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Katherine A Mifflin, Bradley J Kerr
Most autoimmune diseases are associated with pathological pain development. Autoimmune diseases with pathological pain include complex regional pain syndrome, rheumatoid arthritis, and Guillian-Barré syndrome to name a few. The present Review explores research linking the immune system to the development of pathological pain in autoimmune diseases. Pathological pain has been linked to T-cell activation and the release of cytokines from activated microglia in the dorsal horn of the spinal cord. New research on the role of autoantibodies in autoimmunity has generated insights into potential mechanisms of pain associated with autoimmune disease...
July 22, 2016: Journal of Neuroscience Research
Gretchen J Diefenbach, Laura B Bragdon, Luis Zertuche, Christopher J Hyatt, Lauren S Hallion, David F Tolin, John W Goethe, Michal Assaf
BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) holds promise for treating generalised anxiety disorder (GAD) but has only been studied in uncontrolled research. AIMS: This is the first randomised controlled trial ( NCT01659736) to investigate the efficacy and neural correlates of rTMS in GAD. METHOD: Twenty five participants (active n = 13; sham, n = 12) enrolled. rTMS was targeted at the right dorsolateral prefrontal cortex (DLPFC, 1 Hz, 90% resting motor threshold)...
September 2016: British Journal of Psychiatry: the Journal of Mental Science
Nanna B Finnerup, Simon Haroutounian, Peter Kamerman, Ralf Baron, David L H Bennett, Didier Bouhassira, Giorgio Cruccu, Roy Freeman, Per Hansson, Turo Nurmikko, Srinivasa N Raja, Andrew S C Rice, Jordi Serra, Blair H Smith, Rolf-Detlef Treede, Troels S Jensen
The redefinition of neuropathic pain as "pain arising as a direct consequence of a lesion or disease affecting the somatosensory system," which was suggested by the International Association for the Study of Pain (IASP) Special Interest Group on Neuropathic Pain (NeuPSIG) in 2008, has been widely accepted. In contrast, the proposed grading system of possible, probable, and definite neuropathic pain from 2008 has been used to a lesser extent. Here, we report a citation analysis of the original NeuPSIG grading paper of 2008, followed by an analysis of its use by an expert panel and recommendations for an improved grading system...
August 2016: Pain
Pierre Blier
Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), may alleviate depressive symptoms but also leave residual symptoms. The mechanism of action of SSRIs increases serotonin (5-HT) activity but decreases norepinephrine (NE) and dopamine (DA) activity. By engaging additional targets (eg, NE, DA) along with 5-HT, clinicians may help patients with residual symptoms and treatment-resistant depression. Dual-acting agents and combination strategies can be used to target specific symptoms or block/activate specific receptors for broader therapeutic benefits...
March 2016: Journal of Clinical Psychiatry
Valeria Katchan, Paula David, Yehuda Shoenfeld
Cannabinoids have shown to have a variety effects on body systems. Through CB1 and CB2 receptors, amongst other, they exert an effect by modulating neurotransmitter and cytokine release. Current research in the role of cannabinoids in the immune system shows that they possess immunosuppressive properties. They can inhibit proliferation of leucocytes, induce apoptosis of T cells and macrophages and reduce secretion of pro-inflammatory cytokines. In mice models, they are effective in reducing inflammation in arthritis, multiple sclerosis, have a positive effect on neuropathic pain and in type 1 diabetes mellitus...
June 2016: Autoimmunity Reviews
Bridin Murnion
A number of therapeutic uses of cannabis and its derivatives have been postulated from preclinical investigations. Possible clinical indications include spasticity and pain in multiple sclerosis, cancer-associated nausea and vomiting, cancer pain and HIV neuropathy. However, evidence is limited, may reflect subjective rather than objective outcomes, and is not conclusive. Controversies lie in how to produce, supply and administer cannabinoid products. Introduction of cannabinoids therapeutically should be supported by a regulatory and educational framework that minimises the risk of harm to patients and the community...
December 2015: Australian Prescriber
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