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https://www.readbyqxmd.com/read/28340111/assessment-of-patient-reported-outcome-instruments-to-assess-chronic-low-back-pain
#1
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/28339448/efficacious-dorsal-root-ganglion-stimulation-for-painful-small-fiber-neuropathy-a-case-report
#2
Paolo Maino, Eva Koetsier, Alain Kaelin-Lang, Claudio Gobbi, Roberto Perez
Small fiber neuropathy is a disorder of the peripheral nerves with typical symptoms of burning, sharp, and shooting pain and sensory disturbances in the feet. Pain treatment depends principally on the underlying etiology with concurrent administration of antidepressants, anticonvulsants, opioids, and topical treatments like capsaicin and local anesthetics. However, treatments for pain relief in these patients frequently fail. We describe the first case of intractable painful small fiber neuropathy of the foot successfully treated with spinal cord stimulation of the left L5 dorsal root ganglion...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339447/chronic-localized-back-pain-due-to-posterior-cutaneous-nerve-entrapment-syndrome-pocnes-a-new-diagnosis
#3
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/28339440/pulsed-radiofrequency-to-the-dorsal-root-ganglion-in-acute-herpes-zoster-and-postherpetic-neuralgia
#4
Koohyun Kim, Daehyun Jo, EungDon Kim
BACKGROUND: Latent varicella zoster virus reactivates mainly in sensory ganglia such as the dorsal root ganglion (DRG) or trigeminal ganglion. The DRG contains many receptor channels and is an important region for pain signal transduction. Sustained abnormal electrical activity to the spinal cord via the DRG in acute herpes zoster can result in neuropathic conditions such as postherpetic neuralgia (PHN). Although the efficacy of pulsed radiofrequency (PRF) application to the DRG in various pain conditions has been previously reported, the application of PRF to the DRG in patients with herpes zoster has not yet been studied...
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
#5
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
#6
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/28337820/selective-radiofrequency-stimulation-of-the-dorsal-root-ganglion-drg-as-a-method-for-predicting-targets-for-neuromodulation-in-patients-with-post-amputation-pain-a-case-series
#7
Corey W Hunter, Ajax Yang, Tim Davis
OBJECTIVE: While spinal cord stimulation (SCS) has established itself as an accepted and validated treatment for neuropathic pain, there are a number of conditions where it has experienced less, long-term success: post amputee pain (PAP) being one of them. Dorsal root ganglion (DRG) stimulation has shown great promise, particularly in conditions where traditional SCS has fallen short. One major difference between DRG stimulation and traditional SCS is the ability to provide focal stimulation over targeted areas...
March 23, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28334783/amitriptyline-for-musculoskeletal-complaints-a-systematic-review
#8
Jacoline J van den Driest, Sita M A Bierma-Zeinstra, Patrick J E Bindels, Dieuwke Schiphof
Background.: The role of amitriptyline in musculoskeletal pain is not as clearly defined as in classical neuropathic pain conditions. Objective.: To assess the efficacy and effectiveness of amitriptyline in the treatment of pain in musculoskeletal complaints. Methods.: An extensive search (including Medline, Embase and Web of Science) was made up to April 2016 for randomised controlled trials on amitriptyline in musculoskeletal complaints compared to placebo, usual care, or other analgesic use...
January 30, 2017: Family Practice
https://www.readbyqxmd.com/read/28334550/geraniol-promotes-functional-recovery-and-attenuates-neuropathic-pain-in-rats-with-spinal-cord-injury
#9
Yan Lv, Liang Zhang, Na Li, Naiken Mai, Yu Zhang, Shuyi Pan
Geraniol, a plant derived monoterpene, has been extensively studied and showed a wide variety of beneficial effects. The aim of this study was to investigate the therapeutic effect of geraniol on functional recovery and neuropathic pain in rats with spinal cord injury (SCI). Rats received a clip-compression SCI and were treated with geraniol 6 hours following SCI. Treatment of SCI rats with geraniol markedly improved locomotor function, and reduced sensitivity to the mechanical allodynia and thermal hyperalgesia...
March 23, 2017: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/28330877/k-channel-modulatory-subunits-kchip-and-dpp-participate-in-kv4-mediated-mechanical-pain-control
#10
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/28328589/cervical-retrograde-spinal-cord-stimulation-lead-placement-to-treat-failed-back-surgery-syndrome-a-case-report
#11
Noud van Helmond, Caroline N Kardaszewski, Kenneth B Chapman
Spinal cord stimulation is an effective treatment modality for refractory neuropathic pain conditions, but the placement of leads can be challenging due to unforeseen anatomical variations. We used a retrograde C7-T1 approach to place a lead at the bottom of T8 in a patient suffering from failed back surgery syndrome. We were able to achieve adequate stimulation in her lower back and legs, which resulted in significant reduction in pain intensity during the spinal cord stimulation trial. Cervical retrograde placement of leads may represent an alternative method for successful placement of percutaneous leads in patients with abnormal anatomy due to thoracic postsurgical changes...
March 15, 2017: A & A Case Reports
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
#12
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
#13
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
#14
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/28326946/polyamidoamine-dendrimer-conjugated-triamcinolone-acetonide-attenuates-nerve-injury-induced-spinal-cord-microglia-activation-and-mechanical-allodynia
#15
Hwisung Kim, Boomin Choi, Hyoungsub Lim, Hyunjung Min, Jae Hoon Oh, Sunghyun Choi, Joung Goo Cho, Jong-Sang Park, Sung Joong Lee
Background Accumulating evidence on the causal role of spinal cord microglia activation in the development of neuropathic pain after peripheral nerve injury suggests that microglial activation inhibitors might be useful analgesics for neuropathic pain. Studies also have shown that polyamidoamine dendrimer may function as a drug delivery vehicle to microglia in the central nervous system. In this regard, we developed polyamidoamine dendrimer-conjugated triamcinolone acetonide, a previously identified microglial activation inhibitor, and tested its analgesic efficacy in a mouse peripheral nerve injury model...
January 2017: Molecular Pain
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
#16
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/28326936/a-role-for-the-locus-coeruleus-in-the-analgesic-efficacy-of-n-acetylaspartylglutamate-peptidase-gcpii-inhibitors-zj43-and-2-pmpa
#17
Takahiro Nonaka, Toshihiko Yamada, Tatsuhiro Ishimura, Daiying Zuo, John R Moffett, Joseph H Neale, Tatsuo Yamamoto
N-acetylaspartylglutamate (NAAG) is the third most prevalent and widely distributed neurotransmitter in the mammalian nervous system. NAAG activates a group II metabotropic glutamate receptor (mGluR3) and is inactivated by an extracellular enzyme, glutamate carboxypeptidase II (GCPII) in vivo. Inhibitors of this enzyme are analgesic in animal models of inflammatory, neuropathic and bone cancer pain. NAAG and GCPII are present in the locus coeruleus, a center for the descending noradrenergic inhibitory pain system...
January 2017: Molecular Pain
https://www.readbyqxmd.com/read/28326929/dendritic-spine-dysgenesis-in-superficial-dorsal-horn-sensory-neurons-after-spinal-cord-injury
#18
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
https://www.readbyqxmd.com/read/28326925/interaction-of-acupuncture-treatment-and-manipulation-laterality-modulated-by-the-default-mode-network
#19
Xuan Niu, Ming Zhang, Zhenyu Liu, Lijun Bai, Chuanzhu Sun, Shan Wang, Xiaocui Wang, Zhen Chen, Hongyan Chen, Jie Tian
Appropriate selection of ipsilateral or contralateral electroacupuncture (corresponding to the pain site) plays an important role in reaching its better curative effect; however, the involving brain mechanism still remains unclear. Compared with the heat pain model generally established in previous study, capsaicin pain model induces reversible cutaneous allodynia and is proved to be better simulating aspects of clinical nociceptive and neuropathic pain. In the current study, 24 subjects were randomly divided into two groups with a 2 × 2 factorial design: laterality (ipsi- or contralateral side, inter-subject) × treatment with counter-balanced at an interval of one week (verum and placebo electroacupuncture, within-subject)...
January 2017: Molecular Pain
https://www.readbyqxmd.com/read/28325536/self-reported-neuropathic-pain-characteristics-of-women-with-provoked-vulvar-pain-a-preliminary-investigation
#20
Emma Dargie, Ian Gilron, Caroline F Pukall
BACKGROUND: Provoked vestibulodynia (PVD) is a common chronic genital pain condition affecting approximately 12% of premenopausal women. Although parallels have been drawn between PVD and neuropathic pain (NP), no studies have examined self-reported NP characteristics in PVD. AIM: To explore pain symptoms that resemble NP reported by those with PVD and compare responses with those with an established NP condition. METHODS: Women with provoked vulvar pain (PVP; n = 65) completed online questionnaires designed to assess characteristics of NP...
March 15, 2017: Journal of Sexual Medicine
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