1
|
Shillo P, Sloan G, Selvarajah D, Greig M, Gandhi R, Anand P, Edden RA, Wilkinson ID, Tesfaye S. Reduced Thalamic Ī³-Aminobutyric Acid (GABA) in Painless but Not Painful Diabetic Peripheral Neuropathy. Diabetes 2024; 73:1317-1324. [PMID: 38776434 DOI: 10.2337/db23-0921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 05/20/2024] [Indexed: 05/25/2024]
Abstract
Alterations in the structure, function, and microcirculation of the thalamus, a key brain region involved in pain pathways, have previously been demonstrated in patients with painless and painful diabetic peripheral neuropathy (DPN). However, thalamic neurotransmitter levels including Ī³-aminobutyric acid (GABA) (inhibitory neurotransmitter) and glutamate (excitatory neurotransmitter) in different DPN phenotypes are not known. We performed a magnetic resonance spectroscopy study and quantified GABA and glutamate levels within the thalamus, in a carefully characterized cohort of participants with painless and painful DPN. Participants with DPN (painful and painless combined) had a significantly lower GABA:H2O ratio compared with those without DPN (healthy volunteers [HV] and participants with diabetes without DPN [no DPN]). Participants with painless DPN had the lowest GABA:H2O ratio, which reached significance compared with HV and no DPN, but not painful DPN. There was no difference in GABA:H2O in painful DPN compared with all other groups. A significant correlation with GABA:H2O and neuropathy severity was also seen. This study demonstrates that lower levels of thalamic GABA in participants with painless DPN may reflect neuroplasticity due to reduced afferent pain impulses, whereas partially preserved levels of GABA in painful DPN may indicate that central GABAergic pathways are involved in the mechanisms of neuropathic pain in diabetes. ARTICLE HIGHLIGHTS
Collapse
Affiliation(s)
- Pallai Shillo
- Diabetes Research Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, U.K
| | - Gordon Sloan
- Diabetes Research Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, U.K
- Division of Clinical Medicine, University of Sheffield, Sheffield, U.K
| | - Dinesh Selvarajah
- Division of Clinical Medicine, University of Sheffield, Sheffield, U.K
| | - Marni Greig
- Diabetes Research Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, U.K
| | - Rajiv Gandhi
- Diabetes Research Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, U.K
| | - Praveen Anand
- Peripheral Neuropathy Unit, Imperial College London, London, U.K
| | - Richard A Edden
- Department of Neuroradiology, Johns Hopkins University, Baltimore, MD
| | - Iain D Wilkinson
- Academic Unit of Radiology, University of Sheffield, Sheffield, U.K
| | - Solomon Tesfaye
- Diabetes Research Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, U.K
| |
Collapse
|
2
|
Haidary M, Arif S, Hossaini D, Madadi S, Akbari E, Rezayee H. Pain-Insomnia-Depression Syndrome: Triangular Relationships, Pathobiological Correlations, Current Treatment Modalities, and Future Direction. Pain Ther 2024; 13:733-744. [PMID: 38814408 PMCID: PMC11255165 DOI: 10.1007/s40122-024-00614-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 05/10/2024] [Indexed: 05/31/2024] Open
Abstract
Pain-insomnia-depression syndrome (PIDS) is a complex triad of chronic pain, insomnia, and depression that has profound effects on an individual's quality of life and mental health. The pathobiological context of PIDS involves complex neurobiological and physiological mechanisms, including alterations in neurotransmitter systems and impaired pain processing pathways. The first-line therapeutic approaches for the treatment of chronic pain, depression, and insomnia are a combination of pharmacological and non-pharmacological therapies. In cases where patients do not respond adequately to these treatments, additional interventions such as deep brain stimulation (DBS) may be required. Despite advances in understanding and treatment, there are still gaps in knowledge that need to be addressed. To improve our understanding, future research should focus on conducting longitudinal studies to uncover temporal associations, identify biomarkers and genetic markers associated with PIDS, examine the influence of psychosocial factors on treatment responses, and develop innovative interventions that address the complex nature of PIDS. The aim of this study is to provide a comprehensive overview of these components and to discuss their underlying pathobiological relationships.
Collapse
Affiliation(s)
- Murtaza Haidary
- Medical Research and Technology Center, Khatam Al-Nabieen University, Kabul, Afghanistan.
| | - Shamim Arif
- Medical Research Center, Kateb University, Kabul, Afghanistan
| | - Dawood Hossaini
- Department of Biology and Microbiology, Faculty of Medical Laboratory Technology, Khatam Al-Nabieen University, Kabul, Afghanistan
| | - Shekiba Madadi
- Medical Research Center, Kateb University, Kabul, Afghanistan
| | - Elham Akbari
- Department of Biology and Microbiology, Faculty of Medical Laboratory Technology, Khatam Al-Nabieen University, Kabul, Afghanistan
| | - Hossain Rezayee
- Department of Chemistry and Biochemistry, Faculty of Medical Laboratory Technology, Khatam Al-Nabieen University, Kabul, Afghanistan
| |
Collapse
|
3
|
van Leeuwen GJ, van den Heuvel MM, Bindels PJE, Bierma-Zeinstra SMA, van Middelkoop M. Musculoskeletal pain in 13-year-old children: the generation R study. Pain 2024; 165:1806-1813. [PMID: 38345060 PMCID: PMC11247448 DOI: 10.1097/j.pain.0000000000003182] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 12/11/2023] [Accepted: 12/17/2023] [Indexed: 07/17/2024]
Abstract
ABSTRACT Musculoskeletal (MSK) pain is a common reason for consultation in general practice and frequently reported in children and adolescents. This study examined the prevalence of MSK pain in 13-year-old children and assessed associations with physical and psychosocial factors. Data from the Generation R Study, a population-based birth cohort, was used. Prevalence and characteristics of MSK pain were assessed, using a pain mannequin, at 13 years of age (N = 3062). Demographics and data on physical activity, sedentary behaviors, previous reported MSK pain, and behavioral problems were extracted from questionnaires. The body mass index (BMI) SD-score was calculated from objectively measured weight and height. A prevalence of 23.3% was found for MSK pain in children of which 87.2% persisted for more than 3 months (ie, chronic), 45.5% experienced pain daily. More physically active children and children with a higher BMI reported MSK pain more frequently compared with non-MSK pain and no pain. The knee was the most often reported location. Children with MSK pain were more likely to have reported MSK pain at 6 years. Multivariable analyses showed significant associations for male sex (OR 0.74, 95% CI 0.56-0.98), high maternal educational (OR 0.69, 95% CI 0.49-0.96), higher BMI (OR 1.19, 95% CI 1.05-1.35), being physically active (OR 1.41, 95% CI 1.03-1.91), and behavioral problems (OR 1.85, 95% CI 1.33-2.59) with the presence of MSK pain. The chronic nature of MSK pain in combination with the relatively high prevalence of MSK pain in this study shows that MSK pain is already an important problem at a young age.
Collapse
Affiliation(s)
| | | | | | - Sita M. A. Bierma-Zeinstra
- Departments of General Practice and
- Orthopedics and Sports Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | | |
Collapse
|
4
|
Liang Z, Guo Y, Sharma A, McCurdy CR, Prentice BM. Multimodal Image Fusion Workflow Incorporating MALDI Imaging Mass Spectrometry and Microscopy for the Study of Small Pharmaceutical Compounds. Anal Chem 2024; 96:11869-11880. [PMID: 38982936 DOI: 10.1021/acs.analchem.4c01553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Abstract
Multimodal imaging analyses of dosed tissue samples can provide more comprehensive insights into the effects of a therapeutically active compound on a target tissue compared to single-modal imaging. For example, simultaneous spatial mapping of pharmaceutical compounds and endogenous macromolecule receptors is difficult to achieve in a single imaging experiment. Herein, we present a multimodal workflow combining imaging mass spectrometry with immunohistochemistry (IHC) fluorescence imaging and brightfield microscopy imaging. Imaging mass spectrometry enables direct mapping of pharmaceutical compounds and metabolites, IHC fluorescence imaging can visualize large proteins, and brightfield microscopy imaging provides tissue morphology information. Single-cell resolution images are generally difficult to acquire using imaging mass spectrometry but are readily acquired with IHC fluorescence and brightfield microscopy imaging. Spatial sharpening of mass spectrometry images would thus allow for higher fidelity coregistration with other higher-resolution microscopy images. Imaging mass spectrometry spatial resolution can be predicted to a finer value via a computational image fusion workflow, which models the relationship between the intensity values in the mass spectrometry image and the features of a high-spatial resolution microscopy image. As a proof of concept, our multimodal workflow was applied to brain tissue extracted from a Sprague-Dawley rat dosed with a kratom alkaloid, corynantheidine. Four candidate mathematical models, including linear regression, partial least-squares regression, random forest regression, and two-dimensional convolutional neural network (2-D CNN), were tested. The random forest and 2-D CNN models most accurately predicted the intensity values at each pixel as well as the overall patterns of the mass spectrometry images, while also providing the best spatial resolution enhancements. Herein, image fusion enabled predicted mass spectrometry images of corynantheidine, GABA, and glutamine to approximately 2.5 Ī¼m spatial resolutions, a significant improvement compared to the original images acquired at 25 Ī¼m spatial resolution. The predicted mass spectrometry images were then coregistered with an H&E image and IHC fluorescence image of the Ī¼-opioid receptor to assess colocalization of corynantheidine with brain cells. Our study also provides insights into the different evaluation parameters to consider when utilizing image fusion for biological applications.
Collapse
Affiliation(s)
- Zhongling Liang
- Department of Chemistry, University of Florida, Gainesville, Florida 32611, United States
| | - Yingchan Guo
- Department of Chemistry, University of Florida, Gainesville, Florida 32611, United States
| | - Abhisheak Sharma
- Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, Florida 32610, United States
| | - Christopher R McCurdy
- Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, Florida 32610, United States
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, Florida 32610, United States
| | - Boone M Prentice
- Department of Chemistry, University of Florida, Gainesville, Florida 32611, United States
| |
Collapse
|
5
|
Malek N, Gladysz R, Stelmach N, Drag M. Targeting Microglial Immunoproteasome: A Novel Approach in Neuroinflammatory-Related Disorders. ACS Chem Neurosci 2024; 15:2532-2544. [PMID: 38970802 PMCID: PMC11258690 DOI: 10.1021/acschemneuro.4c00099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 06/18/2024] [Accepted: 06/20/2024] [Indexed: 07/08/2024] Open
Abstract
It is widely acknowledged that the aging process is linked to the accumulation of damaged and misfolded proteins. This phenomenon is accompanied by a decrease in proteasome (c20S) activity, concomitant with an increase in immunoproteasome (i20S) activity. These changes can be attributed, in part, to the chronic neuroinflammation that occurs in brain tissues. Neuroinflammation is a complex process characterized by the activation of immune cells in the central nervous system (CNS) in response to injury, infection, and other pathological stimuli. In certain cases, this immune response becomes chronic, contributing to the pathogenesis of various neurological disorders, including chronic pain, Alzheimer's disease, Parkinson's disease, brain traumatic injury, and others. Microglia, the resident immune cells in the brain, play a crucial role in the neuroinflammatory response. Recent research has highlighted the involvement of i20S in promoting neuroinflammation, increased activity of which may lead to the presentation of self-antigens, triggering an autoimmune response against the CNS, exacerbating inflammation, and contributing to neurodegeneration. Furthermore, since i20S plays a role in breaking down accumulated proteins during inflammation within the cell body, any disruption in its activity could lead to a prolonged state of inflammation and subsequent cell death. Given the pivotal role of i20S in neuroinflammation, targeting this proteasome subtype has emerged as a potential therapeutic approach for managing neuroinflammatory diseases. This review delves into the mechanisms of neuroinflammation and microglia activation, exploring the potential of i20S inhibitors as a promising therapeutic strategy for managing neuroinflammatory disorders.
Collapse
Affiliation(s)
- Natalia Malek
- Department
of Chemical Biology and Bioimaging, Wroclaw
University of Science and Technology, ul. Wybrzeze Wyspianskiego 27, 50-370 Wroclaw, Poland
| | - Radoslaw Gladysz
- Department
of Chemical Biology and Bioimaging, Wroclaw
University of Science and Technology, ul. Wybrzeze Wyspianskiego 27, 50-370 Wroclaw, Poland
| | - Natalia Stelmach
- Department
of Chemical Biology and Bioimaging, Wroclaw
University of Science and Technology, ul. Wybrzeze Wyspianskiego 27, 50-370 Wroclaw, Poland
| | - Marcin Drag
- Department
of Chemical Biology and Bioimaging, Wroclaw
University of Science and Technology, ul. Wybrzeze Wyspianskiego 27, 50-370 Wroclaw, Poland
| |
Collapse
|
6
|
Nunes JC, Jegede OO, De Aquino JP. Disentangling the effects of racism-related stress on opioid use disorder and chronic pain outcomes. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2024:1-7. [PMID: 39018662 DOI: 10.1080/00952990.2024.2369866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 06/15/2024] [Indexed: 07/19/2024]
Abstract
In recent years, Black people in the U.S. have had one of the highest increases in opioid overdose mortality rates, despite being less likely to be prescribed opioids for pain. This population is also less likely to receive medications for opioid use disorder (MOUD). Chronic pain is a central factor in understanding this crisis, as minoritized people are more likely to live with undertreated pain, a major risk factor for developing opioid use disorder (OUD). Current practices fail to effectively treat pain among persons with OUD, a missed opportunity that is worse in minoritized populations and further producing disparities. In this perspective, we discuss how racism-related stress and disparities in addiction treatments may impact the pain experience, diagnosis, treatment, contribute to developing OUD, and perpetuate stigma. This high-level perspective invites clinicians and researchers to reflect on the biopsychosocial burden imposed upon historically minoritized people with pain and OUD. To address such complex issues, multidisciplinary efforts and methodological improvements are required, imbued by antiracist values. Collaboration across disciplines is necessary toward the common goal of improving pain management and mitigating opioid mortality among minoritized populations. As antiracist perspectives inform research practices and cultural humility principles guide care, we will be better equipped to close current gaps in knowledge and address widening healthcare disparities.
Collapse
Affiliation(s)
- Julio C Nunes
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Oluwole O Jegede
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Joao P De Aquino
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| |
Collapse
|
7
|
Li Y, Huang Y, Wei F, Li T, Wang Y. Development and validation of a risk prediction model for motoric cognitive risk syndrome in older adults. Aging Clin Exp Res 2024; 36:143. [PMID: 39002102 PMCID: PMC11246282 DOI: 10.1007/s40520-024-02797-5] [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: 04/20/2024] [Accepted: 06/22/2024] [Indexed: 07/15/2024]
Abstract
OBJECTIVE The objective of this study was to develop a risk prediction model for motoric cognitive risk syndrome (MCR) in older adults. METHODS Participants were selected from the 2015 China Health and Retirement Longitudinal Study database and randomly assigned to the training group and the validation group, with proportions of 70% and 30%, respectively. LASSO regression analysis was used to screen the predictors. Then, identified predictors were included in multivariate logistic regression analysis and used to construct model nomogram. The performance of the model was evaluated by area under the receiver operating characteristic (ROC) curve (AUC), calibration curves and decision curve analysis (DCA). RESULTS 528 out of 3962 participants (13.3%) developed MCR. Multivariate logistic regression analysis showed that weakness, chronic pain, limb dysfunction score, visual acuity score and Five-Times-Sit-To-Stand test were predictors of MCR in older adults. Using these factors, a nomogram model was constructed. The AUC values for the training and validation sets of the predictive model were 0.735 (95% CIā=ā0.708-0.763) and 0.745 (95% CIā=ā0.705-0.785), respectively. CONCLUSION The nomogram constructed in this study is a useful tool for assessing the risk of MCR in older adults, which can help clinicians identify individuals at high risk.
Collapse
Affiliation(s)
- Yaqin Li
- School of Nursing, Jinan University, Guangzhou, Guangdong Province, China
| | - Yuting Huang
- School of Nursing, Jinan University, Guangzhou, Guangdong Province, China
| | - Fangxin Wei
- School of Nursing, Jinan University, Guangzhou, Guangdong Province, China
| | - Tanjian Li
- School of Nursing, Jinan University, Guangzhou, Guangdong Province, China
| | - Yu Wang
- The Community Service Center of Jinan University, The First Affiliated Hospital of Jinan University, Tianhe District, Guangzhou, Guangzhou Province, China.
| |
Collapse
|
8
|
Bonanno M, Papa GA, Ruffoni P, Catalioto E, De Luca R, Maggio MG, CalabrĆ² RS. The Effects of Osteopathic Manipulative Treatment on Brain Activity: A Scoping Review of MRI and EEG Studies. Healthcare (Basel) 2024; 12:1353. [PMID: 38998887 PMCID: PMC11241316 DOI: 10.3390/healthcare12131353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 07/01/2024] [Accepted: 07/04/2024] [Indexed: 07/14/2024] Open
Abstract
Osteopathic manipulative treatment (OMT) is a hands-on therapy aiming to achieve the global homeostasis of the patient. OMT focuses on treating the somatic dysfunctions characterized by tissue modifications, body asymmetry, and range-of-motion restrictions. The benefits related to OMT are thought to be associated with the interconnectedness of the body's systems and the inherent capacity for self-healing. However, whether OMT can influence brain activity, and, consequently, neurophysiological responses is an open research question. Our research investigates the literature to identify the effects of OMT on brain activity. The main purpose of the research question is: can OMT influence brain activity and consequently neurophysiological responses? A scoping review was conducted, searching the following databases: PubMed, Google Scholar, and OSTEOMED.DR (Osteopathic Medical Digital Repository), Scopus, Web of Science (WoS), and Science Direct. The initial search returned 114 articles, and after removing duplicates, 69 were considered eligible to be included in the final sample. In the end, eight studies (six randomized controlled trials, one pilot study, and one cross-over study) were finally included and analyzed in this review. In conclusion, OMT seems to have a role in influencing functional changes in brain activity in healthy individuals and even more in patients with chronic musculoskeletal pain. However, further RCT studies are needed to confirm these findings. Registration protocol: CRD42024525390.
Collapse
Affiliation(s)
- Mirjam Bonanno
- IRCCS Centro Neurolesi Bonino-Pulejo, Cda Casazza, SS 113, 98124 Messina, Italy
| | | | - Paola Ruffoni
- International College of Osteopathic Medicine, 20092 Milan, Italy
| | | | - Rosaria De Luca
- IRCCS Centro Neurolesi Bonino-Pulejo, Cda Casazza, SS 113, 98124 Messina, Italy
| | - Maria Grazia Maggio
- IRCCS Centro Neurolesi Bonino-Pulejo, Cda Casazza, SS 113, 98124 Messina, Italy
| | | |
Collapse
|
9
|
Swanson KA, Nguyen KL, Gupta S, Ricard J, Bethea JR. TNFR1/p38Ī±MAPK signaling in NexĀ +Ā supraspinal neurons regulates estrogen-dependent chronic neuropathic pain. Brain Behav Immun 2024; 119:261-271. [PMID: 38570102 PMCID: PMC11162907 DOI: 10.1016/j.bbi.2024.03.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/26/2024] [Accepted: 03/30/2024] [Indexed: 04/05/2024] Open
Abstract
Upregulation of soluble tumor necrosis factor (sTNF) cytokine signaling through TNF receptor 1 (TNFR1) and subsequent neuronal hyperexcitability are observed in both animal models and human chronic neuropathic pain (CNP). Previously, we have shown that estrogen modulates sTNF/TNFR1 signaling in CNP, which may contribute to female prevalence of CNP. The estrogen-dependent role of TNFR1-mediated supraspinal neuronal circuitry in CNP remains unknown. In this study, we interrogated the intersect between supraspinal TNFR1 mediated neuronal signaling and sex specificity by selectively removing TNFR1 in NexĀ +Ā neurons in adult mice (NexCreERT2::TNFR1f/f). We determined that mechanical hypersensitivity induced by chronic constriction injury (CCI) decreases over time in males, but not in females. Subsequently, we investigated two downstream pathways, p38MAPK and NF-ĪŗB, important in TNFR1 signaling and injury response. We detected p38MAPK and NF-ĪŗB activation in male cortical tissue; however, p38MAPK phosphorylation was reduced in NexCreERT2::TNFR1f/f males. We observed a similar recovery from acute pain in male mice following CCI when p38Ī±MAPK was knocked out of supraspinal NexĀ +Ā neurons (NexCreERT2::p38Ī±MAPKf/f), while chronic pain developed in female mice. To explore the intersection between estrogen and inflammation in CNP we used a combination therapy of an estrogen receptor Ī² (ER Ī²) inhibitor with a sTNF/TNFR1 or general p38MAPK inhibitor. We determined both combination therapies lends therapeutic relief to females following CCI comparable to the response evaluated in male mice. These data suggest that TNFR1/p38Ī±MAPK signaling in NexĀ +Ā neurons in CNP is male-specific and lack of therapeutic efficacy following sTNF inhibition in females is due to ER Ī² interference. These studies highlight sex-specific differences in pathways important to pain chronification and elucidate potential therapeutic strategies that would be effective in both sexes.
Collapse
Affiliation(s)
- Kathryn A Swanson
- Department of Biology, Drexel University, Papadakis Integrated Science Building, Philadelphia, PA 19104, USA
| | - Kayla L Nguyen
- Department of Anatomy and Cell Biology, The George Washington University School of Medicine and Health Sciences, Ross Hall, 2300 I (Eye) St NW, Rm.530A, Washington, D.C 20052, USA.
| | - Shruti Gupta
- Department of Anatomy and Cell Biology, The George Washington University School of Medicine and Health Sciences, Ross Hall, 2300 I (Eye) St NW, Rm.530A, Washington, D.C 20052, USA
| | - Jerome Ricard
- Department of Biology, Drexel University, Papadakis Integrated Science Building, Philadelphia, PA 19104, USA
| | - John R Bethea
- Department of Anatomy and Cell Biology, The George Washington University School of Medicine and Health Sciences, Ross Hall, 2300 I (Eye) St NW, Rm.530A, Washington, D.C 20052, USA.
| |
Collapse
|
10
|
Sabater-GĆ”rriz Ć, Montoya P, Riquelme I. Enhanced EEG power density during painful stretching in individuals with cerebral palsy. RESEARCH IN DEVELOPMENTAL DISABILITIES 2024; 150:104760. [PMID: 38795555 DOI: 10.1016/j.ridd.2024.104760] [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: 12/28/2023] [Revised: 04/22/2024] [Accepted: 05/15/2024] [Indexed: 05/28/2024]
Abstract
BACKGROUND Pain perception mechanisms in cerebral palsy remain largely unclear. AIMS This study investigates brain activity in adults with cerebral palsy during painful and non-painful stretching to elucidate their pain processing characteristics. METHODS AND PROCEDURES Twenty adults with cerebral palsy and 20 controls underwent EEG in three conditions: rest, non-painful stretching, and painful stretching. Time-frequency power density of theta, alpha, and beta waves in somatosensory and frontal cortices was analyzed, alongside baseline pressure pain thresholds. OUTCOMES AND RESULTS Cerebral palsy individuals exhibited higher theta, alpha, and beta power density in both cortices during painful stretching compared to rest, and lower during non-painful stretching. Controls showed higher power density during non-painful stretching but lower during painful stretching. Cerebral palsy individuals had higher pain sensitivity, with those more sensitive experiencing greater alpha power density. CONCLUSIONS AND IMPLICATIONS These findings confirm alterations in the cerebral processing of pain in individuals with cerebral palsy. This knowledge could enhance future approaches to the diagnosis and treatment of pain in this vulnerable population.
Collapse
Affiliation(s)
- Ćlvaro Sabater-GĆ”rriz
- Balearic ASPACE Foundation, MarratxĆ, Spain; Health Research Institute of the Balearic Islands (IUNICS-IdISBa), University of the Balearic Islands, Palma de Mallorca, Spain; Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Pedro Montoya
- Health Research Institute of the Balearic Islands (IUNICS-IdISBa), University of the Balearic Islands, Palma de Mallorca, Spain; Center for Mathematics, Computation and Cognition, Federal University of ABC, SĆ£o Bernardo do Campo, Brazil
| | - Inmaculada Riquelme
- Health Research Institute of the Balearic Islands (IUNICS-IdISBa), University of the Balearic Islands, Palma de Mallorca, Spain; Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma de Mallorca, Spain.
| |
Collapse
|
11
|
Hong VM, Rade AD, Yan SM, Bhaskara A, Yousuf MS, Chen M, Martin SF, Liebl DJ, Price TJ, Kolber BJ. Loss of Sigma-2 Receptor/TMEM97 Is Associated with Neuropathic Injury-Induced Depression-Like Behaviors in Female Mice. eNeuro 2024; 11:ENEURO.0488-23.2024. [PMID: 38866499 PMCID: PMC11228697 DOI: 10.1523/eneuro.0488-23.2024] [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: 11/21/2023] [Revised: 04/30/2024] [Accepted: 05/23/2024] [Indexed: 06/14/2024] Open
Abstract
Previous studies have shown that ligands that bind to sigma-2 receptor/TMEM97 (s2R/TMEM97), a transmembrane protein, have anxiolytic/antidepressant-like properties and relieve neuropathic pain-like effects in rodents. Despite medical interest in s2R/TMEM97, little affective and pain behavioral characterization has been done using transgenic mice, which limits the development of s2R/TMEM97 as a viable therapeutic target. Using wild-type (WT) and global Tmem97 knock-out (KO) mice, we sought to identify the contribution of Tmem97 in modulating affective and pain-like behaviors using a battery of affective and pain assays, including open field, light/dark preference, elevated plus maze, forced swim test, tail suspension test, and the mechanical sensitivity tests. Our results demonstrate that female Tmem97 KO mice show less anxiety-like and depressive-like behaviors in light/dark preference and tail suspension tests but not in an open field, elevated plus maze, and forced swim tests at baseline. We next performed spared nerve injury in WT and Tmem97 KO mice to assess the role of Tmem97 in neuropathic pain-induced anxiety and depression. WT mice, but not Tmem97 KO mice, developed a prolonged neuropathic pain-induced depressive-like phenotype when tested 10ā
weeks after nerve injury in females. Our results show that Tmem97 plays a role in modulating anxiety-like and depressive-like behaviors in naive animals with a significant change in the presence of nerve injury in female mice. Overall, these data demonstrate that Tmem97 could be a target to alleviate affective comorbidities of pain disorders.
Collapse
Affiliation(s)
- Veronica M Hong
- Department of Neuroscience, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas 75080
- Center for Advanced Pain Studies, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas 75080
| | - Avaneesh D Rade
- Department of Neuroscience, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas 75080
| | - Shen M Yan
- Department of Neuroscience, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas 75080
| | - Amulya Bhaskara
- Department of Neuroscience, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas 75080
| | - Muhammad Saad Yousuf
- Department of Neuroscience, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas 75080
- Center for Advanced Pain Studies, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas 75080
| | - Min Chen
- Department of Mathematical Sciences, School of Natural Sciences and Mathematics, University of Texas at Dallas, Richardson, Texas 75080
| | - Stephen F Martin
- Department of Chemistry, University of Texas at Austin, Austin, Texas 78712
| | - Daniel J Liebl
- Department of Neurosurgery, University of Miami, Miller School of Medicine, Miami, Florida 33146
| | - Theodore J Price
- Department of Neuroscience, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas 75080
- Center for Advanced Pain Studies, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas 75080
| | - Benedict J Kolber
- Department of Neuroscience, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas 75080
- Center for Advanced Pain Studies, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas 75080
| |
Collapse
|
12
|
Fan C, Wu M, Liu H, Chen X, Gao Z, Zhao X, Zhou J, Jiang Z. Effects of meditation on neural responses to pain: A systematic review and meta-analysis of fMRI studies. Neurosci Biobehav Rev 2024; 162:105735. [PMID: 38821153 DOI: 10.1016/j.neubiorev.2024.105735] [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: 01/18/2024] [Revised: 05/17/2024] [Accepted: 05/19/2024] [Indexed: 06/02/2024]
Abstract
This systematic review investigates the impact of meditation on neural responses to pain, as measured by functional magnetic resonance imaging (fMRI). Up to March 2024, we conducted searches across four databases for human studies implementing fMRI to assess the efficacy of meditation for pain relief. Eighteen studies met the inclusion criteria. Our systematic review indicates that activation of the insula, anterior cingulate cortex, and orbitofrontal cortex is positively associated with meditation for pain relief, while activity in regions like the amygdala and medial prefrontal cortex is negatively correlated with pain relief. Meta-analyses consistently reveal the involvement of various brain regions, including the insula, putamen, amygdala, anterior cingulate cortex, precentral gyrus, postcentral gyrus, inferior parietal lobule, superior temporal gyrus, inferior frontal gyrus, and caudate nucleus, in meditation-induced alleviation of pain. These findings suggest ccthat meditation acts on specific brain regions related to pain, mood, and cognition, providing insight into the potential mechanisms underlying the pain-alleviating effects of meditation on both pain sensations and emotional experiences.
Collapse
Affiliation(s)
- Cheng Fan
- The First Clinical Medical College, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China; Department of Rehabilitation Medicine, The Second Affiliated Hospital, Xi'an Jiaotong University,Ā Xi'an 710004,Ā China; Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Ministry of Education, Fuzhou 350122, China
| | - Mengjiao Wu
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Ministry of Education, Fuzhou 350122, China; College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China; Department of Rehabilitation Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, China
| | - Hong Liu
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Ministry of Education, Fuzhou 350122, China; College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China.
| | - Xiaolin Chen
- Department of Rehabilitation, Dongguan Songshan Lake Tungwah Hospital, DongGuan 523000, China
| | - Zhen Gao
- Department of Rehabilitation, Fuzhou Second Hospital, Fuzhou 350122, China
| | - Xin Zhao
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Ministry of Education, Fuzhou 350122, China; College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China
| | - Jianhao Zhou
- The First Clinical Medical College, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China; Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Ministry of Education, Fuzhou 350122, China
| | - Zheng Jiang
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Ministry of Education, Fuzhou 350122, China; College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China.
| |
Collapse
|
13
|
Sannes AC, Ghani U, Niazi IK, Moberget T, Jonassen R, Haavik H, Gjerstad J. Investigating Whether a Combination of Electro-Encephalography and Gene Expression Profiling Can Predict the Risk of Chronic Pain: A Protocol for an Observational Prospective Cohort Study. Brain Sci 2024; 14:641. [PMID: 39061381 PMCID: PMC11274615 DOI: 10.3390/brainsci14070641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/20/2024] [Accepted: 06/25/2024] [Indexed: 07/28/2024] Open
Abstract
Despite most episodes of low back pain (LBP) being short-lasting, some transition into persistent long-lasting problems. Hence, the need for a deeper understanding of the physiological mechanisms of this is pertinent. Therefore, the aims of the present study are (1) to map pain-induced changes in brain activity and blood gene expression associated with persistent LBP, and (2) to explore whether these brain and gene expression signatures show promise as predictive biomarkers for the development of persistent LBP. The participants will be allocated into three different pain groups (no pain, mild short-lasting, or moderate long-term). One in-person visit, where two blood samples will be collected and sent for RNA sequencing, along with resting 64-channel electro-encephalography measurements before, during, and after a cold pressor test, will be conducted. Thereafter, follow-up questionnaires will be distributed at 2 weeks, 3 months, and 6 months. Recruitment will start during the second quarter of 2024, with expected completion by the last quarter of 2024. The results are expected to provide insight into the relationship between central nervous system activity, gene expression profiles, and LBP. If successful, this study has the potential to provide physiological indicators that are sensitive to the transition from mild, short-term LBP to more problematic, long-term LBP.
Collapse
Affiliation(s)
- Ann-Christin Sannes
- Faculty of Health Science, Oslo Metropolitan University, 0890 Oslo, Norway
- Department for Research and Development in Mental Health, Akershus University Hospital, 1474 LĆørenskog, Norway
| | - Usman Ghani
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand (I.K.N.)
- Faculty of Health & Environmental Sciences, Health & Rehabilitation Research Institute, AUT University, Auckland 1010, New Zealand
| | - Imran Khan Niazi
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand (I.K.N.)
- Faculty of Health & Environmental Sciences, Health & Rehabilitation Research Institute, AUT University, Auckland 1010, New Zealand
- Faculty of Medicine, Aalborg University, 9260 Aalborg, Denmark
| | - Torgeir Moberget
- Faculty of Health Sciences, Kristiania University College, 0107 Oslo, Norway
- Centre for Precision Psychiatry, University of Oslo, 0373 Oslo, Norway
| | - Rune Jonassen
- Faculty of Health Science, Oslo Metropolitan University, 0890 Oslo, Norway
| | - Heidi Haavik
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand (I.K.N.)
| | - Johannes Gjerstad
- Department for Research and Development in Mental Health, Akershus University Hospital, 1474 LĆørenskog, Norway
- Faculty of Health Sciences, Kristiania University College, 0107 Oslo, Norway
| |
Collapse
|
14
|
Zu Y, Zhang Z, Hao Z, Jiang Z, Chen K, Wang Y, Zou C, Ge L, Yu Q, Zheng F, Wang C. Changes in brain structure and function during early aging in patients with chronic low back pain. Front Aging Neurosci 2024; 16:1356507. [PMID: 38912520 PMCID: PMC11190087 DOI: 10.3389/fnagi.2024.1356507] [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: 12/15/2023] [Accepted: 05/29/2024] [Indexed: 06/25/2024] Open
Abstract
Objective To explore the structural and functional changes in cognition-related brain regions in patients with chronic low back pain (CLBP) at earlier ages, and explore the impact of the interaction between CLBP and age on the brain. Methods Seventy-six patients with CLBP were recruited and divided into "younger" age group (20-29āyears, YA), "middle" age group (30-39āyears, MA), and "older" age group (40-49āyears, OA). All patients underwent functional magnetic resonance imaging (fMRI) as well as clinical psychological and pain-related symptoms assessments. Results Structural analysis showed that patients in OA group had lower gray matter (GM) volumes in the orbitofrontal cortex (OFC) bilaterally and the right superior frontal gyrus (SFG) compared to YA group. The resting-state brain activity analysis showed that amplitude of low-frequency fluctuation (ALFF) values in the bilateral postcentral gyrus and left ventral medial prefrontal cortex (mPFC) were significantly different in the OA group. The functional connectivity (FC) in the right ventral dorsolateral prefrontal cortex (DLPFC) and the right insula was significantly decreased in the OA group compared to the YA and MA groups. Likewise, the FC in the left caudal parahippocampal gyrus (PHG) and left inferior parietal lobule (IPL) were significantly lower in the MA and OA groups compared to the YA group. In addition, both the structural properties and the FC values of these brain regions were significantly correlated with age. Conclusion This preliminary study concludes that CLBP affects the aging process. The synergistic effects of CLBP and aging accelerate the functional and structural decline of certain areas of the brain, which not only affects pain processing, but are also may be associated with cognitive declines.
Collapse
Affiliation(s)
- Yao Zu
- Department of Rehabilitation Medicine, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhou Zhang
- Department of Rehabilitation Medicine, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zengming Hao
- Department of Rehabilitation Medicine, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zimu Jiang
- Department of Rehabilitation Medicine, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ke Chen
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yu Wang
- College of Rehabilitation Medicine, Gannan Medical University, Ganzhou, China
| | - Changcheng Zou
- College of Rehabilitation Medicine, Gannan Medical University, Ganzhou, China
| | - Le Ge
- Department of Rehabilitation Medicine, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qiuhua Yu
- Department of Rehabilitation Medicine, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Fuming Zheng
- Department of Rehabilitation Medicine, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chuhuai Wang
- Department of Rehabilitation Medicine, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
15
|
Zhao HQ, Zhou M, Jiang JQ, Luo ZQ, Wang YH. Global trends and hotspots in pain associated with bipolar disorder in the last 20 years: a bibliometric analysis. Front Neurol 2024; 15:1393022. [PMID: 38846044 PMCID: PMC11153732 DOI: 10.3389/fneur.2024.1393022] [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: 02/28/2024] [Accepted: 04/22/2024] [Indexed: 06/09/2024] Open
Abstract
Purpose The prevalence of comorbid pain and Bipolar Disorder in clinical practice continues to be high, with an increasing number of related publications. However, no study has used bibliometric methods to analyze the research progress and knowledge structure in this field. Our research is dedicated to systematically exploring the global trends and focal points in scientific research on pain comorbidity with bipolar disorder from 2003 to 2023, with the goal of contributing to the field. Methods Relevant publications in this field were retrieved from the Web of Science core collection database (WOSSCC). And we used VOSviewer, CiteSpace, and the R package "Bibliometrix" for bibliometric analysis. Results A total of 485 publications (including 360 articles and 125 reviews) from 66 countries, 1019 institutions, were included in this study. Univ Toront and Kings Coll London are the leading research institutions in this field. J Affect Disorders contributed the largest number of articles, and is the most co-cited journal. Of the 2,537 scholars who participated in the study, Stubbs B, Vancampfort D, and Abdin E had the largest number of articles. Stubbs B is the most co-cited author. "chronic pain," "neuropathic pain," "psychological pain" are the keywords in the research. Conclusion This is the first bibliometric analysis of pain-related bipolar disorder. There is growing interest in the area of pain and comorbid bipolar disorder. Focusing on different types of pain in bipolar disorder and emphasizing pain management in bipolar disorder are research hotspots and future trends. The study of pain related bipolar disorder still has significant potential for development, and we look forward to more high-quality research in the future.
Collapse
Affiliation(s)
- Hong Qing Zhao
- Science and Technology Innovation Center, Hunan University of Chinese Medicine, Changsha, China
| | - Mi Zhou
- School of Pharmacy, Hunan University of Chinese Medicine, Changsha, China
| | - Jia Qi Jiang
- School of Pharmacy, Hunan University of Chinese Medicine, Changsha, China
| | - Zhi Qiang Luo
- Department of Graduate School, Hunan University of Chinese Medicine, Changsha, China
| | - Yu Hong Wang
- Department of Graduate School, Hunan University of Chinese Medicine, Changsha, China
| |
Collapse
|
16
|
Olayinka O, Alemu BT, Nkemjika S, Barry DT. Nationwide Assessment of Chronic Pain among Hospitalized Individuals with Co-occurring Post Traumatic Stress Disorder and Substance Use Disorder in the United States. J Dual Diagn 2024:1-10. [PMID: 38704860 DOI: 10.1080/15504263.2024.2347489] [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] [Indexed: 05/07/2024]
Abstract
Objective: Chronic pain (CP) is independently associated with substance use disorders (SUD) and posttraumatic stress disorder (PTSD). However, little is known about factors associated with CP among patients with co-occurring PTSD and SUD. Patterns of hospital resource usage should also be explored further. Methods: Using the 2019 National Inpatient Sample (NIS), we identified 216,125 hospital discharges with co-occurring diagnoses of PTSD and SUD in 2019 and examined their association with CP. Multivariable logistic regression models were used to identify factors associated with an increased likelihood of CP in this cohort. Results: Among those with co-occurring PTSD and SUD (Nā=ā216,125), 35,450 had associated CP, a prevalence of 164.02 cases per 1,000 discharges (95% CI [160.54, 167.52]). Individuals aged 55-64 with co-occurring PTSD and SUD were approximately 7.2 times more likely to experience CP, compared to those aged 16-24 (OR = 7.2; 95% CI [6.09, 8.60]). Being in the CP group was associated with 50% increased odds of insomnia and obesity (OR = 1.5; 95% CI [1.12, 2.03] and OR = 1.5; 95% CI [1.38, 1.55], respectively), 30% increased odds of anxiety (OR = 1.3; 95% CI [1.24, 1.38]), 20% increased odds of attention deficit disorder (ADD;OR = 1.2; 95% CI [1.12, 1.38]) and 10% increased odds of depression (OR = 1.1; 95% CI [1.01, 1.14]). Compared with females, being male was associated with slightly decreased odds of CP (OR = 0.9; 95% CI [0.84, 0.94]). Conclusions: Among hospitalized Americans with co-occurring PTSD and SUD, advanced age, being female, and the presence other mental health disorders were associated with an increased risk of CP. Providers treating co-occurring PTSD/SUD should evaluate for and consider evidence-based management of CP if present.
Collapse
Affiliation(s)
- Olaniyi Olayinka
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Brook T Alemu
- Health Sciences Program, School of Health Sciences, Western Carolina University, Cullowhee, North Carolina, USA
| | - Stanley Nkemjika
- Department of Psychiatry, Interfaith Medical Center, Brooklyn, New York, USA
| | - Declan T Barry
- The APT Foundation, New Haven, Connecticut, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
- Child Study Center, Yale School of Medicine, New Haven, Connecticut, USA
| |
Collapse
|
17
|
Guzzi G, Della Torre A, Bruni A, Lavano A, Bosco V, Garofalo E, La Torre D, Longhini F. Anatomo-physiological basis and applied techniques of electrical neuromodulation in chronic pain. JOURNAL OF ANESTHESIA, ANALGESIA AND CRITICAL CARE 2024; 4:29. [PMID: 38698460 PMCID: PMC11064427 DOI: 10.1186/s44158-024-00167-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 04/24/2024] [Indexed: 05/05/2024]
Abstract
Chronic pain, a complex and debilitating condition, poses a significant challenge to both patients and healthcare providers worldwide. Conventional pharmacological interventions often prove inadequate in delivering satisfactory relief while carrying the risks of addiction and adverse reactions. In recent years, electric neuromodulation emerged as a promising alternative in chronic pain management. This method entails the precise administration of electrical stimulation to specific nerves or regions within the central nervous system to regulate pain signals. Through mechanisms that include the alteration of neural activity and the release of endogenous pain-relieving substances, electric neuromodulation can effectively alleviate pain and improve patients' quality of life. Several modalities of electric neuromodulation, with a different grade of invasiveness, provide tailored strategies to tackle various forms and origins of chronic pain. Through an exploration of the anatomical and physiological pathways of chronic pain, encompassing neurotransmitter involvement, this narrative review offers insights into electrical therapies' mechanisms of action, clinical utility, and future perspectives in chronic pain management.
Collapse
Affiliation(s)
- Giusy Guzzi
- Neurosurgery Department, "R. Dulbecco" Hospital, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Attilio Della Torre
- Neurosurgery Department, "R. Dulbecco" Hospital, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Andrea Bruni
- Anesthesia and Intensive Care Unit, "R. Dulbecco" Univesity Hospital, Department of Medical and Surgical Sciences, Magna Graecia University, Viale Europa, Catanzaro, 88100, Italy
| | - Angelo Lavano
- Neurosurgery Department, "R. Dulbecco" Hospital, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Vincenzo Bosco
- Anesthesia and Intensive Care Unit, "R. Dulbecco" Univesity Hospital, Department of Medical and Surgical Sciences, Magna Graecia University, Viale Europa, Catanzaro, 88100, Italy
| | - Eugenio Garofalo
- Anesthesia and Intensive Care Unit, "R. Dulbecco" Univesity Hospital, Department of Medical and Surgical Sciences, Magna Graecia University, Viale Europa, Catanzaro, 88100, Italy
| | - Domenico La Torre
- Neurosurgery Department, "R. Dulbecco" Hospital, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Federico Longhini
- Anesthesia and Intensive Care Unit, "R. Dulbecco" Univesity Hospital, Department of Medical and Surgical Sciences, Magna Graecia University, Viale Europa, Catanzaro, 88100, Italy.
| |
Collapse
|
18
|
Reddy J, Singhal R, Gaikwad AP, Patel D, Patel P, Gandhi SK. Unraveling the Potential of Electroanalgesia: A Literature Review of Current Therapeutics. Cureus 2024; 16:e61122. [PMID: 38919207 PMCID: PMC11198869 DOI: 10.7759/cureus.61122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2024] [Indexed: 06/27/2024] Open
Abstract
Neuropathic pain (NP), arising from dysfunction in the neurological system, poses a significant challenge in pain management due to its intricate origin and unpredictable response to conventional treatments. Electroanalgesia, a collection of techniques such as transcutaneous electric nerve stimulation (TENS), peripheral electrical nerve stimulation (PENS), spinal cord stimulation (SCS), deep brain stimulation (DBS), and electroacupuncture (EA), presents a potential alternative or complementary approach. This review brings together evidence from 56 studies to evaluate the effectiveness and safety of electroanalgesia in chronic NP. It discusses the mechanisms underlying NP, the indications for electroanalgesia, and the techniques utilized, emphasizing the diverse applications and potential benefits. However, despite its potential uses, electroanalgesia has its limitations, including variable effectiveness and potential adverse effects. Furthermore, the review recognizes the limitations of the methodology and the need for further research to refine treatment protocols and enhance the understanding of electroanalgesia's role in comprehensive pain management strategies.
Collapse
Affiliation(s)
- Jyothsna Reddy
- Department of Internal Medicine, The Tamil Nadu Dr. M.G.R. (M.G.Ramachandran) Medical University, Chennai, IND
| | - Rohan Singhal
- Department of Internal Medicine, Atal Bihari Vajpayee Institute of Medical Sciences, New Delhi, IND
| | - Anand P Gaikwad
- Department of Internal Medicine, King Edward Memorial Hospital, Mumbai, IND
| | - Diya Patel
- Department of Internal Medicine, Gujarat Medical Education and Research Society, Sola, Ahmedabad, IND
| | - Priyansh Patel
- Department of Internal Medicine, Medical College Baroda, Vadodara, IND
| | - Siddharth Kamal Gandhi
- Department of Internal Medicine, Shri M.P. (Meghaji Pethraj) Shah Government Medical College, Jamnagar, IND
| |
Collapse
|
19
|
SoliƱo S, Mignone F, Policastro P, Vuoto T, Pierobon A, Porollan JC. [Prognostic factors for substantial clinical benefit from musculoskeletal pathologies of the shoulder]. ACTA ORTOPEDICA MEXICANA 2024; 38:142-148. [PMID: 38862143 DOI: 10.35366/115808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
INTRODUCTION shoulder plain is a common cause of complain, however a precise diagnosis is hard to achieve. This is why finding factors associated to a good prognosis could help to improve our clinical practice. OBJECTIVE to identify demographic and clinical characteristics from the initial assessment associated with substantial clinical benefit (SCB) in patients with shoulder pain one month after treatment or at patient's discharge. MATERIAL AND METHODS this was a secondary analysis of a prospective cohort of patients with shoulder pain. Demographic and clinical (self-reported scales) factors associated with SCB at discharge or four weeks after the initial assessment, were analyzed. SCB was defined as a score +5 on a Global Rating of Change. A logistic regression model was made in order to identify predictors of SCB. The area under the curve ROC was used to assess the performance of the model with its independent variables. RESULTS 101 patients of 138 were analyzed. The median age was 55 (RIQ 37-61) years old, there were 55 (54.5%) women in the sample. The variables independently associated to SCB were fracture as a reason for admission [adjusted OR 11.8 (95% CI 1.4-101.8); p = 0.024], and durations of shoulder symptoms shorter than seven months [adjusted OR 4.63 (95% CI 1.9-11.1); p = 0.001]. CONCLUSION the diagnosis of fracture and durations of shoulder symptoms shorter than seven months were independently associated with a SCB after one month of treatment or at the patient's discharge.
Collapse
Affiliation(s)
- S SoliƱo
- Unidad de KinesiologĆa, Hospital Carlos G. Durand, Ciudad AutĆ³noma de Buenos Aires, Argentina
| | - F Mignone
- Unidad de KinesiologĆa, Hospital Carlos G. Durand, Ciudad AutĆ³noma de Buenos Aires, Argentina
| | - P Policastro
- Unidad de KinesiologĆa, Hospital Carlos G. Durand, Ciudad AutĆ³noma de Buenos Aires, Argentina
| | - T Vuoto
- Unidad de KinesiologĆa, Hospital Carlos G. Durand, Ciudad AutĆ³noma de Buenos Aires, Argentina
| | - A Pierobon
- Department of Primary Health Care and General Practice, University of Otago. Wellington, Nueva Zelanda
| | - J C Porollan
- Unidad de KinesiologĆa, Hospital Carlos G. Durand, Ciudad AutĆ³noma de Buenos Aires, Argentina
| |
Collapse
|
20
|
Rusbridge C. Neuropathic pain in cats: Mechanisms and multimodal management. J Feline Med Surg 2024; 26:1098612X241246518. [PMID: 38710218 PMCID: PMC11156241 DOI: 10.1177/1098612x241246518] [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] [Indexed: 05/08/2024]
Abstract
PRACTICAL RELEVANCE Chronic pain is a significant welfare concern in cats, and neuropathic pain, which arises from aberrant processing of sensory signals within the nervous system, is a subcategory of this type of pain. To comprehend this condition and how multimodal pharmacotherapy plays a central role in alleviating discomfort, it is crucial to delve into the anatomy of nociception and pain perception. In addition, there is an intricate interplay between emotional health and chronic pain in cats, and understanding and addressing the emotional factors that contribute to pain perception, and vice versa, is essential for comprehensive care.Clinical approach:Neuropathic pain is suspected if there is abnormal sensation in the area of the distribution of pain, together with a positive response to trial treatment with drugs effective for neuropathic pain. Ideally, this clinical suspicion would be supported by confirmation of a lesion at this neurolocalisation using diagnostic modalities such as MRI and neuroelectrophysiology. Alternatively, there may be a history of known trauma at that site. A variety of therapies, including analgesic, anti-inflammatory and adjuvant drugs, and neuromodulation (eg, TENS or acupuncture), can be employed to address different facets of pain pathways.Aim:This review article, aimed at primary care/ general practitioners, focuses on the identification and management of neuropathic pain in cats. Three case vignettes are included and a structured treatment algorithm is presented to guide veterinarians in tailoring interventions.Evidence base:The review draws on current literature, where available, along with the author's extensive experience and research.
Collapse
Affiliation(s)
- Clare Rusbridge
- BVMS, PhD, DipECVN, FRCVS School of Veterinary Medicine, The University of Surrey, Guildford, Surrey, UK; and Wear Referrals Veterinary Specialist & Emergency Hospital, Bradbury, Stockton-on-Tees, UK
| |
Collapse
|
21
|
Dunn M, Rushton AB, Mistry J, Soundy A, Heneghan NR. The biopsychosocial factors associated with development of chronic musculoskeletal pain. An umbrella review and meta-analysis of observational systematic reviews. PLoS One 2024; 19:e0294830. [PMID: 38557647 PMCID: PMC10984407 DOI: 10.1371/journal.pone.0294830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/18/2024] [Indexed: 04/04/2024] Open
Abstract
AIM The aim of this umbrella review was to establish which biopsychosocial factors are associated with development of chronic musculoskeletal pain. METHODS Ovid Medline, Embase, Web of Science Core Collection, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, PsycINFO, CINAHL, PEDro, PROSPERO, Google Scholar and grey literature were searched from database inception to 4th April 2023. Systematic reviews of observational prospective longitudinal studies, including populations with <3 months (not chronic) musculoskeletal pain, investigating biopsychosocial factors that contribute to development of chronic (>3 months) musculoskeletal pain. Two reviewers searched the literature, assessed risk of bias (Assessing the Methodological Quality of Systematic Reviews-2), and evaluated quality (Grading of Recommendations, Assessment, Development and Evaluation) to provide an overall statement on the certainty of evidence for each biopsychosocial factor. Data analysis was performed through random effects meta-analysis (including meta-analysis of meta-analyses where possible) and descriptive synthesis. RESULTS 13 systematic reviews were included comprising 185 original research studies (n = 489,644 participants). Thirty-four biopsychosocial factors are associated with development of chronic musculoskeletal pain. Meta-analyses of odds and/or likelihood ratios were possible for 25 biopsychosocial factors. There is moderate certainty evidence that smoking (OR 1.24 [95%CI, 1.14-1.34), fear avoidance (LR+ 2.11 [95%CI, 1.59-2.8]; LR- 0.5 [95%CI, 0.35-0.71]) poorer support networks (OR 1.21 [95%CI, 1.14-1.29]), lower socioeconomic status (OR 2.0 [95%CI, 1.64-2.42]), and high levels of pain (OR 5.61 [95%CI, 3.74-8.43]) are associated with development of chronic musculoskeletal pain (all P<0.001). Remaining factors are of low or very low certainty evidence. CONCLUSIONS AND RELEVANCE There is moderate certainty evidence that smoking, fear avoidance, poorer support networks, lower socioeconomic status, and high levels of pain are associated with development of chronic musculoskeletal pain. High risk of bias was evident in most included reviews; this highlights the need for higher quality systematic reviews.
Collapse
Affiliation(s)
- Michael Dunn
- Centre of Precision Rehabilitation for Spinal Pain, School of Sport and Exercise Science, University of Birmingham, Birmingham, West Midlands, United Kingdom
- Musculoskeletal Physiotherapy, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom
- Institute of Medical and Biomedical Education, Centre for Allied Health, St. George's University of London, London, United Kingdom
| | - Alison B Rushton
- Centre of Precision Rehabilitation for Spinal Pain, School of Sport and Exercise Science, University of Birmingham, Birmingham, West Midlands, United Kingdom
- School of Physical Therapy, Western University, London, Ontario, Canada
| | - Jai Mistry
- Musculoskeletal Physiotherapy, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom
- School of Physical Therapy, Western University, London, Ontario, Canada
| | - Andrew Soundy
- Centre of Precision Rehabilitation for Spinal Pain, School of Sport and Exercise Science, University of Birmingham, Birmingham, West Midlands, United Kingdom
| | - Nicola R Heneghan
- Centre of Precision Rehabilitation for Spinal Pain, School of Sport and Exercise Science, University of Birmingham, Birmingham, West Midlands, United Kingdom
| |
Collapse
|
22
|
Li HL, Zhang Y, Zhou JW. Acupuncture for radicular pain: a review of analgesic mechanism. Front Mol Neurosci 2024; 17:1332876. [PMID: 38596777 PMCID: PMC11002172 DOI: 10.3389/fnmol.2024.1332876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 02/28/2024] [Indexed: 04/11/2024] Open
Abstract
Radicular pain, a common and complex form of neuropathic pain, presents significant challenges in treatment. Acupuncture, a therapy originating from ancient traditional Chinese medicine and widely utilized for various pain types, including radicular pain, has shown promising outcomes in the management of lumbar radicular pain, cervical radicular pain, and radicular pain due to spinal stenosis. Despite its efficacy, the exact mechanisms through which acupuncture achieves analgesia are not fully elucidated and are the subject of ongoing research. This review sheds light on the current understanding of the analgesic mechanisms of acupuncture for radicular pain, offering valuable perspectives for both clinical application and basic scientific research. Acupuncture is postulated to relieve radicular pain by several mechanisms: peripherally, it reduces muscle spasms, lessens mechanical pressure on nerve roots, and improves microcirculation; at the molecular level, it inhibits the HMGB1/RAGE and TLR4/NF-ĪŗB signaling pathways, thereby decreasing the release of pro-inflammatory cytokines; within the spinal cord, it influences synaptic plasticity; and centrally, it modulates brain function, particularly affecting the medial prefrontal cortex, anterior cingulate cortex, and thalamus within the default mode network. By acting across these diverse biological domains, acupuncture presents an effective treatment modality for radicular pain, and deepening our understanding of the underlying mechanisms regarding analgesia for radicular pain is crucial for enhancing its clinical efficacy and advancement in pain management.
Collapse
Affiliation(s)
- Hong-Lin Li
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yi Zhang
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jian-Wei Zhou
- Academy of Traditional Chinese Medicine Sciences, Chengdu, Sichuan, China
| |
Collapse
|
23
|
Liang Z, Guo Y, Sharma A, McCurdy CR, Prentice BM. A multi-modal image fusion workflow incorporating MALDI imaging mass spectrometry and microscopy for the study of small pharmaceutical compounds. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.03.12.584673. [PMID: 38559145 PMCID: PMC10980041 DOI: 10.1101/2024.03.12.584673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Multi-modal imaging analyses of dosed tissue samples can provide more comprehensive insight into the effects of a therapeutically active compound on a target tissue compared to single-modal imaging. For example, simultaneous spatial mapping of pharmaceutical compounds and endogenous macromolecule receptors is difficult to achieve in a single imaging experiment. Herein, we present a multi-modal workflow combining imaging mass spectrometry with immunohistochemistry (IHC) fluorescence imaging and brightfield microscopy imaging. Imaging mass spectrometry enables direct mapping of pharmaceutical compounds and metabolites, IHC fluorescence imaging can visualize large proteins, and brightfield microscopy imaging provides tissue morphology information. Single-cell resolution images are generally difficult to acquire using imaging mass spectrometry, but are readily acquired with IHC fluorescence and brightfield microscopy imaging. Spatial sharpening of mass spectrometry images would thus allow for higher fidelity co-registration with higher resolution microscopy images. Imaging mass spectrometry spatial resolution can be predicted to a finer value via a computational image fusion workflow, which models the relationship between the intensity values in the mass spectrometry image and the features of a high spatial resolution microscopy image. As a proof of concept, our multi-modal workflow was applied to brain tissue extracted from a Sprague Dawley rat dosed with a kratom alkaloid, corynantheidine. Four candidate mathematical models including linear regression, partial least squares regression (PLS), random forest regression, and two-dimensional convolutional neural network (2-D CNN), were tested. The random forest and 2-D CNN models most accurately predicted the intensity values at each pixel as well as the overall patterns of the mass spectrometry images, while also providing the best spatial resolution enhancements. Herein, image fusion enabled predicted mass spectrometry images of corynantheidine, GABA, and glutamine to approximately 2.5 Ī¼m spatial resolutions, a significant improvement compared to the original images acquired at 25 Ī¼m spatial resolution. The predicted mass spectrometry images were then co-registered with an H&E image and IHC fluorescence image of the Ī¼-opioid receptor to assess co-localization of corynantheidine with brain cells. Our study also provides insight into the different evaluation parameters to consider when utilizing image fusion for biological applications.
Collapse
Affiliation(s)
- Zhongling Liang
- Department of Chemistry, University of Florida, Gainesville, FL 32611
| | - Yingchan Guo
- Department of Chemistry, University of Florida, Gainesville, FL 32611
| | - Abhisheak Sharma
- Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, FL 32610
| | - Christopher R. McCurdy
- Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, FL 32610
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL 32610
| | - Boone M. Prentice
- Department of Chemistry, University of Florida, Gainesville, FL 32611
| |
Collapse
|
24
|
Han S, Wang J, Zhang W, Tian X. Chronic Pain-Related Cognitive Deficits: Preclinical Insights into Molecular, Cellular, and Circuit Mechanisms. Mol Neurobiol 2024:10.1007/s12035-024-04073-z. [PMID: 38470516 DOI: 10.1007/s12035-024-04073-z] [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: 10/13/2023] [Accepted: 02/23/2024] [Indexed: 03/14/2024]
Abstract
Cognitive impairment is a common comorbidity of chronic pain, significantly disrupting patients' quality of life. Despite this comorbidity being clinically recognized, the underlying neuropathological mechanisms remain unclear. Recent preclinical studies have focused on the fundamental mechanisms underlying the coexistence of chronic pain and cognitive decline. Pain chronification is accompanied by structural and functional changes in the neural substrate of cognition. Based on the developments in electrophysiology and optogenetics/chemogenetics, we summarized the relevant neural circuits involved in pain-induced cognitive impairment, as well as changes in connectivity and function in brain regions. We then present the cellular and molecular alternations related to pain-induced cognitive impairment in preclinical studies, mainly including modifications in neuronal excitability and structure, synaptic plasticity, glial cells and cytokines, neurotransmitters and other neurochemicals, and the gut-brain axis. Finally, we also discussed the potential treatment strategies and future research directions.
Collapse
Affiliation(s)
- Siyi Han
- Department of Anesthesiology, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, Hubei, China
| | - Jie Wang
- Wuhan Institute of Physics and Mathematics, Chinese Academy of Sciences, Wuhan, Hubei, China
| | - Wen Zhang
- Department of Anesthesiology, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, Hubei, China.
| | - Xuebi Tian
- Department of Anesthesiology, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, Hubei, China.
| |
Collapse
|
25
|
Zhao W, Yu YM, Wang XY, Xia SH, Ma Y, Tang H, Tao M, Li H, Xu Z, Yang JX, Wu P, Zhang H, Ding HL, Cao JL. CRF regulates pain sensation by enhancement of corticoaccumbal excitatory synaptic transmission. Mol Psychiatry 2024:10.1038/s41380-024-02488-7. [PMID: 38454083 DOI: 10.1038/s41380-024-02488-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 02/08/2024] [Accepted: 02/14/2024] [Indexed: 03/09/2024]
Abstract
Both peripheral and central corticotropin-releasing factor (CRF) systems have been implicated in regulating pain sensation. However, compared with the peripheral, the mechanisms underlying central CRF system in pain modulation have not yet been elucidated, especially at the neural circuit level. The corticoaccumbal circuit, a structure rich in CRF receptors and CRF-positive neurons, plays an important role in behavioral responses to stressors including nociceptive stimuli. The present study was designed to investigate whether and how CRF signaling in this circuit regulated pain sensation under physiological and pathological pain conditions. Our studies employed the viral tracing and circuit-, and cell-specific electrophysiological methods to label the CRF-containing circuit from the medial prefrontal cortex to the nucleus accumbens shell (mPFCCRF-NAcS) and record its neuronal propriety. Combining optogenetic and chemogenetic manipulation, neuropharmacological methods, and behavioral tests, we were able to precisely manipulate this circuit and depict its role in regulation of pain sensation. The current study found that the CRF signaling in the NAc shell (NAcS), but not NAc core, was necessary and sufficient for the regulation of pain sensation under physiological and pathological pain conditions. This process was involved in the CRF-mediated enhancement of excitatory synaptic transmission in the NAcS. Furthermore, we demonstrated that the mPFCCRF neurons monosynaptically connected with the NAcS neurons. Chronic pain increased the protein level of CRF in NAcS, and then maintained the persistent NAcS neuronal hyperactivity through enhancement of this monosynaptic excitatory connection, and thus sustained chronic pain behavior. These findings reveal a novel cell- and circuit-based mechanistic link between chronic pain and the mPFCCRFāāāNAcS circuit and provide a potential new therapeutic target for chronic pain.
Collapse
Affiliation(s)
- Weinan Zhao
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
- Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Yu-Mei Yu
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
- Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Xiao-Yi Wang
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
- Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
- Department of Anesthesiology, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, 210008, Jiangsu, China
| | - Sun-Hui Xia
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
- Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Yu Ma
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
- Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Huimei Tang
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
- Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Mingshu Tao
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
- Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - He Li
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
- Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Zheng Xu
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
- Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Jun-Xia Yang
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
- Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Peng Wu
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
- Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Hongxing Zhang
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
- Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Hai-Lei Ding
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China.
- Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China.
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China.
| | - Jun-Li Cao
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China.
- Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China.
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China.
- Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221002, Jiangsu, China.
| |
Collapse
|
26
|
ÅtefÄnescu E, Strilciuc Å, Chelaru VF, Chira D, MureÅanu D. Blink rate during saccadic eye movements: insights from patients with chronic pain. J Med Life 2024; 17:368-374. [PMID: 39044929 PMCID: PMC11262601 DOI: 10.25122/jml-2024-0271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 05/28/2024] [Indexed: 07/25/2024] Open
Abstract
Chronic pain (CP) significantly impacts quality of life and poses an increasing economic burden on healthcare systems worldwide. This study investigates the relationship between blink rate during saccadic eye movements and pain perception in patients with CP. Ninety-two patients with CP (24 men, 68 women) were assessed using eye-tracking technology during horizontal and vertical saccadic tasks. Pain perception was evaluated using the Central Sensitization Inventory - Part A and the McGill Pain Questionnaire, and anxiety levels were measured using the State-Trait Anxiety Inventory. The results revealed a significant correlation between blink rates in horizontal and vertical tasks (Ļ = 0.668, P < 0.001). However, there was no correlation between blink rate and age, pain perception, or anxiety scores. Conversely, measures of pain perception were positively correlated with each other and with anxiety scores. These findings suggest that while blink rate may reflect oculomotor function, it is not directly influenced by pain perception or anxiety in patients with CP. The present study highlights the potential of eye tracking for the comprehensive assessment and management of patients with CP.
Collapse
Affiliation(s)
- Emanuel ÅtefÄnescu
- Department of Neuroscience, Iuliu HaČieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Åtefan Strilciuc
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
- Research Center for Functional Genomics, Biomedicine, and Translational Medicine, Iuliu HaČieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Vlad-Florin Chelaru
- Department of Neuroscience, Iuliu HaČieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Diana Chira
- Department of Neuroscience, Iuliu HaČieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Dafin MureÅanu
- Department of Neuroscience, Iuliu HaČieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| |
Collapse
|
27
|
Alito A, Verme F, Mercati GP, PiterĆ P, Fontana JM, Capodaglio P. Whole Body Cryostimulation: A New Adjuvant Treatment in Central Sensitization Syndromes? An Expert Opinion. Healthcare (Basel) 2024; 12:546. [PMID: 38470657 PMCID: PMC10931027 DOI: 10.3390/healthcare12050546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/21/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024] Open
Abstract
Central sensitisation is defined as a multifactorial etiopathogenetic condition involving an increase in the reactivity of nociceptive neurons and alterations in pain transmission and perception in the central nervous system. Patients may present with widespread chronic pain, fatigue, sleep disturbance, dizziness, psychological (e.g., depression, anxiety, and anger) and social impairment. Pain can be spontaneous in onset and persistence, characterised by an exaggerated response and spread beyond the site of origin, and sometimes triggered by a non-painful stimulus. Whole-body cryostimulation (WBC) could be an adjuvant therapy in the management of this type of pain because of its global anti-inflammatory effect, changes in cytokines and hormone secretion, reduction in nerve conduction velocity, autonomic modulation, and release of neurotransmitters involved in the pain pathway. In several conditions (e.g., fibromyalgia, rheumatoid arthritis, and chronic musculoskeletal pain), WBC affects physical performance, pain perception, and psychological aspects. Given its multiple targets and effects at different organs and levels, WBC appears to be a versatile adjuvant treatment for a wide range of conditions of rehabilitation interest. Further research is needed to fully understand the mechanisms of analgesic effect and potential actions on pain pathways, as well as to study long-term effects and potential uses in other chronic pain conditions.
Collapse
Affiliation(s)
- Angelo Alito
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, 98125 Messina, Italy;
| | - Federica Verme
- Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, IRCCS, Istituto Auxologico Italiano, San Giuseppe Hospital, Piancavallo, 28824 Verbania, Italy; (F.V.); (P.P.); (P.C.)
| | - Gian Paolo Mercati
- Department of Surgical Sciences, Degree Course in Physiotherapy, University of Torino, 10121 Torino, Italy;
| | - Paolo PiterĆ
- Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, IRCCS, Istituto Auxologico Italiano, San Giuseppe Hospital, Piancavallo, 28824 Verbania, Italy; (F.V.); (P.P.); (P.C.)
| | - Jacopo Maria Fontana
- Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, IRCCS, Istituto Auxologico Italiano, San Giuseppe Hospital, Piancavallo, 28824 Verbania, Italy; (F.V.); (P.P.); (P.C.)
| | - Paolo Capodaglio
- Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, IRCCS, Istituto Auxologico Italiano, San Giuseppe Hospital, Piancavallo, 28824 Verbania, Italy; (F.V.); (P.P.); (P.C.)
- Department of Surgical Sciences, Physical and Rehabilitation Medicine, University of Torino, 10121 Torino, Italy
| |
Collapse
|
28
|
Bonanno M, Papa D, Cerasa A, Maggio MG, CalabrĆ² RS. Psycho-Neuroendocrinology in the Rehabilitation Field: Focus on the Complex Interplay between Stress and Pain. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:285. [PMID: 38399572 PMCID: PMC10889914 DOI: 10.3390/medicina60020285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/02/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024]
Abstract
Chronic stress and chronic pain share neuro-anatomical, endocrinological, and biological features. However, stress prepares the body for challenging situations or mitigates tissue damage, while pain is an unpleasant sensation due to nociceptive receptor stimulation. When pain is chronic, it might lead to an allostatic overload in the body and brain due to the chronic dysregulation of the physiological systems that are normally involved in adapting to environmental challenges. Managing stress and chronic pain (CP) in neurorehabilitation presents a significant challenge for healthcare professionals and researchers, as there is no definitive and effective solution for these issues. Patients suffering from neurological disorders often complain of CP, which significantly reduces their quality of life. The aim of this narrative review is to examine the correlation between stress and pain and their potential negative impact on the rehabilitation process. Moreover, we described the most relevant interventions used to manage stress and pain in the neurological population. In conclusion, this review sheds light on the connection between chronic stress and chronic pain and their impact on the neurorehabilitation pathway. Our results emphasize the need for tailored rehabilitation protocols to effectively manage pain, improve treatment adherence, and ensure comprehensive patient care.
Collapse
Affiliation(s)
- Mirjam Bonanno
- IRCCS Centro Neurolesi Bonino-Pulejo, 98124 Messina, Italy; (M.B.); (R.S.C.)
| | - Davide Papa
- International College of Osteopathic Medicine, 20092 Cinisello Balsamo, Italy;
| | - Antonio Cerasa
- SāAnna Institute, 88900 Crotone, Italy;
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy
- Translational Pharmacology, Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Rende, Italy
| | - Maria Grazia Maggio
- IRCCS Centro Neurolesi Bonino-Pulejo, 98124 Messina, Italy; (M.B.); (R.S.C.)
| | | |
Collapse
|
29
|
Hsiao IH, Yen CM, Hsu HC, Liao HY, Lin YW. Chemogenetics Modulation of Electroacupuncture Analgesia in Mice Spared Nerve Injury-Induced Neuropathic Pain through TRPV1 Signaling Pathway. Int J Mol Sci 2024; 25:1771. [PMID: 38339048 PMCID: PMC10855068 DOI: 10.3390/ijms25031771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/18/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
Neuropathic pain, which is initiated by a malfunction of the somatosensory cortex system, elicits inflammation and simultaneously activates glial cells that initiate neuroinflammation. Electroacupuncture (EA) has been shown to have therapeutic effects for neuropathic pain, although with uncertain mechanisms. We suggest that EA can reliably cure neuropathic disease through anti-inflammation and transient receptor potential V1 (TRPV1) signaling pathways from the peripheral to the central nervous system. To explore this, we used EA to treat the mice spared nerve injury (SNI) model and explore the underlying molecular mechanisms through novel chemogenetics techniques. Both mechanical and thermal pain were found in SNI mice at four weeks (mechanical: 3.23 Ā± 0.29 g; thermal: 4.9 Ā± 0.14 s). Mechanical hyperalgesia was partially attenuated by 2 Hz EA (mechanical: 4.05 Ā± 0.19 g), and thermal hyperalgesia was fully reduced (thermal: 6.22 Ā± 0.26 s) but not with sham EA (mechanical: 3.13 Ā± 0.23 g; thermal: 4.58 Ā± 0.37 s), suggesting EA's specificity. In addition, animals with Trpv1 deletion showed partial mechanical hyperalgesia and no significant induction of thermal hyperalgesia in neuropathic pain mice (mechanical: 4.43 Ā± 0.26 g; thermal: 6.24 Ā± 0.09 s). Moreover, we found increased levels of inflammatory factors such as interleukin-1 beta (IL1-Ī²), IL-3, IL-6, IL-12, IL-17, tumor necrosis factor alpha, and interferon gamma after SNI modeling, which decreased in the EA and Trpv1-/- groups rather than the sham group. Western blot and immunofluorescence analysis showed similar tendencies in the dorsal root ganglion, spinal cord dorsal horn, somatosensory cortex (SSC), and anterior cingulate cortex (ACC). In addition, a novel chemogenetics method was used to precisely inhibit SSC to ACC activity, which showed an analgesic effect through the TRPV1 pathway. In summary, our findings indicate a novel mechanism underlying neuropathic pain as a beneficial target for neuropathic pain.
Collapse
Affiliation(s)
- I-Han Hsiao
- School of Medicine, College of Medicine, China Medical University, Taichung 40402, Taiwan;
- Department of Neurosurgery, China Medical University Hospital, Taichung 40402, Taiwan
| | - Chia-Ming Yen
- Department of Anesthesiology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 42743, Taiwan;
- School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien 97004, Taiwan
| | - Hsin-Cheng Hsu
- School of Post-Baccalaureate Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan;
- Department of Traditional Chinese Medicine, China Medical University Hsinchu Hospital, Hsinchu 302, Taiwan
| | - Hsien-Yin Liao
- School of Post-Baccalaureate Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan;
| | - Yi-Wen Lin
- Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
- Chinese Medicine Research Center, China Medical University, Taichung 40402, Taiwan
| |
Collapse
|
30
|
Rahimibarghani S, Morgan R, Diaz JJ. Neuromodulation Techniques in Chronic Refractory Coccydynia: A Narrative Review. Pain Ther 2024; 13:53-67. [PMID: 38175492 PMCID: PMC10796902 DOI: 10.1007/s40122-023-00572-4] [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: 09/20/2023] [Accepted: 12/15/2023] [Indexed: 01/05/2024] Open
Abstract
Refractory coccydynia is a condition characterized by severe coccygeal pain and poses a challenging management dilemma for clinicians. Advancements in neuromodulation (NM) technology have provided benefits to people experiencing chronic pain that is resistant to standard treatments. This review aims to summarize the spectrum of current NM techniques employed in the treatment of refractory coccydynia along with their effectiveness. A review of studies in the scientific literature from 2012 to 2023 was conducted, revealing a limited number of case reports. Although the available evidence at this time suggests significant pain relief with the utilization of NM techniques, the limited scope and nature of the studies reviewed emphasize the need for large-scale, rigorous, high-level research in this domain in order to establish a comprehensive understanding of the role of NM and its effectiveness in the management of intractable coccydynia.
Collapse
Affiliation(s)
- Sarvenaz Rahimibarghani
- Physical Medicine and Rehabilitation Department, Tehran University of Medical Sciences, Tehran, Iran.
| | - Richard Morgan
- Miami Neuroscience Institute, Baptist Health South Florida, Miami, FL, USA
| | - Jose Juan Diaz
- Physical Medicine and Rehabilitation Department, Larkin Community Hospital, South Miami Campus, South Miami, FL, USA
| |
Collapse
|
31
|
Goudman L, Pilitsis JG, Billet B, De Vos R, Hanssens K, Billot M, Roulaud M, Rigoard P, Moens M. The level of agreement between the numerical rating scale and visual analogue scale for assessing pain intensity in adults with chronic pain. Anaesthesia 2024; 79:128-138. [PMID: 38058100 DOI: 10.1111/anae.16151] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2023] [Indexed: 12/08/2023]
Abstract
The numerical rating scale and visual analogue scale are used to quantify pain intensity. However, it has not yet been explored whether these scores are interchangeable in adults with chronic pain. Data from the prospective multicentre cross-sectional INTERVAL study were used to evaluate the one-dimensionality and agreement between numerical rating scale scores and visual analogue scale scores in adults with chronic pain. Pain intensity scores using the numerical rating scale and visual analogue scale were provided by 366 patients with chronic pain for current, average, minimal and maximal pain. To evaluate whether pain intensity scales are completed in accordance with each other, the proportion of patients who satisfied the following condition was calculated: minimal pain intensityāā¤āmaximal pain intensity. A factor analysis confirmed the one-dimensionality of the pain measures. A significant difference was found between numerical rating scale and visual analogue scale scores for average, current, minimum and maximum pain. Intra-class correlation coefficient estimates ranged from 0.739 to 0.858 and all measures failed to show sufficient and acceptable agreement at the 95% level. The strength of agreement between pain severity categories was classified as 'moderate' for average and minimal pain and 'substantial' for current and maximal pain. The proportion of patients who scored minimal paināā¤āmaximal pain was 97.5% for the numerical rating scale and 89.5% for the visual analogue scale. This study failed to show an acceptable agreement between the numerical rating scale and visual analogue scale when pain intensity was rated by adults with chronic pain, despite showing both scales measure the same information.
Collapse
Affiliation(s)
- L Goudman
- STIMULUS research group, Vrije Universiteit Brussel, Brussels, Belgium
- Research Foundation-Flanders (FWO), Brussels, Belgium
| | - J G Pilitsis
- Florida Atlantic University, Boca Raton, FL, USA
| | - B Billet
- STIMULUS research group, Vrije Universiteit Brussel, Brussels, Belgium
- Pain Clinic, AZ Delta, Roeselare, Belgium
| | - R De Vos
- Pain Clinic, AZ Delta, Roeselare, Belgium
| | - K Hanssens
- Pain Clinic, AZ Delta, Roeselare, Belgium
| | - M Billot
- PRISMATICS Lab, Poitiers University Hospital, Poitiers, France
| | - M Roulaud
- PRISMATICS Lab, Poitiers University Hospital, Poitiers, France
| | - P Rigoard
- PRISMATICS Lab, Poitiers University Hospital, Poitiers, France
- Department of Spine Surgery and Neuromodulation, Poitiers University Hospital, Poitiers, France
| | - M Moens
- STIMULUS research group, Vrije Universiteit Brussel, Brussels, Belgium
- Departments of Neurosurgery and Radiology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| |
Collapse
|
32
|
Yasoda-Mohan A, Vanneste S. Development, Insults and Predisposing Factors of the Brain's Predictive Coding System to Chronic Perceptual Disorders-A Life-Course Examination. Brain Sci 2024; 14:86. [PMID: 38248301 PMCID: PMC10813926 DOI: 10.3390/brainsci14010086] [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: 12/12/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/23/2024] Open
Abstract
The predictive coding theory is currently widely accepted as the theoretical basis of perception and chronic perceptual disorders are explained as the maladaptive compensation of the brain to a prediction error. Although this gives us a general framework to work with, it is still not clear who may be more susceptible and/or vulnerable to aberrations in this system. In this paper, we study changes in predictive coding through the lens of tinnitus and pain. We take a step back to understand how the predictive coding system develops from infancy, what are the different neural and bio markers that characterise this system in the acute, transition and chronic phases and what may be the factors that pose a risk to the aberration of this system. Through this paper, we aim to identify people who may be at a higher risk of developing chronic perceptual disorders as a reflection of aberrant predictive coding, thereby giving future studies more facets to incorporate in their investigation of early markers of tinnitus, pain and other disorders of predictive coding. We therefore view this paper to encourage the thinking behind the development of preclinical biomarkers to maladaptive predictive coding.
Collapse
Affiliation(s)
- Anusha Yasoda-Mohan
- Global Brain Health Institute, Trinity College Dublin, D02 R123 Dublin, Ireland;
- Trinity College Institute for Neuroscience, Trinity College Dublin, D02 R123 Dublin, Ireland
- Lab for Clinical & Integrative Neuroscience, School of Psychology, Trinity College Dublin, D02 R123 Dublin, Ireland
| | - Sven Vanneste
- Global Brain Health Institute, Trinity College Dublin, D02 R123 Dublin, Ireland;
- Trinity College Institute for Neuroscience, Trinity College Dublin, D02 R123 Dublin, Ireland
- Lab for Clinical & Integrative Neuroscience, School of Psychology, Trinity College Dublin, D02 R123 Dublin, Ireland
| |
Collapse
|
33
|
Yu Z, Yang H, Liu LY, Chen L, Su MH, Yang L, Zhu MJ, Yang LL, Liang F, Yu S, Yang J. Altered cognitive control network mediates the association between long-term pain and anxiety symptoms in primary dysmenorrhea. Neuroreport 2024; 35:9-16. [PMID: 37994619 PMCID: PMC10702699 DOI: 10.1097/wnr.0000000000001971] [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: 08/08/2023] [Accepted: 08/31/2023] [Indexed: 11/24/2023]
Abstract
Neuroimaging studies have demonstrated the association of the cognitive control network (CCN) with the maintenance of chronic pain. However, whether and how dorsolateral prefrontal cortex (DLPFC), a key region within the CCN, is altered in menstrual pain is unclear. In this study, we aimed to investigate alterations in the DLPFC functional connectivity network in patients with primary dysmenorrhea (PDM). The study comprised 41 PDM patients and 39 matched healthy controls (HCs), all of whom underwent a resting-state functional MRI scan during the menstrual stage. All participants were instructed to complete the clinical assessment before the MRI scan. We used the DLPFC as the seed in resting-state functional connectivity (rsFC) analysis to investigate the difference between PDM patients and HCs. Compared to HCs, PDM patients showed increased right DLPFC rsFC at the bilateral lingual gyrus, dorsal anterior cingulate cortex (dACC), and middle cingulate cortex, and decreased left DLPFC rsFC at the right orbital frontal cortex. In addition, increased right DLPFC-bilateral dACC connectivity mediated the association between disease duration and the self-rating anxiety scale (SAS) scores in PDM patients. We confirmed that the DLPFC-dACC rsFC was associated with higher SAS scores, which could mediate the association between disease duration and anxiety symptoms in patients with PDM. Our findings provide central pathological evidence for an abnormal rsFC of the CCN in PDM patients, which may contribute to a better understanding of the neuropathophysiological mechanisms underlying PDM.
Collapse
Affiliation(s)
- Zheng Yu
- School of Intelligent Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu
| | - Han Yang
- Division of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University
| | - Li-ying Liu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Lin Chen
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Meng-hua Su
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Lu Yang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Man-jia Zhu
- School of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu
| | - Li-li Yang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Fanrong Liang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Siyi Yu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Jie Yang
- Traditional Chinese Medicine Department, Sichuan Jinxin Xiānan Womenās and Childrenās Hospital
| |
Collapse
|
34
|
Wang X, Zhuang Y, Lin Z, Chen S, Chen L, Huang H, Lin H, Wu S. Research hotspots and trends on neuropathic pain-related mood disorders: a bibliometric analysis from 2003 to 2023. FRONTIERS IN PAIN RESEARCH 2023; 4:1233444. [PMID: 38179224 PMCID: PMC10764508 DOI: 10.3389/fpain.2023.1233444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 12/11/2023] [Indexed: 01/06/2024] Open
Abstract
Introduction Neuropathic Pain (NP) is often accompanied by mood disorders, which seriously affect the quality of life of patients. This study aimed to analyze the hotspots and trends in NP-related mood disorder research using bibliometric methods and to provide valuable predictions for future research in this field. Methods Articles and review articles on NP-related mood disorders published from January 2003 to May 2023 were retrieved from the Web of Science Core Collection. We used CiteSpace to analyze publications, countries, institutions, authors, cited authors, journals, cited journals, references, cited references, and keywords. We also analyzed collaborative network maps and co-occurrence network maps. Results A total of 4,540 studies were collected for analysis. The number of publications concerning NP-related mood disorders every year shows an upward trend. The United States was a major contributor in this field. The University of Toronto was the most productive core institution. C GHELARDINI was the most prolific author, and RH DWORKIN was the most frequently cited author. PAIN was identified as the journal with the highest productivity and citation rate. The current research hotspots mainly included quality of life, efficacy, double-blind methodology, gabapentin, pregabalin, postherpetic neuralgia, and central sensitization. The frontiers in research mainly focused on the mechanisms associated with microglia activation, oxidative stress, neuroinflammation, and NP-related mood disorders. Discussion In conclusion, the present study provided insight into the current state and trends in NP-related mood disorder research over the past 20 years. Consequently, researchers will be able to identify new perspectives on potential collaborators and cooperative institutions, hot topics, and research frontiers in this field.
Collapse
Affiliation(s)
- Xiaohua Wang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Yueyang Zhuang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Zhigang Lin
- Affiliated Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
- Fujian Key Laboratory of Rehabilitation Technology, Fuzhou, Fujian, China
| | - Shuijin Chen
- Affiliated Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
- Fujian Key Laboratory of Rehabilitation Technology, Fuzhou, Fujian, China
| | - Lechun Chen
- Affiliated Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
- Fujian Key Laboratory of Rehabilitation Technology, Fuzhou, Fujian, China
| | - Hongye Huang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Hui Lin
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Shiye Wu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| |
Collapse
|
35
|
Yang Y, Wei X, Tian J, Zhu Y, Jia S, Shu Q. Scalp electroacupuncture targeting the VTA DA neurons to relieve negative emotions and promote the alleviation of chronic pain. Front Neurosci 2023; 17:1323727. [PMID: 38188034 PMCID: PMC10771389 DOI: 10.3389/fnins.2023.1323727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 11/30/2023] [Indexed: 01/09/2024] Open
Abstract
Object Chronic pain and negative emotions are often linked, and both can impact the reward circuit. The use of electroacupuncture (EA) has been found to regulate and improve these conditions. This study explores the potential mechanism of chronic pain relief by adding acupoints with emotional regulation effect to the basis of routine EA analgesia, to optimize the acupoint compatibility scheme of EA in the treatment of analgesia. Method For this study, 42 male Wistar rats were used. Recombinant adeno-associated viruses were used to label and regulate the activity of dopamine (DA) neurons. The rat model was established by complete Freund's adjuvant (CFA). Lower limb electroacupuncture (LEA) was applied to the ST36 and BL60 acupoints. In addition, LEA + scalp EA (SEA) was given using the GV20 and GV24+ acupoints besides ST36 and BL60. To evaluate the pain threshold, we measured 50% paw withdrawal thresholds and thermal paw withdrawal latencies. Negative emotions were evaluated through the open field test, marble-burying test, sucrose preference test, and forced swimming test. Moreover, the conditional place preference test was conducted to measure the reward behavior in response to pain relief. Immunofluorescence staining, Western blotting, and qPCR were used to detect the activity of the VTADA-NAc reward circuit. Result The injection of CFA significantly lowered the pain threshold. As the pain persisted, the anxiety and depression-like behaviors escalated while the response to reward reduced. Meanwhile, the VTADA-NAc pathway was suppressed with pain chronification. However, activating DA neurons in VTA attenuated the effects induced by CFA. LEA could relieve chronic pain, negative emotions, and reward disorders, while also activating the VTADA-NAc pathway. In addition, LEA + SEA exhibited a more pronounced effect compared with LEA alone. Nevertheless, chemogenetic inhibition of DA neurons decreased the efficacy of LEA + SEA in the treatment of chronic pain and associated comorbidities. Conclusion Adding SEA to conventional LEA effectively alleviates negative emotions and chronic pain, potentially due to the activation of the VTADA-NAc reward neural circuit. Thus, LEA + SEA is a more effective treatment for hyperalgesia and associated negative emotions compared with LEA alone.
Collapse
Affiliation(s)
- Yanan Yang
- Department of Traditional Chinese Medicine, China Resources & Wugang General Hospital, Wuhan, China
| | - Xiali Wei
- College of Sports Medicine, Wuhan Sports University, Wuhan, China
| | - Jun Tian
- Department of Rehabilitation, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Ye Zhu
- College of Sports Medicine, Wuhan Sports University, Wuhan, China
- Department of Rehabilitation, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Shaohui Jia
- College of Sports Medicine, Wuhan Sports University, Wuhan, China
| | - Qing Shu
- Department of Rehabilitation, Zhongnan Hospital of Wuhan University, Wuhan, China
| |
Collapse
|
36
|
Anderson AR, Holliday D. Mapping the associations of daily pain, sleep, and psychological distress in a U.S. sample. J Behav Med 2023; 46:973-985. [PMID: 37382795 DOI: 10.1007/s10865-023-00432-8] [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: 01/30/2023] [Accepted: 06/19/2023] [Indexed: 06/30/2023]
Abstract
Chronic pain, sleep problems, and psychological distress (PD) can be disabling conditions and previous research has shown that they are associated. The nuances of the comorbid nature of these conditions may be important to understand for those who treat these conditions. This study examined the bidirectional associations of these health factors concurrently and over time in a sample of U.S. adults (Nā=ā1,008, Mage = 57.68) from the Midlife in the United States (MIDUS) study. Participants reported on their daily pain, sleep quantity, and psychological distress over eight days. A modified Random Intercept Cross-lagged Panel Model was used to analyze the relations, starting with the whole sample and then a comparison of those with and without chronic pain. Results indicated that nightly variation in sleep quantity predicted next day psychological distress for both groups. Sleep quantity also predicted next-day pain, but only for individuals with chronic pain. Associations between pain and psychological distress were found both at the daily level and individual (between-person) level. This between-person association was stronger for those with chronic pain. The lagged associations between sleep, and both pain and psychological distress for the chronic pain group indicate that, increased quantity of sleep predicts decreased next-day pain and psychological distress. Providers could consider this unidirectional lagged relationship when prioritizing treatment for patients with these comorbid conditions. Future research may examine whether responsive, just-in-time treatments might intervene after participants wake from a poor night's sleep to counteract the negative effects of reduced sleep on PD and pain.
Collapse
Affiliation(s)
- Austen R Anderson
- School of Psychology, University of Southern Mississippi, 118 College Dr. #5025, Hattiesburg, MS, 39406, USA.
| | - Danielle Holliday
- School of Psychology, University of Southern Mississippi, 118 College Dr. #5025, Hattiesburg, MS, 39406, USA
| |
Collapse
|
37
|
Holmes S, Reyes N, Huang JJ, Galor A, Pattany PM, Felix ER, Moulton EA. Disentangling the neurological basis of chronic ocular pain using clinical, self-report, and brain imaging data: use of K-means clustering to explore patient phenotypes. Front Neurol 2023; 14:1265082. [PMID: 38033775 PMCID: PMC10687553 DOI: 10.3389/fneur.2023.1265082] [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: 07/28/2023] [Accepted: 10/25/2023] [Indexed: 12/02/2023] Open
Abstract
Introduction The factors that mediate the expression of ocular pain and the mechanisms that promote chronic ocular pain symptoms are poorly understood. Central nervous system involvement has been postulated based on observations of pain out of proportion to nociceptive stimuli in some individuals. This investigation focused on understanding functional connectivity between brain regions implicated in chronic pain in persons reporting ocular pain symptoms. Methods We recruited a total of 53 persons divided into two cohorts: persons who reported no ocular pain, and persons who reported chronic ocular pain, irrespective of ocular surface findings. We performed a resting state fMRI investigation that was focused on subcortical brain structures including the trigeminal nucleus and performed a brief battery of ophthalmological examinations. Results Persons in the pain cohort reported higher levels of pain symptoms relating to neuropathic pain and ocular surface disease, as well as more abnormal tear metrics (stability and tear production). Functional connectivity analysis between groups evinced multiple connections exemplifying both increases and decreases in connectivity including regions such as the trigeminal nucleus, amygdala, and sub-regions of the thalamus. Exploratory analysis of the pain cohort integrating clinical and brain function metrics highlighted subpopulations that showed unique phenotypes providing insight into pain mechanisms. Discussion Study findings support centralized involvement in those reporting ocular-based pain and allude to mechanisms through which pain treatment services may be directed in future research.
Collapse
Affiliation(s)
- Scott Holmes
- Pain and Affective Neuroscience Center, Department of Anesthesia, Critical Care and Pain Medicine, Boston Childrenās Hospital, Harvard Medical School, Boston, MA, United States
- Pediatric Pain Pathway Lab, Boston Childrenās Hospital, Harvard Medical School, Boston, MA, United States
| | - Nicholas Reyes
- Surgical Services, Miami Veterans Administration Medical Center, Miami, FL, United States
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States
| | - Jaxon J. Huang
- Surgical Services, Miami Veterans Administration Medical Center, Miami, FL, United States
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States
| | - Anat Galor
- Surgical Services, Miami Veterans Administration Medical Center, Miami, FL, United States
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States
| | - Pradip M. Pattany
- Department of Radiology, University of Miami, Miami, FL, United States
| | - Elizabeth R. Felix
- Research Service, Miami Veterans Administration Medical Center, Miami, FL, United States
- Physical Medicine and Rehabilitation, University of Miami, Miami, FL, United States
| | - Eric A. Moulton
- Pain and Affective Neuroscience Center, Department of Anesthesia, Critical Care and Pain Medicine, Boston Childrenās Hospital, Harvard Medical School, Boston, MA, United States
- Brain and Eye Pain Imaging Lab, Department of Anesthesia, Critical Care and Pain Medicine, Boston Childrenās Hospital, Harvard Medical School, Boston, MA, United States
- Department of Ophthalmology, Boston Childrenās Hospital, Harvard Medical School, Boston, MA, United States
| |
Collapse
|
38
|
PƔrraga JP, Castellanos A. A Manifesto in Defense of Pain Complexity: A Critical Review of Essential Insights in Pain Neuroscience. J Clin Med 2023; 12:7080. [PMID: 38002692 PMCID: PMC10672144 DOI: 10.3390/jcm12227080] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/10/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023] Open
Abstract
Chronic pain has increasingly become a significant health challenge, not just as a symptomatic manifestation but also as a pathological condition with profound socioeconomic implications. Despite the expansion of medical interventions, the prevalence of chronic pain remains remarkably persistent, prompting a turn towards non-pharmacological treatments, such as therapeutic education, exercise, and cognitive-behavioral therapy. With the advent of cognitive neuroscience, pain is often presented as a primary output derived from the brain, aligning with Engel's Biopsychosocial Model that views disease not solely from a biological perspective but also considering psychological and social factors. This paradigm shift brings forward potential misconceptions and over-simplifications. The current review delves into the intricacies of nociception and pain perception. It questions long-standing beliefs like the cerebral-centric view of pain, the forgotten role of the peripheral nervous system in pain chronification, misconceptions around central sensitization syndromes, the controversy about the existence of a dedicated pain neuromatrix, the consciousness of the pain experience, and the possible oversight of factors beyond the nervous system. In re-evaluating these aspects, the review emphasizes the critical need for understanding the complexity of pain, urging the scientific and clinical community to move beyond reductionist perspectives and consider the multifaceted nature of this phenomenon.
Collapse
Affiliation(s)
- Javier PicaƱol PƔrraga
- Laboratory of Neurophysiology, Biomedicine Department, Faculty of Medicine and Health Sciences, Institute of Neurosciences, University of Barcelona, 08036 Barcelona, Spain
| | | |
Collapse
|
39
|
Lu C, Moliadze V, Nees F. Dynamic processes of mindfulness-based alterations in pain perception. Front Neurosci 2023; 17:1253559. [PMID: 38027503 PMCID: PMC10665508 DOI: 10.3389/fnins.2023.1253559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/05/2023] [Indexed: 12/01/2023] Open
Abstract
Mindfulness-based processes have been shown to enhance attention and related behavioral responses, including analgesia, which is discussed as an effective method in the context of pain interventions. In the present review, we introduce the construct of mindfulness, delineating the concepts, factors, and processes that are summarized under this term and might serve as relevant components of the underlying mechanistic pathways in the field of pain. We also discuss how differences in factors such as definitions of mindfulness, study design, and strategies in mindfulness-based attention direction may need to be considered when putting the findings from previous studies into a whole framework. In doing so, we capitalize on a potential dynamic process model of mindfulness-based analgesia. In this respect, the so-called mindfulness-based analgesia may initially result from improved cognitive regulation strategies, while at later stages of effects may be driven by a reduction of interference between both cognitive and affective factors. With increasing mindfulness practice, pathways and mechanisms of mindfulness analgesia may change dynamically, which could result from adaptive coping. This is underlined by the fact that the neural mechanism of mindfulness analgesia is manifested as increased activation in the ACC and aINS at the beginner level while increased activation in the pINS and reduced activation in the lPFC at the expert level.
Collapse
Affiliation(s)
| | | | - Frauke Nees
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| |
Collapse
|
40
|
Weinerman J, Vazquez A, Schurhoff N, Shatz C, Goldenberg B, Constantinescu D, Hernandez GM. The impacts of anxiety and depression on outcomes in orthopaedic trauma surgery: a narrative review. Ann Med Surg (Lond) 2023; 85:5523-5527. [PMID: 37920654 PMCID: PMC10619579 DOI: 10.1097/ms9.0000000000001307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 09/06/2023] [Indexed: 11/04/2023] Open
Abstract
Introduction The impact of anxiety and depression on outcomes in orthopaedic trauma surgery is a topic of growing research interest. Patients and methods Orthopaedic trauma patients often experience high rates of psychiatric disorders, with anxiety and depression being the most prevalent. Mental health disorders have been shown to increase the risk of negative surgical outcomes and morbidity. This narrative review seeks to summarize the current literature surrounding the impacts of anxiety and depression on orthopaedic trauma surgery outcomes. Discussion There is a bidirectional relationship between chronic pain and mental health disorders, involving overlapping brain regions and neurotransmitter pathways. Anxiety and depression have been identified as predictors of negative surgical outcomes in orthopaedic trauma patients. Screening tools like the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Screener-7 (GAD-7), and Medical Outcomes Study 36-item Short Form (SF-36) can assess mental health status and help tailor interventions. Psychological distress, chronic pain, and traumatic limb amputation are factors that contribute to adverse mental health outcomes in orthopaedic trauma patients. Opioid use for pain management is common in orthopaedic surgery, but it can worsen symptoms of depression and lead to dependency. Non-opioid pain management strategies may improve postoperative outcomes by reducing the impact of opioid-exacerbated depression. Conclusion Mental health interventions, both preoperative and postoperative, are crucial in optimizing surgical outcomes and improving patient quality of life. Multidisciplinary approaches that address both physical and mental health are recommended for orthopaedic trauma patients. Further research is needed to develop effective interventions for improving mental health outcomes in this patient population.
Collapse
Affiliation(s)
- Jonathan Weinerman
- Department of Education, The University of Miami Leonard M. Miller School of Medicine
| | - Arianna Vazquez
- Department of Education, The University of Miami Leonard M. Miller School of Medicine
| | - Nicolette Schurhoff
- Department of Education, The University of Miami Leonard M. Miller School of Medicine
| | - Connor Shatz
- Department of Education, The University of Miami Leonard M. Miller School of Medicine
| | - Brandon Goldenberg
- Department of Orthopaedic Surgery, University of Miami Hospital, Miami, Florida, USA
| | - David Constantinescu
- Department of Orthopaedic Surgery, University of Miami Hospital, Miami, Florida, USA
| | - Giselle M. Hernandez
- Department of Orthopaedic Surgery, University of Miami Hospital, Miami, Florida, USA
| |
Collapse
|
41
|
Oz M, Ozel Asliyuce Y, Demirel A, Cetin H, Ulger O. Determination of cognitive status and influencing variables in patients with chronic neck pain: A cross-sectional study. APPLIED NEUROPSYCHOLOGY. ADULT 2023; 30:764-771. [PMID: 34597197 DOI: 10.1080/23279095.2021.1980795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study aimed to evaluate cognitive function in individuals with chronic neck pain (CNP) and investigate the effects of different variables on cognition. METHODS The sociodemographic characteristics of the individuals who participated in this study were recorded. Pain intensity of the individuals was evaluated using the Visual Analog Scale, pain-related disability was evaluated with the Neck Disability Index and cognitive function was evaluated using Montreal Cognitive Assessment (MoCA). RESULTS For this study, 95 patients with CNP were recruited. The mean age was 45.61āĀ±ā11.14, and the median MoCA score was 24 (20-26), and 64.2% of the patients scored below the original cutoff (<26/30 points). The regression analysis showed that higher age and lower education levels were associated with lower MoCA scores. Education appeared to be the most influential variable. Younger participants (18-45) performed systematically better on naming, attention and language domains than their older counterparts (over 45). CONCLUSIONS The findings suggest that age and education play an important role in MoCA total and domain scores in these patients. While treating these patients, assessment of cognitive function can be useful for effective pain management.
Collapse
Affiliation(s)
- Muzeyyen Oz
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Yasemin Ozel Asliyuce
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Aynur Demirel
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Hatice Cetin
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Ozlem Ulger
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| |
Collapse
|
42
|
Wang J, Liu G, Xu K, Ai K, Huang W, Zhang J. The role of neurotransmitters in mediating the relationship between brain alterations and depressive symptoms in patients with inflammatory bowel disease. Hum Brain Mapp 2023; 44:5357-5371. [PMID: 37530546 PMCID: PMC10543356 DOI: 10.1002/hbm.26439] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 06/07/2023] [Accepted: 07/10/2023] [Indexed: 08/03/2023] Open
Abstract
A growing body of evidence from neuroimaging studies suggests that inflammatory bowel disease (IBD) is associated with functional and structural alterations in the central nervous system and that it has a potential link to emotional symptoms, such as anxiety and depression. However, the neurochemical underpinnings of depression symptoms in IBD remain unclear. We hypothesized that changes in cortical gamma-aminobutyric acid (GABA+) and glutamine (Glx) concentrations are related to cortical thickness and resting-state functional connectivity in IBD as compared to healthy controls. To test this, we measured whole-brain cortical thickness and functional connectivity within the medial prefrontal cortex (mPFC), as well as the concentrations of neurotransmitters in the same brain region. We used the edited magnetic resonance spectroscopy (MRS) with the MEGA-PRESS sequence at a 3āT scanner to quantitate the neurotransmitter levels in the mPFC. Subjects with IBD (Nā=ā37) and healthy control subjects (Nā=ā32) were enrolled in the study. Compared with healthy controls, there were significantly decreased GABA+ and Glx concentrations in the mPFC of patients with IBD. The cortical thickness of patients with IBD was thin in two clusters that included the right medial orbitofrontal cortex and the right posterior cingulate cortex. A seed-based functional connectivity analysis indicated that there was higher connectivity of the mPFC with the left precuneus cortex (PC) and the posterior cingulate cortex, and conversely, lower connectivity in the left frontal pole was observed. The functional connectivity between the mPFC and the left PC was negatively correlated with the IBD questionnaire score (rā=ā-0.388, pā=ā0.018). GABA+ concentrations had a negative correlation with the Hamilton Depression Scale (HAMD) score (rā=ā-0.497, pā=ā0.002). Glx concentration was negatively correlated with the HAMD score (rā=ā-0.496, pā=ā0.002) and positively correlated with the Short-Form McGill Pain Questionnaire score (rā=ā0.330, pā=ā0.046, uncorrected). There was a significant positive correlation between the ratio of Glx to GABA+ and the HAMD score (rā=ā0.428, pā=ā0.008). Mediation analysis revealed that GABA+ significantly mediated the main effect of the relationship between the structural and functional alterations and the severity of depression in patients with IBD. Our study provides initial evidence of neurochemistry that can be used to identify potential mechanisms underlying the modulatory effects of GABA+ on the development of depression in patients with IBD.
Collapse
Affiliation(s)
- Jun Wang
- Department of Magnetic ResonanceLanzhou University Second HospitalLanzhouChina
- Second Clinical SchoolLanzhou UniversityLanzhouChina
- Gansu Province Clinical Research Center for Functional and Molecular ImagingLanzhou University Second HospitalLanzhouChina
| | - Guangyao Liu
- Department of Magnetic ResonanceLanzhou University Second HospitalLanzhouChina
- Gansu Province Clinical Research Center for Functional and Molecular ImagingLanzhou University Second HospitalLanzhouChina
| | - Kun Xu
- Department of Magnetic ResonanceLanzhou University Second HospitalLanzhouChina
- Second Clinical SchoolLanzhou UniversityLanzhouChina
- Gansu Province Clinical Research Center for Functional and Molecular ImagingLanzhou University Second HospitalLanzhouChina
| | - Kai Ai
- Deparment of Clinical and Technical Support, Philips HealthcareXi'anChina
| | - Wenjing Huang
- Department of Magnetic ResonanceLanzhou University Second HospitalLanzhouChina
- Second Clinical SchoolLanzhou UniversityLanzhouChina
- Gansu Province Clinical Research Center for Functional and Molecular ImagingLanzhou University Second HospitalLanzhouChina
| | - Jing Zhang
- Department of Magnetic ResonanceLanzhou University Second HospitalLanzhouChina
- Second Clinical SchoolLanzhou UniversityLanzhouChina
- Gansu Province Clinical Research Center for Functional and Molecular ImagingLanzhou University Second HospitalLanzhouChina
| |
Collapse
|
43
|
Brown AN, Reed CD, Prescott MC, Rhew DC. Randomized Controlled Study in the Use of Aromatherapy for Pain Reduction and to Reduce Opioid Use in the Emergency Department. J Emerg Nurs 2023; 49:890-898. [PMID: 37656114 DOI: 10.1016/j.jen.2023.07.006] [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: 07/20/2022] [Revised: 05/14/2023] [Accepted: 07/26/2023] [Indexed: 09/02/2023]
Abstract
INTRODUCTION This study aimed to evaluate the effects of aromatherapy on emergency department patients' perception of pain and its ability to reduce the use of opioids in an emergency department. METHODS This randomized, controlled, single-blinded study was conducted in a suburban/rural freestanding emergency department with a therapeutic group, sham group, and control group. RESULTS A total of 230 patients, 171 females and 59 males, completed the study. Of those who received the therapeutic agent, an average reduction in pain of 1.04 points on the pain scale was reported, whereas the sham group averaged 0.38 and the control group 0.23. There was a statistically significant reduction of pain scores in the therapeutic group. A total of 13 received opioid pain medication during their visit. Of these, the therapeutic group averaged a total of 2.67 morphine milligram equivalents for their visit compared with 3.63 in the sham group and 4.36 in the control group; however, statistical significance was not achieved. DISCUSSION This study supported what other studies have found, indicating that aromatherapy is effective in reducing pain. A difference between the placebo effect and a true therapeutic effect was seen by using a control group apart from the sham and therapeutic groups. Despite the small effect size (0.3), implementation of aromatherapy into standard practice may be practical considering the anxiolytic effects that have been shown in other studies. Aromatherapy with essential oils should be considered as another tool to use in a multimodal approach in the treatment of pain in the emergency department setting.
Collapse
|
44
|
Ghorayeb JH, Chitneni A, Rupp A, Parkash A, Abd-Elsayed A. Dorsal root ganglion stimulation for the treatment of chronic pelvic pain: A systematic review. Pain Pract 2023; 23:838-846. [PMID: 37246484 DOI: 10.1111/papr.13255] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Chronic pelvic pain (CPP) is a difficult condition to treat. Due to complex pelvic innervation, dorsal column spinal cord stimulation (SCS) has not been shown to produce the same effect as dorsal root ganglion stimulation (DRGS) given emerging evidence suggesting that applying DRGS may result in favorable outcomes for individuals with CPP. The aim of this systematic review is to investigate the clinical use and effectiveness of DRGS for patients with CPP. MATERIALS AND METHODS A systematic review of clinical studies demonstrating the use of DRGS for CPP. Searches were conducted using four electronic databases (PubMed, EMBASE, CINAHL, and Web of Science) across August and September 2022. RESULTS A total of nine studies comprising 65 total patients with variable pelvic pain etiologies met the inclusion criteria. The majority of subjects implanted with DRGS reported >50% mean pain reduction at variable times of follow-up. Secondary outcomes reported throughout studies including quality of life (QOL) and pain medication consumption were reported to be significantly improved. CONCLUSIONS Dorsal root ganglion stimulation for CPP continues to lack supportive evidence from well-designed, high-quality studies and recommendations from consensus committee experts. However, we present consistent evidence from level IV studies showing success with the use of DRGS for CPP in reducing pain symptoms along with reports of improved QOL through periods as short as 2āmonths to as long as 3āyears. Because the available studies at this time are of low quality with a high risk of bias, we strongly recommend the facilitation of high-quality studies with larger sample sizes in order to better ascertain the utility of DRGS for this specific patient population. At the same time, from a clinical perspective, it may be reasonable and appropriate to evaluate patients for DRGS candidacy on a case-by-case basis, especially those patients who report CPP symptoms that are refractory to noninterventional measures and who may not be ideal candidates for other forms of neuromodulation.
Collapse
Affiliation(s)
- Joe H Ghorayeb
- University of Medicine and Health Sciences, New York, New York, USA
| | - Ahish Chitneni
- Department of Rehabilitation and Regenerative Medicine, New York-Presbyterian Hospital - Columbia and Cornell, New York, New York, USA
| | - Adam Rupp
- Department of Physical Medicine and Rehabilitation, University of Kansas Health System, Kansas City, Kansas, USA
| | - Anishinder Parkash
- Department of Physical Medicine and Rehabilitation, Tower Health Reading Hospital/Drexel University COM, Redding, Pennsylvania, USA
| | - Alaa Abd-Elsayed
- Division of Pain Medicine, Department of Anesthesia, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| |
Collapse
|
45
|
Mokhtari T, Lu M, El-Kenawy AEM. Potential anxiolytic and antidepressant-like effects of luteolin in a chronic constriction injury rat model of neuropathic pain: Role of oxidative stress, neurotrophins, and inflammatory factors. Int Immunopharmacol 2023; 122:110520. [PMID: 37478667 DOI: 10.1016/j.intimp.2023.110520] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/07/2023] [Accepted: 06/13/2023] [Indexed: 07/23/2023]
Abstract
This study aimed to examine the effects of luteolin (LUT) on chronic neuropathic pain (NP)-induced mood disorders (i.e., anxiety and depression) by regulating oxidative stress, neurotrophic factors (NFs), and neuroinflammation. Chronic constrictive injury (CCI) was used to induce NP in the animals. Animals in the treatment groups received LUT in three doses of 10, 25, and 50Ā mg/kg for 21Ā days. The severity of pain and mood disorders were examined. Finally, animals were sacrificed, and their brain tissue was used for molecular and histopathological studies. CCI led to cold allodynia and thermal hyperalgesia. Mood alterations were proven in the CCI group, according to the behavioral tests. Levels of glial cell-derived neurotrophic factor (GDNF), brain-derived neurotrophic factor (BDNF), B-cell lymphoma-2 (Bcl2), superoxide dismutase (SOD), catalase (CAT), and nuclear factor erythroid-2-related factor 2 (Nrf2) were reduced in the hippocampus (HPC) and prefrontal cortex (PFC). Furthermore, the levels of MDA, Bcl-2-associatedĀ XĀ protein (Bax), and inflammatory markers, including nuclear factor kappa B (NF-ĪŗB), NLR family pyrin domain containing 3 (NLRP3), interleukin-1Ī² (IL-1Ī²), IL-18, IL-6, and tumor necrosis factor-Ī± (TNF-Ī±) significantly increased in the HPC and PFC following CCI induction. LUT treatment reversed the behavioral alterations via regulation of oxidative stress, neurotrophines, and inflammatory mediators in the HPC and PFC. Findings confirmed the potency of LUT in the improvement of chronic pain-induced anxiety- and depressive-like symptoms, probably through antioxidant, anti-inflammatory, and neuroprotective properties in the HPC and PFC.
Collapse
Affiliation(s)
- Tahmineh Mokhtari
- Hubei Key Laboratory of Embryonic Stem Cell Research, Faculty of Basic Medical Sciences, Hubei University of Medicine, Shiyan 442000, Hubei, People's Republic of China; Department of Histology and Embryology, Faculty of Basic Medical Sciences, Hubei University of Medicine, Shiyan 442000, Hubei, People's Republic of China.
| | - Min Lu
- Hubei Key Laboratory of Embryonic Stem Cell Research, Faculty of Basic Medical Sciences, Hubei University of Medicine, Shiyan 442000, Hubei, People's Republic of China; Department of Histology and Embryology, Faculty of Basic Medical Sciences, Hubei University of Medicine, Shiyan 442000, Hubei, People's Republic of China
| | | |
Collapse
|
46
|
Swanson KA, Nguyen KL, Gupta S, Ricard J, Bethea JR. TNFR1/p38Ī±MAPK signaling in Nex+ supraspinal neurons regulates sex-specific chronic neuropathic pain. RESEARCH SQUARE 2023:rs.3.rs-3273237. [PMID: 37674712 PMCID: PMC10479400 DOI: 10.21203/rs.3.rs-3273237/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
Upregulation of soluble tumor necrosis factor (sTNF) cytokine signaling through TNF receptor 1 (TNFR1) and subsequent neuronal hyperexcitability are observed in both animal models and human chronic neuropathic pain (CNP) [1-4]. To test the hypothesis that supraspinal circuitry is critical to pain chronification, we studied the intersect between supraspinal TNFR1 mediated neuronal signaling and sex specificity by selectively removing TNFR1 in Nex + neurons in adult mice (NexCreERT2::TNFR1f/f). We determined that following chronic constriction injury (CCI), pain resolves in males; however, female acute pain transitions to chronic. Subsequently, we investigated two downstream pathways, p38MAPK and NF-ĪŗB, important in TNFR1 signaling and injury response. We detected p38Ī±MAPK and NF-ĪŗB activation in male cortical tissue; however, p38Ī±MAPK phosphorylation was reduced in NexCreERT2::TNFR1f/f males. We observed similar behavioral results following CCI in NexCreERT2::p38Ī±MAPKf/f mice. Previously, we established estrogen's ability to modulate sTNF/TNFR1 signaling in CNP, which may contribute to female prevalence of CNP [5-9]. To explore the intersection between estrogen and inflammation in CNP we used a combination therapy of an estrogen receptor Ī² (ER Ī²) inhibitor with a sTNF/TNFR1 or general p38MAPK inhibitor. We determined both combination therapies lend "male-like" therapeutic relief to females following CCI. These data suggest that TNFR1/p38Ī±MAPK signaling in Nex + neurons in CNP is male-specific and lack of therapeutic efficacy following sTNF inhibition in females is due to ER Ī² interference. These studies highlight sex-specific differences in pathways important to pain chronification and elucidate potential therapeutic strategies that would be effective in both sexes.
Collapse
|
47
|
GianĆ² M, Franco C, Castrezzati S, Rezzani R. Involvement of Oxidative Stress and Nutrition in the Anatomy of Orofacial Pain. Int J Mol Sci 2023; 24:13128. [PMID: 37685933 PMCID: PMC10487620 DOI: 10.3390/ijms241713128] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/13/2023] [Accepted: 08/17/2023] [Indexed: 09/10/2023] Open
Abstract
Pain is a very important problem of our existence, and the attempt to understand it is one the oldest challenges in the history of medicine. In this review, we summarize what has been known about pain, its pathophysiology, and neuronal transmission. We focus on orofacial pain and its classification and features, knowing that is sometimes purely subjective and not well defined. We consider the physiology of orofacial pain, evaluating the findings on the main neurotransmitters; in particular, we describe the roles of glutamate as approximately 30-80% of total peripheric neurons associated with the trigeminal ganglia are glutamatergic. Moreover, we describe the important role of oxidative stress and its association with inflammation in the etiogenesis and modulation of pain in orofacial regions. We also explore the warning and protective function of orofacial pain and the possible action of antioxidant molecules, such as melatonin, and the potential influence of nutrition and diet on its pathophysiology. Hopefully, this will provide a solid background for future studies that would allow better treatment of noxious stimuli and for opening new avenues in the management of pain.
Collapse
Affiliation(s)
- Marzia GianĆ²
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy; (M.G.); (C.F.); (S.C.)
| | - Caterina Franco
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy; (M.G.); (C.F.); (S.C.)
| | - Stefania Castrezzati
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy; (M.G.); (C.F.); (S.C.)
| | - Rita Rezzani
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy; (M.G.); (C.F.); (S.C.)
- Interdipartimental University Center of Research āAdaption and Regeneration of Tissues and Organs (ARTO)ā, University of Brescia, 25123 Brescia, Italy
- Italian Society for the Study of Orofacial Pain (SocietĆ Italiana Studio Dolore OrofaccialeāSISDO), 25123 Brescia, Italy
| |
Collapse
|
48
|
Abu Rached N, Kley S, Storck M, Meyer T, StĆ¼cker M. Cold Plasma Therapy in Chronic Wounds-A Multicenter, Randomized Controlled Clinical Trial (Plasma on Chronic Wounds for Epidermal Regeneration Study): Preliminary Results. J Clin Med 2023; 12:5121. [PMID: 37568525 PMCID: PMC10419810 DOI: 10.3390/jcm12155121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/27/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023] Open
Abstract
Chronic wounds (CWs) pose a significant health challenge in clinical practice. Standard wound therapy (SWT) is currently considered the gold standard. However, recent evidence suggests that cold plasma therapy (CPT) holds promise for improving CWs. In light of this, the POWER study was conducted as a multicenter, randomized clinical trial to investigate the effect of large-area plasma application compared with SWT in patients with chronic, non-healing arterial or venous wounds on the lower leg. To analyze the interim results, we employed a comprehensive range of statistical tests, including both parametric and non-parametric methods, as well as GLS model regression and an ordinal mixed model. Our findings clearly demonstrate that CPT therapy significantly accelerates wound closure compared with SWT. In fact, complete wound closure was exclusively observed in the CPT group during the intervention period. Additionally, the CPT group required significantly less antibiotic therapy (4%) compared with the SWT group (23%). Furthermore, CPT led to a significant reduction in wound pain and improved quality of life compared with SWT. In conclusion, the study highlights that the combination of CPT and SWT surpasses monotherapy with SWT alone.
Collapse
Affiliation(s)
- Nessr Abu Rached
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Gudrunstr. 56, 44791 Bochum, Germany;
| | - Susanne Kley
- Scientific Institute for Health Economics and Health Research, Markt 9, 04109 Leipzig, Germany;
| | - Martin Storck
- Municipal Hospital Karlsruhe gGmbH, MoltkestraĆe 90, 76133 Karlsruhe, Germany;
| | - Thomas Meyer
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Gudrunstr. 56, 44791 Bochum, Germany;
| | - Markus StĆ¼cker
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Gudrunstr. 56, 44791 Bochum, Germany;
| |
Collapse
|
49
|
Kan S, Fujita N, Shibata M, Miki K, Yukioka M, Senba E. Three weeks of exercise therapy altered brain functional connectivity in fibromyalgia inpatients. NEUROBIOLOGY OF PAIN (CAMBRIDGE, MASS.) 2023; 14:100132. [PMID: 38099286 PMCID: PMC10719530 DOI: 10.1016/j.ynpai.2023.100132] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 04/26/2023] [Accepted: 05/16/2023] [Indexed: 12/17/2023]
Abstract
Background Fibromyalgia (FM) is a chronic pain syndrome characterized by widespread pain, tenderness, and fatigue. Patients with FM have no effective medication so far, and their activity of daily living and quality of life are remarkably impaired. Therefore, new therapeutic approaches are awaited. Recently, exercise therapy has been gathering much attention as a promising treatment for FM. However, the underlying mechanisms are not fully understood, particularly, in the central nervous system, including the brain. Therefore, we investigated functional connectivity changes and their relationship with clinical improvement in patients with FM after exercise therapy to investigate the underlying mechanisms in the brain using resting-state fMRI (rs-fMRI) and functional connectivity (FC) analysis. Methods Seventeen patients with FM participated in this study. They underwent a 3-week exercise therapy on in-patient basis and a 5-min rs-fMRI scan before and after the exercise therapy. We compared the FC strength of sensorimotor regions and the mesocortico-limbic system between two scans. We also performed a multiple regression analysis to examine the relationship between pre-post differences in FC strength and improvement of patients' clinical symptoms or motor abilities. Results Patients with FM showed significant improvement in clinical symptoms and motor abilities. They also showed a significant pre-post difference in FC of the anterior cingulate cortex and a significant correlation between pre-post FC changes and improvement of clinical symptoms and motor abilities. Although sensorimotor regions tended to be related to the improvement of general disease severity and depression, brain regions belonging to the mesocortico-limbic system tended to be related to the improvement of motor abilities. Conclusion Our 3-week exercise therapy could ameliorate clinical symptoms and motor abilities of patients with FM, and lead to FC changes in sensorimotor regions and brain regions belonging to the mesocortico-limbic system. Furthermore, these changes were related to improvement of clinical symptoms and motor abilities. Our findings suggest that, as predicted by previous animal studies, spontaneous brain activities modified by exercise therapy, including the mesocortico-limbic system, improve clinical symptoms in patients with FM.
Collapse
Affiliation(s)
- Shigeyuki Kan
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima Hiroshima 734-8551, Japan
- Department of Anesthesiology and Intensive Care Medicine, 2-2 Yamadaoka, Suita, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan
| | - Nobuko Fujita
- Department of Rehabilitation, Faculty of Health Sciences, Naragakuen University, 3-15-1 Nakatomigaoka, Nara, Nara 631-8524, Japan
| | - Masahiko Shibata
- Department of Rehabilitation, Faculty of Health Sciences, Naragakuen University, 3-15-1 Nakatomigaoka, Nara, Nara 631-8524, Japan
| | - Kenji Miki
- Hayaishi Hospital, 2-75 Fudegasakicho, Tennoji-ku, Osaka, Osaka 543-0027, Japan
- Department of Physical Therapy, Osaka Yukioka College of Health Science, 1-1-41 Sojiji, Ibaraki, Osaka 567-0801, Japan
| | - Masao Yukioka
- Department of Rheumatology, Yukioka Hospital, 2-2-3 Ukita, Kita-ku, Osaka 530-0021, Japan
| | - Emiko Senba
- Department of Physical Therapy, Osaka Yukioka College of Health Science, 1-1-41 Sojiji, Ibaraki, Osaka 567-0801, Japan
| |
Collapse
|
50
|
Bohic M, Upadhyay A, Eisdorfer JT, Keating J, Simon RC, Briones BA, Azadegan C, Nacht HD, Oputa O, Martinez AM, Bethell BN, Gradwell MA, Romanienko P, Ramer MS, Stuber GD, Abraira VE. A new Hoxb8FlpO mouse line for intersectional approaches to dissect developmentally defined adult sensorimotor circuits. Front Mol Neurosci 2023; 16:1176823. [PMID: 37603775 PMCID: PMC10437123 DOI: 10.3389/fnmol.2023.1176823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/04/2023] [Indexed: 08/23/2023] Open
Abstract
Improvements in the speed and cost of expression profiling of neuronal tissues offer an unprecedented opportunity to define ever finer subgroups of neurons for functional studies. In the spinal cord, single cell RNA sequencing studies support decades of work on spinal cord lineage studies, offering a unique opportunity to probe adult function based on developmental lineage. While Cre/Flp recombinase intersectional strategies remain a powerful tool to manipulate spinal neurons, the field lacks genetic tools and strategies to restrict manipulations to the adult mouse spinal cord at the speed at which new tools develop. This study establishes a new workflow for intersectional mouse-viral strategies to dissect adult spinal function based on developmental lineages in a modular fashion. To restrict manipulations to the spinal cord, we generate a brain-sparing Hoxb8FlpO mouse line restricting Flp recombinase expression to caudal tissue. Recapitulating endogenous Hoxb8 gene expression, Flp-dependent reporter expression is present in the caudal embryo starting day 9.5. This expression restricts Flp activity in the adult to the caudal brainstem and below. Hoxb8FlpO heterozygous and homozygous mice do not develop any of the sensory or locomotor phenotypes evident in Hoxb8 heterozygous or mutant animals, suggesting normal developmental function of the Hoxb8 gene and protein in Hoxb8FlpO mice. Compared to the variability of brain recombination in available caudal Cre and Flp lines, Hoxb8FlpO activity is not present in the brain above the caudal brainstem, independent of mouse genetic background. Lastly, we combine the Hoxb8FlpO mouse line with dorsal horn developmental lineage Cre mouse lines to express GFP in developmentally determined dorsal horn populations. Using GFP-dependent Cre recombinase viruses and Cre recombinase-dependent inhibitory chemogenetics, we target developmentally defined lineages in the adult. We show how developmental knock-out versus transient adult silencing of the same RORš lineage neurons affects adult sensorimotor behavior. In summary, this new mouse line and viral approach provides a blueprint to dissect adult somatosensory circuit function using Cre/Flp genetic tools to target spinal cord interneurons based on genetic lineage.
Collapse
Affiliation(s)
- Manon Bohic
- Cell Biology and Neuroscience Department, Rutgers University, The State University of New Jersey, Piscataway, NJ, United States
- W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, Piscataway, NJ, United States
| | - Aman Upadhyay
- Cell Biology and Neuroscience Department, Rutgers University, The State University of New Jersey, Piscataway, NJ, United States
- W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, Piscataway, NJ, United States
- Neuroscience PhD Program at Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, United States
| | - Jaclyn T. Eisdorfer
- Cell Biology and Neuroscience Department, Rutgers University, The State University of New Jersey, Piscataway, NJ, United States
- W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, Piscataway, NJ, United States
| | - Jessica Keating
- Cell Biology and Neuroscience Department, Rutgers University, The State University of New Jersey, Piscataway, NJ, United States
- W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, Piscataway, NJ, United States
- School of Medicine, Oregon Health and Science University, Portland, OR, United States
- M.D./PhD Program in Neuroscience, School of Medicine, Oregon Health and Science University, Portland, OR, United States
| | - Rhiana C. Simon
- Center for the Neurobiology of Addiction, Pain, and Emotion, Department of Anesthesiology and Pain Medicine, Department of Pharmacology, University of Washington, Seattle, WA, United States
| | - Brandy A. Briones
- Center for the Neurobiology of Addiction, Pain, and Emotion, Department of Anesthesiology and Pain Medicine, Department of Pharmacology, University of Washington, Seattle, WA, United States
| | - Chloe Azadegan
- Cell Biology and Neuroscience Department, Rutgers University, The State University of New Jersey, Piscataway, NJ, United States
- W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, Piscataway, NJ, United States
| | - Hannah D. Nacht
- Cell Biology and Neuroscience Department, Rutgers University, The State University of New Jersey, Piscataway, NJ, United States
- W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, Piscataway, NJ, United States
| | - Olisemeka Oputa
- Cell Biology and Neuroscience Department, Rutgers University, The State University of New Jersey, Piscataway, NJ, United States
- W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, Piscataway, NJ, United States
| | - Alana M. Martinez
- Cell Biology and Neuroscience Department, Rutgers University, The State University of New Jersey, Piscataway, NJ, United States
- W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, Piscataway, NJ, United States
| | - Bridget N. Bethell
- International Collaboration on Repair Discoveries and Department of Zoology, The University of British Columbia, Vancouver, BC, Canada
| | - Mark A. Gradwell
- Cell Biology and Neuroscience Department, Rutgers University, The State University of New Jersey, Piscataway, NJ, United States
- W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, Piscataway, NJ, United States
| | - Peter Romanienko
- Genome Editing Shared Resource, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States
| | - Matt S. Ramer
- International Collaboration on Repair Discoveries and Department of Zoology, The University of British Columbia, Vancouver, BC, Canada
| | - Garret D. Stuber
- Center for the Neurobiology of Addiction, Pain, and Emotion, Department of Anesthesiology and Pain Medicine, Department of Pharmacology, University of Washington, Seattle, WA, United States
| | - Victoria E. Abraira
- Cell Biology and Neuroscience Department, Rutgers University, The State University of New Jersey, Piscataway, NJ, United States
- W.M. Keck Center for Collaborative Neuroscience, Rutgers University, The State University of New Jersey, Piscataway, NJ, United States
| |
Collapse
|