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Chronic pain AND neurobiology

David W Dodick
Migraine is a chronic paroxysmal neurological disorder characterised by multiphase attacks of head pain and a myriad of neurological symptoms. The underlying genetic and biological underpinnings and neural networks involved are coming sharply into focus. This progress in the fundamental understanding of migraine has led to novel, mechanism-based and disease-specific therapeutics. In this Seminar, the clinical features and neurobiology of migraine are reviewed, evidence to support available treatment options is provided, and emerging drug, device, and biological therapies are discussed...
March 6, 2018: Lancet
Andrew J Shepherd, Aaron D Mickle, Suraj Kadunganattil, Hongzhen Hu, Durga P Mohapatra
Bone metastasis in breast, prostate and lung cancers often leads to chronic pain, which is poorly managed by existing analgesics. The neurobiological mechanisms that underlie chronic pain associated with bone-metastasized cancers are not well understood, but sensitization of peripheral nociceptors by tumor microenvironment factors has been demonstrated to be important. Parathyroid hormone-related peptide (PTHrP) is highly expressed in bone-metastasized breast and prostate cancers, and is critical to growth and proliferation of these tumors in the bone tumor microenvironment...
2018: Frontiers in Cellular Neuroscience
David Borsook, Andrew M Youssef, Nadia Barakat, Christine B Sieberg, Igor Elman
By unconscious or covert processing of pain we refer to nascent interactions that affect the eventual deliverance of pain awareness. Thus, internal processes (viz., repeated nociceptive events, inflammatory kindling, reorganization of brain networks, genetic) or external processes (viz., environment, socioeconomic levels, modulation of epigenetic status) contribute to enhancing or inhibiting the presentation of pain awareness. Here we put forward the notion that for many patients, ongoing sub-conscious changes in brain function are significant players in the eventual manifestation of chronic pain...
February 21, 2018: Neuroscience and Biobehavioral Reviews
Hanneke L D M Willemen, Annemieke Kavelaars, Judith Prado, Mirjam Maas, Sabine Versteeg, Lara J J Nellissen, Jeshua Tromp, Rafael Gonzalez Cano, Wenjun Zhou, Magnus E Jakobsson, Jędrzej Małecki, George Posthuma, Abdella M Habib, Cobi J Heijnen, Pål Ø Falnes, Niels Eijkelkamp
Chronic pain is a debilitating problem, and insights in the neurobiology of chronic pain are needed for the development of novel pain therapies. A genome-wide association study implicated the 5p15.2 region in chronic widespread pain. This region includes the coding region for FAM173B, a functionally uncharacterized protein. We demonstrate here that FAM173B is a mitochondrial lysine methyltransferase that promotes chronic pain. Knockdown and sensory neuron overexpression strategies showed that FAM173B is involved in persistent inflammatory and neuropathic pain via a pathway dependent on its methyltransferase activity...
February 14, 2018: PLoS Biology
Jo Nijs, Olivier Mairesse, Daniel Neu, Laurence Leysen, Lieven Danneels, Barbara Cagnie, Mira Meeus, Maarten Moens, Kelly Ickmans, Dorien Goubert
Among people with chronic pain, insomnia is highly prevalent, closely related to the mechanism of central sensitization, characterized by low-grade neuroinflammation, and commonly associated with stress or anxiety; in addition, it often does not respond effectively to drug treatments. This review article applies the current understanding of insomnia to clinical practice, including assessment and conservative treatment of insomnia in people with chronic pain. Cognitive-behavioral therapy for insomnia can be efficacious for improvements in sleep initiation, sleep maintenance, perceived sleep quality, and pain interference with daily functioning in people with chronic pain...
February 7, 2018: Physical Therapy
Søren S Olesen, Theresa Krauss, Ihsan Ekin Demir, Oliver H Wilder-Smith, Güralp O Ceyhan, Pankaj J Pasricha, Asbjørn M Drewes
Introduction: Chronic pancreatitis (CP) is a disease characterized by inflammation of the pancreas resulting in replacement of the normal functioning parenchyma by fibrotic connective tissue. This process leads to progressively impairment of exocrine and endocrine function and many patients develop a chronic pain syndrome. Objectives: We aimed to characterize the neurobiological signature of pain associated with CP and to discuss its implications for treatment strategies...
November 2017: Pain Reports (Baltimore, Md.)
M A Fitzcharles, E Eisenberg
Medical cannabis has entered mainstream medicine and is here to stay. Propelled by public advocacy, the media and mostly anecdote rather than sound scientific study, patients worldwide are exploring marijuana use for a vast array of medical conditions including management of chronic pain. Contrary to the usual path of drug approval, medical cannabis has bypassed traditional evidence-based study and has been legalized as a therapeutic product by legislative bodies in various countries. While there is a wealth of basic science and preclinical studies demonstrating effects of cannabinoids in neurobiological systems, especially those pertaining to pain and inflammation, clinical study remains limited...
January 29, 2018: European Journal of Pain: EJP
Olivier George, George F Koob
Drug addiction or substance-use disorder is a chronically relapsing disorder that progresses through binge/intoxication, withdrawal/negative affect and preoccupation/anticipation stages. These stages represent diverse neurobiological mechanisms that are differentially involved in the transition from recreational to compulsive drug use and from positive to negative reinforcement. The progression from recreational to compulsive substance use is associated with downregulation of the brain reward systems and upregulation of the brain stress systems...
September 2017: Dialogues in Clinical Neuroscience
Kıymet Kubra Yurt, Suleyman Kaplan
Diclofenac sodium (DS) is commonly used for the treatment of acute and chronic pain, even for extended periods of time. Over the years, DS has been associated with toxicity in nervous tissue, in addition to its anti-inflammatory properties. Basic neurobiological research has enhanced our understanding of the biological and pathological outcomes of toxicity. Several studies have suggested DS-induced cytotoxicity in the nervous system. Prenatal toxicities of DS are thought to be capable of leading to postnatal defects...
December 27, 2017: Inflammopharmacology
Richard Brockman
Medea, the title character in Euripides' play, murdered her two sons in response to her husband Jason's abandonment. If her behavior can be understood, it is best understood in the context of shame. In an evolutionary context, shame is the affective response to the loss of one's place in the group. This response is related to the neurobiology of pain-not the acute pain experienced through the post-central gyrus, but the chronic, lingering pain that is experienced through the insular and cingulate cortices where homeostasis is regulated "from above...
2017: Psychodynamic Psychiatry
Kristen M Cuevas, Jane Balbo, Krista Duval, Elizabeth A Beverly
Sexual assault is a traumatic event with potentially devastating lifelong effects on physical and emotional health. Sexual assault is associated with gastrointestinal, neurologic, and reproductive symptoms, as well as obesity, diabetes, and chronic pain. With 1 in 3 women and 1 in 6 men experiencing some form of unwanted sexual violence in their lifetime, sexual assault is a significant public health problem that necessitates attention in the medical community. This review discusses relevant literature on the neurobiologic changes that occur as a consequence of sexual assault, such as how the brain responds during a traumatic experience and the impact of trauma on memory...
February 1, 2018: Journal of the American Osteopathic Association
Deepika S Darbari, Amanda M Brandow
Pain is a complex multidimensional experience and the most common morbidity in patients with sickle cell disease (SCD). Tools to assess pain can be of use not only to guide pain treatment but also to provide insight into underlying pain neurobiology. Mechanisms of pain in SCD are multifactorial and are not completely elucidated. Although vaso-occlusion of microcirculation by sickled red cells is believed to be the underlying mechanism of acute vaso-occlusive pain, mechanisms for chronic pain and the transition from acute to chronic pain are under investigation...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
Sebastian Berlit, Stefanie Lis, Katharina Häfner, Nikolaus Kleindienst, Ulf Baumgärtner, Rolf-Detlef Treede, Marc Sütterlin, Christian Schmahl
PURPOSE: To analyse post-partum short- and long-term pain sensitivity and the influence of endogenous pain inhibition as well as distinct psycho-social factors on birth-related pain. METHODS: Pain sensitivity was assessed in 91 primiparous women at three times: 2-6 weeks before, one to 3 days as well as ten to 14 weeks after childbirth. Application of a pressure algometer in combination with a cold pressor test was utilised for measurement of pain sensitivity and assessment of conditioned pain modulation (CPM)...
March 2018: Archives of Gynecology and Obstetrics
Jun Wang, Jie Tu, Bing Cao, Li Mu, Xiangwei Yang, Mi Cong, Aruna S Ramkrishnan, Rosa H M Chan, Liping Wang, Ying Li
Human brain imaging studies have revealed the anterior cingulate cortex (ACC) as a key brain region for mediating visceral-pain-cognitive interactions. Recently, we characterized impairments of long-term potentiation and spike-field coherence in the basolateral amygdala (BLA)-ACC network in association with a decision-making deficit in rats with visceral hypersensitivity (VH). Now, by combining integrative neurobiological approaches, we show that ACC-reactive astrogliosis and activity-dependent impairment of lactate release occur in VH rats...
November 28, 2017: Cell Reports
Andrew J Furman, Timothy J Meeker, Jeremy C Rietschel, Sooyoung Yoo, Janusiya Muthulingam, Mariya Prokhorenko, Michael L Keaser, Ronald N Goodman, Ali Mazaheri, David A Seminowicz
The identification of neurobiological markers that predict individual predisposition to pain are not only important for development of effective pain treatments, but would also yield a more complete understanding of how pain is implemented in the brain. In the current study using electroencephalography (EEG), we investigated the relationship between the peak frequency of alpha activity over sensorimotor cortex and pain intensity during capsaicin-heat pain (C-HP), a prolonged pain model known to induce spinal central sensitization in primates...
November 21, 2017: NeuroImage
Xiaoyu Hu, Fang Huang, Zaijie Jim Wang
Pain is a common and severe symptom in multiple sclerosis (MS), a chronic inflammatory and demyelinating disease of the central nervous system. The neurobiological mechanism underlying MS pain is poorly understood. In this study, we investigated the role of Ca(2+)/calmodulin dependent kinase type IIα (CaMKIIα) in driving chronic pain in MS using a mouse experimental autoimmune encephalomyelitis (EAE) model. We found that spinal CaMKIIα activity was enhanced in EAE correlating with the development of ongoing spontaneous pain and evoked hypersensitivity to mechanical and thermal stimuli...
November 16, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Valerio Chiurchiù, Mario van der Stelt, Diego Centonze, Mauro Maccarrone
Multiple sclerosis is the most common inflammatory demyelinating disease of the central nervous system, caused by an autoimmune response against myelin that eventually leads to progressive neurodegeneration and disability. Although the knowledge on its underlying neurobiological mechanisms has considerably improved, there is a still unmet need for new treatment options, especially for the progressive forms of the disease. Both preclinical and clinical data suggest that cannabinoids, derived from the Cannabis sativa plant, may be used to control symptoms such as spasticity and chronic pain, whereas only preclinical data indicate that these compounds and their endogenous counterparts, i...
October 31, 2017: Progress in Neurobiology
Sara E Berger, Étienne Vachon-Presseau, Taha B Abdullah, Alex T Baria, Thomas J Schnitzer, A Vania Apkarian
Experiences and memories are often mismatched. While multiple studies have investigated psychological underpinnings of recall error with respect to emotional events, the neurobiological mechanisms underlying the divergence between experiences and memories remain relatively unexplored in the domain of chronic pain. Here we examined the discrepancy between experienced chronic low back pain (CBP) intensity (twice daily ratings) and remembered pain intensity (n = 48 subjects) relative to psychometric properties, hippocampus morphology, memory capabilities, and personality traits related to reward...
February 1, 2018: NeuroImage
Theodore J Price, Michael S Gold
Objective: Persistent pain causes untold misery worldwide and is a leading cause of disability. Despite its astonishing prevalence, pain is undertreated, at least in part because existing therapeutics are ineffective or cause intolerable side effects. In this review, we cover new findings about the neurobiology of pain and argue that all but the most transient forms of pain needed to avoid tissue damage should be approached as a disease where a cure can be the goal of all treatment plans, even if attaining this goal is not yet always possible...
October 25, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Ina Skyt, Kurosh Moslemi, Cathrine Baastrup, Kasper Grosen, Fabrizio Benedetti, Gitte L Petersen, Donald D Price, Kathryn T Hall, Ted J Kaptchuk, Peter Svensson, Troels S Jensen, Lene Vase
Placebo effects have been reported in patients with chronic neuropathic pain. Expected pain levels and positive emotions are involved in the observed pain relief, but the underlying neurobiology is largely unknown. Patients with neuropathic pain are highly motivated for pain relief, and as motivational factors such as expectations of reward, as well as pain processing in itself, are related to the dopaminergic system, it can be speculated that dopamine release contributes to placebo effects in neuropathic pain...
October 23, 2017: Pain
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