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Neuropathic Pain OR Refractory Pain

Huiyi H Chang, Jih-Chao Yeh, Jackie Mao, David A Ginsberg, Gamal Ghoniem, Larissa V Rodriguez
AIM: Interstitial cystitis/painful bladder syndrome/(IC/PBS) results in recurring pain in the bladder and surrounding pelvic region caused by abnormal excitability of micturition reflexes. Spinal cord stimulation (SCS) is currently clinically used for the attenuation of neuropathic and visceral pain. The present study examined whether SCS at upper lumbar segments modulates detrusor overactivity and visceral hyperalgesia associated with cystitis in a rat model of cyclophosphamide (CYP)-induced cystitis...
November 9, 2018: Neurourology and Urodynamics
Sean D Kodani, Debin Wan, Karen M Wagner, Sung Hee Hwang, Christophe Morisseau, Bruce D Hammock
Fatty acid amide hydrolase (FAAH) is responsible for regulating concentrations of the endocannabinoid arachidonoyl ethanolamide. Multiple FAAH inhibitors have been developed for clinical trials and have failed to demonstrate efficacy at treating pain, despite promising preclinical data. One approach toward increasing the efficacy of FAAH inhibitors is to concurrently inhibit other targets responsible for regulating pain. Here, we designed dual inhibitors targeting the enzymes FAAH and soluble epoxide hydrolase (sEH), which are targets previously shown to synergize at reducing inflammatory and neuropathic pain...
October 31, 2018: ACS Omega
Jun Li, Jing He, Hu Li, Bi-Fa Fan, Bo-Tao Liu, Peng Mao, Yi Jin, Zhu-Qiang Cheng, Ting-Jie Zhang, Zhi-Fang Zhong, Si-Ji Li, Sai-Nan Zhu, Yi Feng
Neuropathy can contribute to low back pain (LBP) in the region of the back. Our study investigated the proportion of neuropathic pain (NP) in low back region in chronic LBP patients from multicenter and clinics in China and identified associated factors. Assessment was made using a questionnaire and the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS, only tested in low back region), as well as Quantitative Sensory Testing (QST, merely applied to the low back region), the Hospital Anxiety and Depression Scale (HADS) and the Oswestry Disability Index (ODI)...
November 8, 2018: Scientific Reports
Hao Zhang, Toshihide Kashihara, Tsutomu Nakada, Satoshi Tanaka, Kumiko Ishida, Satoshi Fuseya, Hiroyuki Kawagishi, Kenkichi Kiyosawa, Mikito Kawamata, Mitsuhiko Yamada
An injury of the somatosensory system causes neuropathic pain, which is usually refractory to conventional analgesics, thus warranting the development of novel drugs against this kind of pain. The mechanism of neuropathic pain in rats that had undergone left L5 spinal nerve transection was analyzed. After 10 days of the surgery, these rats acquired neuropathic pain. The patch-clamp technique was used on the isolated bilateral L5 dorsal root ganglion neurons. The current-clamped neurons on the ipsilateral side exhibited significantly higher excitability than those on the contralateral side...
November 8, 2018: Journal of Pharmacology and Experimental Therapeutics
Ken Kuwajima, Masahiko Sumitani, Makoto Kurano, Kuniyuki Kano, Masako Nishikawa, Baasanjav Uranbileg, Rikuhei Tsuchida, Toru Ogata, Junken Aoki, Yutaka Yatomi, Yoshitsugu Yamada
The underlying mechanisms of neuropathic pain remain to be elucidated. Basic animal research has suggested that lysophosphatidic acids, which are bioactive lipids produced by autotaxin from lysophosphatidylcholine, may play key roles in the initiation and maintenance of neuropathic pain. Here, we investigated the clinical relevance of lysophosphatidic acids signaling on neuropathic pain in humans. Eighteen patients who had been diagnosed with neuropathic pain with varied etiologies participated in the study...
2018: PloS One
Stephen Butler, Daniel Eek, Lena Ring, Allen Gordon, Rolf Karlsten
Background and aims The RELIEF (Real Life) study by AstraZeneca was designed as an observational study to validate a series of Patient Reported Outcome (PRO) questionnaires in a mixed population of subjects with neuropathic pain (NP) coming from diabetes, neurology and primary care clinics. This article is an analysis of a subset of the information to include the medications used and the effects of pharmacological treatment over 6 months. The RELIEF study was performed during 2010-2013. Methods Subjects were recruited from various specialty clinics and one general practice clinic across Canada...
November 8, 2018: Scandinavian Journal of Pain
M P Jensen, R M Brownstone
BACKGROUND AND OBJECTIVE: Despite the value of spinal cord stimulation (SCS) in treating some patients with focal neuropathic pain, technological advances in stimulator design and treatment protocols have not correlated with significant improvements in clinical outcomes. This may be because incomplete understanding of the mechanisms underlying SCS precludes improvement in clinical efficacy. In this brief review, we (1) review phenomenological effects of SCS, (2) review the literature on proposed spinal sites of action of SCS, and (3) propose a novel hypothesis of mechanism of action...
November 8, 2018: European Journal of Pain: EJP
Sang Woo Kim, Min Cheol Chang
RATIONALE: Epidural hematoma is a possible complication after neuraxial procedures. Recently, caudal epidural pulsed radiofrequency (PRF) stimulation was reported as an effective method for controlling several types of chronic pain. Herein, we report on a patient who developed a lumbar epidural hematoma after receiving caudal epidural PRF stimulation. PATIENT CONCERNS: A 75-year-old woman, who was taking oral warfarin (2 mg/d), received caudal epidural PRF stimulation for symmetrical neuropathic pain in both legs due to chronic idiopathic axonal polyneuropathy...
November 2018: Medicine (Baltimore)
Elizabeth J Richardson, Emily C McKinley, A K M Fazlur Rahman, Phillip Klebine, David T Redden, J Scott Richards
PURPOSE: This study is an examination of the efficacy of a virtual walking protocol to treat spinal cord injury (SCI)-related pain. METHOD: A total of 59 individuals with SCI and neuropathic pain (NP) were randomly assigned to receive 20 min of virtual walking, the treatment condition, or virtual wheeling, the control condition. Although having NP was a requirement to participate in the study, participants also underwent pain classification of up to 3 worst pain sites to also examine the effects of virtual walking on nonneuropathic pain...
November 8, 2018: Rehabilitation Psychology
Kurubaran Ganasegeran, Surajudeen Abiola Abdulrahman, Sami Abdo Radman Al-Dubai, Sin Wan Tham, Muralitharan Perumal
Evidence-based practices that rely upon pain relieving medications and interventional strategies for symptom alleviation in chronic pain survivors have shown modest benefits. The recent emphasis of spiritual care as a new dimension of treatment strategy incorporated within the biopsychosocial model has inspired new hopes to mediate mental and physical health for illness coping. This study aimed to explore the factors associated with spirituality needs among chronic pain patients in a general hospital in Malaysia...
November 8, 2018: Journal of Religion and Health
Majed Jouma Katati, Vidal A Jover, Velasco B Iañez, Pérez M J Navarro, Sabido J de la Cruz, Ortiz G García, Sevilla F Escamilla, Castellanos A Mínguez
Deep brain stimulation (DBS) is used to treat movement disorders, severe psychiatric disorders, and neuropathic pain, among other diseases. Advanced neuroimaging techniques allow direct or indirect localization of the target site, which is verified in many centers by the intraoperative recording of unitary neuronal activity. Intraoperative image acquisition technology (e.g., O-Arm) is increasingly used for accurate electrode positioning throughout the surgery. The aim of our study is to analyze the initial experience of our team in the utilization of O-Arm for planning DBS and monitoring its precision and accuracy throughout the procedure...
November 7, 2018: Acta Neurologica Belgica
Rui Zhou, Jing Wang, Wenjing Qi, Feng-Yu Liu, Ming Yi, Huailian Guo, You Wan
In acute and ongoing pain, the spontaneous oscillatory activity of electroencephalogram (EEG) has been characterized by suppression of alpha band oscillations and enhancement of gamma band oscillations. In pathological chronic pain which is more severe and common in clinic practice, it is of great interest to investigate the oscillatory activity especially at the broad gamma frequency bands. Our present study explored the resting state oscillatory activities of EEG in patients with post-herpetic neuralgia (PHN) over 3 months which is a typical neuropathic pain model in clinical researches...
2018: Frontiers in Neuroscience
Jun-Yih Chen, Li-Wen Chu, Kuang-I Cheng, Su-Ling Hsieh, Yung-Shun Juan, Bin-Nan Wu
Valproate (VPA) is a well-known drug for treating epilepsy and mania, but its action in neuropathic pain is unclear. We used a chronic constriction injury (CCI) model to explore whether VPA prevents neuropathic pain-mediated inflammation and neuronal death. Rats were treated with or without VPA. CCI + VPA rats were intraperitoneally injected with VPA (300 mg/kg/day) from postoperative day (POD) 1 to 14. We measured paw withdrawal latency (PWL) and paw withdrawal threshold (PWT) 1 day before surgery and 1, 3, 7, 14 days after CCI and harvested the sciatic nerves (SN), spinal cord (SC) and dorsal root ganglia (DRG) on POD 3, 7, and 14...
November 7, 2018: Scientific Reports
Murat Alemdar
Fahr disease is an idiopathic disorder characterized with deposition of calcium and a few other minerals in basal ganglia, cerebellum and subcortical brain area. A 51 years old female with the complaints of pain, numbness, tingling and weakness in both upper extremities for six months was referred to our electromyography laboratory with a suspicion of carpal tunnel syndrome. She got the diagnosis of Fahr disease upon the investigations for the convulsions that she experienced ten years ago. Beside, she had a generalized anxiety disoder...
October 2018: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
Resul Yılmaz, Damlanur Üstün, Sema Tuncer Uzun, Ruhiye Reisli, Şeyda Türk
Tardive dyskinesia and tardive dystonia are caused by dopamine receptor blocking agents, mostly antipsychotics and sometimes antidepressants or calcium channel blockers. Duloxetine is a serotonin-noradrenaline reuptake inhibitor used in the treatment of diabetic neuropathic pain and fibromyalgia, as well as major depression. In this case, we aimed to discuss the tardive dyskinesia-like appearance of a patient using duloxetine due to fibromyalgia.
October 2018: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
Haleh Ghavami, Moloud Radfar, Soraya Soheily, Shams Aldin Shamsi, Hamid Reza Khalkhali
OBJECTIVES: Diabetic peripheral neuropathy (DPN) is the most common and troublesome complication of diabetes leading to great morbidity and resulting in a huge economic burden for diabetes care. Over half of people with diabetes develop neuropathy. Also, DPN is a major cause of reduced quality of life due to pain, sensory loss, gait instability, fall-related injury, and foot ulceration and amputation. The aim of this study was evaluating the effects of lifestyle interventions on diabetic neuropathy severity in diabetes type 2 outpatients...
October 2018: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
Leila Sadeghi, Reza Yekta, Gholamreza Dehghan
PURPOSE: Phenytoin is a major anticonvulsant drug that is effective to improve arrhythmia and neuropathic pain. According to early works, phenytoin affected cell membrane depolarization by sodium channel blocking, guanylyl and adenylyl cyclase suppression that cause to intracellular Na+ and Ca2+ downregulation. This study was aimed to clarify some ambiguities in pathophysiological action of phenytoin by in vitro and molecular docking analyses. METHODS: In this study intracellular free Ca2+ of primary culture of embryonic mouse hippocampus evaluated via Fura 2 as fluorescent probe...
November 6, 2018: Daru: Journal of Faculty of Pharmacy, Tehran University of Medical Sciences
Suguru Koyama, Brian W LeBlanc, Kelsey A Smith, Catherine Roach, Joshua Levitt, Muhammad M Edhi, Mai Michishita, Takayuki Komatsu, Okishi Mashita, Aki Tanikawa, Satoru Yoshikawa, Carl Y Saab
We present a multimodal method combining quantitative electroencephalography (EEG), behavior and pharmacology for pre-clinical screening of analgesic efficacy in vivo. The method consists of an objective and non-invasive approach for realtime assessment of spontaneous nociceptive states based on EEG recordings of theta power over primary somatosensory cortex in awake rats. Three drugs were chosen: (1) pregabalin, a CNS-acting calcium channel inhibitor; (2) EMA 401, a PNS-acting angiotensin II type 2 receptor inhibitor; and (3) minocycline, a CNS-acting glial inhibitor...
November 6, 2018: Scientific Reports
Daniyal J Jafree, Joanna M Zakrzewska, Saumya Bhatia, Carolina Venda Nova
BACKGROUND: Better tools are required for the earlier identification and management of orofacial pain with different aetiologies. The painDETECT questionnaire is a patient-completed screening tool with utility for identification of neuropathic pain in a range of contexts. 254 patients, referred from primary care for management of orofacial pain and attending a secondary care centre, were prospectively recruited, and completed the painDETECT prior to consultation. The aim of this study was to determine the accuracy of the painDETECT to detect neuropathic components of orofacial pain, when compared to a reference standard of clinical diagnosis by experienced physicians, in a cohort of hospital-based patients...
November 6, 2018: Journal of Headache and Pain
Y Domon, Y Kitano, M Makino
Mirogabalin, which is a novel ligand for the α₂δ subunit of voltage-gated calcium channels, is under development for the treatment of pain associated with diabetic peripheral neuropathy and postherpetic neuralgia. Mirogabalin possesses unique binding characteristics to α₂δ subunits and potent and long-lasting analgesic effects in peripheral neuropathic pain models. In the present study, we investigated the analgesic effects of mirogabalin in a rat model of spinal cord injury as an experimental animal model for central neuropathic pain...
November 1, 2018: Die Pharmazie
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