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Chronic central pain

Markus Blankenburg, Michael Schroth, Sarah Braun
Primary headache disorders such as migraine and tension-type headache begin as early as childhood or adolescence. Prevalence increases during primary school and adolescence. In tension-type headache, central pain sensitization and activation of central nociceptive neurons plays an important role. Migraine is a primary brain disorder with abnormalities in pain modulating systems and cortical stimulus processing. Bio-psycho-social factors play a decisive role in both types of headache. Secondary headaches due to an inflammatory or a structural brain alteration are rare...
October 15, 2018: Klinische Pädiatrie
Yanjun Liu, Xiangqi Tang
Autoimmune diseases of the nervous system (ADNS) consist of a group of severely disabling disorders characterized by abnormal immune attack against protein components of the nervous system. This type of attack behavior may occur in the central or peripheral nervous system, and in the neuromuscular junction, resulting in neuronal damage, axonal injury, demyelination or destruction of the neuromuscular junction. While the neurological deficits of patients with ADNS have received significant research attention, the manifestation of depression tends to be ignored...
2018: Frontiers in Psychiatry
Zhengdao Deng, Yixin Pan, Dianyou Li, Chencheng Zhang, Haiyan Jin, Tao Wang, Shikun Zhan, Bomin Sun
BACKGROUND: The presence of neuropathic pain can severely impinge on emotional regulation and activities of daily living, including social activities, resulting in diminished life satisfaction. Unfortunately, the majority of patients with neuropathic pain do not experience an amelioration of symptoms from conventional therapies, even when multimodal therapies are used. Chronic refractory neuropathic pain is usually accompanied by severe depression that is prone to incur suicidal events, thus clinical management of chronic neuropathic pain and depression presents a serious challenge for clinicians and patients...
October 10, 2018: World Neurosurgery
Daniela Shaked, Gad Shaked, Gilbert Sebbag, David Czeiger
BACKGROUND: The exact underlying mechanism of whiplash-associated disorders still remains obscure. Central sensitization of the brain to painful stimulus and disturbances in the hypothalamic-pituitary-adrenal axis has been suggested to contribute to the development of whiplash-associated disorders. Although cortisol is a well-known factor in the acute stress response and its effects on chronic pain sensation were studied, information is lacking regarding the relation between acute phase cortisol concentrations and the intensity of whiplash-associated disorders...
October 12, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Dong-Kyun Seo, Sookyung Lee, Gunn Lee, Myung-Su Lee, Syn-Hae Yoon, Seong-Soo Choi, Jin-Woo Shin
A previous study showed that transforaminal balloon adhesiolysis via the safe triangle was effective in lumbar spinal stenosis. However, retrodiscal pathology is difficult to treat with this method. Therefore we attempted retrodiscal balloon adhesiolysis via Kambin's triangle. The design of our study is a retrospective analysis. The setting of our study is a tertiary, interventional pain management practice, speciality referral center.The primary indication for this procedure is radicular pain arising from ipsilateral retrodiscal pathology...
October 2018: Medicine (Baltimore)
Zsuzsa Jenei-Lanzl, Andrea Meurer, Frank Zaucke
Osteoarthritis (OA) can be regarded as a chronic, painful and degenerative disease that affects all tissues of a joint and one of the major endpoints being loss of articular cartilage. In most cases, OA is associated with a variable degree of synovial inflammation. A variety of different cell types including chondrocytes, synovial fibroblasts, adipocytes, osteoblasts and osteoclasts as well as stem and immune cells are involved in catabolic and inflammatory processes but also in attempts to counteract the cartilage loss...
October 9, 2018: Cellular Signalling
Raúl Ferrer-Peña, Daniel Muñoz-García, César Calvo-Lobo, Josué Fernández-Carnero
Objectives: The aims of this study were twofold: 1) to evaluate the differences in pain sensitivity of patients with greater trochanteric pain syndrome (GTPS) and 2) to examine the association between pain expansion, pain severity, and pain-related central sensitization somatosensory variables in patients with GTPS. Study Design: A cross-sectional study. Setting: Primary health care centers. Subjects: The sample consisted of 49 participants with a mean age of 48...
October 11, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Krishnan V Chakravarthy, Fang Xing, Kelly Bruno, Alexander R Kent, Adil Raza, Rene Hurlemann, Thomas M Kinfe
BACKGROUND: There is increasing literature evidence both clinically and experimentally on the existence of potent, adaptive interactions between the central and peripheral aspects of the neuroimmune system in the genesis and maintenance of chronic neuropathic extremity pain and nociceptive back pain. The neuroinflammatory pathways are modulated by the interaction of pro- and anti-inflammatory cytokines and chemokines, which are released by peripheral immune system-derived cell species (macrophages and leukocytes)...
October 12, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Silvana Bonilla, Samuel Nurko
Chronic abdominal pain is frequently encountered in pediatric practice. A large proportion of cases meet Rome criteria for abdominal pain-functional gastrointestinal disorders (AP-FGIDs). These disorders are costly and, in some cases, lead to impairment of daily functioning and overall quality of life. Pathophysiologic mechanisms include early stressful events, visceral hypersensitivity, dysmotility, changes in intestinal microbiota, and altered central nervous system processing. They are considered disorders of the brain-gut interaction...
2018: Clinical and Experimental Gastroenterology
Claire J Han, Monica E Jarrett, Kevin C Cain, Sangeun Jun, Margaret M Heitkemper
Fatigue is the most common extraintestinal symptom in women with irritable bowel syndrome (IBS). Genetic polymorphisms of monoamines are associated with fatigue in many chronic diseases. In this pilot exploratory study, the primary aim was to determine whether genetic polymorphisms of tryptophan hydroxylase ( TPH1/TPH2), serotonin reuptake transporter ( SERT), or catechol-O-methyltransferase ( COMT) are associated with fatigue in women with IBS. Additionally, analysis explored whether these genetic associations with fatigue would be present when controlling for abdominal pain, psychological distress, feeling stressed, and sleepiness during the day...
October 11, 2018: Biological Research for Nursing
Moe Watanabe, Minoru Narita
Pain plays an important role in alerting the body to potential tissue injury and drives behavior that protects the body from further harm. In contrast, chronic pain does not serve this function and instead only provides a persistent sensation of pain and a negative experience. The mesolimbic dopaminergic system has been recognized to play a central role in motivated behaviors, including various types of reward and pleasure. Many dopaminergic neurons may release multiple neurotransmitters, and the physiological role of the co-release of these transmitters has been revealed incrementally...
2018: Advances in Experimental Medicine and Biology
Fusao Kato, Yae K Sugimura, Yukari Takahashi
In addition to the canonical spino-thalamo-cortical pathway, lines of recently accumulated anatomical and physiological evidence suggest that projections originating in nociception-specific neurons in lamina I of the dorsal horn or the spinal nucleus of the trigeminal nerve to the lateral parabrachial nucleus (LPB) and then to the central amygdala (CeA) play essential roles in the nociception-emotion link and its tightening in chronic pain. With recent advances in the artificial manipulation of central neuronal activity, such as those with optogenetics, it is now possible to address many unanswered questions regarding the molecular and cellular mechanisms underlying the plastic changes in this pathway and their role in the pain chronification process...
2018: Advances in Experimental Medicine and Biology
Chih-Peng Lin, Dai-Hua Lu
Opioid analgesics remain the most effective and widely used analgesics for the management of moderate to severe pain, including cancer pain and chronic non-cancer pain. However, the efficacy of long-term opioid analgesics is attenuated by tolerance and/or hyperalgesia after long-term use, preventing adequate pain relief under stable opioid dosages for chronic pain patients. Classical neuron-centered concepts about tolerance, such as internalization of opioid receptors, upregulation of N-methyl-D-aspartate receptor function, or downregulation of glutamate transporter activity, can only partially explain the phenomenon of tolerance...
2018: Advances in Experimental Medicine and Biology
Wei-Hsin Sun, Shih-Ping Dai
Rheumatoid arthritis (RA), characterized by chronic inflammation of synovial joints, is often associated with ongoing pain and increased pain sensitivity. Chronic pain that comes with RA turns independent, essentially becoming its own disease. It could partly explain that a significant number (50%) of RA patients fail to respond to current RA therapies that focus mainly on suppression of joint inflammation. The acute phase of pain seems to associate with joint inflammation in early RA. In established RA, the chronic phase of pain could be linked to inflammatory components of neuron-immune interactions and noninflammatory components...
2018: Advances in Experimental Medicine and Biology
Patrick Welsh
Objective: To report 2 cases of lateral elbow tendinopathy treated with a novel adaptation of tendon neuroplastic training (TNT). Clinical features: Patient 1: A 61-year-old male machine operator presented with one year of bilateral lateral elbow pain related to his occupation of using torque wrenches. Patient 2: A 37-year-old male electrician presented with two months of recurrent left lateral elbow pain related to repetitive motions of gripping and pulling at work...
August 2018: Journal of the Canadian Chiropractic Association
Ann Bugeja, Paula Blanco, Edward G Clark, Manish M Sood
BACKGROUND: The development of proteinuria and reduced glomerular filtration rate is associated with higher mortality among patients with sickle cell disease (SCD). AA amyloidosis, also associated with increased mortality, in SCD is rare. We present a case of a woman with homozygous sickle cell disease with nephrotic syndrome and antibodies to double stranded DNA without clinical features of systemic lupus erythematosus. Kidney biopsy reveals AA amyloidosis and is the first report of concomitant AA amyloidosis with antibodies to double stranded DNA in SCD...
October 10, 2018: BMC Nephrology
Loredana Cavalli, Lucia Briscese, Tiziana Cavalli, Paolo Andre, Maria Chiara Carboncini
Acupuncture therapy has been used to treat several disorders in Asian countries and its use is increasing in Western countries as well. Current literature assessed the safety and efficacy of acupuncture in the acute management and rehabilitation of patients with neurologic disorders. In this paper, the role of acupuncture in the treatment of acute severe acquired brain injuries is described, acting on neuroinflammation, intracranial oedema, oxidative stress, and neuronal regeneration. Moreover, beneficial effects of acupuncture on subacute phase and chronic outcomes have been reported in controlling the imbalance of IGF-1 hormone and in decreasing spasticity, pain, and the incidence of neurovegetative crisis...
2018: Evidence-based Complementary and Alternative Medicine: ECAM
Lizbeth J Ayoub, David A Seminowicz, Massieh Moayedi
Chronic orofacial pain (COFP) disorders are prevalent and debilitating pain conditions affecting the head, neck and face areas. Neuroimaging studies have reported functional and grey matter abnormalities, but not all the studies have reported consistent findings. Identifying convergent abnormalities across COFPs provides a basis for future hypothesis-driven research aimed at elucidating common CNS mechanisms. Here, we perform three coordinate-based meta-analyses according to PRISMA guidelines to elucidate the central mechanisms of orofacial pain disorders...
September 25, 2018: NeuroImage: Clinical
Mohsen Bazargan, James L Smith, Ebony O King
BACKGROUND: Inappropriate use of medications, particularly among minority older adults with co-morbidity, remains a major public health concern. The American Geriatrics Society (AGS) reports that Potentially Inappropriate Medication (PIM) continues to be prescribed for older adults, despite evidence of poor outcomes. The main objective of this study was to examine the prevalence of PIM use among underserved non-institutionalized hypertensive older African-American adults. Furthermore, this study examines potential correlations between PIM use and the number and type of chronic conditions...
October 5, 2018: BMC Geriatrics
Tzu-Hao Harry Chao, Jyh-Horng Chen, Chen-Tung Yen
Neuropathic pain is a major worldwide health problem. Although central sensitization has been reported in well-established neuropathic conditions, information on the acute brain activation patterns in response to peripheral nerve injury is lacking. This study first mapped the brain activity in rats immediately following spared nerve injury (SNI) of the sciatic nerve. Using blood-oxygenation-level-dependent functional magnetic resonance imaging (BOLD-fMRI), we observed sustained activation in the bilateral insular cortices (ICs), primary somatosensory cortex (S1), and cingulate cortex...
October 1, 2018: Molecular Brain
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