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Tanaka K, Kuzumaki N, Hamada Y, Suda Y, Mori T, Nagumo Y, Narita M. Elucidation of the mechanisms of exercise-induced hypoalgesia and pain prolongation due to physical stress and the restriction of movement. NEUROBIOLOGY OF PAIN (CAMBRIDGE, MASS.) 2023; 14:100133. [PMID: 37274841 PMCID: PMC10239008 DOI: 10.1016/j.ynpai.2023.100133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 06/07/2023]
Abstract
Persistent pain signals cause brain dysfunction and can further prolong pain. In addition, the physical restriction of movement (e.g., by a cast) can cause stress and prolong pain. Recently, it has been recognized that exercise therapy including rehabilitation is effective for alleviating chronic pain. On the other hand, physical stress and the restriction of movement can prolong pain. In this review, we discuss the neural circuits involved in the control of pain prolongation and the mechanisms of exercise-induced hypoalgesia (EIH). We also discuss the importance of the mesolimbic dopaminergic network in these phenomena.
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Affiliation(s)
- Kenichi Tanaka
- Department of Pharmacology, Hoshi University School of Pharmacy and Pharmaceutical Sciences, 2-4-41 Ebara, Shinagawa-ku, Tokyo 142-8501, Japan
- Division of Cancer Pathophysiology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Naoko Kuzumaki
- Department of Pharmacology, Hoshi University School of Pharmacy and Pharmaceutical Sciences, 2-4-41 Ebara, Shinagawa-ku, Tokyo 142-8501, Japan
- Division of Cancer Pathophysiology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Yusuke Hamada
- Department of Pharmacology, Hoshi University School of Pharmacy and Pharmaceutical Sciences, 2-4-41 Ebara, Shinagawa-ku, Tokyo 142-8501, Japan
- Division of Cancer Pathophysiology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Yukari Suda
- Department of Pharmacology, Hoshi University School of Pharmacy and Pharmaceutical Sciences, 2-4-41 Ebara, Shinagawa-ku, Tokyo 142-8501, Japan
- Division of Cancer Pathophysiology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Tomohisa Mori
- Department of Pharmacology, Hoshi University School of Pharmacy and Pharmaceutical Sciences, 2-4-41 Ebara, Shinagawa-ku, Tokyo 142-8501, Japan
| | - Yasuyuki Nagumo
- Division of Cancer Pathophysiology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Minoru Narita
- Department of Pharmacology, Hoshi University School of Pharmacy and Pharmaceutical Sciences, 2-4-41 Ebara, Shinagawa-ku, Tokyo 142-8501, Japan
- Division of Cancer Pathophysiology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
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Molot J, Sears M, Marshall LM, Bray RI. Neurological susceptibility to environmental exposures: pathophysiological mechanisms in neurodegeneration and multiple chemical sensitivity. REVIEWS ON ENVIRONMENTAL HEALTH 2022; 37:509-530. [PMID: 34529912 DOI: 10.1515/reveh-2021-0043] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 08/13/2021] [Indexed: 05/23/2023]
Abstract
The World Health Organization lists air pollution as one of the top five risks for developing chronic non-communicable disease, joining tobacco use, harmful use of alcohol, unhealthy diets and physical inactivity. This review focuses on how host defense mechanisms against adverse airborne exposures relate to the probable interacting and overlapping pathophysiological features of neurodegeneration and multiple chemical sensitivity. Significant long-term airborne exposures can contribute to oxidative stress, systemic inflammation, transient receptor subfamily vanilloid 1 (TRPV1) and subfamily ankyrin 1 (TRPA1) upregulation and sensitization, with impacts on olfactory and trigeminal nerve function, and eventual loss of brain mass. The potential for neurologic dysfunction, including decreased cognition, chronic pain and central sensitization related to airborne contaminants, can be magnified by genetic polymorphisms that result in less effective detoxification. Onset of neurodegenerative disorders is subtle, with early loss of brain mass and loss of sense of smell. Onset of MCS may be gradual following long-term low dose airborne exposures, or acute following a recognizable exposure. Upregulation of chemosensitive TRPV1 and TRPA1 polymodal receptors has been observed in patients with neurodegeneration, and chemically sensitive individuals with asthma, migraine and MCS. In people with chemical sensitivity, these receptors are also sensitized, which is defined as a reduction in the threshold and an increase in the magnitude of a response to noxious stimulation. There is likely damage to the olfactory system in neurodegeneration and trigeminal nerve hypersensitivity in MCS, with different effects on olfactory processing. The associations of low vitamin D levels and protein kinase activity seen in neurodegeneration have not been studied in MCS. Table 2 presents a summary of neurodegeneration and MCS, comparing 16 distinctive genetic, pathophysiological and clinical features associated with air pollution exposures. There is significant overlap, suggesting potential comorbidity. Canadian Health Measures Survey data indicates an overlap between neurodegeneration and MCS (p < 0.05) that suggests comorbidity, but the extent of increased susceptibility to the other condition is not established. Nevertheless, the pathways to the development of these conditions likely involve TRPV1 and TRPA1 receptors, and so it is hypothesized that manifestation of neurodegeneration and/or MCS and possibly why there is divergence may be influenced by polymorphisms of these receptors, among other factors.
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Affiliation(s)
- John Molot
- Family Medicine, University of Ottawa Faculty of Medicine, North York, ON, Canada
| | | | | | - Riina I Bray
- Family and Community Medicine, University of Toronto, Toronto, ON, Canada
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Angelopoulou E, Papadopoulos AN, Spantideas N, Bougea A. Migraine, Tension-Type Headache and Parkinson's Disease: A Systematic Review and Meta-Analysis. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:1684. [PMID: 36422223 PMCID: PMC9697239 DOI: 10.3390/medicina58111684] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 11/12/2022] [Accepted: 11/17/2022] [Indexed: 12/01/2023]
Abstract
Background and Objectives: The relationship between migraine and tension-type headache (TTH) with Parkinson's disease (PD) is controversial, while a common pathophysiological link remains obscure. The aim of this systematic review is to investigate the association between PD, migraine and TTH. Materials and Methods: Following PRISMA, we searched MEDLINE, WebofScience, Scopus, CINAHL, Cochrane Library and ClinicalTrials.gov up to 1 July 2022 for observational studies examining the prevalence and/or associations of PD with migraine and TTH. We pooled proportions, standardized mean differences (SMD) and odds ratios (OR) with random effects models. The risk of bias was assessed with the Newcastle-Ottawa scale (PROSPERO CRD42021273238). Results: Out of 1031 screened studies, 12 were finally included in our review (median quality score 6/9). The prevalence of any headache among PD patients was estimated at 49.1% (760 PD patients; 95% CI 24.8-73.6), migraine prevalence at 17.2% (1242 PD patients; 95% CI 9.9-25.9), while 61.5% (316 PD patients; 95% CI 52.6-70.1) of PD patients with migraine reported headache improvement after PD onset. Overall, migraine was not associated with PD (302,165 individuals; ORpooled = 1.11; 95% CI 0.72-1.72).However, cohort studies demonstrated a positive association of PD among lifetime migraineurs (143,583 individuals; ORpooled = 1.54, 95% CI 1.28-1.84), while studies on 12-month migraine prevalence yielded an inverse association (5195 individuals; ORpooled = 0.64, 95% CI 0.43-0.97). Similar findings were reported by 3 studies with data on the TTH-PD relationship (high prevalence, positive association when examined prospectively and an inverse relationship on 12-month prevalence). These data were not quantitatively synthesized due to methodological differences among the studies. Finally, PD patients suffering from any headache had a lower motor unified Parkinson's disease rating scale (UPDRS) score (503 PD patients; SMD -0.39; 95% CI -0.57 to -0.21) compared to PD patients not reporting headache. There is an unclear association of headaches in genetic PD cohorts. Conclusions: Observational data suggest that migraine and TTH could be linked to PD, but the current literature is conflicting.
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Affiliation(s)
- Efthalia Angelopoulou
- Department of Neurology, Medical School, Eginition Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Andreas Nikolaos Papadopoulos
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Nikolaos Spantideas
- Department of Neurology, Medical School, Eginition Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Anastasia Bougea
- Department of Neurology, Medical School, Eginition Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
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Proinflammatory profile in the skin of Parkinson's disease patients with and without pain. PLoS One 2022; 17:e0276564. [PMID: 36301901 PMCID: PMC9612575 DOI: 10.1371/journal.pone.0276564] [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: 08/12/2022] [Accepted: 10/08/2022] [Indexed: 11/05/2022] Open
Abstract
Background Pain is a common non-motor symptom of Parkinson`s disease (PD), however, its pathomechanism remains elusive. Objective We aimed to investigate the local gene expression of selected proinflammatory mediators in patients with PD and correlated our data with patients`pain phenotype. Methods We recruited 30 patients with PD and 30 healthy controls. Pain intensity of patients was assessed using the Numeric Rating Scale (NRS) and patients were stratified into PD pain (NRS≥4) and PD No Pain (NRS<4) subgroups. Skin punch biopsies were immunoassayed for protein-gene product 9.5 as a pan-neuronal marker and intraepidermal nerve fiber density (IEFND). Quantitative real-time polymerase chain reaction (qRT-PCR) analysis was performed to assess the gene expression of inflammatory mediators in the skin compared to controls. Results Patients with PD had lower distal IENFD compared to healthy controls. In skin samples, IL-2 (p<0.001) and TNF-α (p<0.01) were expressed higher in PD patients compared to controls. IL-1β (p<0.05) was expressed higher in the PD pain group compared to healthy controls. PD patients with pain receiving analgesics had a lower expression of TNF-α (p<0.05) in the skin compared to those not receiving treatment. Conclusions Our data suggest the occurrence of a local, peripheral inflammatory response in the skin in PD, but do not support this being a relevant factor contributing to pain in PD.
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Yang QH, Zhang YH, Du SH, Wang YC, Fang Y, Wang XQ. Non-invasive Brain Stimulation for Central Neuropathic Pain. Front Mol Neurosci 2022; 15:879909. [PMID: 35663263 PMCID: PMC9162797 DOI: 10.3389/fnmol.2022.879909] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 05/04/2022] [Indexed: 12/15/2022] Open
Abstract
The research and clinical application of the noninvasive brain stimulation (NIBS) technique in the treatment of neuropathic pain (NP) are increasing. In this review article, we outline the effectiveness and limitations of the NIBS approach in treating common central neuropathic pain (CNP). This article summarizes the research progress of NIBS in the treatment of different CNPs and describes the effects and mechanisms of these methods on different CNPs. Repetitive transcranial magnetic stimulation (rTMS) analgesic research has been relatively mature and applied to a variety of CNP treatments. But the optimal stimulation targets, stimulation intensity, and stimulation time of transcranial direct current stimulation (tDCS) for each type of CNP are still difficult to identify. The analgesic mechanism of rTMS is similar to that of tDCS, both of which change cortical excitability and synaptic plasticity, regulate the release of related neurotransmitters and affect the structural and functional connections of brain regions associated with pain processing and regulation. Some deficiencies are found in current NIBS relevant studies, such as small sample size, difficulty to avoid placebo effect, and insufficient research on analgesia mechanism. Future research should gradually carry out large-scale, multicenter studies to test the stability and reliability of the analgesic effects of NIBS.
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Affiliation(s)
- Qi-Hao Yang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Yong-Hui Zhang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Shu-Hao Du
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Yu-Chen Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Yu Fang
- School of Mechanical and Automotive Engineering, Shanghai University of Engineering Science, Shanghai, China
- *Correspondence: Yu Fang,
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
- Xue-Qiang Wang,
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Chu ECP, Chen ATC, Chiang R. Chiropractic care of Parkinson's disease and deformity. J Med Life 2022; 15:717-722. [PMID: 35815091 PMCID: PMC9262267 DOI: 10.25122/jml-2021-0418] [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: 12/22/2021] [Accepted: 03/07/2022] [Indexed: 11/19/2022] Open
Abstract
Parkinson's disease (PD) is a progressive neurological disease characterized by muscle stiffness, tremor, slowness of movement, and difficulties with posture and walking. Muscle and joint pain are frequent non-motor symptoms of PD. Pain associated with PD is mainly caused by a combination of truncal dystonia, stooped posture, and muscle rigidity. However, PD deformities were rarely discussed in the literature. A 68-year-old Asian female with PD treated with Levodopa for six years complained of progressive neck pain, contractures, and subluxation of both hands in the last two years. A positron emission tomography (PET) scan revealed decreased rostrocaudal gradient uptake in both posterior putamen. After 9 months of multimodal chiropractic rehabilitation, the patient had significant improvement in symptoms, including pain resolution as per the numeric rating scale and physical and mental improvement as per the PD questionnaire. Radiographic measurement showed significantly improved postural alignment and stability. Measurement of joint motion and angles showed an improvement in hand deformity. Although PD is a neurodegenerative disease that is not curable, multimodal rehabilitation may improve neurological and musculoskeletal functions by inducing proprioceptive balance, motor strength, and joint movement. The current study may illustrate multimodal rehabilitation addressing orthopedic deformity associated with symptoms in a PD patient.
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Affiliation(s)
- Eric Chun-Pu Chu
- New York Chiropractic and Physiotherapy Centre, EC Healthcare, Hong Kong SAR, China,Corresponding Author: Eric Chun-Pu Chu, New York Chiropractic and Physiotherapy Centre, EC Healthcare, Hong Kong SAR, China. E-mail:
| | - Alan Te-Chang Chen
- New York Chiropractic and Physiotherapy Centre, EC Healthcare, Hong Kong SAR, China
| | - Ricky Chiang
- School of Health and Rehabilitation Sciences, University of Queensland, St. Lucia, Australia
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Odira HO, Mitema SO, Mapenay IM, Moriasi GA. Anti-inflammatory, Analgesic, and Cytotoxic Effects of The Phytexponent: A Polyherbal Formulation. J Evid Based Integr Med 2022; 27:2515690X221082986. [PMID: 35230885 PMCID: PMC8891872 DOI: 10.1177/2515690x221082986] [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] [Indexed: 11/16/2022] Open
Abstract
The Phytexponent is used to treat pain and inflammation in complementary and alternative medicine practices; however, empirical data supporting its pharmacological efficacy and safety is scanty, hence the present study. We used the carrageenan-induced paw oedema and the acetic acid-induced writhing techniques to determine the anti-inflammatory and analgesic efficacies, respectively, of the Phytexponent in Swiss albino mice models. The 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay technique was used to investigate the in vitro cytotoxic effects of the Phytexponent in the Vero E6 cell line. The Phytexponent exerted significant (P < .05) anti-inflammatory effects in the carrageenan-induced paw oedema mouse model in a dose- and time-dependent manner, with significantly higher efficacy at 250 mg/Kg BW, than indomethacin (4 mg/Kg BW), in the first, second, and third hour (P < .05). Besides, the Phytexponent significantly reduced the acetic acid-induced writhing frequency in mice (P < .05), in a dose-dependent manner, depicting its analgesic efficacy. Notably, the Phytexponent (at doses: 125 mg/Kg BW and 250 mg/Kg BW) exhibited significantly higher analgesic efficacy than the Indomethacin (P<.05). Moreover, the Phytexponent was not cytotoxic to Vero E6 cells (CC50 >1000 µg/ml) compared to cyclophosphamide (CC50 = 2.48 µg/ml). Thus, the Phytexponent has significant in vivo anti-inflammatory and analgesic efficacy in mice models and is not cytotoxic to Vero E6 cell line, depicting its therapeutic potential upon further empirical investigation.
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Affiliation(s)
- Halvince O. Odira
- Department of Public Health, Pharmacology, and Toxicology, College of Veterinary and Agricultural Sciences, University of Nairobi, Nairobi, Kenya
| | - Simon O. Mitema
- Department of Public Health, Pharmacology, and Toxicology, College of Veterinary and Agricultural Sciences, University of Nairobi, Nairobi, Kenya
| | - Isaac M. Mapenay
- Department of Public Health, Pharmacology, and Toxicology, College of Veterinary and Agricultural Sciences, University of Nairobi, Nairobi, Kenya
| | - Gervason A. Moriasi
- Department of Medical Biochemistry, School of Medicine, College of Health Sciences, Mount Kenya University, Thika, Kenya
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Gao L, Huang W, Cai L, Peng Y. Pain Assessment in Chinese Parkinson’s Disease Patients Using King’s Parkinson’s Disease Pain Scale. J Pain Res 2022; 15:715-722. [PMID: 35300403 PMCID: PMC8922447 DOI: 10.2147/jpr.s353249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/26/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Patients and Methods Results Conclusion
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Affiliation(s)
- Liang Gao
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China
| | - Weiling Huang
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China
| | - Laisheng Cai
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China
| | - Yufen Peng
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China
- Correspondence: Yufen Peng; Liang Gao, Tel +86 791-88692511, Email ;
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Chu ECP, Wong AYL, Lee LYK. Chiropractic care for low back pain, gait and posture in a patient with Parkinson's disease: a case report and brief review. AME Case Rep 2021; 5:34. [PMID: 34805753 PMCID: PMC8572672 DOI: 10.21037/acr-21-27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 06/09/2021] [Indexed: 11/06/2022]
Abstract
Parkinson's disease (PD) is a progressive neurological disorder with cardinal motor features of tremor, bradykinesia, muscle rigidity, impaired gait and posture. Muscular pain or arthralgia is a common non-motor symptom in PD. The PD-related pain is probably attributed to a combination of altered posture, abnormal muscle tone, and truncal dystonia. A 59-year-old male taxi-driver with PD treated with levodopa for 18 months complained of progressive low back pain and gait difficulties that prevented him from normal activities in the past 2 months. Magnetic resonance imaging showed degenerative disc disease with multiple levels of bulging discs in the lumbar spine. After 35 chiropractic sessions, there was a significant improvement in various aspects of well-being, including pain resolution measured by a numeric rating scale, physical and mental improvement measured by the Parkinson's Disease Questionnaire, gait stability depicted by gait cyclogram, and better postural alignment and stability assessed by radiographic parameters. The current study may serve as an example of spinal manipulation showing the potential to address gait and posture problems associated with pain in a patient with PD. Aging changes in the muscles, bones and joints may accompany PD. Although PD itself is an incurable neurodegenerative disease, functional capacity of the musculoskeletal system can be enhanced by different types of manual therapy, by means of improving muscle strength, joint mobility, and postural balance. The actual duration in sustaining improved outcomes following a course of manipulative intervention remains to be determined.
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Affiliation(s)
- Eric Chun Pu Chu
- New York Chiropractic and Physiotherapy Centre, 41/F Langham Place Office Tower, Hong Kong, China
| | - Arnold Yu Lok Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Linda Yin King Lee
- School of Nursing and Health Studies, The Open University of Hong Kong, Hong Kong, China
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Cruz-Almeida Y, Crowley SJ, Tanner J, Price CC. Pain Severity and Interference in Different Parkinson's Disease Cognitive Phenotypes. J Pain Res 2020; 13:3493-3497. [PMID: 33402845 PMCID: PMC7778379 DOI: 10.2147/jpr.s270669] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 10/29/2020] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Chronic pain is prevalent in idiopathic Parkinson's disease (PD) with many individuals also experiencing cognitive deficits negatively impacting everyday life. METHODS In this study, we examine differences in pain severity and interference between 113 nondemented individuals with idiopathic PD who were statistically classified as having low executive function (n=24), low memory function (n=35), no cognitive deficits (n=54). The individuals with PD were also compared to matched non-PD controls (n=64). RESULTS PD participants with low executive function reported significantly higher pain interference (p<0.05), despite reporting similar pain severity levels compared to other phenotypes. These differences remained statistically significant, even after accounting for important confounders such as anxiety and depression (p<0.05). DISCUSSION Pain interference in those with lower executive function may represent a target for psychosocial interventions for individuals with pain and PD.
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Affiliation(s)
- Yenisel Cruz-Almeida
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | - Samuel J Crowley
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Jared Tanner
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Catherine C Price
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
- Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
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Duncan RP, Van Dillen LR, Garbutt JM, Earhart GM, Perlmutter JS. Low Back Pain--Related Disability in Parkinson Disease: Impact on Functional Mobility, Physical Activity, and Quality of Life. Phys Ther 2019; 99:1346-1353. [PMID: 31343700 PMCID: PMC6821152 DOI: 10.1093/ptj/pzz094] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 11/08/2018] [Accepted: 02/20/2019] [Indexed: 01/23/2023]
Abstract
BACKGROUND People with Parkinson disease (PD) frequently experience low back pain (LBP), yet the impact of LBP on functional mobility, physical activity, and quality of life (QOL) has not been described in PD. OBJECTIVE The objectives of this study were to describe body positions and functional activities associated with LBP and to determine the relationships between LBP-related disability and PD motor sign severity, physical activity level, and QOL. DESIGN The study was a cross-sectional study. METHODS Thirty participants with idiopathic PD (mean age = 64.6 years [SD = 10.3]; 15 women) completed the Revised Oswestry Disability Questionnaire (RODQ), a measure of LBP-related disability. PD motor symptom severity was measured using the Movement Disorder Society-Unified Parkinson Disease Rating Scale Part III (MDS-UPRDS III). The Physical Activity Scale for the Elderly (PASE) was used to measure self-reported physical activity. The Parkinson Disease Questionnaire-39 (PDQ-39) was used to measure QOL. Descriptive statistics were used to characterize LBP intensity and LBP-related disability. Spearman correlations were used to determine relationships between the RODQ and the MDS-UPDRS III, PASE, and PDQ-39. RESULTS LBP was reported to be of at least moderate intensity by 63.3% of participants. LBP most frequently impaired standing, sleeping, lifting, and walking. The RODQ was significantly related to the MDS-UPDRS III (r = 0.38), PASE (r = -0.37), PDQ-39 summary index (r = 0.55), PDQ-39 mobility subdomain (r = 0.54), and PDQ-39 bodily pain subdomain (r = 0.44). LIMITATIONS Limitations included a small sample of people with mild to moderate PD severity, the fact that RODQ is a less frequently used measure of LBP-related disability, and the lack of a non-PD control group. CONCLUSIONS LBP affected walking, sleeping, standing, and lifting in this small sample of people with mild to moderate PD. Greater LBP-related disability was associated with greater motor sign severity, lower physical activity level, and lower QOL in people with PD.
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Affiliation(s)
- Ryan P Duncan
- Program in Physical Therapy, Washington University School of Medicine in Saint Louis, 4444 Forest Park Blvd, Campus Box 8502, St Louis, MO 63108 (USA)
- Department of Neurology, Washington University School of Medicine in Saint Louis
| | - Linda R Van Dillen
- Program in Physical Therapy, and Department of Orthopaedic Surgery, Washington University School of Medicine in Saint Louis
| | - Jane M Garbutt
- Department of Medicine, and Department of Pediatrics, Washington University School of Medicine in Saint Louis
| | - Gammon M Earhart
- Program in Physical Therapy, Department of Neurology, and Department of Neuroscience, Washington University School of Medicine in Saint Louis
| | - Joel S Perlmutter
- Department of Neurology, Program in Physical Therapy, Department of Neuroscience, Department of Radiology, and Program in Occupational Therapy, Washington University School of Medicine in Saint Louis
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Mlost J, Wąsik A, Michaluk JT, Antkiewicz-Michaluk L, Starowicz K. Changes in Monoaminergic Neurotransmission in an Animal Model of Osteoarthritis: The Role of Endocannabinoid Signaling. Front Mol Neurosci 2018; 11:466. [PMID: 30618615 PMCID: PMC6306412 DOI: 10.3389/fnmol.2018.00466] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 12/03/2018] [Indexed: 12/18/2022] Open
Abstract
Chronic pain is a main symptom of osteoarthritis (OA). Moreover, a high percentage of OA patients suffer from mental health problems. The endocannabinoid (EC) system has attracted attention as an emerging drug target for pain treatment together with its activity on the mesolimbic reward system. Understanding the circuits that govern the reward of pain relief is crucial for the search for effective analgesics. Therefore, we investigated the role of the EC system on dopamine (DA) and noradrenaline (NA) in an animal model of OA-related chronic pain. OA rats exhibited significant decreases in DA metabolism in the nucleus accumbens (NAc), striatum (STR) and hippocampus (HC). NA metabolism was also significantly decreased by chronic pain in OA rats; however, this disruption was limited to the frontal cortex (FCx) and HC. URB597 (an inhibitor of EC metabolism) treatment completely reversed the decreased DA metabolism, especially in the brain reward system and the HC. Furthermore, administration of URB597 normalized the impairment of NA activity in the HC but potentiated the decreased NA levels in the FCx. Our results demonstrated that chronic pain in OA rats was reflected by the inhibition of mesolimbic and mesocortical dopaminergic transmission, and may indicate the pro-pain role of NA in the FCx. The data provide understanding about changes in neurotransmission in chronic pain states and may explain the clinical improvement in perceived life quality following cannabinoid treatment. Additional mechanistic studies in preclinical models examining the intersection between chronic pain and reward circuits may offer new approaches for improving pain therapy.
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Affiliation(s)
- Jakub Mlost
- Department of Neurochemistry, Institute of Pharmacology, Polish Academy of Sciences, Kraków, Poland
| | - Agnieszka Wąsik
- Department of Neurochemistry, Institute of Pharmacology, Polish Academy of Sciences, Kraków, Poland
| | - Jerzy Tadeusz Michaluk
- Department of Neurochemistry, Institute of Pharmacology, Polish Academy of Sciences, Kraków, Poland
| | | | - Katarzyna Starowicz
- Department of Neurochemistry, Institute of Pharmacology, Polish Academy of Sciences, Kraków, Poland
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DosSantos MF, Moura BDS, DaSilva AF. Reward Circuitry Plasticity in Pain Perception and Modulation. Front Pharmacol 2017; 8:790. [PMID: 29209204 PMCID: PMC5702349 DOI: 10.3389/fphar.2017.00790] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Accepted: 10/19/2017] [Indexed: 12/30/2022] Open
Abstract
Although pain is a widely known phenomenon and an important clinical symptom that occurs in numerous diseases, its mechanisms are still barely understood. Owing to the scarce information concerning its pathophysiology, particularly what is involved in the transition from an acute state to a chronic condition, pain treatment is frequently unsatisfactory, therefore contributing to the amplification of the chronic pain burden. In fact, pain is an extremely complex experience that demands the recruitment of an intricate set of central nervous system components. This includes cortical and subcortical areas involved in interpretation of the general characteristics of noxious stimuli. It also comprises neural circuits that process the motivational-affective dimension of pain. Hence, the reward circuitry represents a vital element for pain experience and modulation. This review article focuses on the interpretation of the extensive data available connecting the major components of the reward circuitry to pain suffering, including the nucleus accumbens, ventral tegmental area, and the medial prefrontal cortex; with especial attention dedicated to the evaluation of neuroplastic changes affecting these structures found in chronic pain syndromes, such as migraine, trigeminal neuropathic pain, chronic back pain, and fibromyalgia.
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Affiliation(s)
- Marcos F. DosSantos
- Laboratório de Morfogênese Celular, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Brenda de Souza Moura
- Programa de Pós-Graduação em Radiologia, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Alexandre F. DaSilva
- Headache and Orofacial Pain Effort, Department of Biologic and Materials Sciences, School of Dentistry, Center for Human Growth and Development, Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States
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Rotigotine transdermal patch and sleep in Parkinson's disease: where are we now? NPJ PARKINSONS DISEASE 2017; 3:28. [PMID: 28890931 PMCID: PMC5585311 DOI: 10.1038/s41531-017-0030-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 08/08/2017] [Accepted: 08/10/2017] [Indexed: 11/25/2022]
Abstract
A wide range of sleep dysfunction complicates Parkinson’s disease during its course from prodromal to palliative stage. It is now increasingly acknowledged that sleep disturbances are thus integral to the disease and pose a significant burden impacting on quality of life of patients. Sleep fragmentation, restless legs syndrome, nocturia, and nocturnal pain are regarded as one of the main components of night-time sleep dysfunction with possible secondary impact on cognition and well-being. The role of dopaminergic therapies, particularly using a continuous drug delivery strategy in managing some of these sleep issues, have been reported but the overall concept remains unclear. This review provides an overview of several aspects of night-time sleep dysfunction in Parkinson’s disease and describes all available published open-label and blinded studies that investigated the use of rotigotine transdermal patch targeting sleep. Blinded studies have suggested beneficial effects of rotigotine transdermal patch on maintenance insomnia and restless legs syndrome in Parkinson’s disease patients. Open-label studies support these observations and also suggest beneficial effects on nocturia and nocturnal pain.
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