cytokine levels (IL-1b, IL-6, IL-8, IL-17, TNFα, IFNg) and microbial infection (ELISA and rt-PCR) in blood and disc samples obtained during surgery. MRI scans assessments for disc herniation size/volume (MSU classification/ three-dimensional volumetric analysis). RESULTS Complete data was available from 40 (75%) patients (15 female) aged 44.8±16.3 years. Pain intensity (NRS) positively correlated with pain catastrophizing and CPM (r=0.437, P=0.006; r=0.421, P=0.007; respectively), but not with disc/blood cytokine levels, bacterial infection or MRI measures. CPM (P=0.001) and gender (P=0.029) were associated with average pain intensity (adjusted R2=0.443). CONCLUSIONS This exploratory study suggests that pain catastrophizing, CPM and gender, seem to contribute to pain intensity in patients with painful lumbar radiculopathy. The role of mechanical compression and inflammation in determining the intensity of painful radiculopathy remains obscure.
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Affiliation(s)
- GiL Samuelly-Leichtag
- B. Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Elon Eisenberg
- B. Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.,Institute for Pain Medicine, Rambam Health Care Campus, Haifa, Israel
| | - Yaniv Zohar
- B. Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.,Pathology Laboratory, Rambam Health Care Campus, Haifa, Israel
| | - Maisa Andraous
- Medical Imaging Division, Rambam Health Care Campus, Haifa, Israel
| | - Ayelet Eran
- B. Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.,Medical Imaging Division, Rambam Health Care Campus, Haifa, Israel
| | - Gill E Sviri
- B. Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.,Department of Neurosurgery, Rambam Health Care Campus, Haifa, Israel
| | - Ory Keynan
- Division of Spine Surgery, Department of Orthopedics, Rambam Health Care Campus, Haifa, Israel
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30
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Edwards RR, Campbell C, Schreiber KL, Meints S, Lazaridou A, Martel MO, Cornelius M, Xu X, Jamison RN, Katz JN, Carriere J, Khanuja HP, Sterling RS, Smith MT, Haythornthwaite JA. Multimodal prediction of pain and functional outcomes 6 months following total knee replacement: a prospective cohort study. BMC Musculoskelet Disord 2022; 23:302. [PMID: 35351066 PMCID: PMC8966339 DOI: 10.1186/s12891-022-05239-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 03/16/2022] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Knee osteoarthritis (OA) is among the most common and disabling persistent pain conditions, with increasing prevalence and impact around the globe. In the U.S., the rising prevalence of knee OA has been paralleled by an increase in annual rates of total knee arthroplasty (TKA), a surgical treatment option for late-stage knee OA. While TKA outcomes are generally good, post-operative trajectories of pain and functional status vary substantially; a significant minority of patients report ongoing pain and impaired function following TKA. A number of studies have identified sets of biopsychosocial risk factors for poor post-TKA outcomes (e.g., comorbidities, negative affect, sensory sensitivity), but few prospective studies have systematically evaluated the unique and combined influence of a broad array of factors. METHODS This multi-site longitudinal cohort study investigated predictors of 6-month pain and functional outcomes following TKA. A wide spectrum of relevant biopsychosocial predictors was assessed preoperatively by medical history, patient-reported questionnaire, functional testing, and quantitative sensory testing in 248 patients undergoing TKA, and subsequently examined for their predictive capacity. RESULTS The majority of patients had mild or no pain at 6 months, and minimal pain-related impairment, but approximately 30% reported pain intensity ratings of 3/10 or higher. Reporting greater pain severity and dysfunction at 6 months post-TKA was predicted by higher preoperative levels of negative affect, prior pain history, opioid use, and disrupted sleep. Interestingly, lower levels of resilience-related "positive" psychosocial characteristics (i.e., lower agreeableness, lower social support) were among the strongest, most consistent predictors of poor outcomes in multivariable linear regression models. Maladaptive profiles of pain modulation (e.g., elevated temporal summation of pain), while not robust unique predictors, interacted with psychosocial risk factors such that the TKA patients with the most pain and dysfunction exhibited lower resilience and enhanced temporal summation of pain. CONCLUSIONS This study underscores the importance of considering psychosocial (particularly positively-oriented resilience variables) and sensory profiles, as well as their interaction, in understanding post-surgical pain trajectories.
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Affiliation(s)
- Robert R Edwards
- Department of Anesthesiology, Perioperative & Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, Pain Management Center, 850 Boylston St, MA, 02467, Chestnut Hill, USA.
| | - Claudia Campbell
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kristin L Schreiber
- Department of Anesthesiology, Perioperative & Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, Pain Management Center, 850 Boylston St, MA, 02467, Chestnut Hill, USA
| | - Samantha Meints
- Department of Anesthesiology, Perioperative & Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, Pain Management Center, 850 Boylston St, MA, 02467, Chestnut Hill, USA
| | - Asimina Lazaridou
- Department of Anesthesiology, Perioperative & Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, Pain Management Center, 850 Boylston St, MA, 02467, Chestnut Hill, USA
| | - Marc O Martel
- Faculties of Dentistry & Medicine, McGill University, Strathcona Anatomy & Dentistry building 3640 University Street, Montreal, Qc, H3A 2B2, Canada
| | - Marise Cornelius
- Department of Anesthesiology, Perioperative & Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, Pain Management Center, 850 Boylston St, MA, 02467, Chestnut Hill, USA
| | - Xinling Xu
- Department of Anesthesiology, Perioperative & Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, Pain Management Center, 850 Boylston St, MA, 02467, Chestnut Hill, USA
| | - Robert N Jamison
- Department of Anesthesiology, Perioperative & Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, Pain Management Center, 850 Boylston St, MA, 02467, Chestnut Hill, USA
| | - Jeffrey N Katz
- Departments of Medicine and Orthopedic Surgery, Orthopedic and Arthritis Center for Outcomes Research, Harvard Medical School, Brigham & Women's Hospital, Boston, MA, USA
| | | | - Harpal P Khanuja
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Robert S Sterling
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michael T Smith
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jennifer A Haythornthwaite
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Coxon L, Wiech K, Vincent K. Is There a Neuropathic-Like Component to Endometriosis-Associated Pain? Results From a Large Cohort Questionnaire Study. FRONTIERS IN PAIN RESEARCH 2022; 2:743812. [PMID: 35295529 PMCID: PMC8915551 DOI: 10.3389/fpain.2021.743812] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 10/08/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Pain is one of the primary symptoms of endometriosis, a chronic inflammatory condition characterised by the presence of endometrial tissue outside the uterus. Endometriosis-associated pain is commonly considered as nociceptive in nature, but its clinical presentation suggests that it might have neuropathic-like properties in a subgroup of patients. Methods: This is a cross sectional study using an online survey. The survey was distributed by patient support websites. The survey was composed of validated questionnaires assessing pain symptoms, psychological measures and questions about number of surgeries. Main Results: We had 1,417 responses which met the inclusion criteria. Using standard painDETECT cut-off scores, we found that pain was classified as neuropathic in 40% of patients and as mixed neuropathic/nociceptive in a further 35%. In line with observations in other neuropathic conditions, the neuropathic subgroup reported higher pain intensities, greater psychological distress and cognitive impairment. Neuropathic pain was also more likely in those with more surgeries to the abdomen and a longer history of pain. As revealed by a cluster analysis, those with a neuropathic pain component could further be divided into two subgroups based on their sensory profile. Conclusions: The data presented here indicate that endometriosis-associated pain includes a neuropathic-like component in a substantial proportion of women. Although further investigation is required, our finding challenges the current conceptualisation of endometriosis-associated pain as nociceptive and advocates for a new perspective on this type of pain, which is so debilitating to a large number of women.
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Affiliation(s)
- Lydia Coxon
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Katja Wiech
- Nuffield Department of Clinical Neurosciences, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, United Kingdom
| | - Katy Vincent
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, United Kingdom
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Vriezekolk JE, Peters YAS, Steegers MAH, Davidson ENB, van den Ende CHM. Pain descriptors and determinants of pain sensitivity in knee osteoarthritis: a community-based cross-sectional study. Rheumatol Adv Pract 2022; 6:rkac016. [PMID: 35350719 PMCID: PMC8947773 DOI: 10.1093/rap/rkac016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 02/22/2022] [Indexed: 11/12/2022] Open
Abstract
Abstract
Objectives
To explore pain characteristics in individuals with knee osteoarthritis (KOA), to compare pain sensitivity across individuals with KOA, chronic back pain (CBP) and pain-free individuals (NP), and to examine the relationship between clinical and pain characteristics with pain sensitivity in KOA.
Methods
Cross-sectional, community-based online survey. Two datasets were combined comprising Dutch individuals of ≥ 40 years of age, experiencing chronic knee pain (KOA, N = 445), chronic back pain (CBP, N = 504), or no pain (NP, N = 256). Demographic and clinical characteristics, global health, physical activity/exercise, and pain characteristics including intensity, spreading, duration, quality (SF-MPQ), and sensitivity (PSQ) were assessed. Differences between (sub)groups were examined using analyses of variance or Chi-square tests. Regression analyses were performed to examine determinants of pain sensitivity in the KOA group.
Results
Quality of pain was most commonly described as aching, tender, and tiring-exhausting. Overall, the KOA group had higher levels of pain sensitivity compared to NP group, but lower levels than the CBP group. Univariately, pain intensity, its variability and spreading, global health, exercise, and having comorbidities were weakly related to pain sensitivity (standardized betas: 0.12-0.27). Symptom duration was not related to pain sensitivity. Older age, higher levels of continuous pain, lower levels of global health, and exercise uniquely contributed, albeit modest, to pain sensitivity (P<0.05).
Conclusion
Continuous pain such as aching and tenderness in combination with decreased physical activity may be indicative for a subgroup of individuals at risk for pain sensitivity and, ultimately, poor treatment outcomes.
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Affiliation(s)
- Johanna E Vriezekolk
- Department of Rheumatology Research, Sint Maartenskliniek, Nijmegen, the Netherlands
| | - Yvonne A S Peters
- Department of Rheumatology Research, Sint Maartenskliniek, Nijmegen, the Netherlands
| | - Monique A H Steegers
- Radboud Institute for Health Sciences,Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Anesthesiology, Amsterdam UMC, Amsterdam, the Netherlands
| | | | - Cornelia H M van den Ende
- Department of Rheumatology Research, Sint Maartenskliniek, Nijmegen, the Netherlands
- Department of Rheumatology, Radboud University Medical Center, Nijmegen, the Netherlands
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Kim MS, Koh IJ, Sung YG, Park DC, Yoon EJ, In Y. Influence of increased pain sensitivity on patient-reported outcomes following total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2022; 30:782-790. [PMID: 33486560 DOI: 10.1007/s00167-021-06455-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 01/11/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE The purpose of this study was to discover whether increased pain sensitivity was associated with postoperative pain and patient-reported outcome measures (PROMs) after total knee arthroplasty (TKA). METHODS Pain sensitivity was evaluated preoperatively using a pain sensitivity questionnaire (PSQ). Resting, walking, nighttime, and average pain visual analog scale (VAS) were measured before surgery and 6 weeks, 3 months, 6 months, and 1 year after surgery. PROMs were also evaluated based on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and patient satisfaction. The association between pain VAS average score, WOMAC total score, and PSQ score (minor, moderate, and total score) was assessed at each stage. RESULTS There were 59 patients with a high PSQ score (≥ 5.2) and 53 with a low PSQ score (< 5.2). Up to 1 year postoperatively, the group with high PSQ scores had higher resting, walking, nighttime, and average pain VAS scores than the group with low scores (all p < 0.05). Worse preoperative WOMAC pain, function, and total scores continued until 1 year after surgery in the high-scoring PSQ group (all p < 0.05). The group with low PSQ scores was more satisfied with surgery than the group with high scores (p = 0.027). There was a positive correlation between preoperative PSQ score and pain VAS average score at all time points (all p < 0.05). A relationship between PSQ score and WOMAC total score was also observed (all p < 0.05). CONCLUSION Increased pain sensitivity is a factor related to higher postoperative pain levels and inferior PROMs in patients undergoing primary TKA. LEVEL OF EVIDENCE Case-controlled study, III.
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Affiliation(s)
- Man Soo Kim
- Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - In Jun Koh
- Department of Orthopaedic Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 1021, Tongil Ro, Eunpyeong-gu, Seoul, 03312, Republic of Korea
| | - Yong Gyu Sung
- Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Dong Chul Park
- Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Eun Ji Yoon
- Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Yong In
- Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
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Granot M, Srulovici E, Granovsky Y, Yarnitsky D, Kuperman P. Dispositional and situational personal features and acute post-collision head and neck pain: Double mediation of pain catastrophizing and pain sensitivity. PLoS One 2022; 17:e0262076. [PMID: 35007302 PMCID: PMC8746745 DOI: 10.1371/journal.pone.0262076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 12/17/2021] [Indexed: 11/23/2022] Open
Abstract
Pain variability can be partially attributed to psycho-cognitive features involved in its processing. However, accumulating research suggests that simple linear correlation between situational and dispositional factors may not be sufficiently explanatory, with some positing a role for mediating influences. In addition, acute pain processing studies generally focus on a post-operative model with less attention provided to post-traumatic injury. As such, this study aimed to investigate a more comprehensive pain processing model that included direct and indirect associations between acute pain intensity in the head and neck, pain catastrophizing (using pain catastrophizing scale (PCS)), and pain sensitivity (using the pain sensitivity questionnaire (PSQ)), among 239 patients with post-motor vehicle collision pain. The effect of personality traits (using Ten Items Personality Inventory (TIPI)) and emotional status (using Hospital Anxiety and Depression Scale (HADS) and Perceived Stress Scale (PSS)) on that model was examined as well. To this end, three Structural Equation Modeling (SEM) analyses were conducted. Overall, the data had good fit to all the models, with only PSQ found to have a direct correlation with acute pain intensity. The SEM analyses conversely revealed several mediations. Specifically, that: first, PSQ fully mediated the relationship between PCS and pain intensity; second, PCS and PSQ together fully mediated the relationship between conscientiousness (personality trait) and pain intensity; and finally, emotional status had direct and indirect links with PSQ and pain intensity. In conclusion, these models suggest that during the acute post-collision phase, pain sensitivity intermediates between emotional states and personality traits, partially via elevated pain catastrophizing thoughts.
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Affiliation(s)
- Michal Granot
- Department of Nursing, University of Haifa, Haifa, Israel
| | | | - Yelena Granovsky
- Faculty of Medicine, Technion- Israel Institute of Technology, Haifa, Israel
| | - David Yarnitsky
- Faculty of Medicine, Technion- Israel Institute of Technology, Haifa, Israel
- Department of Neurology, Rambam Health Care Campus, Haifa, Israel
| | - Pora Kuperman
- Department of Neurology, Rambam Health Care Campus, Haifa, Israel
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Inal FY, Gul K, Yilmaz Camgoz Y, Daskaya H, Kocoglu H. Validation of the Turkish version of the Pain Sensitivity Questionnaire in patients with chronic pain. J Int Med Res 2021; 49:3000605211060158. [PMID: 34855531 PMCID: PMC8646826 DOI: 10.1177/03000605211060158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objective The Pain Sensitivity Questionnaire (PSQ) is a clinically beneficial instrument that has been proven to be correlated with various experimental pain sensitivity assessments in healthy people and in patients with chronic pain. In this study, we aimed to translate the PSQ into Turkish (PSQ-T) and validate it for the measurement of pain sensitivity among Turkish people. Methods Seventy-three patients with chronic back pain who were planning to undergo an interventional procedure completed the Brief Pain Inventory-Short Form (BPI-SF), Beck Depression Inventory (BDI), Beck Anxiety Inventory, Pain Catastrophizing Scale, and PSQ prior to their procedure. Subcutaneous infiltration of lidocaine was used as a standardized experimental pain stimulus. Pain was evaluated using a visual analog scale (VAS 1: infiltration in the hand, and VAS 2: infiltration in the procedure area) Results Scores on the PSQ-T were significantly correlated with those on the BPI-SF. A significant positive relationship was observed between VAS 1 and VAS 2 values and the PSQ-T score, BPI pain score, and BPI interference score. Conclusions The PSQ-T can be used as a valid and reliable tool for the assessment of pain sensitivity in the Turkish population.
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Affiliation(s)
- Ferda Yilmaz Inal
- Department of Anaesthesiology and Reanimation, Faculty of Medicine, Istanbul Medeniyet University, Istanbul 34000, Turkey
| | - Kursat Gul
- Department of Anaesthesiology and Reanimation, Faculty of Medicine, Bezmialem Vakif University, Istanbul 34000, Turkey
| | - Yadigar Yilmaz Camgoz
- Clinic of Anaesthesiology and Reanimation, Sultan Abdülhamid Han Training and Research Hospital, Istanbul 34000, Turkey
| | - Hayrettin Daskaya
- Department of Anaesthesiology and Reanimation, Faculty of Medicine, Bezmialem Vakif University, Istanbul 34000, Turkey
| | - Hasan Kocoglu
- Department of Anaesthesiology and Reanimation, Faculty of Medicine, Istanbul Medeniyet University, Istanbul 34000, Turkey
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Sex-Specific Pharmacotherapy for Back Pain: A Proof-of-Concept Randomized Trial. Pain Ther 2021; 10:1375-1400. [PMID: 34374961 PMCID: PMC8586405 DOI: 10.1007/s40122-021-00297-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 07/15/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Preventing transition to chronic back pain (CBP) is a long-sought strategy that could rescue patients from prolonged suffering. Recent rodent and human brain imaging studies suggest involvement of sexually dimorphic, dopaminergic-motivational, mesolimbic circuits in the transition to chronic pain (tCBP), and hint that the combination of carbidopa/levodopa and naproxen (LDP + NPX) may block tCBP. Here we evaluated, in people with recent-onset back pain, whether a 3-month treatment with LDP + NPX is safe, blocks tCBP, and whether its efficacy is sex-dependent. METHODS A total of 72 participants were enrolled and stratified by risk for tCBP using brain-imaging biomarkers. Low-risk participants entered a no-treatment arm. Others were randomized to placebo + naproxen or LDP + NPX for 3 months. RESULTS Both treatments resulted in more than 50% pain relief for approximately 75% of participants. A strong sex by treatment interaction was observed for daily pain intensity (phone NRS, P = 0.007), replicated on 4-week average pain (Pain/4w, P = 0.00001), and in intent-to-treat analysis (Pain/4w, P = 0.000004). Nucleus accumbens functional connectivity with medial prefrontal cortex, a predefined objective biomarker, showed sex dependence at baseline (P = 0.03) and sex-by-treatment interaction effect 3 months after treatment cessation (P = 0.031). Treatment modified the psychological profile of participants, and disrupted brain modeling-based predicted back pain intensity trajectories. Forty participants were queried 3.3 years from trial start; back pain ratings were similar between end of treatment and at 3.3 years (P = 0.62), indicating persistence of relief for this duration. CONCLUSIONS These results provide the first evidence for preventing transition to chronic back pain using sex-specific pharmacotherapy. These provocative observations require confirmation in a larger study. ClinicalTrials.gov identifier: NCT01951105.
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Chen Y, Ye X, Wu H, Huang X, Ke C, Chen Y, Wu H, Wu X. Association of Postpartum Pain Sensitivity and Postpartum Depression: A Prospective Observational Study. Pain Ther 2021; 10:1619-1633. [PMID: 34580805 PMCID: PMC8586323 DOI: 10.1007/s40122-021-00325-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/08/2021] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Postpartum depression (PPD) is a severe psychiatric disorder that negatively affects postnatal mothers worldwide. The aim of the study is to investigate the association between postpartum pain sensitivity and PPD as well as to identify the other potential risk factors for PPD and their interconnections. METHODS The current study was a prospective observational clinical study that enrolled 210 singleton pregnant women in a tertiary referral hospital from January to December 2020. Postpartum pain sensitivity was assessed by the Mandarin Chinese version of the Pain Sensitivity Questionnaire (PSQ), and PSQ-C-total and PSQ-C-minor scores were collected. PPD was screened by self-reporting Edinburgh Postnatal Depression Scale (EPDS), and EPDS total score was recorded. The association between postpartum pain sensitivity and PPD, as well as the risk factors and their interconnections, was analyzed by using a combination of stratified, bivariate, correlation, receiver-operating characteristic (ROC) curve, multivariate logistic regression, and path analysis. RESULTS Overall, 87 of 210 mothers (41.4%) screened positive for PPD. A positive correlation between PSQ-C-total (r = 0.67) or PSQ-C-minor (r = 0.62) and EPDS scores was identified. PSQ-C-total [area under curve (AUC) 0.89, 95% CI 0.84-0.93; P < 0.0001] showed significantly higher diagnostic accuracy compared with PSQ-C-minor (AUC 0.85, 95% CI 0.80-0.90; P < 0.0001) in predicting EPDS scores ≥ 10 points. Multivariate logistic regression indicated that a high PSQ-C-total score [adjusted odds ratio (OR) 1.12, 95% CI 1.08-1.51; P < 0.001] and gestational diabetes (adjusted OR 2.68, 95% CI 0.96-7.47; P = 0.045) were independent risk factors, while breastfeeding (adjusted OR: 0.34, 95% CI 0.15-0.78; P = 0.007) and normal birth weight (adjusted OR 0.17, 95% CI 0.05-0.61; P = 0.0047) were independently associated with decreasing adjusted ORs for EPDS scores ≥ 10 points. The path analysis model indicated that PSQ-C-total scores and gestational diabetes showed bidirectional effects, while birth weight and breastfeeding only had a direct impact on EPDS scores ≥ 10 points. CONCLUSION Increased postpartum pain sensitivity was closely associated with EPDS scores ≥ 10 points, and PSQ-C scores could be a reliable predictor. Moreover, gestational diabetes, low occurrence of breastfeeding, and low birth weight were the risk factors for EPDS scores ≥ 10 points. TRIAL REGISTRATION ChiCTR.org.cn identifier, ChiCTR-2000033091.
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Affiliation(s)
- Yu Chen
- grid.415108.90000 0004 1757 9178Department of Anesthesiology, Jinshan Branch of Fujian Provincial Hospital, No. 516, South of Jinrong Rd, Fuzhou, 350028 China ,grid.256112.30000 0004 1797 9307Department of Anesthesiology, Fujian Provincial Clinical Medical College, Fujian Medical University, Fuzhou, 350001 China
| | - Xin Ye
- grid.256112.30000 0004 1797 9307Department of Anesthesiology, Fujian Provincial Clinical Medical College, Fujian Medical University, Fuzhou, 350001 China ,grid.415108.90000 0004 1757 9178Department of Anesthesiology, Fujian Provincial Hospital, Fuzhou, 350001 China
| | - Han Wu
- grid.415108.90000 0004 1757 9178Department of Anesthesiology, Jinshan Branch of Fujian Provincial Hospital, No. 516, South of Jinrong Rd, Fuzhou, 350028 China
| | - Xinlei Huang
- grid.256112.30000 0004 1797 9307Department of Anesthesiology, Fujian Provincial Clinical Medical College, Fujian Medical University, Fuzhou, 350001 China ,grid.415108.90000 0004 1757 9178Department of Anesthesiology, Fujian Provincial Hospital, Fuzhou, 350001 China
| | - Congrong Ke
- grid.415108.90000 0004 1757 9178Department of Obstetrics and Gynecology, Jinshan Branch of Fujian Provincial Hospital, Fuzhou, 350028 China
| | - Yanqing Chen
- grid.415108.90000 0004 1757 9178Department of Anesthesiology, Jinshan Branch of Fujian Provincial Hospital, No. 516, South of Jinrong Rd, Fuzhou, 350028 China ,grid.256112.30000 0004 1797 9307Department of Anesthesiology, Fujian Provincial Clinical Medical College, Fujian Medical University, Fuzhou, 350001 China
| | - Huanghui Wu
- Department of Anesthesiology, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, No. 2000, East of Xiang'an Rd, Xiamen, 361102, China. .,Department of Anesthesiology and Perioperative Medicine, 900 Hospital of the Joint Logistics Team of the PLA, Fuzhou, 350025, China.
| | - Xiaodan Wu
- Department of Anesthesiology, Jinshan Branch of Fujian Provincial Hospital, No. 516, South of Jinrong Rd, Fuzhou, 350028, China. .,Department of Anesthesiology, Fujian Provincial Clinical Medical College, Fujian Medical University, Fuzhou, 350001, China.
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Yaari L, Dolev A, Kittani M, Yassin M, Gbaren M, Feicht E, Haviv B. Preoperative pain sensitivity questionnaire helps customize pain management after arthroscopic partial meniscectomy. Knee Surg Sports Traumatol Arthrosc 2021; 29:4198-4204. [PMID: 33704517 DOI: 10.1007/s00167-021-06438-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 01/07/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate correlations between preoperative pain sensitivity and postoperative analgesic consumption together with pain perception shortly after arthroscopic partial meniscectomy in non-arthritic knees. METHODS Ninety-nine patients who underwent primary arthroscopic meniscectomy were prospectively divided into three postoperative treatment groups that were prescribed with betamethasone injection (at the end of surgery), oral celecoxib or rescue analgesia (control). Preoperative pain sensitivity was evaluated by pain sensitivity questionnaires (PSQ). Patients were followed for the first three postoperative weeks to evaluate knee injury and osteoarthritis outcome score (KOOS) pain scores and analgesics consumption. Statistical analysis included correlations among preoperative pain sensitivity, postoperative pain levels and analgesics consumption. A receiver operating characteristic curve was plotted to investigate the cutoff values of the PSQ score to predict insufficient postoperative pain reduction. RESULTS There were no differences at baseline among all study groups in age, sex, BMI, level of activity, comorbidities and surgical findings. At the final follow-up, KOOS pain scores improved in all groups (p < 0.001). Mean final KOOS pain scores were 76.1 ± 15.2 for the betamethasone group, 70.8 ± 12.6 for the celecoxib group and 78.7 ± 11.6 for the control group. No differences in scores were observed among groups (n.s.). In the control group, a negative correlation was observed between PSQ score and KOOS-pain scores at the end of the follow-up in addition to a positive correlation between PSQ score and rescue analgesia consumption at the first postoperative week. The optimal cutoff value for PSQ score to predict insufficient improvement in KOOS-pain subscale was 5.0 points. CONCLUSIONS A cutoff value of pain sensitivity questionnaire score above 5.0 points was determined to identify patients with higher sensitivity to pain who underwent arthroscopic partial meniscectomy. These patients reported relatively increased pain and consumed more rescue analgesics postoperatively unless treated with a single intraoperative corticosteroids injection or oral non-steroidal anti-inflammatories. Therefore, surgeons can use pain sensitivity questionnaire score as a preoperative tool to identify patients with high sensitivity to pain and customize their postoperative analgesics protocol to better fit their pain levels. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Lee Yaari
- Arthroscopy and Sports Injuries Unit, Rabin Medical Center, Hasharon Hospital, 7 Keren Kayemet St, 49372, Petach-Tikva, Israel
- Orthopedic Department, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel
- Orthopedic Department, Rabin Medical Center, Hasharon Hospital, Petach-Tikva, Israel
| | - Amir Dolev
- Orthopedic Department, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel
- Orthopedic Department, Rabin Medical Center, Hasharon Hospital, Petach-Tikva, Israel
| | - Mohamed Kittani
- Arthroscopy and Sports Injuries Unit, Rabin Medical Center, Hasharon Hospital, 7 Keren Kayemet St, 49372, Petach-Tikva, Israel
- Orthopedic Department, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel
- Orthopedic Department, Rabin Medical Center, Hasharon Hospital, Petach-Tikva, Israel
| | - Mustafa Yassin
- Arthroscopy and Sports Injuries Unit, Rabin Medical Center, Hasharon Hospital, 7 Keren Kayemet St, 49372, Petach-Tikva, Israel
- Orthopedic Department, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel
- Orthopedic Department, Rabin Medical Center, Hasharon Hospital, Petach-Tikva, Israel
| | - Mahmod Gbaren
- Orthopedic Department, Rabin Medical Center, Hasharon Hospital, Petach-Tikva, Israel
| | - Elia Feicht
- Orthopedic Department, Rabin Medical Center, Hasharon Hospital, Petach-Tikva, Israel
| | - Barak Haviv
- Arthroscopy and Sports Injuries Unit, Rabin Medical Center, Hasharon Hospital, 7 Keren Kayemet St, 49372, Petach-Tikva, Israel.
- Orthopedic Department, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel.
- Orthopedic Department, Rabin Medical Center, Hasharon Hospital, Petach-Tikva, Israel.
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Quistrebert-Davanne V, Hardouin JB, Riant T, Ploteau S, Rigaud J, Levesque A. [Psychometric validation of Convergence criteria PP]. Prog Urol 2021; 31:1192-1200. [PMID: 34493442 DOI: 10.1016/j.purol.2021.07.011] [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: 03/04/2021] [Revised: 06/29/2021] [Accepted: 07/16/2021] [Indexed: 10/20/2022]
Abstract
CONTEXT The PP Convergences criteria group together 10 of the most significant clinical criteria for sensitization in the context of chronic pelvic pain. They are the result of a consensus of experts and represent to date the only clinical evaluation guide to identify patients with pelvic perineal pain in whom a pelvic sensitization component can be evoked. OBJECTIVE This work concerns the psychometric validation of these criteria. The aim is to answer 3 questions: 1) is the instrument reliable (i.e., sensitive, specific and accurate)?; 2) can we define a screening score for pelvic-perineal pain by sensitization from the CPP criteria?; 3) can combinations of criteria be defined to predict pelvic-perineal sensitization from the CPP criteria? METHODOLOGY AND SUBJECTS In total, 308 patients with pelviperineal pain were recruited during their medical consultation. PROCEDURE Fifteen expert physicians were asked to judge the presence or absence of the 10 CPP criteria and to make a diagnosis of the presence or absence of pelviperineal sensitization in their patient. RESULTS ROC curve analysis indicated that a score of 5 was the closest to a perfect score with a sensitivity of 95% and a specificity of 87%. They also indicate that the CPP criteria have a very good sensitivity (97%) and specificity (91%) and present globally a good reproducibility on all the criteria (Kappa>0.6). Finally, the statistical analyses reveal that the most discriminating criterion for predicting sensitization is Q8 (pain persisting after sexual activity). CONCLUSION The CPP criteria represent a very good screening tool for pelvic sensitization. The score of 5 corresponds to the score at which the patient has sufficient clinical criteria to be classified as sensitized. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- V Quistrebert-Davanne
- Centre fédératif de pelvipérinéologie et clinique urologique, CHU de Nantes, Nantes, France.
| | - J-B Hardouin
- Observatoire régional de la santé du Centre, Nantes, France
| | - T Riant
- CETD M Bensignor, hôpital privé du Confluent groupe VIVALTO, Nantes, France
| | - S Ploteau
- Centre fédératif de pelvipérinéologie et clinique urologique, CHU de Nantes, Nantes, France
| | - J Rigaud
- Centre fédératif de pelvipérinéologie et clinique urologique, CHU de Nantes, Nantes, France
| | - A Levesque
- Centre fédératif de pelvipérinéologie et clinique urologique, CHU de Nantes, Nantes, France
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Klute M, Laekeman M, Kuss K, Petzke F, Dieterich A, Leha A, Neblett R, Ehrhardt S, Ulma J, Schäfer A. Cross-cultural adaptation and validation of the German Central Sensitization Inventory (CSI-GE). BMC Musculoskelet Disord 2021; 22:708. [PMID: 34407773 PMCID: PMC8375049 DOI: 10.1186/s12891-021-04481-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 06/14/2021] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The Central Sensitization Inventory (CSI) is a screening tool designed to detect symptoms related to Central Sensitization (CS) and Central Sensitivity Syndromes (CSS) by measuring the degree of related phenomena. The objective of this study was to create a German, culturally-adapted version of the CSI and to test its psychometric properties. METHODS A German version of the CSI (CSI-GE) was developed, culturally-adapted, and pretested for comprehensibility. The psychometric properties of the resulting version were validated in a clinical study with chronic pain and pain-free control subjects. To assess retest reliability, the CSI-GE was administered twice to a subgroup of patients. Structural validity was tested using factor analyses. To investigate construct validity a hypotheses testing approach was used, including (1) correlations between the CSI-GE and several other well-established questionnaires as well as (2) an investigation of the CSI-GE discriminative power between different subgroups of participants believed to have different degrees of CS. RESULTS The CSI-GE showed excellent reliability, including high test-retest characteristics. Factor analyses confirmed a bi-factor dimensionality as has been determined previously. Analysing construct validity 6 out of 11 hypotheses (55%) were met. CSI-GE scores differentiated between subgroups according to expectations. Correlations between CSI-GE scores and other questionnaires suggested that none of the correlated constructs was identical, but there was overlap with other questionnaires based on symptom load. Several correlations did not fit with our current understanding of CS. CONCLUSION The CSI-GE appears to be a reliable tool for measuring CS/CSS-related symptomatology. Whether this implies that the CSI-GE measures the degree of CS within an individual subject remains unknown. The resulting score should be interpreted cautiously until further clarification of the construct.
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Affiliation(s)
- Michel Klute
- Pain Clinic, Department of Anaesthesiology, University Medical Center, Georg August University of Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany.
| | - Marjan Laekeman
- Physiological Psychology, Otto-Friedrich- University of Bamberg, Bamberg, Germany
| | - Katrin Kuss
- Department of General Practice/Family Medicine, Philipps University Marburg, Marburg, Germany
| | - Frank Petzke
- Pain Clinic, Department of Anaesthesiology, University Medical Center, Georg August University of Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Angela Dieterich
- Physiotherapy, Faculty of Health, Safety, Society, Furtwangen University, Furtwangen, Germany
| | - Andreas Leha
- Department of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany
| | | | - Steffen Ehrhardt
- Faculty of Social Sciences, City University of Applied Sciences, Bremen, Germany
| | - Joachim Ulma
- Clinic for Pain Medicine Bremen, Rotes-Kreuz-Krankenhaus Bremen, Bremen, Germany
| | - Axel Schäfer
- Faculty of Social Work and Health, University of Applied Science and Art, Hildesheim, Germany
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Ding JE, Kim YH, Yi SM, Graham AD, Li W, Lin MC. Ocular surface cooling rate associated with tear film characteristics and the maximum interblink period. Sci Rep 2021; 11:15030. [PMID: 34294850 PMCID: PMC8298610 DOI: 10.1038/s41598-021-94568-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 07/12/2021] [Indexed: 02/07/2023] Open
Abstract
The surface of the human eye is covered with a protective tear film that refreshes with each blink. Natural blinking occurs involuntarily, but one can also voluntarily blink or refrain from blinking. The maximum time one can refrain from blinking until the onset of discomfort is the maximum interblink period (MIBP). During the interblink period the tear film evaporates and thins from the ocular surface. Infrared thermography provides a non-invasive measure of the ocular surface temperature (OST). Due to evaporation, ocular surface cooling (OSC) generally occurs when the eyes are open and exposed to the environment. The purpose of our study was to investigate the effect of OSC rate on the MIBP, and to investigate the association of the MIBP with tear film characteristics in subjects who do and do not exhibit OSC. The MIBP was measured simultaneously with OST over time. Non-invasive tear breakup time, tear meniscus height, tear lipid layer thickness, and Schirmer I test strip wetted lengths were measured on a day prior to the thermography visit. Subjects were divided into cooling and non-cooling groups based on OSC rate, and demographic and tear film characteristics were tested for inter-group differences. A faster OSC rate was associated with an exponentially shorter duration of the MIBP overall and within the cooling group alone. Faster non-invasive tear breakup time was significantly associated with a shorter MIBP in both groups. These results suggest that tear film evaporation initiates a pathway that results in the onset of ocular discomfort and the stimulus to blinking. The presence of a subset of subjects with no or minimal OSC who nevertheless have a short MIBP indicates that evaporative cooling is not the only mechanism responsible for the onset of ocular discomfort.
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Affiliation(s)
- Jennifer E. Ding
- grid.47840.3f0000 0001 2181 7878Clinical Research Center, School of Optometry, University of California, Berkeley, 360 Minor Hall, Berkeley, CA 94720-2020 USA
| | - Young Hyun Kim
- grid.47840.3f0000 0001 2181 7878Clinical Research Center, School of Optometry, University of California, Berkeley, 360 Minor Hall, Berkeley, CA 94720-2020 USA ,grid.47840.3f0000 0001 2181 7878Vision Science Graduate Group, University of California, Berkeley, CA 94720 USA ,grid.47840.3f0000 0001 2181 7878Chemical and Biomolecular Engineering Department, University of California, Berkeley, CA 94720 USA
| | - Sarah M. Yi
- grid.47840.3f0000 0001 2181 7878Clinical Research Center, School of Optometry, University of California, Berkeley, 360 Minor Hall, Berkeley, CA 94720-2020 USA
| | - Andrew D. Graham
- grid.47840.3f0000 0001 2181 7878Clinical Research Center, School of Optometry, University of California, Berkeley, 360 Minor Hall, Berkeley, CA 94720-2020 USA
| | - Wing Li
- grid.47840.3f0000 0001 2181 7878Clinical Research Center, School of Optometry, University of California, Berkeley, 360 Minor Hall, Berkeley, CA 94720-2020 USA
| | - Meng C. Lin
- grid.47840.3f0000 0001 2181 7878Clinical Research Center, School of Optometry, University of California, Berkeley, 360 Minor Hall, Berkeley, CA 94720-2020 USA ,grid.47840.3f0000 0001 2181 7878Vision Science Graduate Group, University of California, Berkeley, CA 94720 USA
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No pain, still gain (of function): the relation between sensory profiles and the presence or absence of self-reported pain in a large multicenter cohort of patients with neuropathy. Pain 2021; 162:718-727. [PMID: 32868752 DOI: 10.1097/j.pain.0000000000002058] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 07/22/2020] [Indexed: 12/12/2022]
Abstract
ABSTRACT The pathophysiology of pain in neuropathy is complex and may be linked to sensory phenotypes. Quantitative sensory testing, a standardized method to evaluate sensory profiles in response to defined stimuli, assesses functional integrity of small and large nerve fiber afferents and central somatosensory pathways. It has revealed detailed insights into mechanisms of neuropathy, yet it remains unclear if pain directly affects sensory profiles. The main objective of this study was to investigate sensory profiles in patients with various neuropathic conditions, including polyneuropathy, mononeuropathy, and lesions to the central nervous system, in relation to self-reported presence or absence of pain and pain sensitivity using the Pain Sensitivity Questionnaire. A total of 443 patients (332 painful and 111 painless) and 112 healthy participants were investigated. Overall, loss of sensation was equally prevalent in patients with and without spontaneous pain. Pain thresholds were equally lowered in both patient groups, demonstrating that hyperalgesia and allodynia are just as present in patients not reporting any pain. Remarkably, this was similar for dynamic mechanical allodynia. Hypoalgesia was more pronounced in painful polyneuropathy, whereas hyperalgesia was more frequent in painful mononeuropathy (compared with painless conditions). Self-reported pain sensitivity was significantly higher in painful than in painless neuropathic conditions. Our results reveal the presence of hyperalgesia and allodynia in patients with central and peripheral lesions of the somatosensory system not reporting spontaneous pain. This shows that symptoms and signs of hypersensitivity may not necessarily coincide and that painful and painless neuropathic conditions may mechanistically blend into one another.
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Shulman J, Zurakowski D, Keysor J, Jervis K, Sethna NF. Offset analgesia identifies impaired endogenous pain modulation in pediatric chronic pain disorders. Pain 2021; 161:2852-2859. [PMID: 32658151 DOI: 10.1097/j.pain.0000000000001984] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Offset analgesia (OA), a psychophysical test of endogenous pain inhibition, is diminished in many adult chronic pain disorders but OA has not been investigated in youth with chronic pain disorders. This study assessed OA responses in 30 youth with chronic primary and secondary pain disorders and 32 healthy controls. The OA, control, and constant thermal tests were evoked with an individualized noxious heat stimulus of approximately 50/100 mm on a visual analogue scale followed by 1°C offset temperature. This study also examined the association of OA responses with 2 self-report measures of pain sensitivity, the Central Sensitization Inventory (CSI) and Pain Sensitivity Questionnaire. Patients exhibited diminished capacity to activate OA with a reduction in ΔeVASc of 53 ± 29% vs controls 74 ± 24% (P = 0.003) even after multivariate regression adjusting for age, sex, and body mass index. Patients also showed decreased ability to habituate to a constant noxious heat stimulus compared to controls (P = 0.021). Central Sensitization Inventory scores showed excellent predictive accuracy in differentiating patients from controls (area under the curve = 0.95; 95% CI: 0.91-0.99) and CSI score ≥30 was identified as an optimal cutoff value. Pain Sensitivity Questionnaire scores did not differentiate patients from controls nor correlate with OA. In this study, 60% of youth with chronic pain showed reduced capacity for endogenous pain inhibition.
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Affiliation(s)
- Julie Shulman
- Department of Physical and Occupational Therapy, Boston Children's Hospital, Boston, MA, United States.,Interprofessional PhD in Rehabilitation Science Program, MGH Institute of Health Professions, Boston, MA, United States
| | - David Zurakowski
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA, United States.,Department of Anesthesiology, Harvard Medical School, Boston, MA, United States
| | - Julie Keysor
- Interprofessional PhD in Rehabilitation Science Program, MGH Institute of Health Professions, Boston, MA, United States
| | - Kelsey Jervis
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Navil F Sethna
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA, United States.,Department of Anesthesiology, Harvard Medical School, Boston, MA, United States
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Pain Sensitivity, Negative Affect, and Alcohol Use Disorder Status: A Moderated Mediation Study of Emotion Dysregulation. J Clin Med 2021; 10:jcm10061321. [PMID: 33806849 PMCID: PMC8005076 DOI: 10.3390/jcm10061321] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/13/2021] [Accepted: 03/18/2021] [Indexed: 12/24/2022] Open
Abstract
Previous work suggests that the association between pain and emotional processes among individuals with alcohol use disorder (AUD) may differ from healthy controls. This study investigates whether pain sensitivity mediates the association between negative affect and emotional dysregulation and whether this association differs across AUD status using moderated mediation. The sample included 165 individuals diagnosed with AUD and 110 healthy controls. Of interest was pain sensitivity, as assessed with the Pain Sensitivity Questionnaire, negative affect, as assessed with the Beck Depression Inventory, and emotional dysregulation, as assessed with the Difficulties in Emotional regulation Scale. Age, biological sex, and current pain severity were included as covariates. The results support a moderated partial mediation model that explained 44% of the variance in emotional dysregulation. The findings indicate that negative affect is related to higher pain sensitivity across groups. Moreover, pain sensitivity partially mediated the association between negative affect and emotional dysregulation, but in opposite directions depending on AUD status. Among healthy controls, greater pain sensitivity was related to better emotional regulation, while greater pain sensitivity led to greater emotional dysregulation among individuals with AUD. The potential parallels in the underlying neurobiological mechanisms of emotionality, pain, and AUD suggest that interventions targeting pain may improve adaptive affect regulation skills, which in turn could reduce negative affect and its effect on pain sensitivity among individuals with AUD.
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Kiani P, Merlo A, Saeed HM, Benson S, Bruce G, Hoorn R, Kraneveld AD, van de Loo AJAE, Severeijns NR, Sips ASM, Scholey A, Garssen J, Verster JC. Immune Fitness and the Psychosocial and Health Consequences of the COVID-19 Pandemic Lockdown in The Netherlands: Methodology and Design of the CLOFIT Study. Eur J Investig Health Psychol Educ 2021; 11:199-218. [PMID: 34542459 PMCID: PMC8314332 DOI: 10.3390/ejihpe11010016] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 02/02/2021] [Accepted: 02/19/2021] [Indexed: 01/07/2023] Open
Abstract
This article provides an overview of the design and methodology of the "Corona lockdown: how fit are you?" (CLOFIT) study, including the questionnaires and scales that were included in the online survey. The aim of the CLOFIT study was to investigate the psychosocial and health consequences of the coronavirus disease 2019 (COVID-19) pandemic in the Netherlands. The survey was conducted among the Dutch population to collect data on immune fitness and the psychological and health consequences of the 2019 coronavirus disease (COVID-19) pandemic lockdown in the Netherlands. The CLOFIT dataset contains measures from N = 1910 participants and is broadly representative of the Dutch general population. The dataset represents both sexes, a range of ages including the elderly, different education levels, and ethnic backgrounds. The cohort also includes people with a diverse health status and range of medication use.
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Affiliation(s)
- Pantea Kiani
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584CG Utrecht, The Netherlands; (P.K.); (A.M.); (H.M.S.); (R.H.); (A.D.K.); (A.J.A.E.v.d.L.); (N.R.S.); (A.S.M.S.); (J.G.)
| | - Agnese Merlo
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584CG Utrecht, The Netherlands; (P.K.); (A.M.); (H.M.S.); (R.H.); (A.D.K.); (A.J.A.E.v.d.L.); (N.R.S.); (A.S.M.S.); (J.G.)
| | - Hama M. Saeed
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584CG Utrecht, The Netherlands; (P.K.); (A.M.); (H.M.S.); (R.H.); (A.D.K.); (A.J.A.E.v.d.L.); (N.R.S.); (A.S.M.S.); (J.G.)
| | - Sarah Benson
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC 3122, Australia; (S.B.); (A.S.)
| | - Gillian Bruce
- Division of Psychology and Social Work, School of Education and Social Sciences, University of the West of Scotland, Paisley PA1 2BE, UK;
| | - Rosalie Hoorn
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584CG Utrecht, The Netherlands; (P.K.); (A.M.); (H.M.S.); (R.H.); (A.D.K.); (A.J.A.E.v.d.L.); (N.R.S.); (A.S.M.S.); (J.G.)
- Clinical Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, 1081BT Amsterdam, The Netherlands
| | - Aletta D. Kraneveld
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584CG Utrecht, The Netherlands; (P.K.); (A.M.); (H.M.S.); (R.H.); (A.D.K.); (A.J.A.E.v.d.L.); (N.R.S.); (A.S.M.S.); (J.G.)
| | - Aurora J. A. E. van de Loo
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584CG Utrecht, The Netherlands; (P.K.); (A.M.); (H.M.S.); (R.H.); (A.D.K.); (A.J.A.E.v.d.L.); (N.R.S.); (A.S.M.S.); (J.G.)
| | - Noortje R. Severeijns
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584CG Utrecht, The Netherlands; (P.K.); (A.M.); (H.M.S.); (R.H.); (A.D.K.); (A.J.A.E.v.d.L.); (N.R.S.); (A.S.M.S.); (J.G.)
| | - Annabel S. M. Sips
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584CG Utrecht, The Netherlands; (P.K.); (A.M.); (H.M.S.); (R.H.); (A.D.K.); (A.J.A.E.v.d.L.); (N.R.S.); (A.S.M.S.); (J.G.)
| | - Andrew Scholey
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC 3122, Australia; (S.B.); (A.S.)
| | - Johan Garssen
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584CG Utrecht, The Netherlands; (P.K.); (A.M.); (H.M.S.); (R.H.); (A.D.K.); (A.J.A.E.v.d.L.); (N.R.S.); (A.S.M.S.); (J.G.)
- Global Centre of Excellence Immunology, Nutricia Danone Research, 3584CT Utrecht, The Netherlands
| | - Joris C. Verster
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584CG Utrecht, The Netherlands; (P.K.); (A.M.); (H.M.S.); (R.H.); (A.D.K.); (A.J.A.E.v.d.L.); (N.R.S.); (A.S.M.S.); (J.G.)
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC 3122, Australia; (S.B.); (A.S.)
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Saeed HM, Sips ASM, Owen LJ, Verster JC. The Relationship between Pain Sensitivity, Pain Catastrophizing and Hangover Severity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2047. [PMID: 33669813 PMCID: PMC7922170 DOI: 10.3390/ijerph18042047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 11/16/2022]
Abstract
Recent research found a significant and positive correlation between hangover severity and pain catastrophizing. The current study aimed to verify these findings. Data from N = 673 subjects with a mean (SD) age of 42.2 (19.1) years old (range: 18 to 87 years old) was evaluated. An online survey collected data on alcohol consumption and hangovers related to their heaviest drinking occasion between 15 January and 14 March 2020. When correcting for the amount of alcohol consumed, significant correlations were found between hangover severity and both sensitivity to pain (r = 0.085, p = 0.029) and pain catastrophizing (r = 0.095, p = 0.015). In addition, subjective intoxication correlated significantly with sensitivity to pain (r = 0.080, p = 0.041) and pain catastrophizing (r = 0.099, p = 0.011). Overall, the results were more pronounced in men than women, and the associations with pain catastrophizing were strongest for the subscale assessing rumination. In conclusion, although statistically significant, the observed correlations were of small magnitude. Nevertheless, the observations confirm previous findings that suggest a link between pain perception, alcohol consumption, and hangover severity, which warrants further investigation.
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Affiliation(s)
- Hama M. Saeed
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584CG Utrecht, The Netherlands; (H.M.S.); (A.S.M.S.)
| | - Annabel S. M. Sips
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584CG Utrecht, The Netherlands; (H.M.S.); (A.S.M.S.)
| | - Lauren J. Owen
- Department of Psychology, School of Health and Society, University of Salford, Frederick Road, Salford M6 6PU, UK;
| | - Joris C. Verster
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584CG Utrecht, The Netherlands; (H.M.S.); (A.S.M.S.)
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC 3122, Australia
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Kim S, Bae DW, Park SG, Park JW. The impact of Pain-related emotions on migraine. Sci Rep 2021; 11:577. [PMID: 33436778 PMCID: PMC7804193 DOI: 10.1038/s41598-020-80094-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 12/14/2020] [Indexed: 02/07/2023] Open
Abstract
The response to pain is highly individual and can be influenced by complex emotional perception. This study aims to investigate the status of the pain-related emotional response, and the influence on headache characteristics and disability in migraine. We studied the pain-related emotional response in 145 consecutive migraine patients using the Pain Anxiety Symptoms Scale (PASS), the Pain Catastrophizing Scale (PCS), and the Pain Sensitivity Questionnaire (PSQ) and compared them with 106 healthy controls. We investigated the relationship between emotional factors and migraine characteristics. The effect of pain-related emotion on migraine-related disability assessed with the Headache Impact Test-6 (HIT-6) and the Migraine Disability Assessment (MIDAS). Migraine patients showed significantly higher scores on total PASS (p < 0.001), PCS (p < 0.001) and PSQ (p = 0.002) compared to the healthy controls. The HIT-6 was weakly correlated with PASS (r = 0.390, p < 0.001) and PCS (r = 0.354, p < 0.001). PASS-Total (p = 0.001), headache frequency (p = 0.003), and HADS-Anxiety (p = 0.028) were independent variables associated with HIT-6. Headache frequency (p < 0.001) was an independent variable associated with MIDAS. The structural equation model indicated that headache severity has direct loading on emotion and subsequently influenced migraine-related disability. Disability has a significant effect on the frequency of abortive medication use. Migraine patients have altered emotional responses to pain perception. Pain-related anxiety made an important contribution to headache-related disability. The present results suggest that the management of disability by considering various pain-related emotional factors may be necessary for the therapeutic aspects of migraine.
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Affiliation(s)
- Seonghoon Kim
- Department of Neurology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dae-Woong Bae
- Department of Neurology, St. Vincent's hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sang-Gue Park
- Department of Applied Statistics, Chung-Ang University, Seoul, Republic of Korea
| | - Jeong-Wook Park
- Department of Neurology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Förtsch EMAD, Baumgart P, Teismann T, Ruscheweyh R, Hasenbring MI. No game, more pain - Examining possible long term effects and underlying mechanisms of habitual violent video gaming on the acquired capability for suicide. Psychiatry Res 2021; 295:113512. [PMID: 33213935 DOI: 10.1016/j.psychres.2020.113512] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 10/14/2020] [Indexed: 10/23/2022]
Abstract
According to Joiner`s interpersonal-psychological theory of suicide repeated engagement in suicidal behavior or so-called painful and provocative events constitutes the acquired capability for suicide (ACS) comprising two facets: enhanced pain tolerance and fearlessness about death (FAD). Recent research showed that single bouts of violent-video-gaming (VVG) increase pain tolerance. It is unknown whether individuals who habitually play VVGs at a high frequency rate show higher signs of ACS in terms of low pain sensitivity, high tolerance and lowered FAD compared to non-gamers. In a cross-sectional case-control study, we compared pain sensitivity and tolerance during a 5-min Cold-Pressor-Test (CPT) besides FAD in young males, playing VVGs highly frequent (n = 18) vs. non-gamers (n = 17). Mood was rated before and after the CPT. We found higher CPT-pain tolerance, lower intensity ratings and higher FAD scores among gamers compared to non-gamers. A significant time x group interaction of pain ratings indicated a process of habituation in the gamers. An increase of positive mood in the gamers emphasizes the role of opponent processes. The results suggest that habitual VVG might reflect a repetitive behavior enhancing the ACS.
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Affiliation(s)
- E-M A D Förtsch
- Department of Medical Psychology and Sociology, Faculty of Medicine, Ruhr-University of Bochum, Universitätsstr. 150, 44780 Bochum, Germany.
| | - P Baumgart
- Department of Medical Psychology and Sociology, Faculty of Medicine, Ruhr-University of Bochum, Universitätsstr. 150, 44780 Bochum, Germany
| | - T Teismann
- Department of Clinical Psychology and Psychotherapy, Faculty of Psychology, Ruhr University of Bochum, Bochum, Germany
| | - R Ruscheweyh
- Department of Neurology, Ludwig Maximilians University Munich, Munich, Germany
| | - M I Hasenbring
- Department of Medical Psychology and Sociology, Faculty of Medicine, Ruhr-University of Bochum, Universitätsstr. 150, 44780 Bochum, Germany
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49
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van Ettinger-Veenstra H, Boehme R, Ghafouri B, Olausson H, Wicksell RK, Gerdle B. Exploration of Functional Connectivity Changes Previously Reported in Fibromyalgia and Their Relation to Psychological Distress and Pain Measures. J Clin Med 2020; 9:E3560. [PMID: 33167371 PMCID: PMC7694394 DOI: 10.3390/jcm9113560] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 10/27/2020] [Accepted: 11/03/2020] [Indexed: 11/18/2022] Open
Abstract
Neural functional connectivity changes in the default mode network (DMN), Central executive network (CEN), and insula have been implicated in fibromyalgia (FM) but stem from a sparse set of small-scale studies with limited power for the investigation of confounding effects. We investigated whether anxiety, depression, pain sensitivity, and pain intensity modulated functional connectivity related to DMN nodes, CEN nodes, and insula. Resting-state functional magnetic resonance imaging data were collected from 31 females with FM and 28 age-matched healthy controls. Connectivity was analysed with a region-based connectivity analysis between DMN nodes in ventromedial prefrontal cortex (vmPFC) and posterior cingulate cortex, CEN nodes in the intraparietal sulcus (IPS), and bilateral insula. FM patients displayed significantly higher levels of anxiety and depressive symptoms than controls. The right IPS node of the CEN showed a higher level of connectivity strength with right insula in FM with higher pain intensity compared to controls. More anxiety symptoms in FM correlated with higher levels of connectivity strength between the vmPFC DMN node and right sensorimotor cortex. These findings support the theory of altered insular connectivity in FM and also suggest altered IPS connectivity in FM. Interestingly, no change in insular connectivity with DMN was observed.
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Affiliation(s)
- Helene van Ettinger-Veenstra
- Department of Clinical Neuroscience, Karolinska Institute, S-171 77 Stockholm, Sweden;
- Center for Medical Image Science and Visualization (CMIV), Linköping University, S-581 85 Linköping, Sweden; (H.O.); (B.G.)
| | - Rebecca Boehme
- Center for Medical Image Science and Visualization (CMIV), Linköping University, S-581 85 Linköping, Sweden; (H.O.); (B.G.)
- Center for Social and Affective Neuroscience (CSAN), Linköping University, S-581 85 Linköping, Sweden
| | - Bijar Ghafouri
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, S-581 85 Linköping, Sweden;
| | - Håkan Olausson
- Center for Medical Image Science and Visualization (CMIV), Linköping University, S-581 85 Linköping, Sweden; (H.O.); (B.G.)
- Center for Social and Affective Neuroscience (CSAN), Linköping University, S-581 85 Linköping, Sweden
| | - Rikard K. Wicksell
- Department of Clinical Neuroscience, Karolinska Institute, S-171 77 Stockholm, Sweden;
| | - Björn Gerdle
- Center for Medical Image Science and Visualization (CMIV), Linköping University, S-581 85 Linköping, Sweden; (H.O.); (B.G.)
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, S-581 85 Linköping, Sweden;
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50
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Abstract
Central sensitization is a physiological mechanism associated with enhanced sensitivity and pain responses. At present, central sensitization cannot be determined directly in humans, but certain signs and symptoms may be suggestive of it. Although central sensitization has received increasing attention in the clinical literature, there is a risk that certain distinctions are being lost. This paper summarizes current knowledge of the physiology of central sensitization and its possible manifestations in patients, in order to inform a debate about the relevance of central sensitization for physical therapists. It poses 6 challenges associated with the application of central sensitization concepts in clinical practice and makes suggestions for assessment, treatment, and use of terminology. Physical therapists are asked to be mindful of central sensitization and consider potential top-down as well as bottom-up drivers, in the context of a person-centered biopsychosocial approach. J Orthop Sports Phys Ther 2020;50(11):592-596. doi:10.2519/jospt.2020.0610.
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