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Edwards KA, Lii T, Schouten TD, Kearney KM, Ziadni MS, Darnall BD, Mackey SC, Gilam G. Is There an Association Between Lateralization of Chronic Pain in the Body and Depression? THE JOURNAL OF PAIN 2024:S1526-5900(24)00371-7. [PMID: 38341013 DOI: 10.1016/j.jpain.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/20/2024] [Accepted: 02/03/2024] [Indexed: 02/12/2024]
Abstract
Depression commonly co-occurs with chronic pain and can worsen pain outcomes. Recent theoretical work has hypothesized that pain localized to the left hemibody is a risk factor for worse depression due to overlap in underlying neural substrates. This hypothesis has not been tested a priori. Using a large sample of treatment-seeking adults with mixed-etiology chronic pain (N = 1,185), our cross-sectional study tested whether patients with left-sided pain endorse worse depressive symptoms. We also examined differences in other pain-related functioning measures. We tested 4 comparisons based on painful body areas using the CHOIR body map: 1) only left-sided (OL) versus any right-sided pain; 2) only right-sided (OR) versus any left-sided pain; 3) OL versus OR versus bilateral pain; and 4) more left-sided versus more right-sided versus equal-sided pain. Analysis of variance models showed OL pain was not associated with worse depression (F = 5.50, P = .019). Any left-sided pain was associated with worse depression, though the effect was small (F = 8.58, P = .003, Cohens d = .29). Bilateral pain was associated with worse depression (F = 8.05, P < .001, Cohens d = .24-.33). Regardless of pain location, more body areas endorsed was associated with greater depression. Although a more rigorous assessment of pain laterality is needed, our findings do not support the hypothesis that left-lateralized pain is associated with worse depression. PERSPECTIVE: Pain lateralized to the left side of the body has been hypothesized as a risk factor for worse depression in chronic pain, despite never being tested in a large, real-world sample of patients with chronic pain. Findings showed that more widespread pain, not pain laterality, was associated with worse depression.
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Affiliation(s)
- Karlyn A Edwards
- Division of Pain Medicine, Department of Anesthesiology, Perioperative & Pain Medicine, Stanford University School of Medicine, Stanford, California
| | - Theresa Lii
- Division of Pain Medicine, Department of Anesthesiology, Perioperative & Pain Medicine, Stanford University School of Medicine, Stanford, California
| | - Troy D Schouten
- Division of Pain Medicine, Department of Anesthesiology, Perioperative & Pain Medicine, Stanford University School of Medicine, Stanford, California
| | - Katherine M Kearney
- Division of Pain Medicine, Department of Anesthesiology, Perioperative & Pain Medicine, Stanford University School of Medicine, Stanford, California
| | - Maisa S Ziadni
- Division of Pain Medicine, Department of Anesthesiology, Perioperative & Pain Medicine, Stanford University School of Medicine, Stanford, California
| | - Beth D Darnall
- Division of Pain Medicine, Department of Anesthesiology, Perioperative & Pain Medicine, Stanford University School of Medicine, Stanford, California
| | - Sean C Mackey
- Division of Pain Medicine, Department of Anesthesiology, Perioperative & Pain Medicine, Stanford University School of Medicine, Stanford, California
| | - Gadi Gilam
- Division of Pain Medicine, Department of Anesthesiology, Perioperative & Pain Medicine, Stanford University School of Medicine, Stanford, California; Institute of Biomedical and Oral Research, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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Ikwuegbuenyi CA, Ooi SZY, Takoutsing BD, Jesuyajolu DA, Nwanmah C, Olobatoke T, Ogunfolaji O, David S, Ojo T, Umutoni A. Current state of management and outcomes of facial nerve palsy in low-income and middle-income countries: a scoping review protocol. BMJ Open 2023; 13:e065435. [PMID: 36596636 PMCID: PMC9815042 DOI: 10.1136/bmjopen-2022-065435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION The aim of the protocol is to present the methodology of a scoping review that aims to synthesise up-to-date evidence on the management and outcomes of facial nerve palsy in low-income and middle-income countries (LMICs). METHODS AND ANALYSIS The scoping review will be conducted per the Arksey and O'Malley's framework and the Joanna Briggs Institute Reviewers' Manual. The scoping review question, eligibility criteria and search strategy will be developed in accordance to the Population, Concept, and Context strategy. The search will be conducted in electronic bibliographic databases (Medline (OVID), Embase, WHO Global Index Medicus, Cochrane Library, Global Health, African Journals Online). The review will synthesise and report the findings with descriptive statistics and a narrative description of both quantitative and qualitative evidence. ETHICS AND DISSEMINATION This scoping review does not require ethical approval. This protocol will describe the proposed scoping review that will map the evidence on the management and outcomes of facial nerve palsies in LMICs. The proposed review aims to collate and summarise published literature to inform policy-makers and healthcare organisations and governments and to identify knowledge gaps that will translate into future research priorities in LMICs.
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Affiliation(s)
| | | | | | | | | | - Tunde Olobatoke
- Association of Future African Neurosurgeons, Yaounde, Cameroon
| | | | - Samuel David
- Association of Future African Neurosurgeons, Yaounde, Cameroon
| | - Tioluwani Ojo
- Association of Future African Neurosurgeons, Yaounde, Cameroon
| | - Alice Umutoni
- Association of Future African Neurosurgeons, Yaounde, Cameroon
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Rist TM, Segars K, Oyer SL. Influence of Subclinical Anxiety and Depression on Quality of Life and Perception of Facial Paralysis. Facial Plast Surg Aesthet Med 2023; 25:27-31. [PMID: 35984930 DOI: 10.1089/fpsam.2022.0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Introduction: Patients with facial paralysis have increased psychosocial distress, which affects overall quality of life (QOL). Objective: To evaluate the relationship between QOL and paralysis severity among patients with subclinical anxiety and/or depression. Methods: Patients with facial paralysis were screened for anxiety and depression using the Generalized Anxiety Disorder-2 and Patient Health Questionnaire-2 surveys. QOL scores (Facial Clinimetric Evaluation) and paralysis severity scores (House-Brackmann [HB] and Sunnybrook [SB]) were collected. Patients with a mental health diagnosis or treatment were excluded. Univariate and multivariate analyses and Pearson's correlations were performed after stratifying by anxiety and/or depression screenings. Results: Positive anxiety and depression screening rates were 25.78% and 22.66%, respectively. Patients screening positive had significantly worse QOL scores despite no difference in paralysis severity. QOL scores did not correlate with SB scores among patients who screened positive for depression. Conclusion: Patients screening positive for anxiety and/or depression demonstrated worse QOL, which did not correlate with paralysis severity suggesting that health care professionals should remain alert to mental health symptoms when QOL impairment is out of proportion with the severity of paralysis.
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Affiliation(s)
- Tyler M Rist
- Department of Otolaryngology Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Kelly Segars
- Department of Radiology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Samuel L Oyer
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology Head and Neck Surgery, University of Virginia, Charlottesville, Virginia, USA
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Song GM, Mou KJ. Effect of the acupuncture within 24 hour after the onset of peripheral facial paralysis. Asian J Surg 2022; 45:3024. [PMID: 35850903 DOI: 10.1016/j.asjsur.2022.06.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 06/30/2022] [Indexed: 12/15/2022] Open
Affiliation(s)
- Guo-Min Song
- Department of Rehabilitation Medicine, Bishan Hospital of Chongqing Medical University, Bishan Hospital of Chongqing, Chongqing, 400000, China
| | - Ke-Jie Mou
- Department of Neurosurgery, Bishan Hospital of Chongqing Medical University, Bishan Hospital of Chongqing, Chongqing, 400000, China.
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Maallo AMS, Moulton EA, Sieberg CB, Giddon DB, Borsook D, Holmes SA. A lateralized model of the pain-depression dyad. Neurosci Biobehav Rev 2021; 127:876-883. [PMID: 34090918 DOI: 10.1016/j.neubiorev.2021.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/01/2021] [Indexed: 11/25/2022]
Abstract
Chronic pain and depression are two frequently co-occurring and debilitating conditions. Even though the former is treated as a physical affliction, and the latter as a mental illness, both disorders closely share neural substrates. Here, we review the association of pain with depression, especially when symptoms are lateralized on either side of the body. We also explore the overlapping regions in the forebrain implicated in these conditions. Finally, we synthesize these findings into a model, which addresses gaps in our understanding of comorbid pain and depression. Our lateralized pain-depression dyad model suggests that individuals diagnosed with depression should be closely monitored for pain symptoms in the left hemibody. Conversely, for patients in pain, with the exception of acute pain with a known source, referrals in today's pain centers for psychological evaluation should be part of standard practice, within the framework of an interdisciplinary approach to pain treatment.
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Affiliation(s)
- Anne Margarette S Maallo
- Center for Pain and the Brain, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Eric A Moulton
- Center for Pain and the Brain, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Christine B Sieberg
- Center for Pain and the Brain, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Biobehavioral Pediatric Pain Lab, Department of Psychiatry & Behavioral Sciences, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Donald B Giddon
- Harvard School of Dental Medicine, Harvard University, Boston, MA, USA; Pain Management Center, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - David Borsook
- Harvard Medical School, Boston, MA, USA; Departments of Psychiatry and Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Scott A Holmes
- Center for Pain and the Brain, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
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Klassen AF, Rae C, Gallo L, Norris JH, Bogart K, Johnson D, Van Laeken N, Baltzer HL, Murray DJ, Hol MLF, O T, Wong Riff KWY, Cano SJ, Pusic AL. Psychometric Validation of the FACE-Q Craniofacial Module for Facial Nerve Paralysis. Facial Plast Surg Aesthet Med 2021; 24:1-7. [PMID: 33826408 DOI: 10.1089/fpsam.2020.0575] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Systematic reviews have identified the need for a patient-reported outcome measure for facial nerve paralysis (FNP). The aim of this study was to determine the psychometric properties of FACE-Q Craniofacial module scales when used in a combined sample of children and older adults with FNP. Methods: Data were collected between December 2016 and December 2019. We conducted qualitative interviews with children and adults with FNP. FACE-Q data were collected from patients aged 8 years and older with FNP. Rasch measurement theory analysis was used to examine the reliability and validity of the relevant scales in the FNP sample. Results: Twenty-five patients provided 2052 qualitative codes related to appearance, physical, psychological, and social function. Many patient concerns were common across age. The field-test sample included 235 patients aged 8-81 years. Of the 13 scales examined, all 122 items had ordered thresholds and good item fit to the Rasch model. For 12 scales, person separation index values were ≥0.79 and Cronbach's alpha values were ≥0.82. The 13th scale's reliability values were ≥0.71. Conclusion: The FACE-Q Craniofacial module scales described in this study can be used to collect and compare evidence-based outcome data from children and adults with FNP.
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Affiliation(s)
- Anne F Klassen
- Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Charlene Rae
- Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Lucas Gallo
- Division of Plastic Surgery, McMaster University, Hamilton, Canada
| | - Jonathan H Norris
- Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, United Kingdom
| | - Kathleen Bogart
- School of Psychological Science, Oregon State University, Corvallis, Oregon, USA
| | - David Johnson
- Oxford Craniofacial Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Nancy Van Laeken
- Division of Plastic Surgery, University of British Columbia, Vancouver, Canada
| | - Heather L Baltzer
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Toronto, University Health Network, Toronto, Canada
| | - Dylan J Murray
- National Paediatric Craniofacial Centre, Children's Health Ireland, Dublin, Ireland.,Department of Plastic Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Marinka L F Hol
- Department of Otolaryngocoloy and Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Teresa O
- Department of Otolaryngology-Head and Neck Surgery, Vascular Birthmark Institute of New York, Lenox Hill/Manhattan Eye, Ear and Throat Hospitals, New York, New York, USA
| | - Karen W Y Wong Riff
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Hospital for Sick Children, Ontario, Canada
| | - Stefan J Cano
- Modus Outcomes, Letchworth Garden City, United Kingdom
| | - Andrea L Pusic
- Division of Plastic and Reconstructive Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Heydenrych I. The Treatment of Facial Asymmetry with Botulinum Toxin: Current Concepts, Guidelines, and Future Trends. Indian J Plast Surg 2020; 53:219-229. [PMID: 32884188 PMCID: PMC7458832 DOI: 10.1055/s-0040-1715189] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
This article will describe facial asymmetry secondary to facial nerve paralysis (FNP), and review current concepts, guidelines, and future trends. Despite the increasing use of botulinum toxin (BoNTA) in treating FNP, ideal dosage, timing, and additional therapies are not unequivocally established. Facial asymmetry significantly impacts quality of life (QOL) by strongly affecting self-perception and social interactions; injectables may mediate great clinical improvement. This article provides practical guidelines for the use of BoNTA and provides schemes for accurate assessment and documentation. A systematic, stepwise approach is recommended with methodical assessment, meticulous placement, conservative dosage, and careful follow-up. Future trends include the potential use of newly developed toxins, muscle modification with fillers, improved imaging techniques, and targeted QOL studies. Hopefully, a growing number of aesthetic injectors may become technically proficient and join multidisciplinary teams for managing FNP.
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Affiliation(s)
- Izolda Heydenrych
- Department of Dermatology, Cape Town Cosmetic Dermatology Centre, Central Park on Esplanade, Century City, Cape Town, South Africa
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