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Sangha MS, Baker M, Baldwin AJ, Murray A. Assessing the effect of the cost-of-living crisis on hot water bottle-related burns in the United Kingdom, a single-centre retrospective observational study. JPRAS Open 2024; 39:313-320. [PMID: 38380183 PMCID: PMC10878842 DOI: 10.1016/j.jpra.2024.01.008] [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: 12/07/2023] [Accepted: 01/17/2024] [Indexed: 02/22/2024] Open
Abstract
Background The cost-of-living crisis (CoLC) is an economic climate that the United Kingdom (UK) has been experiencing since late 2021, characterized by an increase in the price of essential goods faster than real-term incomes. Food and fuel poverty has ensued. This study aimed to assess whether the CoLC is associated with an increase in hot water bottle (HWB)-related burns as patients seek alternative heating sources to keep warm. Methods Records of patients treated for HWB burns between December 2019 and March 2023 were reviewed for patient demographics, burn depth and surface area, patient comorbidities, and patient index of multiple deprivation (IMD). The incidence of admissions, IMD, and severity of injury were compared prior to and during the CoLC using either independent t-test or Kruskal-Wallis H test. Results Between December 2019 and March 2023, 177 patients were treated for HWB burns, 79 prior to the CoLC, and 98 during. Of the patients, 55 patients were male and 122 females. An independent t-test comparing average monthly admissions prior and during the CoLC identified a significant difference (p = 0.042), with a mean increase of 1.85 cases (95% CI: 0.71-3.63). Additionally, a Kruskal-Wallis H test showed statistically significant difference in the number of patients treated for HWB burns between the seasons (p = 0.001). An independent t-test comparing average patient IMD prior and during the CoLC identified no difference (p = 0.33). Conclusion The increase in HWB burns coincides with the increase in energy costs and general cost of living that has occurred in the UK since October 2021.
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Affiliation(s)
- Mahaveer S. Sangha
- Corresponding author at: Foundation Year 2 Doctor, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, UK.
| | - Michelle Baker
- Department of Plastic & Reconstructive Surgery, Stoke Mandeville Hospital, Aylesbury, UK
| | - Alexander J. Baldwin
- Department of Plastic & Reconstructive Surgery, Stoke Mandeville Hospital, Aylesbury, UK
| | - Alexandra Murray
- Department of Plastic & Reconstructive Surgery, Stoke Mandeville Hospital, Aylesbury, UK
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Sprouse Blum AS, DaSilva LA, Greenberg MD, Nissenbaum AJ, Shapiro RE, Littenberg B. Comparison of migraine with left- versus right-sided headache: A cross-sectional study. Headache 2024; 64:259-265. [PMID: 38433351 DOI: 10.1111/head.14689] [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: 06/15/2023] [Revised: 12/21/2023] [Accepted: 12/21/2023] [Indexed: 03/05/2024]
Abstract
OBJECTIVE The goal of this study was to clarify whether clinical differences exist between patients with migraine who experience headache that is typically left-sided ("left-migraine") versus right-sided ("right-migraine") during attacks. BACKGROUND Migraine has been associated with unilateral headache for millennia and remains a supportive trait for the clinical diagnosis of migraine of the International Classification of Headache Disorders. It is currently unknown why headache in migraine is commonly unilateral, and whether headache-sidedness is associated with other clinical features. METHODS This is a cross-sectional study comparing left- versus right-migraine using all available intake questionnaires of new patients evaluated at an academic tertiary headache center over a 20-year period. Eligibility was based on patient written responses indicating the typical location of headache during attacks. In our analyses, the side of headache (left or right) was the predictor variable. The outcomes included various migraine characteristics and psychiatric comorbidities. RESULTS We identified 6527 patients with migraine, of which 340 met study eligibility criteria. Of these, 48.8% (166/340) had left migraine, and 51.2% (174/340) had right migraine. When comparing patients with left- versus right-migraine, patients with left migraine experienced 3.6 fewer headache-free days (95% confidence interval [CI] 1.3-5.9; p = 0.002) and 2.4 more severe headache days (95% CI 0.8-4.1; p = 0.004) in the previous 4 weeks. No significant differences in age, sex, handedness, migraine characteristics, or psychiatric comorbidities were identified between the two groups. CONCLUSIONS Patients with migraine with typically left-sided headache during attacks reported a higher burden of headache frequency and severity than those with typically right-sided headache during attacks. These findings may have implications for our understanding of migraine pathophysiology, treatment, and clinical trial design.
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Affiliation(s)
- Adam S Sprouse Blum
- Department of Neurological Sciences, University of Vermont, Burlington, Vermont, USA
| | | | | | | | - Robert E Shapiro
- Department of Neurological Sciences, University of Vermont, Burlington, Vermont, USA
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Mehsein Z, Kobaïter-Maarrawi S, Samaha H, El Shami M, Albeaini S, Maarrawi J. Right posterior insular epidural stimulation in rats with neuropathic pain induces a frequency-dependent and opioid system-mediated reduction of pain and its comorbid anxiety and depression. Prog Neuropsychopharmacol Biol Psychiatry 2024; 128:110845. [PMID: 37619765 DOI: 10.1016/j.pnpbp.2023.110845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/29/2023] [Accepted: 08/19/2023] [Indexed: 08/26/2023]
Abstract
Neuropathic pain (NP) is a sensory, emotional, and persistent disturbing experience caused by a lesion or disease of the somatosensory system which can lead when chronic to comorbidities such as anxiety and depression. Available treatments (pharmacotherapy, neurostimulation) have partial and unpredictable response; therefore, it seems necessary to find a new therapeutical approach that could alleviate most related symptoms and improve patients 'emotional state'. Posterior Insula seems to be a potential target of neurostimulation for pain relief. However, its effects on pain-related anxiety and depression remain unknown. Using rats with spared nerve injury (SNI), this study aims to elucidate the correlation between NP and anxio-depressive disorders, evaluate potential analgesic, anxiolytic, and antidepressant effects of right posterior insula stimulation (IS) using low (LF-IS, 50 Hz) or high (HF-IS, 150 Hz) frequency and assess endogenous opioid involvement in these effects. Results showed positive correlation between NP, anxiety, and depression. LF-IS reversed anhedonia and despair-like behavior through pain alleviation, whereas HF-IS only reduced anhedonia, all effects involving endogenous opioids. These findings support the link between NP and anxio-depressive disorders. Moreover, IS appears to have analgesic, anxiolytic and antidepressant effects mediated by the endogenous opioid system, making it a promising target for neurostimulation.
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Affiliation(s)
- Zeinab Mehsein
- Laboratory of Research in Neuroscience (LAREN), Pôle Technologie Santé (PTS), Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Sandra Kobaïter-Maarrawi
- Laboratory of Research in Neuroscience (LAREN), Pôle Technologie Santé (PTS), Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon.
| | - Hady Samaha
- Laboratory of Research in Neuroscience (LAREN), Pôle Technologie Santé (PTS), Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Mohamad El Shami
- Laboratory of Research in Neuroscience (LAREN), Pôle Technologie Santé (PTS), Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Sylvana Albeaini
- Laboratory of Research in Neuroscience (LAREN), Pôle Technologie Santé (PTS), Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Joseph Maarrawi
- Laboratory of Research in Neuroscience (LAREN), Pôle Technologie Santé (PTS), Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon; Department of Neurosurgery - Hôtel-Dieu de France Hospital, Beirut, Lebanon
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Bao JD, Rosser MA, Park SH, Baker AK, Martucci KT. Interplay between noxious heat sensitivity and temporal summation magnitude in patients with fibromyalgia and long-term opioid use. Front Neurosci 2023; 17:1275921. [PMID: 37901425 PMCID: PMC10600517 DOI: 10.3389/fnins.2023.1275921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 09/26/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction In chronic pain conditions such as fibromyalgia (FM), pain amplification within the central nervous system, or "central sensitization," may contribute to the development and maintenance of chronic pain. Chronic pain treatments include opioid therapy, and opioid therapy may maladaptively increase central sensitization, particularly in patients who take opioids long-term. However, it has remained unknown how central sensitization is impacted in patients who use opioids long-term. Methods To investigate how long-term opioid therapy affects central sensitization, we used the validated measure of temporal summation. The temporal summation measurement consists of applying a series of noxious stimuli to a patient's skin and then calculating changes in the patient's pain rating to each stimulus. Using this measurement, we evaluated temporal summation in study participants with fibromyalgia who take opioids long-term (i.e., greater than 90 days duration; n = 24, opioid-FM). We compared opioid-FM responses to 2 control groups: participants with fibromyalgia who do not take opioids (n = 33, non-opioid FM), and healthy controls (n = 31). For the temporal summation measurement, we applied a series of 10 noxious heat stimuli (sensitivity-adjusted temperatures) to the ventral forearm (2s duration of each stimulus, applied once every 3 s). Additionally, we collected responses to standard pain and cognitive-affective questionnaires to assess pain severity and other factors. Results and discussion Group differences in sensitivity-adjusted stimulus temperatures were observed, with only the non-opioid FM group requiring significantly lower stimulus temperatures (The opioid-FM group also required lower temperatures, but not significantly different from the control group). However, all 3 groups exhibited similar magnitudes of temporal summation. Across combined FM groups, temporal summation negatively correlated with pain severity (r = -0.31, p = 0.021). Within the opioid-FM group, higher pain sensitivity to heat (i.e., lower sensitivity-adjusted temperatures) showed a trend relationship with higher opioid dosage (r = -0.45, p = 0.036), potentially reflective of opioid-related hyperalgesia. Our findings also indicated that heightened pain severity may skew sensitivity-adjusted temporal summation, thereby limiting its utility for measuring central sensitization. Overall, in participants taking opioids, temporal summation may be influenced by hypersensitivity to heat pain, which appeared to vary with opioid dosage.
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Affiliation(s)
- Jason D. Bao
- Human Affect and Pain Neuroscience Laboratory, Department of Anesthesiology, Duke University Medical Center, Durham, NC, United States
- Center for Translational Pain Medicine, Duke University Medical Center, Durham, NC, United States
| | - Morgan A. Rosser
- Department of Anesthesiology, Biostatistics Group, Duke University School of Medicine, Durham, NC, United States
| | - Su Hyoun Park
- Human Affect and Pain Neuroscience Laboratory, Department of Anesthesiology, Duke University Medical Center, Durham, NC, United States
- Center for Translational Pain Medicine, Duke University Medical Center, Durham, NC, United States
| | - Anne K. Baker
- Human Affect and Pain Neuroscience Laboratory, Department of Anesthesiology, Duke University Medical Center, Durham, NC, United States
- Center for Translational Pain Medicine, Duke University Medical Center, Durham, NC, United States
| | - Katherine T. Martucci
- Human Affect and Pain Neuroscience Laboratory, Department of Anesthesiology, Duke University Medical Center, Durham, NC, United States
- Center for Translational Pain Medicine, Duke University Medical Center, Durham, NC, United States
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Areal AT, Singh N, Zhao Q, Berdel D, Koletzko S, von Berg A, Gappa M, Heinrich J, Standl M, Abramson MJ, Schikowski T. The Influence of Short-Term Weather Parameters and Air Pollution on Adolescent Airway Inflammation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6827. [PMID: 37835097 PMCID: PMC10572171 DOI: 10.3390/ijerph20196827] [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: 07/11/2023] [Revised: 09/14/2023] [Accepted: 09/18/2023] [Indexed: 10/15/2023]
Abstract
Fraction of exhaled Nitric Oxide (FeNO) is a marker of airway inflammation. We examined the main effects and interactions of relative humidity (RH) and air pollution on adolescents' FeNO. Two thousand and forty-two participants from the 15-year follow-up of the German GINIplus and LISA birth cohorts were included. Daily meteorological (maximum [Tmax], minimum [Tmin] and mean [Tmean] temperatures and RH) and air pollution [Ozone (O3), nitrogen dioxide (NO2) and particulate matter < 2.5 µm (PM2.5)] were assessed. Linear models were fitted with Ln(FeNO) as the outcome. Increases in FeNO indicate an increase in lung inflammation. Increased FeNO was associated with an increase in temperature, PM2.5, O3 and NO2. A 5% increase in RH was associated with a decrease in FeNO. Interactions between RH and high (p = 0.007) and medium (p = 0.050) NO2 were associated with increases in FeNO; while interactions between RH and high (p = 0.042) and medium (p = 0.040) O3 were associated with decreases in FeNO. Adverse effects were present for male participants, participants with low SES, participants with chronic respiratory disease, and participants from Wesel. Short-term weather and air pollution have an effect on lung inflammation in German adolescents. Future research should focus on further assessing the short-term effect of multiple exposures on lung inflammation in adolescents.
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Affiliation(s)
- Ashtyn Tracey Areal
- IUF—Leibniz Research Institute for Environmental Medicine, 40225 Düsseldorf, Germany; (A.T.A.); (N.S.); (Q.Z.)
- Department of Epidemiology, Medical Research School, Heinrich-Heine-University, 40225 Düsseldorf, Germany
| | - Nidhi Singh
- IUF—Leibniz Research Institute for Environmental Medicine, 40225 Düsseldorf, Germany; (A.T.A.); (N.S.); (Q.Z.)
| | - Qi Zhao
- IUF—Leibniz Research Institute for Environmental Medicine, 40225 Düsseldorf, Germany; (A.T.A.); (N.S.); (Q.Z.)
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250100, China
| | - Dietrich Berdel
- Department of Pediatrics, Research Institute, Marien-Hospital Wesel, 46483 Wesel, Germany; (D.B.); (A.v.B.)
| | - Sibylle Koletzko
- Department of Pediatrics, Dr. von Hauner Children’s Hospital Munich, University Hospital, LMU Munich, 80539 Munich, Germany;
- Department of Pediatrics, Gastroenterology and Nutrition, School of Medicine Collegium Medicum, University of Warmia and Mazury, 10-082 Olsztyn, Poland
| | - Andrea von Berg
- Department of Pediatrics, Research Institute, Marien-Hospital Wesel, 46483 Wesel, Germany; (D.B.); (A.v.B.)
| | - Monika Gappa
- Department of Paediatrics, Evangelisches Krankenhaus, 40217 Düsseldorf, Germany;
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80539 Munich, Germany;
- German Center for Lung Research (DZL), 35392 Gießen, Germany;
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Marie Standl
- German Center for Lung Research (DZL), 35392 Gießen, Germany;
- Institute of Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health, 85764 Neuherberg, Germany
| | - Michael J. Abramson
- School of Public Health & Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia;
| | - Tamara Schikowski
- IUF—Leibniz Research Institute for Environmental Medicine, 40225 Düsseldorf, Germany; (A.T.A.); (N.S.); (Q.Z.)
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Tochihara Y, Wakabayashi H, Lee JY, Wijayanto T, Hashiguchi N, Saat M. How humans adapt to hot climates learned from the recent research on tropical indigenes. J Physiol Anthropol 2022; 41:27. [PMID: 35836266 PMCID: PMC9281079 DOI: 10.1186/s40101-022-00302-3] [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: 03/20/2022] [Accepted: 07/03/2022] [Indexed: 11/10/2022] Open
Abstract
AbstractThis review mainly aimed to introduce the findings of research projects comparing the responses of tropical and temperate indigenes to heat. From a questionnaire survey on thermal sensation and comfort of Indonesians and Japanese, we found that the thermal descriptor “cool” in tropical indigenes connotes a thermally comfortable feeling, suggesting that linguistic heat acclimatization exists on a cognitive level. Ten male students born and raised in Malaysia were invited to Fukuoka, Japan, and compared their responses with 10 Japanese male students with matched physical fitness and morphological characteristics. Cutaneous thermal sensitivity: The sensitivities were measured at 28 °C. The forehead warm sensitivity was significantly blunted in Malaysians. The less sensitivity to the warmth of tropical indigenes is advantageous in respect to withstanding heat stress with less discomfort and a greater ability to work in hot climates. Passive heat stress: Thermoregulatory responses, especially sweating, were investigated, during the lower leg hot bathing (42 °C for 60 min). The rectal temperature at rest was higher in Malaysians and increased smaller during immersion. There was no significant difference in the total amount of sweating between the two groups, while the local sweating on the forehead and thighs was lesser in Malaysians, suggesting distribution of sweating was different from Japanese. Exercise: Malaysian showed a significantly smaller increase in their rectal temperature during 55% maximal exercise for 60 min in heat (32 °C 70% relative humidity), even with a similar sweating and skin blood flow response in Japanese. The better heat tolerance in Malaysians could be explained by the greater convective heat transfer from the body core to the skin due to the greater core-to-skin temperature gradient. In addition, when they were hydrated, Malaysian participants showed better body fluid regulation with smaller reduction in plasma volume at the end of the exercise compared to the non-hydrated condition, whereas Japanese showed no difference between hydration conditions. We further investigated the de-acclimatization of heat adaptation by longitudinal observation on the heat tolerance of international students who had moved from tropical areas to Fukuoka for several years.
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Khabbazi A, Farzaneh R, Mahmoudi M, Shahi M, Jabbaripour Sarmadian A, Babapour E, Alizadeh L, Khabbazi R, Nouri-Vaskeh M. Cold intolerance and associated factors: a population study. Sci Rep 2022; 12:18029. [PMID: 36302950 PMCID: PMC9613912 DOI: 10.1038/s41598-022-21842-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 10/04/2022] [Indexed: 01/24/2023] Open
Abstract
Cold intolerance has been defined as a set of symptoms including pain, tingling, numbness, chills, stiffness, weakness, swelling or skin color changes on exposure to cold. Cold intolerance may have a profound effect on health-related quality of life. In this cross-sectional study, we investigated primarily the prevalence of cold intolerance and secondly associated factors in the general population of Tabriz. Simple random sampling of individuals aged ≥ 18 was performed from the population covered by Emamieh health center under the supervision of Tabriz University of Medical Sciences. A telephone interview was conducted with the participants by the general physician of that center. In participants with a positive response to each of two questions "I am oversensitive to cold" and "I experience pain or discomfort when exposed to cold" a Cold Intolerance Symptom Severity (CISS) questionnaire was filled. We used a cut off value 50 for defining cold intolerance. Of the 353 person who received telephone calls, 322 answered questions. Cold related symptoms and cold intolerance were reported in 144 (44.7%) and 38 (11.1%) persons, respectively. Cold intolerance was significantly more common in females and people with comorbidities. Cold intolerance led to a decrease in quality of job in 27 (8.4%) and a change in job in 6 (1.9%) persons. In conclusion, cold intolerance is a common problem in the general population of Tabriz.
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Affiliation(s)
- Alireza Khabbazi
- grid.412888.f0000 0001 2174 8913Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Imamreza Hospital, Flat 1, P.O Box 5166614756, Tabriz, Iran
| | - Rojin Farzaneh
- grid.412888.f0000 0001 2174 8913Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Imamreza Hospital, Flat 1, P.O Box 5166614756, Tabriz, Iran
| | - Maryam Mahmoudi
- grid.412888.f0000 0001 2174 8913Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Imamreza Hospital, Flat 1, P.O Box 5166614756, Tabriz, Iran
| | - Mohammad Shahi
- grid.412888.f0000 0001 2174 8913Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Imamreza Hospital, Flat 1, P.O Box 5166614756, Tabriz, Iran
| | - Amirreza Jabbaripour Sarmadian
- grid.412888.f0000 0001 2174 8913Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Imamreza Hospital, Flat 1, P.O Box 5166614756, Tabriz, Iran
| | - Elaheh Babapour
- grid.412888.f0000 0001 2174 8913Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Imamreza Hospital, Flat 1, P.O Box 5166614756, Tabriz, Iran
| | - Leila Alizadeh
- grid.412888.f0000 0001 2174 8913Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Raha Khabbazi
- grid.412888.f0000 0001 2174 8913Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Imamreza Hospital, Flat 1, P.O Box 5166614756, Tabriz, Iran
| | - Masoud Nouri-Vaskeh
- grid.412888.f0000 0001 2174 8913Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Imamreza Hospital, Flat 1, P.O Box 5166614756, Tabriz, Iran
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Jubileum E, Binzen U, Treede RD, Greffrath W. Temporal and spatial summation of laser heat stimuli in cultured nociceptive neurons of the rat. Pflugers Arch 2022; 474:1003-1019. [PMID: 35867188 PMCID: PMC9393153 DOI: 10.1007/s00424-022-02728-1] [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: 03/09/2022] [Revised: 07/04/2022] [Accepted: 07/05/2022] [Indexed: 12/04/2022]
Abstract
We studied the efficacy of a near-infrared laser (1475 nm) to activate rat dorsal root ganglion (DRG) neurons with short punctate radiant heat pulses (55 µm diameter) and investigated temporal and spatial summation properties for the transduction process for noxious heat at a subcellular level. Strength-duration curves (10–80 ms range) indicated a minimum power of 30.2mW for the induction of laser-induced calcium transients and a chronaxia of 13.9 ms. However, threshold energy increased with increasing stimulus duration suggesting substantial radial cooling of the laser spot. Increasing stimulus duration demonstrated suprathreshold intensity coding of calcium transients with less than linear gains (Stevens exponents 0.29/35mW, 0.38/60mW, 0.46/70mW). The competitive TRPV1 antagonist capsazepine blocked responses to short near-threshold stimuli and significantly reduced responses to longer duration suprathreshold heat. Heating 1/3 of the soma of a neuron was sufficient to induce calcium transients significantly above baseline (p < 0.05), but maximum amplitude was only achieved by centering the laser over the entire neuron. Heat-induced calcium increase was highest in heated cell parts but rapidly reached unstimulated areas reminiscent of spreading depolarization and opening of voltage-gated calcium channels. Full intracellular equilibrium took about 3 s, consistent with a diffusion process. In summary, we investigated transduction mechanisms for noxious laser heat pulses in native sensory neurons at milliseconds temporal and subcellular spatial resolution and characterized strength duration properties, intensity coding, and spatial summation within single neurons. Thermal excitation of parts of a nociceptor spread via both membrane depolarization and intracellular calcium diffusion.
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Affiliation(s)
- Elisabeth Jubileum
- Department of Neurophysiology, Mannheim Center for Translational Neuroscience (MCTN), Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Str. 13-17, 68167, Mannheim, Germany.,Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Rheinhessen Clinics, Hartmühlenweg 2-4, 55122, Mainz, Germany.,Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Uta Binzen
- Department of Neurophysiology, Mannheim Center for Translational Neuroscience (MCTN), Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Str. 13-17, 68167, Mannheim, Germany.,Department of Cardiovascular Physiology, European Center for Angioscience (ECAS), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Rolf-Detlef Treede
- Department of Neurophysiology, Mannheim Center for Translational Neuroscience (MCTN), Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Str. 13-17, 68167, Mannheim, Germany
| | - Wolfgang Greffrath
- Department of Neurophysiology, Mannheim Center for Translational Neuroscience (MCTN), Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Str. 13-17, 68167, Mannheim, Germany.
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Wei X, Shi G, Tu J, Zhou H, Duan Y, Lee CK, Wang X, Liu C. Structural and Functional Asymmetry in Precentral and Postcentral Gyrus in Patients With Unilateral Chronic Shoulder Pain. Front Neurol 2022; 13:792695. [PMID: 35250808 PMCID: PMC8892006 DOI: 10.3389/fneur.2022.792695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 01/13/2022] [Indexed: 12/25/2022] Open
Abstract
Objective The purpose of this study was to explore the structural and functional asymmetry of precentral and postcentral gyrus in patients with unilateral chronic shoulder pain (CSP) utilizing MRI. Patients and Methods We collected structural and resting-state functional MRI (rs-fMRI) data in 22 left-sided, 15 patients with right-sided CSP, and 24 healthy controls (HCs). Here, we performed the structural asymmetry and seed-based functional connectivity (FC) analyses. We extracted regional cortical thickness and surface area measurements from T1-weighted MRI images, using asymmetry indexes (AIs) to assess asymmetries. We used Data Processing and Analysis for Brain Imaging software for seed-based FC analysis and selected unilateral-precentral and postcentral as the regions of interest. Then, we performed group comparisons of the neuroimaging metrics, and also explored the relationships between brain asymmetry and clinical variables. Results We found significant differences in surface area AIs of the precentral among three groups, the AI values were negatively correlated with the visual analog scale score and positively correlated with Constant–Murley scores (CMS) in the left-sided CSP group. Further, FC of left postcentral with cingulate gyrus and left paracentral lobule showed significant group differences; FC of right postcentral with left caudate, left paracentral, and left postcentral were different among groups; FC of right precentral with the cingulate gyrus, precuneus, and left paracentral revealed significant group differences. Besides, there was a positive correlation between right precentral-cingulate gyrus FC and CMS in the right-sided CSP group. Conclusion Surface area and FC patterns asymmetry exist in precentral and postcentral gyrus in patients with unilateral CSP. Asymmetry trend is associated with pain severity and shoulder joint function impairment. Brain structural and functional asymmetry may be an important indicator for understanding the potential mechanism of chronic pain.
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Affiliation(s)
- Xiaoya Wei
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Guangxia Shi
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Jianfeng Tu
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Hang Zhou
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Yanshan Duan
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Chin Kai Lee
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Xu Wang
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
- Xu Wang
| | - Cunzhi Liu
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
- *Correspondence: Cunzhi Liu
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The role of negative emotions in sex differences in pain sensitivity. Neuroimage 2021; 245:118685. [PMID: 34740794 DOI: 10.1016/j.neuroimage.2021.118685] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/24/2021] [Accepted: 10/25/2021] [Indexed: 01/09/2023] Open
Abstract
Pain perception varies widely among individuals due to the varying degrees of biological, psychological, and social factors. Notably, sex differences in pain sensitivity have been consistently observed in various experimental and clinical investigations. However, the neuropsychological mechanism underlying sex differences in pain sensitivity remains unclear. To address this issue, we quantified pain sensitivity (i.e., pain threshold and tolerance) using the cold pressure test and negative emotions (i.e., pain-related fear, pain-related anxiety, trait anxiety, and depression) using well-established questionnaires and collected magnetic resonance imaging (MRI) data (i.e., high-resolution T1 structural images and resting-state functional images) from 450 healthy subjects. We observed that, as compared to males, females exhibited lower pain threshold and tolerance. Notably, sex differences in pain sensitivity were mediated by pain-related fear and anxiety. Specifically, pain-related fear and anxiety were the complementary mediators of the relationship between sex and pain threshold, and they were the indirect-only mediators of the relationship between sex and pain tolerance. Besides, structural MRI data revealed that the amygdala subnuclei (i.e., the lateral and basal nuclei in the left hemisphere) volumes were the complementary mediators of the relationship between sex and pain-related fear, which further influenced pain sensitivity. Altogether, our results provided a comprehensive picture of how negative emotions (especially pain-related negative emotions) and related brain structures (especially the amygdala) contribute to sex differences in pain sensitivity. These results deepen our understanding of the neuropsychological underpinnings of sex differences in pain sensitivity, which is important to tailor a personalized method for treating pain according to sex and the level of pain-related negative emotions for patients with painful conditions.
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Spinal and Cerebral Integration of Noxious Inputs in Left-handed Individuals. Brain Topogr 2021; 34:568-586. [PMID: 34338897 DOI: 10.1007/s10548-021-00864-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 07/23/2021] [Indexed: 10/20/2022]
Abstract
Some pain-related information is processed preferentially in the right cerebral hemisphere. Considering that functional lateralization can be affected by handedness, spinal and cerebral pain-related responses may be different between right- and left-handed individuals. Therefore, this study aimed to investigate the cortical and spinal mechanisms of nociceptive integration when nociceptive stimuli are applied to right -handed vs. left -handed individuals. The NFR, evoked potentials (ERP: P45, N100, P260), and event-related spectral perturbations (ERSP: theta, alpha, beta and gamma band oscillations) were compared between ten right-handed and ten left-handed participants. Pain was induced by transcutaneous electrical stimulation of the lower limbs and left upper limb. Stimulation intensity was adjusted individually in five counterbalanced conditions of 21 stimuli each: three unilateral (right lower limb, left lower limb, and left upper limb stimulation) and two bilateral conditions (right and left lower limbs, and the right lower limb and left upper limb stimulation). The amplitude of the NFR, ERP, ERSP, and pain ratings were compared between groups and conditions using a mixed ANOVA. A significant increase of responses was observed in bilateral compared with unilateral conditions for pain intensity, NFR amplitude, N100, theta oscillations, and gamma oscillations. However, these effects were not significantly different between right- and left-handed individuals. These results suggest that spinal and cerebral integration of bilateral nociceptive inputs is similar between right- and left-handed individuals. They also imply that pain-related responses measured in this study may be examined independently of handedness.
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12
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Mekjavic IB, Yogev D, Ciuha U. Perception of Thermal Comfort during Skin Cooling and Heating. Life (Basel) 2021; 11:life11070681. [PMID: 34357053 PMCID: PMC8303551 DOI: 10.3390/life11070681] [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: 05/24/2021] [Revised: 07/09/2021] [Accepted: 07/10/2021] [Indexed: 11/16/2022] Open
Abstract
Due to the static and dynamic activity of the skin temperature sensors, the cutaneous thermal afferent information is dependent on the rate and direction of the temperature change, which would suggest different perceptions of temperature and of thermal comfort during skin heating and cooling. This hypothesis was tested in the present study. Subjects (N = 12; 6 females and 6 males) donned a water-perfused suit (WPS) in which the temperature was varied in a saw-tooth manner in the range from 27 to 42 °C. The rate of change of temperature of the water perfusing the suit (TWPS) was 1.2 °C min-1 during both the heating and cooling phases. The trial was repeated thrice, with subjects reporting their perception of the temperature and thermal comfort at each 3 °C change in TWPS. In addition, subjects were instructed to report when they perceived TWPS uncomfortably cool and warm during cooling and heating, respectively. Subjects reproducibly identified the boundaries of their Thermal Comfort Zone (TCZ), defined as the lower (Tlow) and upper (Thigh) temperatures at which subjects reported slight thermal discomfort. During the heating phase, Tlow and Thigh were 30.0 ± 1.5 °C and 35.1 ± 2.9 °C, respectively. During the cooling phase, the boundary temperatures of Tlow and Thigh were 35.4 ± 1.9 °C and 38.7 ± 2.3 °C, respectively. The direction of the change in the cutaneous temperature stimulus affects the boundaries of the TCZ, such that they are higher during cooling and lower during heating. These findings are explained on the basis of the neurophysiology of thermal perception. From an applied perspective, the most important observation of the present study was the strong correlation between the perception of thermal comfort and the behavioral regulation of thermal comfort. Although it is not surprising that the action of regulating thermal comfort is aligned with its perception, this link has not been proven for humans in previous studies. The results therefore provide a sound basis to consider ratings of thermal comfort as reflecting behavioral actions to achieve the sensation of thermal neutrality.
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Sakuma S, Inamoto K, Yamaguchi Y, Takagi S, Higuchi N. Changes in prefrontal cerebral hemodynamics during intermittent pain stimulation to gingiva: Preliminary study using functional near infrared spectroscopy. J Dent Sci 2021; 16:980-986. [PMID: 34141113 PMCID: PMC8189836 DOI: 10.1016/j.jds.2020.09.013] [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: 08/08/2020] [Revised: 09/18/2020] [Accepted: 09/18/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND/PURPOSE Elucidating the transmission mechanism of pain signals from the orofacial area and the corresponding modification mechanism will not only aid in the understanding of pain mechanisms but also provide useful information regarding the development of pain mitigation methods. In this study, the involvement of the pain suppression system in the trigeminal area was investigated through an analysis of the activation status over time in the prefrontal cortex using functional near-infrared spectroscopy (fNIRS). MATERIALS AND METHODS In 28 healthy, right-handed male volunteers (average age, 30.1 ± 4.2 years) as subjects, a mild, intermittent, acute pain stimulus was administered through the implementation of pocket probing of the gingiva surrounding the right maxillary central incisor. In the prefrontal cortex, the levels of hemoglobin (Hb) were measured using the fNIRS measurement system. Average values of both oxy-Hb and deoxy-Hb were calculated at four stages: rest stage, 20 s prior to the pain stimulus application, and three stages at 20-s intervals within 1 min of stimulation. One-way analysis of variance and multiple comparisons were used to compare representative values to investigate the changes due to pain. RESULTS Oxy-Hb levels decreased the most during the 20 s stage directly after stimulus application. This change was seen mainly on the contralateral side, after which it returned to the resting baseline level before the stimulus application. CONCLUSION Our data demonstrate that in healthy males, a mechanism exists to mitigate pain involving the pain suppression system in the 20 s after feeling mild pain to the gingiva.
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Affiliation(s)
- Shigemitsu Sakuma
- Department of Fixed Prosthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Kyoko Inamoto
- Department of Endodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Yoshihiro Yamaguchi
- Department of Fixed Prosthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Shinya Takagi
- Department of Fixed Prosthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Naoya Higuchi
- Department of Endodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
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14
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Hager L, Averbeck B, Voelcker-Rehage C, Kutz DF. Sex differences in the consumption of over-the-counter analgesics among amateur volleyball players. BMC Sports Sci Med Rehabil 2021; 13:45. [PMID: 33910635 PMCID: PMC8082781 DOI: 10.1186/s13102-021-00273-5] [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: 11/25/2020] [Accepted: 04/19/2021] [Indexed: 11/13/2022]
Abstract
Background Compared with the normal adult population, athletes of several sport disciplines, such as endurance sports, ball sports, cycling and swimming, have higher use of over-the-counter analgesics (OTC analgesics). The aim of this study was to describe the epidemiology of OTC analgesic use in volleyball players as a typical competitive sport discipline. One particular focus was placed on the analysis whether the athletes’ use of OTC analgesics was influenced by their performance motivation. Methods A cross-sectional survey among amateur volleyball players was carried out using a web-based sports questionnaire. The study included athletes of both sexes, 18 years and older, currently playing in a German volleyball league. The athletes’ sport-related complaints were evaluated regarding the use of OTC analgesics. The use of OTC analgesics by athletes was compared with their performance motivation, based on the „Achievement Motives Scale - Sport” (AMS-Sport) questionnaire. Results The analysis of 114 completed questionnaires of amateur athletes revealed that the use of OTC analgesics was sex dependent, with a higher prevalence of use in female players (60%) versus male players (38%). The main reasons for consumption of OTC analgesics were pain in the head, knee and shoulder. The most frequently taken drug was ibuprofen, most often taken at competitions and over a period of 4 years (median). The analysis of the AMS-Sport questionnaire revealed that a logistic regression model for estimating the probability of drug use can be explained by the factors hope of success and years of playing practise in female players but not male players. In females, an increase in the factor hope of success resulted in a lower probability of OTC analgesic use, while an increase in years of playing practise resulted in a higher probability of use. Conclusion The average duration that volleyball players in this study took OTC analgesics was higher than that of the German population, and OTC analgesic use was more prevalent in female than male volleyball players. Thus, to reduce the prevalence of OTC analgesic use, educational programs should be implemented in sports teams; and, to reduce direct and indirect social pressure, sports teams should also receive sex-specific psychological support. Supplementary Information The online version contains supplementary material available at 10.1186/s13102-021-00273-5.
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Affiliation(s)
- Lisa Hager
- Institute of Human Movement Science and Health, Chemnitz University of Technology, Chemnitz, Germany
| | - Beate Averbeck
- Walter Brendel Center of Experimental Medicine, Biomedical Center Munich, University of Munich, Munich, Germany
| | - Claudia Voelcker-Rehage
- Institute of Human Movement Science and Health, Chemnitz University of Technology, Chemnitz, Germany.,Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Muenster, Muenster, Germany
| | - Dieter F Kutz
- Institute of Human Movement Science and Health, Chemnitz University of Technology, Chemnitz, Germany. .,Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Muenster, Muenster, Germany.
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15
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Ghodrati M, Walton DM, MacDermid JC. Exploring the Domains of Gender as Measured by a New Gender, Pain and Expectations Scale. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2021; 2:87-96. [PMID: 33937906 PMCID: PMC8080910 DOI: 10.1089/whr.2020.0109] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/22/2021] [Indexed: 05/03/2023]
Abstract
Background: While sex- or gender-based differences in pain expression have been documented, exploration of traditionally genderized traits on pain has been hampered by the lack of strong measurement tools. This study evaluated the structural validity of a 16-item "Gender personality traits" subscale of a recently developed Gender, Pain and Expectations Scale (GPES). Methods: Data were drawn from an existing database of 248 participants (65.7% female). Maximum likelihood-based confirmatory factor analysis was carried out while considering the conceptual meaningfulness of subscales to evaluate the factor structure identified by these traits. Construct validity was explored using a priori hypotheses regarding anticipated mean differences in scores between biological male and female participants. Results: A meaningful factor structure could not be defined with all 16 items. Through conceptual and statistical triangulation a three-factor structure informed by 10 items was identified that satisfied acceptable fit criteria. The factors were termed "Emotive," "Relationship-Oriented," and "Goal-Oriented." Evidence of construct validity was supported through significant sex-based differences (p ≤ 0.02) in the expected directions for all three subscales. Conclusions: Review of the items in the three factors led the researchers to endorse a move away from naming these "masculine" and "feminine," rather focusing on the nature of the traits: "Relationship-oriented," "Emotive," and "Goal-oriented." Implications for researchers conducting sex/gender-based pain research are discussed. Clinical Trial Registration number: NCT02711085.
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Affiliation(s)
- Maryam Ghodrati
- Health and Rehabilitation Sciences Program, University of Western Ontario, London, Canada
| | - David M. Walton
- Health and Rehabilitation Sciences Program, University of Western Ontario, London, Canada
| | - Joy C. MacDermid
- Health and Rehabilitation Sciences Program, University of Western Ontario, London, Canada
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16
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Zhang H, Lu X, Bi Y, Hu L. A modality selective effect of functional laterality in pain detection sensitivity. Sci Rep 2021; 11:6883. [PMID: 33767243 PMCID: PMC7994376 DOI: 10.1038/s41598-021-85111-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 02/24/2021] [Indexed: 12/30/2022] Open
Abstract
The ability to detect environmental changes is essential to determine the appropriate reaction when facing potential threats. Both detection and reaction functions are critical to survival, and the superior performance of motor reaction for the dominant hand is well recognized in humans. However, it is not clear whether there exists laterality in sensitivity to detect external changes and whether the possible laterality is associated with sensory modality and stimulus intensity. Here, we tested whether the perceptual sensitivity and electrophysiological responses elicited by graded sensory stimuli (i.e., nociceptive somatosensory, non-nociceptive somatosensory, auditory, and visual) that were delivered on/near the left and right hands would be different for right-handed individuals. We observed that perceived intensities and most brain responses were significantly larger when nociceptive stimuli were delivered to the left side (i.e., the non-dominant hand) than to the right side (i.e., the dominant hand). No significant difference was observed between the two sides for other modalities. The higher sensitivity to detect nociceptive stimuli for the non-dominant hand would be important to provide a prompt reaction to noxious events, thus compensating for its worse motor performance. This laterality phenomenon should be considered when designing experiments for pain laboratory studies and evaluating regional sensory abnormalities for pain patients.
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Affiliation(s)
- Huijuan Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100101, China
| | - Xuejing Lu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China. .,Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100101, China.
| | - Yanzhi Bi
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100101, China
| | - Li Hu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China. .,Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100101, China.
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Abstract
Chemotherapeutic agents can cause peripheral neuropathy, a deleterious side effect of cancer treatment. Hyperbaric oxygen (HBO2) treatment has shown great potential for decreasing pain in numerous clinical pain conditions and in preclinical studies. This study was designed to test whether HBO2 might also be useful for treating chemotherapy-induced peripheral neuropathy. Male and female Sprague-Dawley rats were injected with 1 mg/kg paclitaxel or vehicle every other day for 7 days to induce allodynia, followed by either one single, or four daily 60-min exposures to HBO2 or room air. Mechanical and cold allodynia as well as locomotor behavior and body weight were assessed intermittently for several weeks. Estrous cycling was also tracked in female rats. Paclitaxel caused pronounced mechanical allodynia in both sexes that was completely reversed by either one or four treatments of HBO2. Females in all treatment groups showed greater cold acetone scores than males, and acetone scores were not reliably reduced by HBO2 treatment. Neither paclitaxel nor HBO2 treatment altered locomotor behavior or estrous cycling. We conclude that HBO2 treatment was highly effective at reducing mechanical allodynia in paclitaxel-treated rats without affecting weight gain, locomotion, or estrous cycling, suggesting that HBO2 may be effective for treating chemotherapy-induced neuropathic pain without producing significant side effects.
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18
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Changes of EEG band oscillations to tonic cold pain and the behavioral inhibition and fight-flight-freeze systems. PERSONALITY NEUROSCIENCE 2019; 2:e12. [PMID: 32435747 PMCID: PMC7219698 DOI: 10.1017/pen.2019.9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 08/21/2019] [Accepted: 09/10/2019] [Indexed: 12/20/2022]
Abstract
Using electroencephalography (EEG) power measures within conventional delta, theta, alpha, beta, and gamma bands, the aims of the current study were to highlight cortical correlates of subjective perception of cold pain (CP) and the associations of these measures with behavioral inhibition system (BIS), fight-flight-freeze system (FFFS), and behavioral approach system personality traits. EEG was recorded in 55 healthy right-handed women under (i) a white noise interruption detection condition (Baseline); (ii) enduring CP induced by the cold cup test. CP and Baseline EEG band power scores within conventional frequency bands served for covariance analyses. We found that: (1) higher Pain scorers had higher EEG beta power changes at left frontal, midline central, posterior temporal leads; (2) higher BIS was associated with greater EEG delta activity changes at parietal scalp regions; (3) higher FFFS was associated with higher EEG delta activity changes at temporal and left-parietal regions, and with lower EEG gamma activity changes at right parietal regions. High FFFS, compared to Low FFFS scorers, also showed a lower gamma power across the midline, posterior temporal, and parietal regions. Results suggest a functional role of higher EEG beta activity in the subjective perception of tonic pain. EEG delta activity underpins conflict resolution system responsible for passive avoidance control of pain, while higher EEG delta and lower EEG gamma activity changes, taken together, underpin active avoidance system responsible for pain escape behavior.
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Takenaka S, Makino T, Sakai Y, Kashii M, Iwasaki M, Yoshikawa H, Kaito T. Prognostic impact of intra- and postoperative management of dural tear on postoperative complications in primary degenerative lumbar diseases. Bone Joint J 2019; 101-B:1115-1121. [DOI: 10.1302/0301-620x.101b9.bjj-2019-0381.r1] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Aims The aim of this study was to explore risk factors for complications associated with dural tear (DT), including the types of DT, and the intra- and postoperative management of DT. Patients and Methods Between 2012 and 2017, 12 171 patients with degenerative lumbar diseases underwent primary lumbar spine surgery. We investigated five categories of potential predictors: patient factors (sex, age, body mass index, and primary disease), surgical factors (surgical procedures, operative time, and estimated blood loss), types of DT (inaccessible for suturing/clipping and the presence of cauda equina/nerve root herniation), repair techniques (suturing, clipping, fibrin glue, polyethylene glycol (PEG) hydrogel, and polyglycolic acid sheet), and postoperative management (drainage duration). Postoperative complications were evaluated in terms of dural leak, prolonged bed rest, headache, nausea/vomiting, delayed wound healing, postoperative neurological deficit, surgical site infection (SSI), and reoperation for DT. We performed multivariable regression analyses to evaluate the predictors of postoperative complications associated with DT. Results In total, 429/12 171 patients (3.5%) had a DT. Multivariable analysis revealed that PEG hydrogel significantly reduced the incidence of dural leak and prolonged bed rest, and that patients treated with sealants (fibrin glue and PEG hydrogel) significantly less frequently suffered from headache. A longer drainage duration significantly increased the incidence of headache, nausea/vomiting, and delayed wound healing. Headache and nausea/vomiting were significantly more prevalent in younger female patients. Postoperative neurological deficit and reoperation for DT significantly depended on the presence of cauda equina/nerve root herniation. A longer operative time was the sole independent risk factor for SSI and was also a risk factor for dural leak, prolonged bed rest, and nausea/vomiting. Conclusion Sealants, particularly PEG hydrogel, may be useful in reducing symptoms related to cerebrospinal fluid leakage, whereas prolonged drainage may be unnecessary. Younger female patients should be carefully treated when DT occurs. Cite this article: Bone Joint J 2019;101-B:1115–1121.
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Affiliation(s)
- Shota Takenaka
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takahiro Makino
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yusuke Sakai
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masafumi Kashii
- Department of Orthopaedic Surgery, Toyonaka Municipal Hospital, Osaka, Japan
| | - Motoki Iwasaki
- Department of Orthopaedic Surgery, Osaka-Rosai Hospital, Osaka, Japan
| | - Hideki Yoshikawa
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takashi Kaito
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
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Kim HK, Kim ME. Comparison of unpleasant and pain thresholds of thermal stimuli in the orofacial regions: a psychophysical study using quantitative sensory testing in healthy young men. Somatosens Mot Res 2018; 35:139-147. [PMID: 30107761 DOI: 10.1080/08990220.2018.1491837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Purpose/Aim: To gain a better understanding of the psychophysics of thermal pain perception in a clinical setting, this study investigated whether thermal thresholds of unpleasantness are different from pain thresholds of cold and heat stimuli. Of particular interest was the relationship between unpleasantness and pain thresholds for cold vs heat stimuli. MATERIAL AND METHODS Thirty healthy male volunteers (mean age 26.1 years, range 23 to 32 years) participated. Thermal detection, cold pain (CPT) and heat pain (HPT) thresholds were measured at 5 trigeminal sites by the method of limits using quantitative sensory testing (QST), followed by cold unpleasant (CUT) and heat unpleasant (HUT) thresholds. RESULTS The temperatures at which individuals first reported thermal sensations as unpleasant or painful substantially differed among subjects. CUT exhibited a higher mean value with less variability than CPT, and HUT presented a lower mean than HPT (p < .001). As with CPT, CUT did not show any significant difference between the test sites. On the other hand, HUT, like HPT, exhibited site differences (p < .001). There was moderate correlation between CUT and CPT, whereas HUT and HPT were strongly correlated. The relationship between unpleasant and pain thresholds of cold vs heat stimuli was significantly different even when controlling for test site variability (p < .001). CONCLUSION These findings indicate that unpleasant and pain thresholds to thermal stimuli differ in healthy young men. Of particular note is the distinct relationship of unpleasant and pain thresholds of cold vs heat stimuli, revealing the thermal difference in temperature transition from unpleasantness to pain.
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Affiliation(s)
- Hye-Kyoung Kim
- a Department of Oral Medicine School of Dentistry , Dankook University , Chungnam , Republic of Korea
| | - Mee-Eun Kim
- a Department of Oral Medicine School of Dentistry , Dankook University , Chungnam , Republic of Korea
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Ikoma T, Bendixen KH, Arima T, Dawson A, Yamaguchi T, List T, Svensson P. Effects of Low-Intensity Contractions of Different Craniofacial Muscles in Healthy Participants - An Experimental Cross-Over Study. Headache 2018; 58:559-569. [DOI: 10.1111/head.13280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 12/24/2017] [Accepted: 12/26/2017] [Indexed: 12/24/2022]
Affiliation(s)
- Tomoko Ikoma
- Faculty of Dental Medicine and Graduate School of Dental Medicine; Hokkaido University; Sapporo Japan
| | - Karina Haugaard Bendixen
- Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health; Aarhus University; Aarhus Denmark
- Scandinavian Center for Orofacial Neurosciences (SCON); Denmark , Sweden (A. Dawson, T. List)
| | - Taro Arima
- Section of International Affairs, Faculty of Dental Medicine and Graduate School of Dental Medicine; Hokkaido University; Sapporo Japan (Taro Arima)
| | - Andreas Dawson
- Scandinavian Center for Orofacial Neurosciences (SCON); Denmark , Sweden (A. Dawson, T. List)
- Centre for Oral Rehabilitation, Östergötland County Council; Linköping Norrköping Sweden
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology; Malmö University; Malmö Sweden
| | - Taihiko Yamaguchi
- Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine and Graduate School of Dental Medicine; Hokkaido University; Sapporo Japan
| | - Thomas List
- Scandinavian Center for Orofacial Neurosciences (SCON); Denmark , Sweden (A. Dawson, T. List)
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology; Malmö University; Malmö Sweden (Thomas List)
| | - Peter Svensson
- Scandinavian Center for Orofacial Neurosciences (SCON); Denmark , Sweden (A. Dawson, T. List)
- Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health; Aarhus University; Aarhus Denmark
- Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
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22
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Wang Y, Mo X, Zhang J, Fan Y, Wang K, Peter S. Quantitative sensory testing (QST) in the orofacial region of healthy Chinese: influence of site, gender and age. Acta Odontol Scand 2018; 76:58-63. [PMID: 28958193 DOI: 10.1080/00016357.2017.1383511] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To establish a preliminary thermal and mechanical somatosensory profile using a standardized quantitative sensory testing (QST) to investigate site, gender and age differences in healthy Chinese. MATERIALS AND METHODS Twenty younger (age: 20-40 years, 10 men, 10 women) and twenty older (age: 41-61 years, 10 men, 10 women) healthy participants completed the study. Cold detection threshold (CDT), warm detection threshold (WDT), cold pain threshold (CPT), heat pain threshold (HPT), mechanical detection threshold (MDT) and mechanical pain threshold (MPT) were measured at five sites: Left hand, bilaterally at the mental area, tip of tongue and the lower lip mucosa. Mixed model ANOVAs with repeated measures were used to analyze the data. RESULTS MDT(p < .001) and MPT (p < .05) were significantly higher on the hand compared to the mental areas. The CDT ( p = .006) was significantly higher and WDT (p < .001) was significantly lower at the tongue compared to lip mucosa and CDT (p < .001) was higher at the tongue mucosa than at the mental areas. WDT (p < .001) and HPT (p < .05) were significantly higher at the tip of the tongue and the lower lip mucosa compared to the mental areas. Significantly lower sensitivity for WDT (p < .001) and CDT (p = .004) were found in the older group compared to the younger group. Significant gender differences were found with less sensitivity for WDT (p = .024) and MDT (p = .003) in men compared to women. CONCLUSIONS Application of standardized QST can provide valuable information of orofacial somatosensory phenotypes in a Chinese population. Age, gender and site are mandatory to control for.
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Affiliation(s)
- Yanting Wang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Department of Endodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
- Yixing Institute of Preventive Dentistry, Yixing, China
| | - Xueyin Mo
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Department of Endodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
- Hangzhou ivy dental clinic Co., Limited, Hangzhou, China
| | - Jinglu Zhang
- Orofacial Pain & TMD Research Unit, Institute of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Yuan Fan
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Department of Endodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Kelun Wang
- Orofacial Pain & TMD Research Unit, Institute of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
- Center for Sensory–Motor Interaction (SMI), Aalborg University, Aalborg, Denmark
| | - Svensson Peter
- Department of Dentistry and Oral Health, Section of Orofacial Pain and Jaw Function, Aarhus University, Aarhus, Denmark
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
- Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark
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Eken A, Kara M, Baskak B, Baltacı A, Gökçay D. Differential efficiency of transcutaneous electrical nerve stimulation in dominant versus nondominant hands in fibromyalgia: placebo-controlled functional near-infrared spectroscopy study. NEUROPHOTONICS 2018; 5:011005. [PMID: 28894759 PMCID: PMC5584730 DOI: 10.1117/1.nph.5.1.011005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 08/10/2017] [Indexed: 05/14/2023]
Abstract
Using functional near-infrared spectroscopy (fNIRS), modulation of hemodynamic responses by transcutaneous electrical nerve stimulation (TENS) during delivery of nociceptive stimulation was investigated in fibromyalgia (FM) patients and healthy controls for both hands. Two experiments were conducted: (1) median nerve stimulation with TENS and (2) painful stimulation using electronic von Frey filaments with TENS/placebo TENS. Mean [Formula: see text] brain activity was compared across groups and conditions using factorial ANOVA. Dominant (right) hand stimulation indicated significant interactions between group and condition in both hemispheres. Post hoc results revealed that FM patients showed an increased activation in "pain + TENS" condition compared to the "pain + placebo TENS" condition while the brain activity patterns for these conditions in controls were reversed. Left-hand stimulation resulted in similar TENS effects (reduced activation for "pain + TENS" than "pain + placebo TENS") in both groups. TENS effects in FM patients might be manipulated by the stimulation side. While the nondominant hand was responsive to TENS treatment, the dominant hand was not. These results indicate that stimulation side might be an effective factor in FM treatment by using TENS. Future studies are needed to clarify the underlying mechanism for these findings.
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Affiliation(s)
- Aykut Eken
- Düzce University, Faculty of Engineering, Biomedical Engineering Department, Düzce, Turkey
| | - Murat Kara
- Hacettepe University Medical School, Department of Physical and Rehabilitation Medicine, Ankara, Turkey
| | - Bora Baskak
- Ankara University Medical School, Department of Psychiatry, Ankara, Turkey
- Ankara University, Brain Research and Application Center, Ankara, Turkey
| | - Ayşegül Baltacı
- Yenimahalle Education and Research Hospital, Department of Physical and Rehabilitation Medicine, Ankara, Turkey
| | - Didem Gökçay
- Middle East Technical University, Informatics Institute, Department of Health Informatics, Ankara, Turkey
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Averbeck B, Seitz L, Kolb FP, Kutz DF. Sex differences in thermal detection and thermal pain threshold and the thermal grill illusion: a psychophysical study in young volunteers. Biol Sex Differ 2017; 8:29. [PMID: 28859684 PMCID: PMC5579939 DOI: 10.1186/s13293-017-0147-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 08/01/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Sex-related differences in human thermal and pain sensitivity are the subject of controversial discussion. The goal of this study in a large number of subjects was to investigate sex differences in thermal and thermal pain perception and the thermal grill illusion (TGI) as a phenomenon reflecting crosstalk between the thermoreceptive and nociceptive systems. The thermal grill illusion is a sensation of strong, but not necessarily painful, heat often preceded by transient cold upon skin contact with spatially interlaced innocuous warm and cool stimuli. METHODS The TGI was studied in a group of 78 female and 58 male undergraduate students and was evoked by placing the palm of the right hand on the thermal grill (20/40 °C interleaved stimulus). Sex-related thermal perception was investigated by a retrospective analysis of thermal detection and thermal pain threshold data that had been measured in student laboratory courses over 5 years (776 female and 476 male undergraduate students) using the method of quantitative sensory testing (QST). To analyse correlations between thermal pain sensitivity and the TGI, thermal pain threshold and the TGI were determined in a group of 20 female and 20 male undergraduate students. RESULTS The TGI was more pronounced in females than males. Females were more sensitive with respect to thermal detection and thermal pain thresholds. Independent of sex, thermal detection thresholds were dependent on the baseline temperature with a specific progression of an optimum curve for cold detection threshold versus baseline temperature. The distribution of cold pain thresholds was multi-modal and sex-dependent. The more pronounced TGI in females correlated with higher cold sensitivity and cold pain sensitivity in females than in males. CONCLUSIONS Our finding that thermal detection threshold not only differs between the sexes but is also dependent on the baseline temperature reveals a complex processing of "cold" and "warm" inputs in thermal perception. The results of the TGI experiment support the assumption that sex differences in cold-related thermoreception are responsible for sex differences in the TGI.
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Affiliation(s)
- Beate Averbeck
- Department of Physiology, University of Munich, Munich, Germany
- Department of Physiology, Biomedical Center Munich (BMC), University of Munich, Planegg-Martinsried, D-82152 Germany
| | - Lena Seitz
- Department of Physiology, University of Munich, Munich, Germany
| | - Florian P. Kolb
- Department of Physiology, University of Munich, Munich, Germany
| | - Dieter F. Kutz
- Institute of Human Movement Science and Health, Faculty of Behavioral and Social Science, Chemnitz University of Technology, Chemnitz, Germany
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Petrescu CI. Certain personal and environmental factors as predictors of thermal sensation perceived by a population of students in a university setting from Timisoara, Romania: a case study. Environ Health Prev Med 2017; 22:56. [PMID: 29165168 PMCID: PMC5664419 DOI: 10.1186/s12199-017-0664-1] [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: 01/18/2017] [Accepted: 06/04/2017] [Indexed: 11/16/2022] Open
Abstract
Background The aim of the performed study was to investigate personal and environmental factors as predictors of thermal sensation perceived by a population of students in a university setting. Methods The study consisted of two samples, a winter sample (154 students: 44.2% males and 55.8% females, aged 19–30 years) and a spring sample (147 students: 52.4% males and 47.6% females, aged 19–30 years), randomly selected from the same population of students. The method was an observational inquiry (case study) with a standardized questionnaire (11 items, 3 items for thermal sensation assessing through 3 scales with 3, 5 and 7 steps, alpha Cronbach’s index 0.854) applied and establishing 3 microclimate factors (air temperature, relative humidity and wind velocity), with calculation of normal effective temperature. The survey was performed over four successive days, during two seasons (winter—February and spring—May). Results The performed study demonstrated a tendency of students to perceive the comfortably cold more frequently than comfortably warm throughout the 4 days of the survey during the winter, except Monday. Thermal sensation of discomfort was more frequently perceived as warm than cold throughout the spring time of the survey and winter, except Tuesday. Predictors of thermal sensation perceived by students in the amphitheatre were as follows: nationality (−2loglikelihood change or chi square = 42.12, Sig. 0.000), relative humidity (chi square = 10.65, Sig. 0.005) and gender during the winter, and wind velocity (change in −2loglikelihood = 11.96, Sig. 0.001) and nationality during the spring. Conclusions Certain personal and environmental factors were suggested as predictors for thermal sensation perceived by a population of students in a study setting.
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Affiliation(s)
- Cristina I Petrescu
- Department of Hygiene, "Victor Babes" University of Medicine and Pharmacy Timisoara, Victor Babes 16, 300226, Timisoara, Romania. .,, Sabinei 3A/18, 300424, Timisoara, Romania.
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26
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Fouché JJ, Van Loghem JAJ, Thuis J, De Heer LM, van Oijen MGH. Left/Right Pain Asymmetry With Injectable Cosmetic Treatments for the Face. Aesthet Surg J 2017; 37:708-714. [PMID: 28333175 DOI: 10.1093/asj/sjw214] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Pain is processed and experienced differently on the left (L) and right (R) sides of the body; however, L/R pain asymmetry with cosmetic treatments of the face has not been evaluated. OBJECTIVES The authors compared patient ratings of L/R facial pain during and immediately after injectable cosmetic treatments. METHODS In this cross-sectional multicenter pragmatic study, pain levels were evaluated for 302 patients who underwent facial treatments with botulinum toxin (BTX) and/or impermanent soft-tissue filler (STF). Patients indicated pain intensity on each side of the face with a visual analogue scale (VAS; 0, no pain; 10, worst pain). RESULTS Combined mean VAS scores for BTX and STF treatments (L, 3.79 vs R, 3.42), and individual scores for BTX (L, 3.60 vs R, 3.30) or STF (L, 4.22 vs R, 3.69) treatments were significantly different, with pain rated as worse on the L side of the face (all P < 0.01). When treatments were performed first on the L side, patients rated the overall experience as significantly less painful than when treatments were begun on the R side. BTX treatments with a 29-gauge (G) needle were significantly more painful than with a 33-G needle. CONCLUSIONS To lessen pain with injectable facial treatments, the authors recommend placing the first injection on the L side of the face and, when possible, employing a high-G needle. LEVEL OF EVIDENCE 2
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Affiliation(s)
- Jacobus Johannes Fouché
- Drs Fouché, Van Loghem, and Thuis are aesthetic surgeons in private practice in Amsterdam, Netherlands. Dr De Heer is a Cardiothoracic Surgeon Registrar, Department of Cardiothoracic Surgery, University Medical Centre Utrecht, Netherlands. Dr Van Oijen is an Associate Professor, Department of Medical Oncology, Academic Medical Centre, University of Amsterdam, Netherlands
| | - Jani Adriaan Jochem Van Loghem
- Drs Fouché, Van Loghem, and Thuis are aesthetic surgeons in private practice in Amsterdam, Netherlands. Dr De Heer is a Cardiothoracic Surgeon Registrar, Department of Cardiothoracic Surgery, University Medical Centre Utrecht, Netherlands. Dr Van Oijen is an Associate Professor, Department of Medical Oncology, Academic Medical Centre, University of Amsterdam, Netherlands
| | - Job Thuis
- Drs Fouché, Van Loghem, and Thuis are aesthetic surgeons in private practice in Amsterdam, Netherlands. Dr De Heer is a Cardiothoracic Surgeon Registrar, Department of Cardiothoracic Surgery, University Medical Centre Utrecht, Netherlands. Dr Van Oijen is an Associate Professor, Department of Medical Oncology, Academic Medical Centre, University of Amsterdam, Netherlands
| | - Linda Marije De Heer
- Drs Fouché, Van Loghem, and Thuis are aesthetic surgeons in private practice in Amsterdam, Netherlands. Dr De Heer is a Cardiothoracic Surgeon Registrar, Department of Cardiothoracic Surgery, University Medical Centre Utrecht, Netherlands. Dr Van Oijen is an Associate Professor, Department of Medical Oncology, Academic Medical Centre, University of Amsterdam, Netherlands
| | - Martijn G H van Oijen
- Drs Fouché, Van Loghem, and Thuis are aesthetic surgeons in private practice in Amsterdam, Netherlands. Dr De Heer is a Cardiothoracic Surgeon Registrar, Department of Cardiothoracic Surgery, University Medical Centre Utrecht, Netherlands. Dr Van Oijen is an Associate Professor, Department of Medical Oncology, Academic Medical Centre, University of Amsterdam, Netherlands
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Abstract
Definition and taxonomy This review deals with neuropathic pain of traumatic origin affecting the trigeminal nerve, i.e. painful post-traumatic trigeminal neuropathy (PTTN). Symptomatology The clinical characteristics of PTTN vary considerably, partly due to the type and extent of injury. Symptoms involve combinations of spontaneous and evoked pain and of positive and negative somatosensory signs. These patients are at risk of going through unnecessary dental/surgical procedures in the attempt to eradicate the cause of the pain, due to the fact that most dentists only rarely encounter PTTN. Epidemiology Overall, approximately 3% of patients with trigeminal nerve injuries develop PTTN. Patients are most often female above the age of 45 years, and both physical and psychological comorbidities are common. Pathophysiology PTTN shares many pathophysiological mechanisms with other peripheral neuropathic pain conditions. Diagnostic considerations PTTN may be confused with one of the regional neuralgias or other orofacial pain conditions. For intraoral PTTN, early stages are often misdiagnosed as odontogenic pain. Pain management Management of PTTN generally follows recommendations for peripheral neuropathic pain. Expert opinion International consensus on classification and taxonomy is urgently needed in order to advance the field related to this condition.
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Affiliation(s)
- Lene Baad-Hansen
- 1 Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.,2 Scandinavian Center for Orofacial Neurosciences (SCON), Denmark/Sweden
| | - Rafael Benoliel
- 3 Rutgers School of Dental Medicine, Rutgers State University of New Jersey, Newark, NJ, USA
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Ipsilateral Putamen and Insula Activation by Both Left and Right GB34 Acupuncture Stimulation: An fMRI Study on Healthy Participants. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:4173185. [PMID: 28053642 PMCID: PMC5178348 DOI: 10.1155/2016/4173185] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 09/25/2016] [Accepted: 11/15/2016] [Indexed: 11/18/2022]
Abstract
The modulatory effects on the brain during right versus left side acupuncture stimulation of the same acupuncture point have been a subject of controversy. For clarification of this important methodological issue, the present study was designed to compare the blood oxygen level-dependent responses of acupuncture stimulation on the right versus left Yanglingquan (GB34). Twenty-two healthy subjects received right or left GB34 acupuncture. Our results show that acupuncture on the left GB34 induced neural responses in the left putamen, caudate body, insula, postcentral gyrus, claustrum, right and left thalamus, right middle frontal gyrus, hypothalamus, and subthalamic nucleus. Acupuncture on the right GB34 induced neural responses in the right middle frontal gyrus, inferior parietal lobule, thalamus, putamen, lateral globus pallidus, medial globus pallidus, and insula. Interestingly, the putamen and insula were ipsilaterally activated by acupuncture on either the left or right GB34; therefore, they seem to be the main target areas affected by GB34 acupuncture. This is the first reported functional magnetic resonance imaging study directly comparing needling on the right and left GB34. Although more replication studies are needed, our preliminary results prove that acupuncture has different modulatory effects on the brain when performed on the right versus left side.
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Striatal-enriched protein tyrosine phosphatase modulates nociception: evidence from genetic deletion and pharmacological inhibition. Pain 2016; 157:377-386. [PMID: 26270590 DOI: 10.1097/j.pain.0000000000000329] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The information from nociceptors is processed in the dorsal horn of the spinal cord by complex circuits involving excitatory and inhibitory interneurons. It is well documented that GluN2B and ERK1/2 phosphorylation contributes to central sensitization. Striatal-enriched protein tyrosine phosphatase (STEP) dephosphorylates GluN2B and ERK1/2, promoting internalization of GluN2B and inactivation of ERK1/2. The activity of STEP was modulated by genetic (STEP knockout mice) and pharmacological (recently synthesized STEP inhibitor, TC-2153) approaches. STEP(61) protein levels in the lumbar spinal cord were determined in male and female mice of different ages. Inflammatory pain was induced by complete Freund's adjuvant injection. Behavioral tests, immunoblotting, and electrophysiology were used to analyze the effect of STEP on nociception. Our results show that both genetic deletion and pharmacological inhibition of STEP induced thermal hyperalgesia and mechanical allodynia, which were accompanied by increased pGluN2B(Tyr1472) and pERK1/2(Thr202/Tyr204)levels in the lumbar spinal cord. Striatal-enriched protein tyrosine phosphatase heterozygous and knockout mice presented a similar phenotype. Furthermore, electrophysiological experiments showed that TC-2153 increased C fiber-evoked spinal field potentials. Interestingly, we found that STEP(61) protein levels in the lumbar spinal cord inversely correlated with thermal hyperalgesia associated with age and female gender in mice. Consistently, STEP knockout mice failed to show age-related thermal hyperalgesia, although gender-related differences were preserved. Moreover, in a model of inflammatory pain, hyperalgesia was associated with increased phosphorylation-mediated STEP(61) inactivation and increased pGluN2B(Tyr1472) and pERK1/2(Thr202/Tyr204)levels in the lumbar spinal cord. Collectively, the present results underscore an important role of spinal STEP activity in the modulation of nociception.
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Rowbotham SJ, Holler J, Wearden A, Lloyd DM. I see how you feel: Recipients obtain additional information from speakers' gestures about pain. PATIENT EDUCATION AND COUNSELING 2016; 99:1333-1342. [PMID: 26996051 DOI: 10.1016/j.pec.2016.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 03/07/2016] [Accepted: 03/13/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Despite the need for effective pain communication, pain is difficult to verbalise. Co-speech gestures frequently add information about pain that is not contained in the accompanying speech. We explored whether recipients can obtain additional information from gestures about the pain that is being described. METHODS Participants (n=135) viewed clips of pain descriptions under one of four conditions: 1) Speech Only; 2) Speech and Gesture; 3) Speech, Gesture and Face; and 4) Speech, Gesture and Face plus Instruction (short presentation explaining the pain information that gestures can depict). Participants provided free-text descriptions of the pain that had been described. Responses were scored for the amount of information obtained from the original clips. FINDINGS Participants in the Instruction condition obtained the most information, while those in the Speech Only condition obtained the least (all comparisons p<0.001). CONCLUSIONS Gestures produced during pain descriptions provide additional information about pain that recipients are able to pick up without detriment to their uptake of spoken information. PRACTICE IMPLICATIONS Healthcare professionals may benefit from instruction in gestures to enhance uptake of information about patients' pain experiences.
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Affiliation(s)
- Samantha J Rowbotham
- School of Psychological Sciences, University of Manchester, Manchester, UK; Menzies Centre for Health Policy, School of Public Health, University of Sydney, Sydney, Australia; The Australian Prevention Partnership Centre, Sax Institute, Sydney, Australia.
| | - Judith Holler
- Max Planck Institute for Psycholinguistics, Nijmegen, Netherlands.
| | - Alison Wearden
- School of Psychological Sciences, University of Manchester, Manchester, UK.
| | - Donna M Lloyd
- School of Psychology, University of Leeds, Leeds, UK.
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Larson RA, Carter JR. Total Sleep Deprivation and Pain Perception during Cold Noxious Stimuli in Humans. Scand J Pain 2016; 13:12-16. [PMID: 27867438 DOI: 10.1016/j.sjpain.2016.05.037] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND AIMS A substantial portion of the population suffers from chronic pain leading to significant health care costs and lost productivity. Loss of sleep duration and quality are widely reported in patients suffering from a variety of acute or chronic pain conditions. Conversely, sleep loss has been known to elevate pain perception; thus a potential bi-directional relationship exists between sleep deprivation and pain. To date, the majority of studies examining the relationship between experimentally induced pain and sleep loss have focused on the measurement of pain threshold. Additionally, despite evidence of sex differences in ratings of perceived pain, previous studies examining pain following sleep loss have not probed for sex differences. We examined the effects of 24-hour total sleep deprivation (TSD) on perceived pain during a 2-minute cold pressor test (CPT). We hypothesized that TSD would augment perceived pain and that women would demonstrate an elevated pain response compared to men. METHODS Testing was carried out in 14 men and 13 women. All subjects reported to be nonsmokers with no history of cardiovascular disease, autonomic dysfunction, asthma, or diabetes. All female subjects were free of oral contraceptive use, and were tested during the early follicular phase of the menstrual cycle. Trial order was randomized and testing sessions (Normal sleep (NS) and TSD) were separated by approximately one month. Subjects immersed their left hand, up to the wrist, in an ice water bath (~1°C), and perceived pain was recorded every 15 seconds from a modified Borg scale (6-20 arbitrary units a.u.). RESULTS Perceived pain responses during CPT were augmented following TSD (Δ1.2 a.u.; time × condition, p<0.05). The augmented pain response following TSD was noted when perceived pain was expressed as mean (NS Δ7.0±0.5 vs. TSD Δ8.2±0.5 a.u.; p<0.05) or peak (NS Δ8.9±0.6 vs. TSD Δ10.2±0.5 a.u.; p<0.05) perceived pain. The effects of TSD on perceived pain were similar in both men and women (condition × time × sex, p>0.05). CONCLUSIONS AND IMPLICATIONS We conclude that TSD significantly augments perceived pain during CPT, but this response was not sex dependent. These findings support emerging evidence that adequate sleep represents a relevant, and cost effective, preventative/therapeutic strategy to reduce self-perceived pain in both men and women.
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Affiliation(s)
- Robert A Larson
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI, United States
| | - Jason R Carter
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI, United States
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Tracy LM, Georgiou-Karistianis N, Gibson SJ, Giummarra MJ. Location, location, location: Variation in sensitivity to pain across the body. Eur J Pain 2016; 20:1721-1729. [PMID: 27221216 DOI: 10.1002/ejp.895] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2016] [Indexed: 01/10/2023]
Abstract
BACKGROUND There is evidence that sensitivity to noxious stimuli differs between the sexes and across the body, but few studies have investigated differences in the perception and experience of acute pain stimuli across the body in healthy individuals. METHODS We recruited 52 healthy participants, aged 18-36 (50% men) and administered 39, 42 and 45 °C stimuli at four body sites bilaterally to examine differences in the experience of pain intensity and unpleasantness between body sites via an 11-point numerical rating scale. RESULTS Noxious and innocuous thermal heat stimuli were perceived as significantly more intense when delivered to the wrist (M = 3.98, SD = 1.93) and back (M = 4.07, SD = 1.98) compared to the shoulder (M = 3.45, SD = 1.91) and leg (M = 3.46, SD = 1.87). Pain unpleasantness ratings yielded similar findings; stimuli were perceived as more unpleasant when administered to the wrist (M = 2.83, SD = 1.93) and lower back (M = 3.04, SD = 2.11) compared to the shoulder (M = 2.63, SD = 1.85) and leg (M = 2.26, SD = 1.82). CONCLUSIONS These findings suggest that painful thermal stimuli delivered to the wrist and back are perceived as more intense and unpleasant compared with other body sites in healthy persons. These differences may be due to variations in receptor density, or the relative importance of these sites for daily living and survival. SIGNIFICANCE Moreover, these insights are helpful for the design of studies investigating pain experience in healthy persons in experimental or clinical settings. WHAT DOES THIS STUDY ADD?: We tested sensitivity to acute suprathreshold thermal stimulations across a range of body sites to investigate for potential variability. We found significant differences in the perceived intensity and unpleasantness of noxious and innocuous thermal stimuli at the wrist and lower back, compared with the shoulder and leg. These results suggest that pain experience is driven by receptor density or the relative functional importance of these sites.
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Affiliation(s)
- L M Tracy
- School of Psychological Sciences and Monash Institute for Cognitive and Clinical Neurosciences, Monash University, Clayton, Australia.
- Caulfield Pain Management and Research Centre, Caulfield, Australia.
| | - N Georgiou-Karistianis
- School of Psychological Sciences and Monash Institute for Cognitive and Clinical Neurosciences, Monash University, Clayton, Australia
| | - S J Gibson
- Caulfield Pain Management and Research Centre, Caulfield, Australia
- National Aging Research Institute, Parkville, Australia
| | - M J Giummarra
- School of Psychological Sciences and Monash Institute for Cognitive and Clinical Neurosciences, Monash University, Clayton, Australia
- Caulfield Pain Management and Research Centre, Caulfield, Australia
- School of Public Health & Preventative Medicine, Monash University, Clayton, Australia
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Watson DH, Drummond PD. The Role of the Trigemino Cervical Complex in Chronic Whiplash Associated Headache: A Cross Sectional Study. Headache 2016; 56:961-75. [PMID: 27091393 DOI: 10.1111/head.12805] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 01/05/2016] [Accepted: 02/15/2016] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To investigate signs of central sensitization in a cohort of patients with chronic whiplash associated headache (CWAH). BACKGROUND Central sensitization is one of the mechanisms leading to chronicity of primary headache, and thus might contribute to CWAH. However, the pathophysiological mechanism of CWAH is poorly understood and whether it is simply an expression of the primary headache or has a distinct pathogenesis remains unclear. Thus, the factors involved in the genesis of CWAH require further investigation. METHODS Twenty-two patients with CWAH (20 females, 2 males; age 25-50 years, mean age 36.3 years) and 25 asymptomatic participants (13 females, 12 males; age 18-50 years, mean age 35.6 years) rated glare and light-induced discomfort in response to light from an ophthalmoscope. Hyperalgesia evoked by a pressure algometer was assessed bilaterally on the forehead, temples, occipital base, and the middle phalanx of the third finger. The number, latency, area under the curve, and recovery cycle of nociceptive blink reflexes elicited by a supraorbital electrical stimulus were also recorded. RESULTS Eight and 6 CWAH patients had migrainous and tension-type headache (TTH) profiles, respectively; the remainder had features attributable to both migraine and TTH. Patients in the whiplash group reported significantly greater light-induced pain than controls (8.48 ± .35 vs 6.66 ± .43 on a 0-10 scale; P = .001). The CWAH patients reported significantly lower pressure pain thresholds at all sites. For stimuli delivered at 20 second intervals, whiplash patients were more responsive than controls (4.8 ± .6 blinks vs 3.0 ± .6 blinks in a block of 10 stimuli; P = .036). While R2 latencies and the area under the curve for the 20 second interval trials were comparable in both groups, there was a significant reduction of the area under the curve from the first to the second of the 2-second interval trials only in controls (99 ± 8% of baseline in whiplash patients vs 68 ± 7% in controls; P = .009). The recovery cycle was comparable for both groups. CONCLUSIONS Our results corroborate previous findings of mechanical hypersensitivity and photophobia in CWAH patients. The neurophysiological data provide further evidence for hyperexcitability in central nociceptive pathways, and endorse the hypothesis that CWAH may be driven by central sensitization.
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Affiliation(s)
- Dean H Watson
- School of Psychology and Exercise Science, Murdoch University, Murdoch, Western Australia, Australia
| | - Peter D Drummond
- School of Psychology and Exercise Science, Murdoch University, Murdoch, Western Australia, Australia
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Kwon YS, Robergs RA, Mermier CM, Schneider SM, Gurney AB. Palm Cooling and Heating Delays Fatigue During Resistance Exercise In Women. J Strength Cond Res 2015; 29:2261-9. [DOI: 10.1519/jsc.0b013e31829cef4e] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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35
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Grint NJ, Whay HR, Beths T, Yvorchuk K, Murrell JC. Challenges of thermal nociceptive threshold testing in the donkey. Vet Anaesth Analg 2015; 42:205-14. [DOI: 10.1111/vaa.12182] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Accepted: 07/26/2013] [Indexed: 11/28/2022]
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36
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Rowbotham S, Wardy AJ, Lloyd DM, Wearden A, Holler J. Increased pain intensity is associated with greater verbal communication difficulty and increased production of speech and co-speech gestures. PLoS One 2014; 9:e110779. [PMID: 25343486 PMCID: PMC4208777 DOI: 10.1371/journal.pone.0110779] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 09/24/2014] [Indexed: 11/17/2022] Open
Abstract
Effective pain communication is essential if adequate treatment and support are to be provided. Pain communication is often multimodal, with sufferers utilising speech, nonverbal behaviours (such as facial expressions), and co-speech gestures (bodily movements, primarily of the hands and arms that accompany speech and can convey semantic information) to communicate their experience. Research suggests that the production of nonverbal pain behaviours is positively associated with pain intensity, but it is not known whether this is also the case for speech and co-speech gestures. The present study explored whether increased pain intensity is associated with greater speech and gesture production during face-to-face communication about acute, experimental pain. Participants (N = 26) were exposed to experimentally elicited pressure pain to the fingernail bed at high and low intensities and took part in video-recorded semi-structured interviews. Despite rating more intense pain as more difficult to communicate (t(25) = 2.21, p = .037), participants produced significantly longer verbal pain descriptions and more co-speech gestures in the high intensity pain condition (Words: t(25) = 3.57, p = .001; Gestures: t(25) = 3.66, p = .001). This suggests that spoken and gestural communication about pain is enhanced when pain is more intense. Thus, in addition to conveying detailed semantic information about pain, speech and co-speech gestures may provide a cue to pain intensity, with implications for the treatment and support received by pain sufferers. Future work should consider whether these findings are applicable within the context of clinical interactions about pain.
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Affiliation(s)
- Samantha Rowbotham
- School of Psychological Sciences, University of Manchester, Manchester, United Kingdom
| | - April J. Wardy
- School of Psychological Sciences, University of Manchester, Manchester, United Kingdom
| | - Donna M. Lloyd
- Institute of Psychological Sciences, University of Leeds, Leeds, United Kingdom
| | - Alison Wearden
- School of Psychological Sciences, University of Manchester, Manchester, United Kingdom
| | - Judith Holler
- Max Planck Institute for Psycholinguistics, Nijmegen, Netherlands
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Ichesco E, Schmidt-Wilcke T, Bhavsar R, Clauw DJ, Peltier SJ, Kim J, Napadow V, Hampson JP, Kairys AE, Williams DA, Harris RE. Altered resting state connectivity of the insular cortex in individuals with fibromyalgia. THE JOURNAL OF PAIN 2014; 15:815-826.e1. [PMID: 24815079 PMCID: PMC4127388 DOI: 10.1016/j.jpain.2014.04.007] [Citation(s) in RCA: 114] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 04/07/2014] [Accepted: 04/15/2014] [Indexed: 12/27/2022]
Abstract
UNLABELLED The insular cortex (IC) and cingulate cortex (CC) are critically involved in pain perception. Previously we demonstrated that fibromyalgia (FM) patients have greater connectivity between the insula and default mode network at rest, and that changes in the degree of this connectivity were associated with changes in the intensity of ongoing clinical pain. In this study we more thoroughly evaluated the degree of resting-state connectivity to multiple regions of the IC in individuals with FM and healthy controls. We also investigated the relationship between connectivity, experimental pain, and current clinical chronic pain. Functional connectivity was assessed using resting-state functional magnetic resonance imaging in 18 FM patients and 18 age- and sex-matched healthy controls using predefined seed regions in the anterior, middle, and posterior IC. FM patients exhibited greater connectivity between 1) right mid IC and right mid/posterior CC and right mid IC, 2) right posterior IC and left CC, and 3) right anterior IC and left superior temporal gyrus. Healthy controls displayed greater connectivity between left anterior IC and bilateral medial frontal gyrus/anterior cingulate cortex; and left posterior IC and right superior frontal gyrus. Within the FM group, greater connectivity between the IC and CC was associated with decreased pressure-pain thresholds. PERSPECTIVE These data provide further support for altered resting-state connectivity between the IC and other brain regions known to participate in pain perception/modulation, which may play a pathogenic role in conditions such as FM. We speculate that altered IC connectivity is associated with the experience of chronic pain in individuals with FM.
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Affiliation(s)
- Eric Ichesco
- Department of Anesthesiology, Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor, Michigan.
| | - Tobias Schmidt-Wilcke
- Department of Anesthesiology, Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor, Michigan; Department of Neurology, Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Rupal Bhavsar
- Department of Anesthesiology, Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor, Michigan; Neurology Department, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Daniel J Clauw
- Department of Anesthesiology, Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor, Michigan
| | - Scott J Peltier
- Functional MRI Laboratory, University of Michigan, Ann Arbor, Michigan
| | - Jieun Kim
- MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts
| | - Vitaly Napadow
- MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts; Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Radiology, Logan College of Chiropractic, Chesterfield, Missouri
| | - Johnson P Hampson
- Department of Anesthesiology, Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor, Michigan
| | - Anson E Kairys
- Department of Anesthesiology, Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor, Michigan; Department of Psychology, University of Colorado Denver, Denver, Colorado
| | - David A Williams
- Department of Anesthesiology, Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor, Michigan
| | - Richard E Harris
- Department of Anesthesiology, Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor, Michigan
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Grint NJ, Beths T, Yvorchuk K, Taylor PM, Dixon M, Whay HR, Murrell JC. The influence of various confounding factors on mechanical nociceptive thresholds in the donkey. Vet Anaesth Analg 2014; 41:421-9. [DOI: 10.1111/vaa.12132] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Accepted: 05/19/2013] [Indexed: 11/28/2022]
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Wang R, Cui L, Zhou W, Wang C, Zhang J, Wang K, Svensson P. Reliability study of thermal quantitative sensory testing in healthy Chinese. Somatosens Mot Res 2014; 31:198-203. [PMID: 24945099 DOI: 10.3109/08990220.2014.914485] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Test-retest reliability is important to establish for any diagnostic tool. The reliability of quantitative sensory testing (QST) in the trigeminal region has recently been described in Caucasians as well as differences in absolute thresholds and responses between Caucasians and Chinese. However, the test-retest reliability has not been determined in a Chinese population. OBJECTIVE To provide novel information on the test-retest reliability of thermal QST in the trigeminal and spinal system in healthy Chinese. METHODS Twenty healthy volunteers (10 women and 10 men) participated. Cold detection threshold (CDT), warm detection threshold (WDT), cold pain threshold (CPT), and heat pain threshold (HPT) were measured at two sites: the surface of the left hand and the left masseter. The testing was performed over three consecutive stimuli trials, three sessions conducted on one day and repeated one week later. Data were analyzed with intra-tester reliability test and four-way analysis of variance (ANOVA) for repeated measures. RESULTS There was a tendency for the first trial in CDT (p = 0.005), CPT (p = 0.02), and HPT (p < 0.001) to reflect higher sensitivity than the subsequent two trials. Most variables showed acceptable to excellent reliability and non-significant difference across different trials (ICC: 0.912-0.989), sessions (ICC: 0.791-0.977), and days (ICC: 0.415-0.837). Between-site differences were significant for CDT (p = 0.003) and HPT (p = 0.045) with higher sensitivity at the masseter muscle. There were significant gender differences with higher sensitivity in women for CPT (p = 0.001) and HPT (p = 0.001). CONCLUSION Test site and gender affect thermal thresholds substantially. The test-retest reliability of most thermal threshold measures were acceptable for assessing somatosensory function, however, innocuous thresholds appear to be associated with larger variability than noxious thresholds in a Chinese population.
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Affiliation(s)
- Ruixia Wang
- Orofacial Pain & TMD Research Unit, Institute of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University , Nanjing , China
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40
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An G, Li W, Yan T, Li S. Estrogen rapidly enhances incisional pain of ovariectomized rats primarily through the G protein-coupled estrogen receptor. Int J Mol Sci 2014; 15:10479-91. [PMID: 24921706 PMCID: PMC4100163 DOI: 10.3390/ijms150610479] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2014] [Revised: 05/10/2014] [Accepted: 05/13/2014] [Indexed: 01/24/2023] Open
Abstract
It has become increasingly apparent that the pain threshold of females and males varies in an estrogen dependent manner. To investigate the modulation of pain by estrogen and the molecular mechanisms involved in this process. A total of 48 rats were ovariectomized (OVX). At 14 and 20 days after OVX, rats were divided into eight groups: groups 1–4 were administered drugs intravenously (IV); groups 5–8 were administered through intrathecal (IT) catheter. Hind paw incision was made in all animals to determine incisional pain. Paw withdraw threshold (PWT) was tested prior to and 24 h after incision. The test drugs were applied 24 h after the incision. Rats were either IV or IT administered with: 17-β-estradiol (E2), G protein-coupled estrogen receptor (GPER)-selective agonist (G1), GPER-selective antagonist (G15) and E2 (G15 + E2), or solvent. Before and 30 min after IV drug administration and 20 min during the IT catheter administration, PWT was tested and recorded. 24 h after incisional surgery, the PWT of all rats significantly decreased. Both in the IV group and IT group: administration of E2 and G1 significantly decreased PWT. Neither administration of G15 + E2 nor solvent significantly changed PWT. Estrogen causes rapid reduction in the mechanical pain threshold of OVX rats via GPER.
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Affiliation(s)
- Guanghui An
- Department of Anesthesiology, Shanghai First People's Hospital, Shanghai 200080, China.
| | - Wenhui Li
- Department of Anesthesiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200090, China.
| | - Tao Yan
- Department of Anesthesiology, Shanghai First People's Hospital, Shanghai 200080, China.
| | - Shitong Li
- Department of Anesthesiology, Shanghai First People's Hospital, Shanghai 200080, China.
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Williams MD, Kirkpatrick AE, Griffith E, Benito J, Hash J, Lascelles BDX. Feasibility and repeatability of thermal quantitative sensory testing in normal dogs and dogs with hind limb osteoarthritis-associated pain. Vet J 2013; 199:63-7. [PMID: 24316154 DOI: 10.1016/j.tvjl.2013.11.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 09/17/2013] [Accepted: 11/03/2013] [Indexed: 02/07/2023]
Abstract
The objectives of this study were to determine whether thermal quantitative sensory testing (QST) can be performed in client-owned dogs, is repeatable and whether QST differs between normal dogs and dogs with hind limb osteoarthritis (OA). This clinical, prospective, observational study used clinically normal dogs (n=23) and dogs with OA-associated hind limb pain (n=9). Thermal QST was performed in standing dogs using a high-powered light source delivered by a previously validated system. Dogs were tested on two occasions, 2 weeks apart. Five tests were performed on each hind limb at each time point. Repeated measures analysis of variance was used to evaluate the effects of leg, time point and OA/normal status on thermal threshold latencies (TTL). Additionally, paired t tests were used to compare the TTL of left and right limbs within groups and between time points. Thermal thresholds were successfully measured in 32 client-owned dogs without prior training. TTL were significantly different between normal and OA dogs (P=0.012). There was no difference between limbs (P=0.744) or time periods (P=0.572), when analyzed by repeated measures analysis of variance, and no interactions between group and limb, visit and limb, or visit and group. In conclusion, thermal thresholds can be measured in client owned dogs with no prior training and are repeatable from week to week. Further data are required to determine if OA results in thermal hypoalgesia as measured at the distal hind limb and whether this is an indication of central sensitization.
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Affiliation(s)
- Morika D Williams
- Comparative Pain Research Laboratory (CPRL), Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA
| | - Amy E Kirkpatrick
- Comparative Pain Research Laboratory (CPRL), Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA
| | - Emily Griffith
- Center for Comparative Medicine and Translational Research, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA; Department of Statistics, North Carolina State University, Raleigh, NC 27695, USA
| | - Javier Benito
- Comparative Pain Research Laboratory (CPRL), Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA
| | - Jon Hash
- Comparative Pain Research Laboratory (CPRL), Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA
| | - B D X Lascelles
- Comparative Pain Research Laboratory (CPRL), Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA; Center for Comparative Medicine and Translational Research, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA; Department of Clinical Sciences Surgery Section, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA.
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Pienimäki T, Karppinen J, Rintamäki H, Borodulin K, Laatikainen T, Jousilahti P, Hassi J, Näyhä S. Prevalence of cold-related musculoskeletal pain according to self-reported threshold temperature among the Finnish adult population. Eur J Pain 2013; 18:288-98. [PMID: 23881586 DOI: 10.1002/j.1532-2149.2013.00368.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2013] [Indexed: 11/09/2022]
Abstract
BACKGROUND Exposure to cold reportedly increases musculoskeletal pains. We assessed the prevalence of such pain and self-reported threshold temperature (TT) at which the pain emerges. METHODS A random sample of 6591 people in Finland, aged 25-74 years, answered a questionnaire on repeated cold-related musculoskeletal pain (CMP) and its TT. The response rate was 64%. We used quantile regression to quantify the effects of personal characteristics and region of residence on TT at various locations of its distribution. RESULTS Of the participants, 1892 (30%) experienced CMP in at least one body site and 1692 reported TT. Ten percent of the participants who perceived CMP did so at -2 °C, 50% at -14 °C and 90% at -23 °C. Residence in the South elevated TT by 1-6 °C compared with residence in the North, depending on the proportion of participants reporting CMP at various temperatures. Joint disorders increased TT at milder temperatures, at which only 10% of all participants perceived CMP, whereas back disorders did so mainly at lower temperatures, at which 70% were affected. Overweight was associated with a 2 °C lower TT, and physical inactivity with a 1 °C higher TT, and TT increased by 1 °C per 10-year increase in age. The greatest model-estimated difference in median TT between subgroups was 12 °C. CONCLUSIONS People suffering from musculoskeletal disorders and those living in the warmer areas of Finland need special advice to protect themselves against the cold. Our study provides preliminary information to support such advice.
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Affiliation(s)
- T Pienimäki
- Social Insurance Institution, Regional Office for Northern Finland, Oulu, Finland
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Vassal F, Créac'h C, Convers P, Laurent B, Garcia-Larrea L, Peyron R. Modulation of laser-evoked potentials and pain perception by transcutaneous electrical nerve stimulation (TENS): a placebo-controlled study in healthy volunteers. Clin Neurophysiol 2013; 124:1861-7. [PMID: 23639375 DOI: 10.1016/j.clinph.2013.04.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Revised: 03/19/2013] [Accepted: 04/02/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate the effects of transcutaneous electrical nerve stimulation (TENS) on brain nociceptive responses (laser-evoked potentials, LEPs) and pain perception. METHODS Twenty healthy subjects were included. Nociceptive CO(2)-laser pulses were sequentially delivered to the dorsum of both feet. The amplitude of LEPs and nociceptive thresholds were collected in three consecutive conditions: T1: "sham" TENS (2 Hz/low-intensity) positioned heterotopically, over the left thigh; T2: "active" TENS (120 Hz/low-intensity) applied homotopically, over the left common peroneal nerve; and T3: "sham" TENS (replication of condition T1). RESULTS Compared with "sham" TENS, "active" TENS significantly decreased the LEPs amplitude. This effect was observed exclusively when "active" TENS was applied ipsilaterally to the painful stimulus. Nociceptive thresholds increased with sessions in both limbs, but the increase observed during the "active" condition of TENS (T2) exceeded significantly that observed during the condition T3 only on the foot ipsilateral to TENS. CONCLUSIONS Compared with a credible placebo TENS, high-frequency TENS induced a significant attenuation of both the acute pain and LEPs induced by noxious stimuli applied on the same dermatome. SIGNIFICANCE This modulation of subjective and objective concomitants of pain processing reflects a real neurophysiological TENS-related effect on nociceptive transmission.
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Affiliation(s)
- François Vassal
- Service de Neurochirurgie, Hôpital Nord, Centre Hospitalier Régional Universitaire de Saint-Etienne, France.
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Increasing acclimation period improves the reproducibility of short-heating local thermal hyperemia. Microvasc Res 2013; 85:93-8. [DOI: 10.1016/j.mvr.2012.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 10/24/2012] [Accepted: 11/05/2012] [Indexed: 01/05/2023]
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Kranz GS, Hahn A, Baldinger P, Haeusler D, Philippe C, Kaufmann U, Wadsak W, Savli M, Hoeflich A, Kraus C, Vanicek T, Mitterhauser M, Kasper S, Lanzenberger R. Cerebral serotonin transporter asymmetry in females, males and male-to-female transsexuals measured by PET in vivo. Brain Struct Funct 2012; 219:171-83. [PMID: 23224294 DOI: 10.1007/s00429-012-0492-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 11/21/2012] [Indexed: 12/15/2022]
Abstract
The serotonergic system modulates brain functions that are considered to underlie affective states, emotion and cognition. Several lines of evidence point towards a strong lateralization of these mental processes, which indicates similar asymmetries in associated neurotransmitter systems. Here, our aim was to investigate a potential asymmetry of the serotonin transporter distribution using positron emission tomography and the radioligand [(11)C]DASB in vivo. As brain asymmetries may differ between sexes, we further aimed to compare serotonin transporter asymmetry between females, males and male-to-female (MtF) transsexuals whose brains are considered to be partly feminized. Voxel-wise analysis of serotonin transporter binding in all groups showed both strong left and rightward asymmetries in several cortical and subcortical structures including temporal and frontal cortices, anterior cingulate, hippocampus, caudate and thalamus. Further, male controls showed a rightward asymmetry in the midcingulate cortex, which was absent in females and MtF transsexuals. The present data support the notion of a lateralized serotonergic system, which is in line with previous findings of asymmetric serotonin-1A receptor distributions, extracellular serotonin concentrations, serotonin turnover and uptake. The absence of serotonin transporter asymmetry in the midcingulate in MtF transsexuals may be attributed to an absence of brain masculinization in this region.
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Affiliation(s)
- Georg S Kranz
- Functional, Molecular and Translational Neuroimaging Lab, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
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Leite-Almeida H, Cerqueira JJ, Wei H, Ribeiro-Costa N, Anjos-Martins H, Sousa N, Pertovaara A, Almeida A. Differential effects of left/right neuropathy on rats’ anxiety and cognitive behavior. Pain 2012; 153:2218-2225. [DOI: 10.1016/j.pain.2012.07.007] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Revised: 06/21/2012] [Accepted: 07/05/2012] [Indexed: 11/29/2022]
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Alabas OA, Tashani OA, Johnson MI. Effects of ethnicity and gender role expectations of pain on experimental pain: a cross-cultural study. Eur J Pain 2012; 17:776-86. [PMID: 23070971 DOI: 10.1002/j.1532-2149.2012.00229.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2012] [Indexed: 01/21/2023]
Abstract
BACKGROUND Gender role expectations of pain (GREP) have been shown to mediate sex differences in experimental pain. Few studies have investigated the role of ethnicity in shaping GREP. The aim of this study was to examine interactions between ethnicity and GREP on experimentally induced pressure and ischaemic pain in Libyan and white British students in their respective countries. METHODS Libyan (n = 124) and white British (n = 51) students completed a GREP questionnaire and their response to experimental pain was measured. Blunt pressure pain threshold (PPT) was measured over the 1st interosseous muscle using algometry. Pain intensity and pain unpleasantness (100 mm visual analogue scale) were measured at 1-min intervals during a submaximal effort tourniquet test on the forearm. RESULTS Multivariate analysis of variance detected significant effects for Sex and Ethnicity on pain measurements. Men had higher PPTs than women (p < 0.001). Libyans had higher PPTs than white British participants (p < 0.001). There were significant effects for Sex and Ethnicity for pain intensity ratings (p < 0.01) but no significant differences between the sexes in pain unpleasantness (p > 0.05). Libyan participants had higher pain intensity (p < 0.01) and pain unpleasantness (p < 0.05) ratings compared with white British participants. There were effects for Sex and Ethnicity for all GREP dimensions. Libyan participants exhibited stronger stereotypical views in GREP than white British participants (p < 0.001). CONCLUSIONS GREP was the mediator of sex but not ethnic differences in pain report, suggesting that gender stereotypical attitudes to pain account for differences in pain expression between men and women.
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Affiliation(s)
- O A Alabas
- Faculty of Health and Social Sciences, Leeds Metropolitan University, Leeds, UK.
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Stimulus site and modality dependence of functional activity within the human spinal cord. J Neurosci 2012; 32:6231-9. [PMID: 22553029 DOI: 10.1523/jneurosci.2543-11.2012] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Chronic pain is thought to arise because of maladaptive changes occurring within the peripheral nervous system and CNS. The transition from acute to chronic pain is known to involve the spinal cord (Woolf and Salter, 2000). Therefore, to investigate altered human spinal cord function and translate results obtained from other species, a noninvasive neuroimaging technique is desirable. We have investigated the functional response in the cervical spinal cord of 18 healthy human subjects (aged 22-40 years) to noxious thermal and non-noxious tactile stimulation of the left and right forearms. Physiological noise, which is a significant source of signal variability in the spinal cord, was accounted for in the general linear model. Group analysis, performed using a mixed-effects model, revealed distinct regions of activity that were dependent on both the side and the type of stimulation. In particular, thermal stimulation on the medial aspect of the wrist produced activity within the C6/C5 segment ipsilateral to the side of stimulation. Similar to data recorded in animals (Fitzgerald, 1982), painful thermal stimuli produced increased ipsilateral and decreased contralateral blood flow, which may reflect, respectively, excitatory and inhibitory processes. Nonpainful punctate stimulation of the thenar eminence provoked more diffuse activity but was still ipsilateral to the side of stimulation. These results present the first noninvasive evidence for a lateralized response to noxious and non-noxious stimuli in the human spinal cord. The development of these techniques opens the path to understanding, at a subject-specific level, central sensitization processes that contribute to chronic pain states.
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Validation of the numerical rating scale for pain intensity and unpleasantness in pediatric acute postoperative pain: sensitivity to change over time. THE JOURNAL OF PAIN 2012; 13:359-69. [PMID: 22424915 DOI: 10.1016/j.jpain.2011.12.010] [Citation(s) in RCA: 126] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Revised: 12/14/2011] [Accepted: 12/23/2011] [Indexed: 11/22/2022]
Abstract
UNLABELLED This study evaluates the construct validity (including sensitivity to change) of the numerical rating scale (NRS) for pain intensity (I) and unpleasantness (U) and participant pain scale preferences in children/adolescents with acute postoperative pain. Eighty-three children aged 8 to 18 years (mean = 13.8, SD = 2.4) completed 3 pain scales including NRS, Verbal Rating Scale (VRS), and faces scales (Faces Pain Scale-Revised [FPS-R] and Facial Affective Scale [FAS], respectively) for pain intensity (I) and unpleasantness (U) 48 to 72 hours after major surgery, and the NRS, VRS and Functional Disability Index (FDI) 2 weeks after surgery. As predicted, the NRSI correlated highly with the VRSI and FPS-R and the NRSU correlated highly with the VRSU and FAS 48 to 72 hours after surgery. The FDI correlated moderately with the NRS at both time points. Scores on the NRSI and NRSU at 48 to 72 hours were significantly higher than at 2 weeks after surgery. Children found the faces scales the easiest to use while the VRS was liked the least and was the hardest to use. The NRS has adequate evidence of construct validity including sensitivity for both pain intensity and unpleasantness. This study further supports the validity of the NRS as a tool to measure both intensity and unpleasantness of acute pain in children. PERSPECTIVE This article evaluates the construct validity including sensitivity of the Numerical Rating Scale for pain intensity and pain unpleasantness over time in children after major surgery. The NRS could be used by clinicians to assess these 2 different dimensions of children's pain experience in acute pain settings.
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Racine M, Tousignant-Laflamme Y, Kloda LA, Dion D, Dupuis G, Choinière M. A systematic literature review of 10 years of research on sex/gender and experimental pain perception - part 1: are there really differences between women and men? Pain 2012; 153:602-618. [PMID: 22192712 DOI: 10.1016/j.pain.2011.11.025] [Citation(s) in RCA: 437] [Impact Index Per Article: 36.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Revised: 11/15/2011] [Accepted: 11/22/2011] [Indexed: 01/08/2023]
Abstract
The purpose of this systematic review was to summarize and critically appraise the results of 10 years of human laboratory research on pain and sex/gender. An electronic search strategy was designed by a medical librarian and conducted in multiple databases. A total of 172 articles published between 1998 and 2008 were retrieved, analyzed, and synthesized. The first set of results (122 articles), which is presented in this paper, examined sex difference in the perception of laboratory-induced thermal, pressure, ischemic, muscle, electrical, chemical, and visceral pain in healthy subjects. This review suggests that females (F) and males (M) have comparable thresholds for cold and ischemic pain, while pressure pain thresholds are lower in F than M. There is strong evidence that F tolerate less thermal (heat, cold) and pressure pain than M but it is not the case for tolerance to ischemic pain, which is comparable in both sexes. The majority of the studies that measured pain intensity and unpleasantness showed no sex difference in many pain modalities. In summary, 10 years of laboratory research have not been successful in producing a clear and consistent pattern of sex differences in human pain sensitivity, even with the use of deep, tonic, long-lasting stimuli, which are known to better mimic clinical pain. Whether laboratory studies in healthy subjects are the best paradigm to investigate sex differences in pain perception is open to question and should be discussed with a view to enhancing the clinical relevance of these experiments and developing new research avenues.
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Affiliation(s)
- Mélanie Racine
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec, Canada École de réadaptation, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada Life Sciences Library, McGill University, Montreal, Quebec, Canada Department of Family Medicine and Emergency, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada Research Centre, Montreal Heart Institute, Montreal, Quebec, Canada Department of Anaesthesiology, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
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