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Zi‐Han X, Nan A, Rui CJ, Yong‐Long Y. Modulation of pain perceptions following treadmill running with different intensities in females. Physiol Rep 2023; 11:e15831. [PMID: 37749050 PMCID: PMC10519819 DOI: 10.14814/phy2.15831] [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: 07/10/2023] [Revised: 09/12/2023] [Accepted: 09/12/2023] [Indexed: 09/27/2023] Open
Abstract
We aimed to compare the effects of three intensities of treadmill running on exercise-induced hypoalgesia (EIH) in healthy individuals. We anticipated that the primary and secondary changes in pain perception and modulation may differ between running intensities. Sixty-six women were randomly assigned to one of three treadmill running intensities for 35 min: 40% reserved heart rate (HRR), 55% HRR, or 70% HRR. The effects of EIH were assessed using pressure pain thresholds (PPT) and tolerance thresholds (PPTol). We measured conditional pain modulation (CPM). Compared with baseline, PPT and PPTol significantly increased in all groups during running and at the 5-10-min follow-up. The PPT and PPTol changes in the moderate- and low-intensity groups were significantly higher than those in the high-intensity group during running and 24 h after running, while the CPM responses of the high-intensity group were significantly reduced at the 24-h follow-up. Moderate- and low-intensity running may elicit significant primary and secondary (persisting over 24 h) EIH effects and increase CPM responses in females. However, high-intensity running induced only limited analgesic effects and reduced CPM responses, which may be attributed to the activation of endogenous pain modulation.
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Affiliation(s)
- Xu Zi‐Han
- School of Sport Medicine and RehabilitationBeijing Sport UniversityBeijingChina
| | - An Nan
- School of Sport Medicine and RehabilitationBeijing Sport UniversityBeijingChina
| | - Chang Jeremy Rui
- Department of Rehabilitation SciencesThe Hong Kong Polytechnic UniversityHong KongChina
| | - Yang Yong‐Long
- School of Sport Medicine and RehabilitationBeijing Sport UniversityBeijingChina
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Imbe H, Ihara H. Mu opioid receptor expressing neurons in the rostral ventromedial medulla are the source of mechanical hypersensitivity induced by repeated restraint stress. Brain Res 2023:148465. [PMID: 37331575 DOI: 10.1016/j.brainres.2023.148465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/11/2023] [Accepted: 06/13/2023] [Indexed: 06/20/2023]
Abstract
Repeated exposure to psychophysical stress often causes an increase in sensitivity and response to pain. This phenomenon is commonly called stress-induced hyperalgesia (SIH). Although psychophysical stress is a well-known risk factor for numerous chronic pain syndromes, the neural mechanism underlying SIH has not yet been elucidated. The rostral ventromedial medulla (RVM) is a key output element of the descending pain modulation system. Descending signals from the RVM have a major impact on spinal nociceptive neurotransmission. In the present study, to clarify changes in the descending pain modulatory system in rats with SIH, we examined the expression of Mu opioid receptor (MOR) mRNA, MeCP2 and global DNA methylation in the RVM after repeated restraint stress for 3 weeks. Additionally, we microinjected neurotoxin dermorphin-SAP into the RVM. The repeated restraint stress for 3 weeks induced mechanical hypersensitivity in the hind paw, a significant increase in the expression of MOR mRNA and MeCP2, and a significant decrease in global DNA methylation in the RVM. The MeCP2 binding to MOR gene promoter in the RVM was significantly decreased in rats with repeated restraint stress. Furthermore, microinjection of dermorphin-SAP into the RVM prevented the mechanical hypersensitivity induced by repeated restraint stress. Although, because of the lack of specific antibody to MOR, we could not show a quantitative analysis in the number of MOR-expressing neurons after the microinjection, these results suggest that MOR-expressing neurons in the RVM induce SIH after repeated restraint stress.
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Affiliation(s)
- Hiroki Imbe
- Department of Physiology, Wakayama Medical University, Kimiidera 811-1, Wakayama City, 641-8509, Japan.
| | - Hayato Ihara
- Radioisotope Laboratory Center, Wakayama Medical University, Kimiidera 811-1, Wakayama City, 641-8509, Japan
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Sleijser-Koehorst MLS, Koop MA, Coppieters MW, Lutke Schipholt IJ, Radisic N, Hooijmans CR, Scholten-Peeters GGM. The effects of aerobic exercise on neuroimmune responses in animals with traumatic peripheral nerve injury: a systematic review with meta-analyses. J Neuroinflammation 2023; 20:104. [PMID: 37138291 PMCID: PMC10155410 DOI: 10.1186/s12974-023-02777-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 04/11/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Increasing pre-clinical evidence suggests that aerobic exercise positively modulates neuroimmune responses following traumatic nerve injury. However, meta-analyses on neuroimmune outcomes are currently still lacking. This study aimed to synthesize the pre-clinical literature on the effects of aerobic exercise on neuroimmune responses following peripheral nerve injury. METHODS MEDLINE (via Pubmed), EMBASE and Web of Science were searched. Controlled experimental studies on the effect of aerobic exercise on neuroimmune responses in animals with a traumatically induced peripheral neuropathy were considered. Study selection, risk of bias assessment and data extraction were performed independently by two reviewers. Results were analyzed using random effects models and reported as standardized mean differences. Outcome measures were reported per anatomical location and per class of neuro-immune substance. RESULTS The literature search resulted in 14,590 records. Forty studies were included, reporting 139 comparisons of neuroimmune responses at various anatomical locations. All studies had an unclear risk of bias. Compared to non-exercised animals, meta-analyses showed the following main differences in exercised animals: (1) in the affected nerve, tumor necrosis factor-α (TNF-α) levels were lower (p = 0.003), while insulin-like growth factor-1 (IGF-1) (p < 0.001) and Growth Associated Protein 43 (GAP43) (p = 0.01) levels were higher; (2) At the dorsal root ganglia, brain-derived neurotrophic factor (BDNF)/BDNF mRNA levels (p = 0.004) and nerve growth factor (NGF)/NGF mRNA (p < 0.05) levels were lower; (3) in the spinal cord, BDNF levels (p = 0.006) were lower; at the dorsal horn, microglia (p < 0.001) and astrocyte (p = 0.005) marker levels were lower; at the ventral horn, astrocyte marker levels (p < 0.001) were higher, and several outcomes related to synaptic stripping were favorably altered; (4) brainstem 5-HT2A receptor levels were higher (p = 0.001); (5) in muscles, BDNF levels (p < 0.001) were higher and TNF-α levels lower (p < 0.05); (6) no significant differences were found for systemic neuroimmune responses in blood or serum. CONCLUSION This review revealed widespread positive modulatory effects of aerobic exercise on neuroimmune responses following traumatic peripheral nerve injury. These changes are in line with a beneficial influence on pro-inflammatory processes and increased anti-inflammatory responses. Given the small sample sizes and the unclear risk of bias of the studies, results should be interpreted with caution.
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Affiliation(s)
- Marije L S Sleijser-Koehorst
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences-Program Musculoskeletal Health, Vrije Universiteit Amsterdam, Van Der Boechorststraat 9, 1081 BT, Amsterdam, The Netherlands.
| | - Meghan A Koop
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences-Program Musculoskeletal Health, Vrije Universiteit Amsterdam, Van Der Boechorststraat 9, 1081 BT, Amsterdam, The Netherlands
| | - Michel W Coppieters
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences-Program Musculoskeletal Health, Vrije Universiteit Amsterdam, Van Der Boechorststraat 9, 1081 BT, Amsterdam, The Netherlands
- Menzies Health Institute Queensland, Griffith University, Brisbane and Gold Coast, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane and Gold Coast, Australia
| | - Ivo J Lutke Schipholt
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences-Program Musculoskeletal Health, Vrije Universiteit Amsterdam, Van Der Boechorststraat 9, 1081 BT, Amsterdam, The Netherlands
- Department of Clinical Chemistry, Laboratory Medical Immunology, Amsterdam University Medical Centre, Location VUmc, Amsterdam, The Netherlands
| | - Nemanja Radisic
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences-Program Musculoskeletal Health, Vrije Universiteit Amsterdam, Van Der Boechorststraat 9, 1081 BT, Amsterdam, The Netherlands
| | - Carlijn R Hooijmans
- Department of Anesthesiology, Pain and Palliative Care (Meta Research Team), Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Gwendolyne G M Scholten-Peeters
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences-Program Musculoskeletal Health, Vrije Universiteit Amsterdam, Van Der Boechorststraat 9, 1081 BT, Amsterdam, The Netherlands.
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Xu ZH, An N, Wang ZR. Exercise-Induced Hypoalgesia Following Proprioceptive Neuromuscular Facilitation and Resistance Training Among Individuals With Shoulder Myofascial Pain: Randomized Controlled Trial. JMIRX MED 2022; 3:e40747. [PMID: 37725522 PMCID: PMC10414395 DOI: 10.2196/40747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 11/20/2022] [Accepted: 12/07/2022] [Indexed: 09/21/2023]
Abstract
BACKGROUND Various exercises can attenuate pain perception in healthy individuals and may interact with the descending pain modulation in the central nervous system. However, the analgesic effects of exercise in patients with myofascial pain can be disrupted by the pathological changes during chronic pain conditions. Thus, the exercises targeted on the facilitation of the sensory-motor interaction may have a positive impact on the restoration of the descending pain modulation and the analgesia effects. OBJECTIVE This paper estimates the effect of proprioceptive neuromuscular facilitation (PNF) and resistance training on exercise-induced hypoalgesia (EIH) and conditioned pain modulation (CPM) among patients with myofascial pain syndrome. METHODS A total of 76 female patients with myofascial pain syndrome (aged 18-30 years), with the pain in the upper trapezius and a visual analog scale score of greater than 30/100 mm, were enrolled in the study. Participants were randomly assigned into 3 intervention groups, including isometric (n=18, 24%), isotonic (n=19, 25%), and PNF (n=20, 26%) exercises, as well as 1 control group (n=19, 25%) with no intervention. Pressure pain threshold and the CPM responses at the myofascial trigger point, arm, and leg sites were assessed before and after the exercise session. The effective EIH response was reflected in the improvement of pressure pain thresholds. RESULTS There was an increase in pressure pain thresholds and CPM responses at trigger point (P<.001 and P<.001), arm (P<.001 and P<.001), and leg sites (P<.001 and P=.03) in participants who performed PNF and isotonic exercise, while the isometric exercise only increased pressure pain thresholds at leg sites (P=.03). Compared with the control group, both the isotonic (P=.02) and PNF (P<.001) groups showed greater EIH responses at the trigger points. In comparison to the control group, only the PNF exercise (P=.01) significantly improved pressure pain thresholds and CPM responses at arm and leg sites compared to the control group. CONCLUSIONS PNF, isotonic, and isometric exercises could lead to local and global EIH effects. The improvement in CPM response following PNF and isotonic exercises suggested that the EIH mechanisms of different resistance exercises may be attributed to the enhancement of the endogenous pain modulation via the motor-sensory interaction from the additional eccentric and dynamic muscle contraction. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCtr202111090819166165; https://tinyurl.com/2ab93p7n.
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Affiliation(s)
- Zi-Han Xu
- School of Sport Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Nan An
- School of Sport Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Zi-Ru Wang
- School of Sport Medicine and Rehabilitation, Beijing Sport University, Beijing, China
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Kong Y, Kuss M, Shi Y, Fang F, Xue W, Shi W, Liu Y, Zhang C, Zhong P, Duan B. Exercise facilitates regeneration after severe nerve transection and further modulates neural plasticity. Brain Behav Immun Health 2022; 26:100556. [PMID: 36405423 PMCID: PMC9673108 DOI: 10.1016/j.bbih.2022.100556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/03/2022] [Accepted: 11/11/2022] [Indexed: 11/13/2022] Open
Abstract
Patients with severe traumatic peripheral nerve injury (PNI) always suffer from incomplete recovery and poor functional outcome. Physical exercise-based rehabilitation, as a non-invasive interventional strategy, has been widely acknowledged to improve PNI recovery by promoting nerve regeneration and relieving pain. However, effects of exercise on chronic plastic changes following severe traumatic PNIs have been limitedly discussed. In this study, we created a long-gap sciatic nerve transection followed by autograft bridging in rats and tested the therapeutic functions of treadmill running with low intensity and late initiation. We demonstrated that treadmill running effectively facilitated nerve regeneration and prevented muscle atrophy and thus improved sensorimotor functions and walking performance. Furthermore, exercise could reduce inflammation at the injured nerve as well as prevent the overexpression of TRPV1, a pain sensor, in primary afferent sensory neurons. In the central nervous system, we found that PNI induced transcriptive changes at the ipsilateral lumber spinal dorsal horn, and exercise could reverse the differential expression for genes involved in the Notch signaling pathway. In addition, through neural imaging techniques, we found volumetric, microstructural, metabolite, and neuronal activity changes in supraspinal regions of interest (i.e., somatosensory cortex, motor cortex, hippocampus, etc.) after the PNI, some of which could be reversed through treadmill running. In summary, treadmill running with late initiation could promote recovery from long-gap nerve transection, and while it could reverse maladaptive plasticity after the PNI, exercise may also ameliorate comorbidities, such as chronic pain, mental depression, and anxiety in the long term.
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Affiliation(s)
- Yunfan Kong
- Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, NE, 68198, USA
- Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Mitchell Kuss
- Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, NE, 68198, USA
- Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Yu Shi
- School of Biological Sciences, University of Nebraska Lincoln, Lincoln, NE, 68588, USA
| | - Fang Fang
- Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, NE, 68198, USA
- Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Wen Xue
- Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, NE, 68198, USA
- Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Wen Shi
- Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, NE, 68198, USA
- Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Yutong Liu
- Department of Radiology, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Chi Zhang
- School of Biological Sciences, University of Nebraska Lincoln, Lincoln, NE, 68588, USA
- Center for Plant Science Innovation, University of Nebraska-Lincoln, Lincoln, NE, 68588, USA
| | - Peng Zhong
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Bin Duan
- Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, NE, 68198, USA
- Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA
- Department of Surgery, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA
- Department of Mechanical and Materials Engineering, University of Nebraska-Lincoln, Lincoln, NE, 68588, USA
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Hasegawa M, Piriyaprasath K, Otake M, Kamimura R, Saito I, Fujii N, Yamamura K, Okamoto K. Effect of daily treadmill running exercise on masseter muscle nociception associated with social defeat stress in mice. Eur J Oral Sci 2022; 130:e12882. [DOI: 10.1111/eos.12882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 05/23/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Mana Hasegawa
- Division of Oral Physiology Faculty of Dentistry and Graduate School of Medical and Dental Sciences Niigata University Niigata City Japan
- Division of General Dentistry and Dental Clinical Education Unit Faculty of Dentistry and Graduate School of Medical and Dental Sciences Niigata University Niigata City Japan
| | - Kajita Piriyaprasath
- Division of Oral Physiology Faculty of Dentistry and Graduate School of Medical and Dental Sciences Niigata University Niigata City Japan
- Department of Restorative Dentistry Faculty of Dentistry Naresuan University Phitsanulok Thailand
| | - Masanori Otake
- Division of Orthodontics Faculty of Dentistry and Graduate School of Medical and Dental Sciences Niigata University Niigata City Japan
| | - Rantaro Kamimura
- Division of Orthodontics Faculty of Dentistry and Graduate School of Medical and Dental Sciences Niigata University Niigata City Japan
| | - Isao Saito
- Division of Orthodontics Faculty of Dentistry and Graduate School of Medical and Dental Sciences Niigata University Niigata City Japan
| | - Noritaka Fujii
- Division of General Dentistry and Dental Clinical Education Unit Faculty of Dentistry and Graduate School of Medical and Dental Sciences Niigata University Niigata City Japan
| | - Kensuke Yamamura
- Division of Oral Physiology Faculty of Dentistry and Graduate School of Medical and Dental Sciences Niigata University Niigata City Japan
| | - Keiichiro Okamoto
- Division of Oral Physiology Faculty of Dentistry and Graduate School of Medical and Dental Sciences Niigata University Niigata City Japan
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Efficacy of the Motivational Interviewing-Walk Intervention for Chemotherapy-Induced Peripheral Neuropathy and Quality of Life During Oxaliplatin Treatment: A Pilot Randomized Controlled Trial. Cancer Nurs 2021; 45:E531-E544. [PMID: 34483279 DOI: 10.1097/ncc.0000000000001003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Oxaliplatin-induced peripheral neuropathy (OIPN) is prevalent among gastrointestinal cancer survivors and often impairs quality of life (QOL). OBJECTIVE This pilot randomized controlled trial aimed to explore the effect of an 8-week home-based brisk walking (the "MI-Walk") intervention on (1) OIPN severity and (2) QOL at 8 weeks, compared with physical activity (PA) education alone in oxaliplatin-receiving adults with gastrointestinal cancer. INTERVENTIONS/METHODS Participants (N = 57) recruited from 5 infusion sites received PA education at their second oxaliplatin visit, followed by phone assessments of adverse events over 8 weeks. Half (n = 29) received additional MI-Walk intervention motivational supports (eg, a Fitbit Charge 2 and motivational enhancement therapy sessions). Self-reported OIPN, QOL, and PA were measured before and after intervention. RESULTS The intervention compared with the control condition had no effect on sensory OIPN (mean difference [X¯[INCREMENT]] = -0.01; P > .99), motor OIPN (X¯[INCREMENT] = 2.39; P = .17), and QOL (X¯[INCREMENT] = -1.43; P > .99). Eight-week sensory (X¯ =11.48 ± 0.38) and motor OIPN severities (X¯ = 7.48 ± 0.36) were mild but higher than baseline (P ≤ .01). Self-reported PA level increased over time in both groups (X¯[INCREMENT] = 44.85; P = .01). Averaging ≥225 moderate to vigorous PA minutes per week led to less sensory OIPN, particularly finger/hand tingling (X¯[INCREMENT] = -26.35; P = .01). CONCLUSIONS This study failed to detect beneficial effects of the MI-Walk intervention; however, the findings suggest that aerobic walking may blunt but not completely prevent OIPN. Further research is necessary. IMPLICATIONS FOR PRACTICE Although the effectiveness of brisk walking in reducing OIPN is unclear, this study supports prior evidence that moderate to vigorous PA is beneficial and safe during chemotherapy treatment.
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Leitzelar BN, Koltyn KF. Exercise and Neuropathic Pain: A General Overview of Preclinical and Clinical Research. SPORTS MEDICINE-OPEN 2021; 7:21. [PMID: 33751253 PMCID: PMC7984211 DOI: 10.1186/s40798-021-00307-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 02/11/2021] [Indexed: 12/14/2022]
Abstract
Neuropathic pain is a disease of the somatosensory system that is characterized by tingling, burning, and/or shooting pain. Medication is often the primary treatment, but it can be costly, thus there is an interest in understanding alternative low-cost treatments such as exercise. The following review includes an overview of the preclinical and clinical literature examining the influence of exercise on neuropathic pain. Preclinical studies support the hypothesis that exercise reduces hyperalgesia and allodynia in animal models of neuropathic pain. In human research, observational studies suggest that those who are more physically active have lower risk of developing neuropathic pain compared to those who are less active. Exercise studies suggest aerobic exercise training (e.g., 16 weeks); a combination of aerobic and resistance exercise training (e.g., 10–12 weeks); or high-intensity interval training (e.g., 15 weeks) reduces aspects of neuropathic pain such as worst pain over the past month, pain over the past 24 h, pain scores, or pain interference. However, not all measures of pain improve following exercise training (e.g., current pain, heat pain threshold). Potential mechanisms and future directions are also discussed to aid in the goal of understanding the role of exercise in the management of neuropathic pain. Future research using standardized methods to further understanding of the dose of exercise needed to manage neuropathic pain is warranted.
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Affiliation(s)
- Brianna N Leitzelar
- Department of Kinesiology, University of Wisconsin-Madison, 1300 University Ave., Madison, WI, 53706, USA
| | - Kelli F Koltyn
- Department of Kinesiology, University of Wisconsin-Madison, 1300 University Ave., Madison, WI, 53706, USA.
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Abstract
Chemotherapy-induced peripheral neuropathy (CIPN) is an unsolved and potentially life-compromising problem for most patients receiving neurotoxic chemotherapy. It manifests with numbness, tingling, and possibly neuropathic pain and motor and autonomic symptoms. This review aims to provide an evidence synthesis that prepares nurses to comprehensively assess, provide supportive care for, and critically evaluate the literature on CIPN. The prevalence, significance, characteristics, mechanisms, and risk factors of CIPN will be discussed, as well as nursing-relevant evidence on the assessment, prevention, and management of CIPN. The importance of critical literature evaluation before clinical implementation to reduce physical and financial harms to patients will also be highlighted.
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WeiWei Y, WenDi F, Mengru C, Tuo Y, Chen G. The cellular mechanism by which the rostral ventromedial medulla acts on the spinal cord during chronic pain. Rev Neurosci 2021; 32:545-558. [PMID: 33565739 DOI: 10.1515/revneuro-2020-0121] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 12/18/2020] [Indexed: 11/15/2022]
Abstract
Clinical therapies for chronic pain are limited. While targeted drugs are promising therapies for chronic pain, they exhibit insufficient efficacy and poor targeting. The occurrence of chronic pain partly results from central changes caused by alterations in neurons in the rostral ventromedial medulla (RVM) in the brainstem regulatory pathway. The RVM, which plays a key role in the descending pain control pathway, greatly contributes to the development and maintenance of pain. However, the exact roles of the RVM in chronic pain remain unclear, making it difficult to develop new drugs targeting the RVM and related pathways. Here, we first discuss the roles of the RVM and related circuits in chronic pain. Then, we analyze synaptic transmission between RVM neurons and spinal cord neurons, specifically focusing on the release of neurotransmitters, to explore the cellular mechanisms by which the RVM regulates chronic pain. Finally, we propose some ideas for the development of drugs targeting the RVM.
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Affiliation(s)
- Yu WeiWei
- Key Laboratory of Neuroregeneration of Jiangsu and the Ministry of Education, Co-innovation Center of Neuroregeneration, Nantong University, Nantong226001, China
| | - Fei WenDi
- Key Laboratory of Neuroregeneration of Jiangsu and the Ministry of Education, Co-innovation Center of Neuroregeneration, Nantong University, Nantong226001, China
| | - Cui Mengru
- Department of Anesthesiology, Affiliated Hospital of Nantong University, Nantong226001, China
| | - Yang Tuo
- Department of Hand Surgery, China-Japan Union Hospital of Jilin University, Changchun130033, China
| | - Gang Chen
- Department of Anesthesiology, Affiliated Hospital of Nantong University, Nantong226001, China.,Department of Tissue and Embryology, Medical School of Nantong University, Co-innovation Center of Neuroregeneration, Nantong University, Nantong226001, China
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Knoerl R, Gilchrist L, Kanzawa-Lee GA, Donohoe C, Bridges C, Lavoie Smith EM. Proactive Rehabilitation for Chemotherapy-Induced Peripheral Neuropathy. Semin Oncol Nurs 2020; 36:150983. [DOI: 10.1016/j.soncn.2019.150983] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Slivicki RA, Mali SS, Hohmann AG. Voluntary exercise reduces both chemotherapy-induced neuropathic nociception and deficits in hippocampal cellular proliferation in a mouse model of paclitaxel-induced peripheral neuropathy. NEUROBIOLOGY OF PAIN 2019; 6:100035. [PMID: 31528755 PMCID: PMC6739464 DOI: 10.1016/j.ynpai.2019.100035] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 08/21/2019] [Accepted: 08/25/2019] [Indexed: 12/18/2022]
Abstract
Paclitaxel treatment did not alter voluntary running activity. Voluntary running reduced mechanical and cold allodynia induced by paclitaxel. Voluntary running reduced paclitaxel-induced deficits in hippocampal cellular proliferation.
Chemotherapy-induced peripheral neuropathy (CIPN) is a common dose-limiting side-effect of all major chemotherapeutic agents. Here, we explored efficacy of voluntary exercise as a nonpharmacological strategy for suppressing two distinct adverse side effects of chemotherapy treatment. We evaluated whether voluntary running would suppress both neuropathic pain and deficits in hippocampal cell proliferation in a mouse model of CIPN induced by the taxane chemotherapeutic agent paclitaxel. Mice were given free access to running wheels or were housed without running wheels during one of three different intervention phases: 1) during the onset (i.e. development phase) of paclitaxel-induced neuropathy, 2) prior to dosing with paclitaxel or its vehicle, or 3) following the establishment (i.e. maintenance phase) of paclitaxel-induced neuropathy. Paclitaxel treatment did not alter running wheel behavior relative to vehicle-treated animals in any study. Animals that engaged in voluntary running during the development phase of paclitaxel-induced neuropathy failed to display mechanical or cold hypersensitivities relative to sedentary control animals that did not have access to running wheels. A prior history of voluntary running delayed the onset of, but did not fully prevent, development of paclitaxel-induced neuropathic pain behavior. Voluntary running reduced already established mechanical and cold allodynia induced by paclitaxel. Importantly, voluntary running did not alter mechanical or cold responsivity in vehicle-treated animals, suggesting that the observed antinociceptive effect of exercise was dependent upon the presence of the pathological pain state. In the same animals evaluated for nociceptive responding, paclitaxel also reduced cellular proliferation but not cellular survival in the dentate gyrus of the hippocampus, as measured by immunohistochemistry for Ki67 and BrdU expression, respectively. Voluntary running abrogated paclitaxel-induced reductions in cellular proliferation to levels observed in vehicle-treated mice and also increased BrdU expression levels irrespective of chemotherapy treatment. Our studies support the hypothesis that voluntary exercise may be beneficial in suppressing both neuropathic pain and markers of hippocampal cellular function that are impacted by toxic challenge with chemotherapeutic agents.
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Affiliation(s)
- Richard A. Slivicki
- Program in Neuroscience, Indiana University, Bloomington, IN, United States
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, United States
| | - Sonali S. Mali
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, United States
| | - Andrea G. Hohmann
- Program in Neuroscience, Indiana University, Bloomington, IN, United States
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, United States
- Gill Center for Biomolecular Science, Indiana University, Bloomington, IN, United States
- Corresponding author at: Department of Psychological and Brain Sciences, Indiana University, 1101 E 10th Street, Bloomington, IN 47405-7007, United States.
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Guo JB, Chen BL, Wang Y, Zhu Y, Song G, Yang Z, Zheng YL, Wang XQ, Chen PJ. Meta-Analysis of the Effect of Exercise on Neuropathic Pain Induced by Peripheral Nerve Injury in Rat Models. Front Neurol 2019; 10:636. [PMID: 31258512 PMCID: PMC6587136 DOI: 10.3389/fneur.2019.00636] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 05/30/2019] [Indexed: 11/30/2022] Open
Abstract
Background: There is accumulating evidence showing that exercise therapy may play an active role in peripheral neuropathic pain (NP). However, there have been no meta-analysis to investigate the effects of exercise on NP induced by peripheral nerve injury in rat models. Methods: PubMed, EMBASE, and Web of Science were searched from inception to January 2019. A random-effect model was implemented to provide effect estimates for pain-related behavioral test outcome. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated. Results: Fourteen studies were included. For the mechanical withdrawal threshold, rats in the exercised group exhibited significantly higher thresholds than those in the control group, with a MD of 0.91 (95% CI 0.11–1.71), 3.11 (95% CI 1.56–4.66), 3.48 (95% CI 2.70–4.26), 4.16 (95% CI 2.53–5.79), and 5.58 (95% CI 3.44–7.73) at 1, 2, 3, 4, and 5 weeks, respectively. Additionally, thermal withdrawal latency increased in the exercised group compared with the control group, with a MD of 2.48 (95% CI 0.59–4.38), 3.57 (95% CI 2.10–5.05), 3.92 (95% CI 2.82–5.03), and 2.84 (95% CI 1.29–4.39) at 1, 2, 3, and 4 weeks, respectively. Subgroup analyses were performed for pain models, exercise start point, exercise forms, and duration, which decreased heterogeneity to some extent. Conclusion: This meta-analysis indicated that exercise provoked an increase in mechanical withdrawal threshold and thermal withdrawal latency in animal NP models. Exercise therapy may be a promising non-pharmacologic therapy to prevent the development of NP. Further, preclinical studies focused on improving experiment design and reporting are still needed.
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Affiliation(s)
- Jia-Bao Guo
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Bing-Lin Chen
- The Second Clinical Medical School, Xuzhou Medical University, Xuzhou, China
| | - Ying Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Yi Zhu
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ge Song
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Zheng Yang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Yi-Li Zheng
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Pei-Jie Chen
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
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Pereira ES, Krause Neto W, Calefi AS, Georgetti M, Guerreiro L, Zocoler CAS, Gama EF. EXTREME CONDITIONING TRAINING: ACUTE EFFECTS ON MOOD STATE. REV BRAS MED ESPORTE 2019. [DOI: 10.1590/1517-869220192502197823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
ABSTRACT Introduction: The search for strategies aimed at reducing daily stress is increasing in the current literature. As a result, several types of fitness training are constantly being investigated for their influence on mood states. However, we know little about strategies that use higher intensities. Objective: To investigate the acute effects of an extreme conditioning training (ECT) session on the mood states of individuals with or without prior experience in this type of training. Methods: Volunteers were divided into TRAINED (n = 10) and CONDITIONED (n = 10) groups, undergoing a single 9-minute ECT session. Mood states (BRUMS scale) were analyzed at baseline, immediately afterwards, and after 30 minutes. Results: Anger, confusion and tension were significantly reduced in both groups immediately afterwards and post 30 minutes. The TRAINED group showed a significant reduction in fatigue 30 minutes after the end of the session. Effect size for all variables was considered small to moderate. The TRAINED group had significantly increased vigor immediately after the end of the session compared to baseline. However, the CONDITIONED group had significantly reduced vigor 30 minutes afterwards, in comparison to baseline. The increase in vigor in the TRAINED group was considered moderate (ES = 0.68), while the decrease in vigor in the CONDITIONED group was considered major (ES = −0.88). Conclusion: An ECT session is powerful enough to induce significant, albeit small and moderate, changes in mood states in both trained and untrained individuals in this particular type of exercise. Level of evidence II, Therapeutic studies-investigation of treatment results.
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Affiliation(s)
- Emy Suelen Pereira
- Universidade São Judas Tadeu, Brazil; Universidade São Judas Tadeu, Brazil
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15
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OHLMAN THOMAS, MILLER LEAH, NAUGLE KEITHE, NAUGLE KELLYM. Physical Activity Levels Predict Exercise-induced Hypoalgesia in Older Adults. Med Sci Sports Exerc 2018; 50:2101-2109. [DOI: 10.1249/mss.0000000000001661] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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16
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Abstract
PURPOSE OF REVIEW Physical activity is increasingly recommended for chronic pain. In this review, we briefly survey recent, high-quality meta-analyses on the effects of exercise in human chronic pain populations, followed by a critical discussion of the rodent literature. RECENT FINDINGS Most meta-analytical studies on the effects of exercise in human chronic pain populations describe moderate improvements in various types of chronic pain, despite substantial variability in the outcomes reported in the primary literature. The most consistent findings suggest that while greater adherence to exercise programs produces better outcomes, there is minimal support for the superiority of one type of exercise over another. The rodent literature similarly suggests that while regular exercise reduces hypersensitivity in rodent models of chronic pain, exercise benefits do not appear to relate to either the type of injury or any particular facet of the exercise paradigm. Potential factors underlying these results are discussed, including the putative involvement of stress-induced analgesic effects associated with certain types of exercise paradigms. Exercise research using rodent models of chronic pain would benefit from increased attention to the role of stress in exercise-induced analgesia, as well as the incorporation of more clinically relevant exercise paradigms.
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Affiliation(s)
- Mark Henry Pitcher
- Pain and Integrative Neuroscience Laboratory, National Center for Complementary and Integrative Health, National Institutes of Health, Room 1E-420, 35A Convent Drive, Bethesda, MD, 20892, USA.
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17
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Altered Gene Expression of RNF34 and PACAP Possibly Involved in Mechanism of Exercise-Induced Analgesia for Neuropathic Pain in Rats. Int J Mol Sci 2017; 18:ijms18091962. [PMID: 28902127 PMCID: PMC5618611 DOI: 10.3390/ijms18091962] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 08/29/2017] [Accepted: 09/04/2017] [Indexed: 01/19/2023] Open
Abstract
Despite the availability of several modalities of treatment, including surgery, pharmacological agents, and nerve blocks, neuropathic pain is often unresponsive and sometimes progresses to intractable chronic pain. Although exercise therapy is a candidate for treatment of neuropathic pain, the mechanism underlying its efficacy has not been elucidated. To clarify the molecular mechanism for pain relief induced by exercise, we measured Rnf34 and Pacap mRNA levels in the spinal cord dorsal horn of SNL rats, a model of neuropathic pain. SNL model rats exhibited stable mechanical hyperalgesia for at least 6 weeks. When the rats were forced to exercise on a treadmill, mechanical and thermal hyperalgesia were significantly ameliorated compared with the non-exercise group. Accordingly, gene expression level of Rnf34 and Pacap were also significantly altered in the time course analysis after surgery. These results suggest that exercise therapy possibly involves pain relief in SNL rats by suppressing Rnf34 and Pacap expression in the spinal cord.
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18
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Lima LV, DeSantana JM, Rasmussen LA, Sluka KA. Short-duration physical activity prevents the development of activity-induced hyperalgesia through opioid and serotoninergic mechanisms. Pain 2017; 158:1697-1710. [PMID: 28621702 PMCID: PMC5561491 DOI: 10.1097/j.pain.0000000000000967] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Regular physical activity prevents the development of chronic muscle pain through the modulation of central mechanisms that involve rostral ventromedial medulla (RVM). We tested if pharmacological blockade or genetic deletion of mu-opioid receptors in physically active mice modulates excitatory and inhibitory systems in the RVM in an activity-induced hyperalgesia model. We examined response frequency to mechanical stimulation of the paw, muscle withdrawal thresholds, and expression of phosphorylation of the NR1 subunit of the N-methyl-D-aspartate receptor (p-NR1) and serotonin transporter (SERT) in the RVM. Mice that had performed 5 days of voluntary wheel running prior to the induction of the model were compared with sedentary mice. Sedentary mice showed significant increases in mechanical paw withdrawal frequency and a reduction in muscle withdrawal threshold; wheel running prevented the increase in paw withdrawal frequency. Naloxone-treated and MOR mice had increases in withdrawal frequency that were significantly greater than that in physically active control mice and similar to sedentary mice. Immunohistochemistry in the RVM showed increases in p-NR1 and SERT expression in sedentary mice 24 hours after the induction of the model. Wheel running prevented the increase in SERT, but not p-NR1. Physically active, naloxone-treated, and MOR mice showed significant increases in SERT immunoreactivity when compared with wild-type physically active control mice. Blockade of SERT in the RVM in sedentary mice reversed the activity-induced hyperalgesia of the paw and muscle. These results suggest that analgesia induced by 5 days of wheel running is mediated by mu-opioid receptors through the modulation of SERT, but not p-NR1, in RVM.
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MESH Headings
- Animals
- Disease Models, Animal
- Female
- Gene Expression Regulation/physiology
- Hyperalgesia/etiology
- Hyperalgesia/prevention & control
- Male
- Medulla Oblongata/metabolism
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- Nerve Tissue Proteins/metabolism
- Pain Measurement
- Pain Threshold/physiology
- Physical Conditioning, Animal/methods
- Physical Stimulation/adverse effects
- Receptors, N-Methyl-D-Aspartate/metabolism
- Receptors, Opioid, mu/genetics
- Receptors, Opioid, mu/metabolism
- Serotonin Plasma Membrane Transport Proteins/metabolism
- Statistics, Nonparametric
- Time Factors
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Affiliation(s)
- Lucas V Lima
- Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, USA
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju/Se, Brazil
| | - Josimari M DeSantana
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju/Se, Brazil
- Department of Physical Therapy, Federal University of Sergipe, Aracaju/Se, Brazil
| | - Lynn A Rasmussen
- Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, USA
| | - Kathleen A Sluka
- Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, USA
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19
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Lima LV, Abner TSS, Sluka KA. Does exercise increase or decrease pain? Central mechanisms underlying these two phenomena. J Physiol 2017; 595:4141-4150. [PMID: 28369946 PMCID: PMC5491894 DOI: 10.1113/jp273355] [Citation(s) in RCA: 207] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 03/07/2017] [Indexed: 01/13/2023] Open
Abstract
Exercise is an integral part of the rehabilitation of patients suffering a variety of chronic musculoskeletal conditions, such as fibromyalgia, chronic low back pain and myofascial pain. Regular physical activity is recommended for treatment of chronic pain and its effectiveness has been established in clinical trials for people with a variety of pain conditions. However, exercise can also increase pain making participation in rehabilitation challenging for the person with pain. Animal models of exercise-induced pain have been developed and point to central mechanisms underlying this phenomena, such as increased activation of NMDA receptors in pain-modulating areas. Meanwhile, a variety of basic science studies testing different exercise protocols, show exercise-induced analgesia involves activation of central inhibitory pathways. Opioid, serotonin and NMDA mechanisms acting in rostral ventromedial medulla promote analgesia associated with exercise. This review explores and discusses current evidence on central mechanisms underlying exercised-induced pain and analgesia.
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Affiliation(s)
- Lucas V. Lima
- Department of Physical Therapy and Rehabilitation Science, Pain Research ProgramUniversity of IowaIowa CityIA52242USA
| | - Thiago S. S. Abner
- Department of Physical Therapy and Rehabilitation Science, Pain Research ProgramUniversity of IowaIowa CityIA52242USA
| | - Kathleen A. Sluka
- Department of Physical Therapy and Rehabilitation Science, Pain Research ProgramUniversity of IowaIowa CityIA52242USA
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20
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Zhao H, Alam A, Chen Q, Eusman M, Pal A, Eguchi S, Wu L, Ma D. The role of microglia in the pathobiology of neuropathic pain development: what do we know? Br J Anaesth 2017; 118:504-516. [DOI: 10.1093/bja/aex006] [Citation(s) in RCA: 132] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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21
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Modest Amounts of Voluntary Exercise Reduce Pain- and Stress-Related Outcomes in a Rat Model of Persistent Hind Limb Inflammation. THE JOURNAL OF PAIN 2017; 18:687-701. [PMID: 28185925 DOI: 10.1016/j.jpain.2017.01.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 01/13/2017] [Accepted: 01/17/2017] [Indexed: 11/23/2022]
Abstract
Aerobic exercise improves outcomes in a variety of chronic health conditions, yet the support for exercise-induced effects on chronic pain in humans is mixed. Although many rodent studies have examined the effects of exercise on persistent hypersensitivity, the most used forced exercise paradigms that are known to be highly stressful. Because stress can also produce analgesic effects, we studied how voluntary exercise, known to reduce stress in healthy subjects, alters hypersensitivity, stress, and swelling in a rat model of persistent hind paw inflammation. Our data indicate that voluntary exercise rapidly and effectively reduces hypersensitivity as well as stress-related outcomes without altering swelling. Moreover, the level of exercise is unrelated to the analgesic and stress-reducing effects, suggesting that even modest amounts of exercise may impart significant benefit in persistent inflammatory pain states. PERSPECTIVE Modest levels of voluntary exercise reduce pain- and stress-related outcomes in a rat model of persistent inflammatory pain, independently of the amount of exercise. As such, consistent, self-regulated activity levels may be more relevant to health improvement in persistent pain states than standardized exercise goals.
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22
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Abstract
This paper is the thirty-eighth consecutive installment of the annual review of research concerning the endogenous opioid system. It summarizes papers published during 2015 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists. The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior, and the roles of these opioid peptides and receptors in pain and analgesia, stress and social status, tolerance and dependence, learning and memory, eating and drinking, drug abuse and alcohol, sexual activity and hormones, pregnancy, development and endocrinology, mental illness and mood, seizures and neurologic disorders, electrical-related activity and neurophysiology, general activity and locomotion, gastrointestinal, renal and hepatic functions, cardiovascular responses, respiration and thermoregulation, and immunological responses.
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, Flushing, NY 11367, United States.
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