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Sympathetically maintained pain

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https://www.readbyqxmd.com/read/27535916/localized-sympathectomy-reduces-mechanical-hypersensitivity-by-restoring-normal-immune-homeostasis-in-rat-models-of-inflammatory-pain
#1
Wenrui Xie, Sisi Chen, Judith A Strong, Ai-Ling Li, Ian P Lewkowich, Jun-Ming Zhang
UNLABELLED: Some forms of chronic pain are maintained or enhanced by activity in the sympathetic nervous system (SNS), but attempts to model this have yielded conflicting findings. The SNS has both pro- and anti-inflammatory effects on immunity, confounding the interpretation of experiments using global sympathectomy methods. We performed a "microsympathectomy" by cutting the ipsilateral gray rami where they entered the spinal nerves near the L4 and L5 DRG. This led to profound sustained reductions in pain behaviors induced by local DRG inflammation (a rat model of low back pain) and by a peripheral paw inflammation model...
August 17, 2016: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/27471314/clonidine-and-ketamine-for-stable-hemodynamics-in-off-pump-coronary-artery-bypass
#2
Jigar Patel, Rajesh Thosani, Jignesh Kothari, Pankaj Garg, Himani Pandya
BACKGROUND: The current era of fast-track extubation and faster recovery after cardiac surgery requires agents that provide perioperative sedation, suppress sympathetic response, reduce opioid requirement, and maintain hemodynamic stability. METHODS: In a prospective randomized double-blind study, 75 off-pump coronary artery bypass patients were divided into 3 groups of 25 each: group A had clonidine 1 µg·kg(-1), group B had clonidine 1 µg·kg(-1) and ketamine 1 mg·kg(-1), and group C had a saline placebo...
September 2016: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/26777300/potential-role-of-estrogen-in-maintaining-the-imbalanced-sympathetic-and-sensory-innervation-in-endometriosis
#3
REVIEW
Yanchun Liang, Shuzhong Yao
Endometriosis, one of the most common benign gynecological diseases, affects millions of women of childbearing age. Endometriosis-associated pain is a major cause of disability and compromised quality of life in women. Neuropathic mechanisms are believed to play an important role. An imbalanced sympathetic and sensory innervation (reduced sympathetic innervation, with unchanged or increased sensory innervation in endometriotic lesions) has been demonstrated in endometriosis in recent studies. And it is believed to contribute to the pathogenesis of endometriosis-associated pain...
March 15, 2016: Molecular and Cellular Endocrinology
https://www.readbyqxmd.com/read/26581872/the-rostral-ventromedial-medulla-control-of-cutaneous-vasomotion-of-paws-and-tail-in-the-rat-implication-for-pain-studies
#4
Nabil El Bitar, Bernard Pollin, Gan Huang, André Mouraux, Daniel Le Bars
Thermal neutrality in rodents is achieved by large cyclic variations of the sympathetic drive of the vasomotion of the tail and paws, the most widely used target organs in current acute or chronic animal models of pain. Given the pivotal functional role of rostral ventromedial medulla (RVM) in nociception and rostral medullary raphe (rMR) in thermoregulation, two largely overlapping brain regions, we aimed at circumscribing the brainstem regions that are the source of premotor afferents to sympathetic preganglionic neurons that control the vasomotor tone of the tail and hind paws...
February 1, 2016: Journal of Neurophysiology
https://www.readbyqxmd.com/read/26557377/treatment-of-complex-regional-pain-syndrome-type-i-with-bisphosphonates
#5
REVIEW
Andrea Giusti, Gerolamo Bianchi
Complex regional pain syndrome type I (CRPS-I) is a common and disabling disorder affecting a peripheral limb, usually developing after a trauma to an extremity. CRPS-I is characterised by presence of spontaneous pain, allodynia and hyperalgesia, disproportionate to the inciting event and by a variety of autonomic disturbances and trophic abnormalities. The pathophysiology of CRPS-I has not been fully understood. Experimental models have suggested that an initial triggering event may produce the release of proinflammatory neuropeptides and cytokines, generating a sort of neurogenic inflammation...
2015: RMD Open
https://www.readbyqxmd.com/read/26240553/chronic-visceral-pain-secondary-to-ventral-disc-herniation-development-of-visceral-complex-regional-pain-syndrome
#6
Gabriela Rocha Lauretti, Raquel de Oliveira
When an organ disease is ruled out as the origin of pelvic pain, the superior hypogastric plexus (SHP) injury and consequent dysfunction could be the mechanism of visceral chronic pain perpetuation. As much as a dorsal discus herniation may harm the dorsal or ventral roots, a ventral discus herniation at L4-L5 or L5-S1 may result in direct physical trauma to the SHP, maintaining chronic visceral pain mediated by sympathetic dysfunction, conceivably also afferent fibers dysfunction. We propose that similarly to nociceptive somatic dysfunction named complex regional pain syndrome, the maintained sympathetic pelvic pain secondary to straight physical damage to the SHP characterize in fact the same disease, but in nociceptive visceral tissue, named visceral complex regional pain syndrome, a concept constructed based on the International Association for the Study of Pain criteria (1994)...
July 2015: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/26211335/-nerve-growth-factor-and-the-physiology-of-pain-the-relationships-among-interoception-sympathetic-neurons-and-the-emotional-response-indicated-by-the-molecular-pathophysiology-of-congenital-insensitivity-to-pain-with-anhidrosis
#7
REVIEW
Yasuhiro Indo
Nerve growth factor (NGF) is a neurotrophic factor essential for the survival and maintenance of neurons. Congenital insensitivity to pain with anhidrosis (CIPA) is caused by loss-of-function mutations in NTRK1, which encodes a receptor tyrosine kinase, TrkA, for NGF. Mutations in NTRK1 cause the selective loss of NGF-dependent neurons, including both NGF-dependent primary afferents and sympathetic postganglionic neurons, in otherwise intact systems. The NGF-dependent primary afferents are thinly myelinated AΔ or unmyelinated C-fibers that are dependent on the NGF-TrkA system during development...
May 2015: No to Hattatsu. Brain and Development
https://www.readbyqxmd.com/read/26136792/algodystrophy-recent-insight-into-the-pathogenic-framework
#8
REVIEW
Massimo Varenna, Francesca Zucchi
Algodystrophy, nowadays called CRPS I, is a painful syndrome characterized by sensory and vasomotor disturbance, edema and functional impairment. Significant progress in knowledge about the pathogenic mechanisms of the disease have been recently achieved, but they are not yet fully understood and some clinical aspects are still lacking of a whole pathogenetic comprehension. The local release of pro-inflammatory neuropeptides and some cytokines may be the event that triggers and maintains the disease, causing hyperalgesia and allodynia...
January 2015: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/26058872/bimodal-modulation-of-ipsilateral-spinal-coeruleo-spinal-pathway-in-crps-a-novel-model-for-explaining-different-clinical-features-of-the-syndrome
#9
Cesar R Carcamo
OBJECTIVE: The objective is to present a hypothesis to explain the sensory, autonomic, and motor disturbances associated with complex regional pain syndrome (CRPS) syndrome. METHODS: The author reviewed the available and relevant literature, which was supplemented with research on experimental animal models, with a focus on how they may translate into humans, particularly in areas about pathophysiologic mechanisms of CRPS. RESULTS: We propose that different CRPS subtypes may result from facilitative or inhibitory influences exerted by the spinal-coeruleo-spinal pathway in three sites at the spinal cord: the dorsal horn (DH), intermediolateral cell column (IML) and ventral horn (VH)...
August 2015: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/26011726/complex-regional-pain-syndrome-and-dysautonomia-in-a-14-year-old-girl-responsive-to-therapeutic-plasma-exchange
#10
Jeanne E Hendrickson, Emma T Hendrickson, Eric A Gehrie, Davinder Sidhu, Gerd Wallukat, Ingolf Schimke, Christopher A Tormey
Reflex sympathetic dystrophy, also known as complex regional pain syndrome (CRPS), has recently been shown to be associated with autoantibodies against β2-adrenergic and muscarinic M2 receptors. In addition to pain and sudomotor/vasomotor symptoms, dysautonomia is also observed in a subset of CRPS patients. Despite its severity, there are few effective therapies for CRPS described to date. We report a case of a 14-year-old girl with CRPS of her right leg and dysautonomia (gastroparesis, postural tachycardia) refractory to multiple therapies, successfully treated with therapeutic plasma exchange (TPE) with albumin replacement...
August 2016: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/25960898/neuralgia-of-the-glossopharyngeal-nerve-in-a-patient-with-posttonsillectomy-scarring-recovery-after-local-infiltration-of-procaine-case-report-and-pathophysiologic-discussion
#11
L Fischer, S M Ludin, K Puente de la Vega, M Sturzenegger
We describe a patient with a three-year history of severe progressive left-sided glossopharyngeal neuralgia (GPN) that failed to adequately respond to various drug therapies. The application of lidocaine spray to the posterior pharyngeal wall provided no more than short-term relief. Apart from a large hypertrophic tonsillectomy scar on the left side all clinical and radiologic findings were normal. In terms of therapeutic local anaesthesia, the hypertrophic tonsillectomy scar tissue was completely infiltrated with the local anaesthetic (LA) procaine 1%...
2015: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/25865020/use-of-hormonal-therapy-is-associated-with-reduced-nerve-fiber-density-in-deep-infiltrating-rectovaginal-endometriosis
#12
Satu Tarjanne, Cecilia H M Ng, Frank Manconi, Johanna Arola, Maarit Mentula, Bharvi Maneck, Ian S Fraser, Oskari Heikinheimo
OBJECTIVE: To study the density of nerve fibers in cases of deep infiltrating endometriosis (DIE) of the rectovaginal septum in relation to various clinical factors. DESIGN: A research laboratory-based study. SETTING: A tertiary center together with a research laboratory. METHODS: Archived DIE tissue samples from 45 women operated upon for rectovaginal septum DIE were re-examined histologically, and by immunohistochemistry...
July 2015: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/25627679/norepinephrine-deficiency-with-normal-blood-pressure-control-in-congenital-insensitivity-to-pain-with-anhidrosis
#13
Lucy Norcliffe-Kaufmann, Stuart D Katz, Felicia Axelrod, Horacio Kaufmann
OBJECTIVE: Congenital insensitivity to pain with anhidrosis (CIPA) is caused by mutations in the NKTR1 gene. This affects the development of nerve growth factor (NGF)-dependent neurons including sympathetic cholinergic neurons in the skin, causing anhidrosis. Cardiovascular and blood pressure regulation appears normal, but the integrity of sympathetic adrenergic neurons has not been tested. METHODS: We examined the effect of posture on blood pressure, heart rate, plasma concentration of catecholamines, vasopressin, endothelin, and renin activity in 14 patients with CIPA, 10 patients with chronically deficient sympathetic activity (pure autonomic failure), and 15 normal age-matched controls...
May 2015: Annals of Neurology
https://www.readbyqxmd.com/read/25498793/the-involvement-of-the-trpa1-receptor-in-a-mouse-model-of-sympathetically-maintained-neuropathic-pain
#14
Francielle de Vargas Pinheiro, Jardel Gomes Villarinho, Cássia Regina Silva, Sara Marchesan Oliveira, Kelly de Vargas Pinheiro, Delia Petri, Mateus Fortes Rossato, Gustavo Petri Guerra, Gabriela Trevisan, Maribel Antonello Rubin, Pierangelo Geppetti, Juliano Ferreira, Eunice André
Sympathetic fibres maintain some forms of neuropathic pain, but the underlying mechanisms are poorly understood. Therefore, this study investigated the possible involvement of transient receptor potential ankyrin 1 (TRPA1) and the role of the sympathetic nervous system (involved in sympathetically maintained neuropathic pain) in a model of neuropathic pain induced by sciatic nerve chronic constriction injury (CCI) in mice. Systemic injection of the selective TRPA1 antagonist HC-030031 reversed the mechanical and cold allodynia that was induced by sciatic nerve chronic constriction injury (CCI)...
January 15, 2015: European Journal of Pharmacology
https://www.readbyqxmd.com/read/25296247/nicardipine-is-superior-to-esmolol-for-the-management-of-postcraniotomy-emergence-hypertension-a-randomized-open-label-study
#15
RANDOMIZED CONTROLLED TRIAL
John F Bebawy, Christopher C Houston, Jenna L Kosky, Ahmed M Badri, Laura B Hemmer, Natalie C Moreland, Louanne M Carabini, Antoun Koht, Dhanesh K Gupta
BACKGROUND: Emergence hypertension after craniotomy is a well-documented phenomenon for which natural history is poorly understood. Most clinicians attribute this phenomenon to an acute and transient increase in catecholamine release, but other mechanisms such as neurogenic hypertension or activation of the renin-angiotensin-aldosterone system have also been proposed. In this open-label study, we compared the monotherapeutic antihypertensive efficacy of the 2 most titratable drugs used to treat postcraniotomy emergence hypertension: nicardipine and esmolol...
January 2015: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/25289130/successful-treatment-of-severe-sympathetically-maintained-pain-following-anterior-spine-surgery
#16
Jae Hee Woo, Hahck Soo Park
Sympathetic dysfunction is one of the possible complications of anterior spine surgery; however, it has been underestimated as a cause of complications. We report two successful experiences of treating severe dysesthetic pain occurring after anterior spine surgery, by performing a sympathetic block. The first patient experienced a burning and stabbing pain in the contralateral upper extremity of approach side used in anterior cervical discectomy and fusion, and underwent a stellate ganglion block with a significant relief of his pain...
July 2014: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/25247914/local-anesthetic-sympathectomy-restores-fmri-cortical-maps-in-crps-i-after-upper-extremity-stellate-blockade-a-prospective-case-study
#17
Philipp Stude, Elena K Enax-Krumova, Melanie Lenz, Silke Lissek, Volkmar Nicolas, Soeren Peters, Amy Westermann, Martin Tegenthoff, Christoph Maier
BACKGROUND: Patients with complex regional pain syndrome type I (CRPS I) show a cortical reorganization with contralateral shrinkage of cortical maps in S1. The relevance of pain and disuse for the development and the maintenance of this shrinkage is unclear. OBJECTIVE: Aim of the study was to assess whether short-term pain relief induces changes in the cortical representation of the affected hand in patients with CRPS type I. STUDY DESIGN: Case series analysis of prospectively collected data...
September 2014: Pain Physician
https://www.readbyqxmd.com/read/25221588/neuronal-changes-resulting-in-up-regulation-of-alpha-1-adrenoceptors-after-peripheral-nerve-injury
#18
REVIEW
Peter D Drummond
Under normal conditions, the sympathetic neurotransmitter noradrenaline inhibits the production and release of pro-inflammatory cytokines. However, after peripheral nerve and tissue injury, pro-inflammatory cytokines appear to induce the expression of the alpha1A-adrenoceptor subtype on immune cells and perhaps also on other cells in the injured tissue. In turn, noradrenaline may act on up-regulated alpha1-adrenoceptors to increase the production of the pro-inflammatory cytokine interleukin-6. In addition, the release of inflammatory mediators and nerve growth factor from keratinocytes and other cells may augment the expression of alpha1-adrenoceptors on peripheral nerve fibers...
July 15, 2014: Neural Regeneration Research
https://www.readbyqxmd.com/read/25135151/complex-regional-pain-syndrome-treated-with-intravenous-immunoglobulin-in-a-patient-with-common-variable-immune-deficiency
#19
Raffi Tachdjian
INTRODUCTION: Common variable immunodeficiency (CVID) represents a large heterogeneous group of antibody-deficiency syndromes associated with a wide range of clinical features and a lack of defined causes in the realm of primary immunodeficiencies. Here, we present a case of CVID in a 62-year-old white male patient with a history of longstanding complex regional pain syndrome (CRPS). CASE PRESENTATION: His medical history included multiple sinus infections per year and several pneumonias requiring antibiotics...
December 2013: Pain and Therapy
https://www.readbyqxmd.com/read/24844294/targeted-delivery-of-a-snare-protease-to-sensory-neurons-using-a-single-chain-antibody-scfv-against-the-extracellular-domain-of-p2x-3-inhibits-the-release-of-a-pain-mediator
#20
Hui Ma, Jianghui Meng, Jiafu Wang, Stephen Hearty, J Oliver Dolly, Richard O'Kennedy
P2X3 (P2X purinoceptor 3) is predominantly expressed on nociceptive sensory neurons and plays a crucial role in signalling leading to chronic inflammatory pain and some features of neuropathic pain. Thus it represents a potential target for pain therapeutics. BoNT/A (botulinum neurooxin type A) effectively relieves certain types of pain through inhibiting the neuronal release of pain peptides. A recombinant single-chain variable fragment (scFv) antibody designated MH7C was generated against the extracellular domain of P2X3 using phage display...
September 1, 2014: Biochemical Journal
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