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Sahbaie P, Guo TZ, Shi XY, Kingery WS, Clark JD. Effects of immunosuppression after limb fracture in mice on nociceptive, cognitive, and anxiety-related outcomes. Pain Rep 2024; 9:e1179. [PMID: 39263006 PMCID: PMC11390048 DOI: 10.1097/pr9.0000000000001179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 06/14/2024] [Accepted: 06/20/2024] [Indexed: 09/13/2024] Open
Abstract
Introduction Chronic pain is a common and problematic consequence of injuries with few proven methods for prevention or treatment. In addition to pain, functional limitations and neuropsychiatric changes such as cognitive impairment and anxiety worsen outcomes. Objectives To determine whether inhibiting activation of the adaptive immune response after limb fracture would reduce pain, functional loss, memory changes, and anxiety. Methods These experiments used a murine tibial fracture/cast immobilization model that develops these adverse outcomes. Adaptive immunity was blocked using the immunosuppressant FK506 beginning at the time of fracture. Results The administration of FK506 reduced mechanical allodynia and hind limb unweighting for weeks after cast removal as well as nonevoked pain measures. Fracture was associated with working memory loss in the Y-maze assay in vehicle- but not FK506-treated mice. Object recognition memory was not improved with FK506 after fracture. Also, vehicle- but not FK506-treated mice developed an anxiety phenotype. Impaired running wheel performance after cast removal over the following 2 weeks was not improved with FK506 administration. In addition, FK506 treatment blocked Immunoglobulin M (IgM) accumulation in the skin of the fractured limbs, and hippocampal enhancement of matrix metalloproteinase-8 expression, a metalloproteinase associated with neuroplastic changes after injuries, was completely blocked. Conclusion Taken together, our results show that blocking the adaptive immune response after limb trauma reduces the severity of nociceptive and biological changes. The same treatment may reduce the adverse consequences of anxiety and memory deficits using some measures, but other measures of memory are not affected, and activity is not enhanced.
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Affiliation(s)
- Peyman Sahbaie
- Anesthesiology Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
- Department of Anesthesia, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Tian-Zhi Guo
- Anesthesiology Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
- Palo Alto Veterans Institute for Research, Palo Alto, CA, USA
| | - Xiao-You Shi
- Anesthesiology Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
- Department of Anesthesia, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Wade S Kingery
- Palo Alto Veterans Institute for Research, Palo Alto, CA, USA
| | - J David Clark
- Anesthesiology Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
- Department of Anesthesia, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
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Pourgravand P, Mofateh R, Orakifar N, Shaterzadeh-Yazdi MJ, Seyedtabib M, Saki R. Effects of attentional focus on quiet standing balance control in individuals with non-specific chronic low back pain. Hum Mov Sci 2024; 97:103271. [PMID: 39167852 DOI: 10.1016/j.humov.2024.103271] [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: 02/27/2024] [Revised: 08/11/2024] [Accepted: 08/14/2024] [Indexed: 08/23/2024]
Abstract
Despite the widespread research about the effects of attentional focus on balance control in different populations, to the best of our knowledge, no study has yet investigated the effects of attentional focus instructions on balance control in individuals with chronic low back pain (CLBP). Therefore, this study was aimed to compare the effects of internal focus (IF) and external focus (EF) of attention on quiet standing balance control between individuals with CLBP and healthy controls. Twenty individuals with CLBP and 20 healthy controls were enrolled in this quasi-experimental study. The participants were asked to stand still with eyes open and eyes closed while performing three tasks: baseline standing with no focus instructions, internally focusing on their feet, and externally focusing on two markers were placed on the force platform. Statistical analyses showed a significant main effect of group for mean total velocity (p = 0.02), area (p = 0.01), and displacement in mediolateral (ML) direction (p = 0.003). Moreover, a significant main effect of vision was observed for mean total velocity (p < 0.001), area (p < 0.001), and displacement in anteroposterior (AP) (p < 0.001) and ML directions (p < 0.001). Also, the results revealed a significant main effect of attentional focus for mean total velocity (p < 0.001), area (p < 0.001), and displacement in AP (p < 0.001) and ML directions (p = 0.01). Our results showed that in both healthy controls and individuals with CLBP, EF led to improve quiet standing balance control compared to IF and control conditions. From a clinical perspective, it may be useful for physical therapists to consider the use of instruction cues that direct performer's attention away from the body for improving quiet standing balance control in individuals with CLBP.
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Affiliation(s)
- Pardis Pourgravand
- Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Student Research Committee, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Razieh Mofateh
- Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Physiotherapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran..
| | - Neda Orakifar
- Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Physiotherapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad-Jafar Shaterzadeh-Yazdi
- Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Physiotherapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Seyedtabib
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ramin Saki
- Department of Mechanics Faculty of Chamran University of Khozestan, Ahvaz, Iran
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Liu Z, Fan J, Bu H, Fu L, Li C, Ma L, Kong C, Lu Z, Li X, Wang J, Liu Q, Yuan J, Fan X. Causal associations between frailty and low back pain: a bidirectional two-sample mendelian randomization study. Aging Clin Exp Res 2024; 36:191. [PMID: 39259375 PMCID: PMC11390933 DOI: 10.1007/s40520-024-02843-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Accepted: 08/28/2024] [Indexed: 09/13/2024]
Abstract
BACKGROUND Previous observational studies have revealed a potentially robust bidirectional relationship between frailty and low back pain (LBP). However, the precise causal relationship remains unclear. METHODS To examine the potential causal association between frailty and LBP, we conducted bidirectional two-sample Mendelian randomization analysis (MR) study. Genetic data on frailty index (FI) and LBP were acquired from publicly available genome-wide association studies (GWAS). Various MR methodologies were utilized, such as inverse variance weighting (IVW), weighted median, and MR-Egger, to evaluate causality. Additionally, sensitivity analyses were conducted to evaluate the robustness of the findings. RESULTS Genetically predicted higher FI (IVW, odds ratio [OR] = 1.66, 95% CI 1.17-2.36, p = 4.92E-03) was associated with a higher risk of LBP. As for the reverse direction, genetic liability to LBP showed consistent associations with a higher FI (IVW, OR = 1.13, 95% CI 1.07-1.19, p = 2.67E-05). The outcomes from various MR techniques and sensitivity analyses indicate the robustness of our findings. CONCLUSION Our research findings provide additional evidence bolstering the bidirectional causal relationship between frailty and LBP.
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Affiliation(s)
- Zuying Liu
- Department of Pain Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, Henan Province, China
| | - Jiaming Fan
- Department of Pain Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, Henan Province, China
| | - Huilian Bu
- Department of Pain Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, Henan Province, China
| | - Lijun Fu
- Department of Pain Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, Henan Province, China
| | - Cong Li
- Department of Pain Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, Henan Province, China
| | - Letian Ma
- Department of Pain Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, Henan Province, China
| | - Cunlong Kong
- Department of Pain Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, Henan Province, China
| | - Zhongyuan Lu
- Department of Pain Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, Henan Province, China
| | - Xinxin Li
- Department of Pain Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, Henan Province, China
| | - Jian Wang
- Department of Human Anatomy, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, 450001, Henan Province, China
| | - Qingying Liu
- Department of Pain Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, Henan Province, China.
| | - Jingjing Yuan
- Henan Province International Joint Laboratory of Pain, Cognition and Emotion, Zhengzhou, 450000, Henan Province, China.
- Department of Anesthesiology, Pain and Perioperative Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, Henan Province, China.
| | - Xiaochong Fan
- Department of Pain Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, Henan Province, China.
- Henan Province International Joint Laboratory of Pain, Cognition and Emotion, Zhengzhou, 450000, Henan Province, China.
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Yuan H, Wang S, Sun Y, Liu M, Wu F, Sun H, Zhou F. Association between chronic pain classes and cognitive function in older adults: A cross-sectional study based on latent class analysis. Geriatr Nurs 2024; 56:312-320. [PMID: 38422626 DOI: 10.1016/j.gerinurse.2024.02.028] [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: 12/15/2023] [Revised: 02/16/2024] [Accepted: 02/20/2024] [Indexed: 03/02/2024]
Abstract
The purpose of this study was to identify latent classes of chronic pain in older adults based on perceptual, cognitive, behavioral, emotional and social factors, and to explore the associations between each class of chronic pain and different cognitive domains. A total of 629 participants were included. Three classes of chronic pain were identified: "episodic recurrent mild pain with good psychosocial state" (class 1), "episodic recurrent moderate pain with general psychosocial state" (class 2) and "continuous multilocational severe pain with attacks accompanied by poor psychosocial state and avoidance of activity" (class 3). After adjusting for relevant confounders, chronic pain presenting as class 1 was associated with worse memory; class 2 was associated with worse global cognitive function, memory, information processing speed, and executive function; and class 3 was additionally associated with worse attention compared to class 2. The findings contribute to the development of targeted programs for treating pain and improving cognitive functioning.
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Affiliation(s)
- Hui Yuan
- School of Nursing, Xuzhou Medical University, Jiangsu, PR China
| | - Shuo Wang
- School of Nursing, Xuzhou Medical University, Jiangsu, PR China
| | - Yumei Sun
- School of Nursing, Peking University, Beijing, PR China
| | - Mengdie Liu
- School of Nursing, Xuzhou Medical University, Jiangsu, PR China
| | - Feng Wu
- School of Nursing, Xuzhou Medical University, Jiangsu, PR China
| | - Hongyu Sun
- School of Nursing, Peking University, Beijing, PR China.
| | - Fang Zhou
- School of Nursing, Xuzhou Medical University, Jiangsu, PR China.
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de Melo TS, Barbosa IDO, Menegalli-Santos L, de Castro GF, Trishina A, Santos-de-Araújo AD, Prati JM, Pontes-Silva A, Zharikov Y. Microglia role in the pain phenomenon. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 70:e20230891. [PMID: 38126413 PMCID: PMC10740183 DOI: 10.1590/1806-9282.20230891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 08/11/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Thayná Soares de Melo
- Universidade Federal de São Carlos, Physical Therapy Department – São Carlos (SP), Brazil
| | | | | | | | - Aleksandra Trishina
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Institute of Clinical Medicine – Moscow, Russia
| | | | - José Mário Prati
- Universidade Federal de São Carlos, Physical Therapy Department – São Carlos (SP), Brazil
| | - André Pontes-Silva
- Universidade Federal de São Carlos, Physical Therapy Department – São Carlos (SP), Brazil
| | - Yury Zharikov
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Department of Human Anatomy and Histology – Moscow, Russia
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