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Chronic neuropathic pain

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https://www.readbyqxmd.com/read/28350939/the-advancing-role-of-neuromodulation-for-the-management-of-chronic-treatment-refractory-pain
#1
Mohammed F Shamji, Cecile De Vos, Ashwini Sharan
Neuropathic pain is a common cause of disability and health care utilization. While judicious pharmacotherapy and management of comorbid psychological distress can provide for improved quality of life, some patients with treatment-refractory disease require more invasive therapies. Spinal cord stimulation can provide for improvement in pain and decrease in medication utilization, with level 1 evidence supporting its use across various pain etiologies including persistent postoperative neuropathic pain, complex regional pain syndrome, chronic inoperable limb ischemia, treatment refractory angina, and painful diabetic neuropathy...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28341786/effectiveness-of-foot-fasciotomies-in-foot-and-ankle-trauma
#2
Katherine M Bedigrew, D J Stinner, J F Kragh, B K Potter, S B Shawen, J R Hsu
BACKGROUND: Foot compartment syndrome (FCS) has been reported to cause neuropathic pain, claw or hammer toes, and motor and sensory disturbances. The optimal treatment of FCS is controversial. The purpose of this study was to determine if foot fasciotomies improve patient outcomes in high-energy, combat-related lower extremity trauma. METHODS: Medical records of patients with documented FCS from May 2007 to January 2009 were retrospectively reviewed. Consecutive, matched control patients were identified based on similar hindfoot, mid-foot and/or forefoot injuries who did not undergo foot fasciotomy during the same period...
March 23, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28340167/factors-influencing-cognitive-impairment-in-neuropathic-and-musculoskeletal-pain-and-fibromyalgia
#3
Begoña Ojeda, María Dueñas, Alejandro Salazar, Juan Antonio Mico, Luis Miguel Torres, Inmaculada Failde
Objective.:  To assess cognitive performance of chronic pain (CP) patients diagnosed with three types of pain-neuropathic pain (NP), musculoskeletal (MSK), and fibromyalgia (FM)-and to analyze the factors influencing cognitive difficulties in each group. Methods.:  Two hundred fifty-four CP patients-104 NP, 99 MSK, 51 FM-and 72 pain-free subjects were included in the study. The "Test Your Memory" (TYM) scale was used to assess cognitive performance. Pain intensity was measured by means of the visual analog scale (VAS); the Hospital Anxiety and Depression scale was used to assess mental status, and the Medical Outcome Study (MOS) sleep scale to assess sleep quality...
March 13, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28340111/assessment-of-patient-reported-outcome-instruments-to-assess-chronic-low-back-pain
#4
Abhilasha Ramasamy, Mona L Martin, Steven I Blum, Hiltrud Liedgens, Charles Argoff, Rainer Freynhagen, Mark Wallace, Kelly P McCarrier, Donald M Bushnell, Noël V Hatley, Donald L Patrick
Objective. : To identify patient-reported outcome (PRO) instruments that assess chronic low back pain (cLBP) symptoms (specifically pain qualities) and/or impacts for potential use in cLBP clinical trials to demonstrate treatment benefit and support labeling claims. Design. : Literature review of existing PRO measures. Methods. : Publications detailing existing PRO measures for cLBP were identified, reviewed, and summarized. As recommended by the US Food & Drug Administration (FDA) PRO development guidance, standard measurement characteristics were reviewed, including development history, psychometric properties (validity and reliability), ability to detect change, and interpretation of observed changes...
March 6, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339447/chronic-localized-back-pain-due-to-posterior-cutaneous-nerve-entrapment-syndrome-pocnes-a-new-diagnosis
#5
Oliver B Boelens, Robert C Maatman, Marc R Scheltinga, Kees van Laarhoven, Rudi M Roumen
Most patients with chronic back pain suffer from degenerative thoracolumbovertebral disease. However, the following case illustrates that a localized peripheral nerve entrapment must be considered in the differential diagnosis of chronic back pain. We report the case of a 26-year-old woman with continuous excruciating pain in the lower back area. Previous treatment for nephroptosis was to no avail. On physical examination the pain was present in a 2 x 2 cm area overlying the twelfth rib some 4 cm lateral to the spinal process...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339433/management-of-neuropathic-chronic-pain-with-methadone-combined-with-ketamine-a-randomized-double-blind-active-controlled-clinical-trial
#6
Flavia Karine Rigo, Gabriela Trevisan, Maria C Godoy, Mateus Fortes Rossato, Gerusa D Dalmolin, Mariane A Silva, Mirian S Menezes, Wolnei Caumo, Juliano Ferreira
BACKGROUND: Methadone and ketamine are used in neuropathic pain management. However, the benefits of both drugs association are uncertain in the treatment of neuropathic pain. OBJECTIVE: Our primary objective was test the hypothesis that oral methadone combined with oral ketamine is more effective than oral methadone or ketamine alone in reducing neuropathic pain. STUDY DESIGN: We conducted a randomized, double blind, active-controlled parallel-group clinical trial...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339431/perioperative-ketamine-administration-for-thoracotomy-pain
#7
Daniel W Moyse, Alan D Kaye, James H Diaz, Muhammad Y Qadri, David Lindsay, Srinivas Pyati
BACKGROUND: Of all the postsurgical pain conditions, thoracotomy pain poses a particular therapeutic challenge in terms of its prevalence, severity, and ensuing postoperative morbidity. Multiple pain generators contribute to the severity of post-thoracotomy pain, and therefore a multimodal analgesic therapy is considered to be a necessary strategy. Along with opioids, thoracic epidural analgesia, and paravertebral blocks, N-Methyl-D-Aspartate (NMDA) receptor antagonists such as ketamine have been used as adjuvants to improve analgesia...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339077/paeoniflorin-attenuates-the-neuroinflammatory-response-in-a-rat-model-of-chronic-constriction-injury
#8
Jianyu Zhou, Jingxia Wang, Wei Li, Chenglong Wang, Li Wu, Jianjun Zhang
Neuropathic pain remains the most frequent cause of suffering and disability worldwide. Paeoniflorin (PF), a water‑soluble monoterpene glycoside extracted from the roots of Paeonia lactiflora Pall, has a wide range of pharmacological functions. Although the neuroprotective effect of PF has been reported in animal models of neuropathology, no systematic investigation has reported on the analgesic properties of PF in neuropathic pain. The aim of the present study was to investigate whether PF can alleviate neuropathic pain and to examine its possible mechanism...
March 24, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28337946/up-regulation-of-cxcr4-expression-contributes-to-persistent-abdominal-pain-in-rats-with-chronic-pancreatitis
#9
Hong-Yan Zhu, Xuelian Liu, Xiuhua Miao, Di Li, Shusheng Wang, Guang-Yin Xu
Background Pain in patients with chronic pancreatitis is critical hallmark that accompanied inflammation, fibrosis, and destruction of glandular pancreas. Many researchers have demonstrated that stromal cell-derived factor 1 (also named as CXCL12) and its cognate receptor C-X-C chemokine receptor type 4 (CXCR4) involved in mediating neuropathic and bone cancer pain. However, their roles in chronic pancreatic pain remain largely unclear. Methods Chronic pancreatitis was induced by intraductal injection of trinitrobenzene sulfonic acid to the pancreas...
January 2017: Molecular Pain
https://www.readbyqxmd.com/read/28337574/the-rs504393-influences-the-level-of-nociceptive-factors-and-enhances-opioid-analgesic-potency-in-neuropathic-rats
#10
Klaudia Kwiatkowski, Anna Piotrowska, Ewelina Rojewska, Wioletta Makuch, Joanna Mika
Increasing evidence has indicated that activated glial cells releasing nociceptive factors, such as interleukins and chemokines, are of key importance for neuropathic pain. Significant changes in the production of nociceptive factors are associated with the low effectiveness of opioids in neuropathic pain. Recently, it has been suggested that CCL2/CCR2 signaling is important for nociception. Here, we studied the time course changes in the mRNA/protein level of CD40/Iba-1, CCL2 and CCR2 in the spinal cord/dorsal root ganglia (DRG) in rats following chronic constriction injury (CCI) of the sciatic nerve...
March 23, 2017: Journal of Neuroimmune Pharmacology: the Official Journal of the Society on NeuroImmune Pharmacology
https://www.readbyqxmd.com/read/28336100/in-vivo-evaluation-of-the-hippocampal-glutamate-gaba-and-the-bdnf-levels-associated-with-spatial-memory-performance-in-a-rodent-model-of-neuropathic-pain
#11
S Saffarpour, M Shaabani, N Naghdi, M Farahmandfar, A Janzadeh, F Nasirinezhad
BACKGROUND: Patients with chronic pain usually suffer from learning and memory impairment which may significantly decrease their quality of life. Despite laboratory and clinical studies, the mechanism underlying this memory impairment remains elusive. We evaluated the effect of chronic pain on the glutamate and GABA levels and BDNF expression in the CA1 region of hippocampus as a possible explanation for memory impairment related to neuropathic pain. METHODS: In this respect, 30 male rats were randomly allocated to 3 groups as control, sham and neuropathic...
March 20, 2017: Physiology & Behavior
https://www.readbyqxmd.com/read/28331359/pregnancy-suppresses-neuropathic-pain-induced-by-chronic-constriction-injury-in-rats-through-the-inhibition-of-tnf-%C3%AE
#12
Yoshiko Onodera, Megumi Kanao-Kanda, Hirotsugu Kanda, Tomoki Sasakawa, Hiroshi Iwasaki, Takayuki Kunisawa
PURPOSE: Pregnancy-induced analgesia develops during late pregnancy, but it is unclear whether this analgesia is effective against neuropathic pain. The detailed molecular mechanisms underlying pregnancy-induced analgesia have not been investigated. We examined the antinociceptive effect of pregnancy-induced analgesia in a neuropathic pain model and the expression of tumor necrosis factor (TNF)-α, glial fibrillary acidic protein (GFAP), Iba-1, and c-Fos in the spinal dorsal horn just before parturition...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28330877/k-channel-modulatory-subunits-kchip-and-dpp-participate-in-kv4-mediated-mechanical-pain-control
#13
Yen-Ling Kuo, Jen-Kun Cheng, Wen-Hsien Hou, Yu-Cheng Chang, Po-Hao Du, Jhao-Jun Jian, Ruey-Horng Rau, Jung-Hui Yang, Cheng-Chang Lien, Meei-Ling Tsaur
The K(+) channel pore-forming subunit Kv4.3 is expressed in a subset of non-peptidergic nociceptors within the dorsal root ganglion (DRG), and knockdown of Kv4.3 selectively induces mechanical hypersensitivity, a major symptom of neuropathic pain. K(+) channel modulatory subunits KChIP1, KChIP2 and DPP10 are coexpressed in Kv4.3(+) DRG neurons, but whether they participate in Kv4.3-mediated pain control is unknown. Here, we show the existence of a Kv4.3/KChIP1/KChIP2/DPP10 complex (abbreviated as the Kv4 complex) in the endoplasmic reticulum and cell surface of DRG neurons...
March 22, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28330489/profiling-intraoral-neuropathic-disturbances-following-lingual-nerve-injury-and-in-burning-mouth-syndrome
#14
Amely Hartmann, Robin Seeberger, Malte Bittner, Roman Rolke, Claudia Welte-Jzyk, Monika Daubländer
BACKGROUND: The aim of the study was to analyse intraoral neurophysiological changes in patients with unilateral lingual nerve lesions as well as patients with Burning Mouth Syndrome (BMS) by applying a standardized Quantitative Sensory Testing (QST) protocol. METHODS: The study included patients suffering from a peripheral lesion of the lingual nerve (n = 4), from BMS (n = 5) and healthy controls (n = 8). Neurophysiological tests were performed in the innervation areas of the tongue bilaterally...
March 23, 2017: BMC Oral Health
https://www.readbyqxmd.com/read/28328700/lumbar-tactile-acuity-in-patients-with-low-back-pain-and-healthy-controls-systematic-review-and-meta-analysis
#15
Wacław Adamczyk, Kerstin Luedtke, Edward Saulicz
OBJECTIVE: Diminished tactile acuity in chronic non-neuropathic pain syndromes has been attributed to central pain processing and cortical reorganization. The latter was recently targeted in clinical trials that demonstrated no clear advantages over traditional approaches for the reduction of nonspecific low back pain (LBP). The aim of this systematic review and meta-analysis was to summarize the current evidence on tactile acuity in LBP and pain-free controls. METHODS: Six databases were independently searched by 2 researchers...
March 21, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28328571/neuropathic-pain-induced-enhancement-of-spontaneous-and-pain-evoked-neuronal-activity-in-the-periaqueductal-gray-that-is-attenuated-by-gabapentin
#16
Vijay K Samineni, Louis S Premkumar, Carl L Faingold
Neuropathic pain is a debilitating pathological condition that is poorly understood. Recent evidence suggests that abnormal central processing occurs during the development of neuropathic pain induced by the cancer chemotherapeutic agent, paclitaxel. Yet, it is unclear what role neurons in supraspinal pain network sites, such as the periaqueductal gray, play in altered behavioral sensitivity seen during chronic pain conditions. To elucidate these mechanisms, we studied the spontaneous and thermally-evoked firing patterns of ventrolateral periaqueductal gray (vlPAG) neurons in awake behaving rats treated with paclitaxel to induce neuropathic pain...
March 21, 2017: Pain
https://www.readbyqxmd.com/read/28328324/trial-of-pregabalin-for-acute-and-chronic-sciatica
#17
Stephanie Mathieson, Christopher G Maher, Andrew J McLachlan, Jane Latimer, Bart W Koes, Mark J Hancock, Ian Harris, Richard O Day, Laurent Billot, Justin Pik, Stephen Jan, C-W Christine Lin
Background Sciatica can be disabling, and evidence regarding medical treatments is limited. Pregabalin is effective in the treatment of some types of neuropathic pain. This study examined whether pregabalin may reduce the intensity of sciatica. Methods We conducted a randomized, double-blind, placebo-controlled trial of pregabalin in patients with sciatica. Patients were randomly assigned to receive either pregabalin at a dose of 150 mg per day that was adjusted to a maximum dose of 600 mg per day or matching placebo for up to 8 weeks...
March 23, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28326950/efficacy-of-the-topical-5-lidocaine-medicated-plaster-in-the-treatment-of-chronic-post-thoracotomy-neuropathic-pain
#18
Pasquale Sansone, Maria Beatrice Passavanti, Alfonso Fiorelli, Caterina Aurilio, Umberto Colella, Lorenzo De Nardis, Valerio Donatiello, Vincenzo Pota, Maria Caterina Pace
AIM: To assess the efficacy of the topical 5% lidocaine medicated plaster (Versatis(®), Grünenthal GmbH, Aachen, Germany) in patients with post-thoracotomy neuropathic pain. PATIENTS & METHODS: Patients were randomized to receive the topical 5% lidocaine medicated plaster (n = 33) or non-medicated placebo plasters (n = 30) for 12 h every day for 8 weeks. Laser-evoked potentials (LEPs) were measured, and various questionnaires/scales completed. RESULTS: Numeric Rating Scale pain scores improved significantly (p < 0...
March 3, 2017: Pain Management
https://www.readbyqxmd.com/read/28326943/analgesia-induced-by-the-epigenetic-drug-l-acetylcarnitine-outlasts-the-end-of-treatment-in-mouse-models-of-chronic-inflammatory-and-neuropathic-pain
#19
Serena Notartomaso, Giada Mascio, Matteo Bernabucci, Cristina Zappulla, Pamela Scarselli, Milena Cannella, Tiziana Imbriglio, Roberto Gradini, Giuseppe Battaglia, Valeria Bruno, Ferdinando Nicoletti
Background L-acetylcarnitine, a drug marketed for the treatment of chronic pain, causes analgesia by epigenetically up-regulating type-2 metabotropic glutamate (mGlu2) receptors in the spinal cord. Because the epigenetic mechanisms are typically long-lasting, we hypothesized that analgesia could outlast the duration of L-acetylcarnitine treatment in models of inflammatory and neuropathic pain. Results A seven-day treatment with L-acetylcarnitine (100 mg/kg, once a day, i.p.) produced an antiallodynic effect in the complete Freund adjuvant mouse model of chronic inflammatory pain...
January 2017: Molecular Pain
https://www.readbyqxmd.com/read/28326929/dendritic-spine-dysgenesis-in-superficial-dorsal-horn-sensory-neurons-after-spinal-cord-injury
#20
Xiaoyu C Cao, Laura W Pappalardo, Stephen G Waxman, Andrew M Tan
Neuropathic pain is a major complication of spinal cord injury, and despite aggressive efforts, this type of pain is refractory to available clinical treatment. Our previous work has demonstrated a structure-function link between dendritic spine dysgenesis on nociceptive sensory neurons in the intermediate zone, laminae IV/V, and chronic pain in central nervous system and peripheral nervous system injury models of neuropathic pain. To extend these findings, we performed a follow-up structural analysis to assess whether dendritic spine remodeling occurs on superficial dorsal horn neurons located in lamina II after spinal cord injury...
January 2017: Molecular Pain
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