European Journal of Pain最新文献

{"title":"Patterns of antidepressant use in people with low back pain: A retrospective study using workers' compensation data","authors":"Giovanni E. Ferreira,&nbsp;Michael Di Donato,&nbsp;Christopher G. Maher,&nbsp;Christina Abdel Shaheed,&nbsp;Stephanie Mathieson,&nbsp;Alex Collie","doi":"10.1002/ejp.4773","DOIUrl":"10.1002/ejp.4773","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Antidepressants are commonly used to treat low back pain (LBP), but little is known about patterns of antidepressant use in this population. This study aimed to identify patterns of antidepressant dispensing and switching in Australian workers with an accepted workers' compensation claim for LBP, and to investigate factors associated with dispensing and switching.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included data from accepted workers' compensation time loss claims for LBP between 2010 and 2018 with a 2-year follow-up. We described the type of antidepressant dispensed, the time for the index antidepressant to be dispensed, and whether people in the study switched to a different antidepressant. Logistic regression models investigated factors associated with antidepressants being dispensed for the first time and for switching to a different antidepressant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Antidepressants were dispensed to 2476 people with LBP (14%) at least once after a median (IQR) of 28 (10.9–54.7) weeks. Amitriptyline was the most dispensed antidepressant at any one point (47.8%), and the most common index antidepressant (42.9%). Also, 32.7% of people switched to a different antidepressant at least once. Sex, age, having been dispensed opioids, gabapentinoids or diazepam prior to antidepressants being dispensed, having used psychological services, and socioeconomic disadvantage were associated with antidepressant dispensing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>One in seven people with LBP were dispensed an antidepressant, most commonly amitriptyline. Antidepressants were commonly used in combination with other pain medicines such as opioids, gabapentinoids and diazepam.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>Antidepressants were dispensed to one in seven people with low back pain, most commonly amitriptyline followed by duloxetine. Antidepressants were typically dispensed after 6 months and after other medicines such as opioids, gabapentinoids and diazepam had been dispensed. Due to the administrative nature of the data, the study cannot infer whether antidepressants were dispensed to treat pain or other health problems, such as a mental health condition.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors' reply to the comment by Zhu et al.","authors":"Morten Pallisgaard Støve,&nbsp;Line Ørum Hansen,&nbsp;Kristian Kloppenborg Elmbæk,&nbsp;Stig Peter Magnusson,&nbsp;Janus Laust Thomsen,&nbsp;Allan Riis","doi":"10.1002/ejp.4770","DOIUrl":"10.1002/ejp.4770","url":null,"abstract":"<p>We appreciate the comment on our article ‘The effect of stretching intensity on pain sensitivity: A randomized crossover study on healthy adults’ (Støve, Hansen, et al., <span>2024</span>) by Zhu et al. (Binbin, <span>2024</span>). We want to acknowledge the authors for initiating an important discussion on how stretching intensity and body position influence the stretching effects.</p><p>We agree that, for pain modulation, our findings indicate that gentler, lower-intensity stretching may be preferable to high-intensity stretching, particularly in clinical populations (Støve, Hansen, et al., <span>2024</span>). This could apply both to pain modulation and to exercise adherence. However, it is important to note that stretching exercises are employed in various clinical contexts and are not always primarily aimed at modulating pain. By way of illustration, current evidence shows a dose–response relationship between stretching intensity and flexibility, with higher-intensity stretching yielding greater acute flexibility gains (Thomas et al., <span>2018</span>).</p><p>In our study, we utilized a seated stretching position in the Biodex as it ensured good experimental control. However, this approach may have limited clinical applicability. Although the effect of different body positions during stretching on pain modulation was beyond the scope of the present study, current evidence indicates that comparable pain modulation effects from static stretching exercises can be achieved across various delivery methods, including home-based, therapist-guided and machine-assisted stretching approaches (Støve et al., <span>2021</span>; Støve, Hirata, &amp; Palsson, <span>2024</span>; Støve, Thomsen, et al., <span>2024</span>).</p><p>We agree that the clinical implications of our findings go beyond basic static stretching and may extend to various exercise modalities that incorporate stretching elements, such as yoga, proprioceptive neuromuscular facilitation (PNF) and Tai Chi. However, additional work is needed to explore the factors that determine the analgesic effect of stretching exercises in different populations to enable the adaptation of interventions for diverse patient populations. The present results invite the hypothesis that the sensory perception of the stretching stimuli (e.g. the sensation of stretch, stiffness, discomfort or tightness) and the stretch duration may be key factors in determining the magnitude of stretch-induced hypoalgesia.</p><p>MPS wrote the first draft, which AR, LØH, KKE, JLT and SPM critically revised. All authors have read and approved the final manuscript.</p><p>This project was funded by the Frimodt-Heinecke Foundation. The funding body had no role in the design, collection, analysis, interpretation of data or in writing the manuscript.</p><p>The authors declare that they have no competing interests.</p>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.4770","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How the magnitude and precision of pain predictions shape pain experiences","authors":"Suzanne M. J. C. Derksen,&nbsp;Maria Konttinen,&nbsp;Anastasiia Myronenko,&nbsp;Ben Seymour,&nbsp;Kaya J. Peerdeman","doi":"10.1002/ejp.4769","DOIUrl":"10.1002/ejp.4769","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In Bayesian models including predictive processing, the magnitude and precision of pain expectancies are key determinants of perception. However, relatively few studies have directly tested whether this holds for pain, and results so far have been inconclusive. Here, we investigated expectancy effects on pain experiences and associated affective responses.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In two studies, healthy participants (&lt;i&gt;n&lt;/i&gt; = 30 in each) received painful electrical stimuli preceded by explicit pain predictions. In study 1, the magnitude of pain predictions and administered pain intensities were varied. In study 2, the magnitude and precision of pain predictions were varied, while administered pain intensity was kept constant. Experienced pain intensity was the primary outcome in both studies.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Pain experiences assimilated towards both under- and overpredictions of pain. In study 1, however, effects were small, if present at all, for non-painful stimuli and effects were not necessarily larger with predictions of greater magnitude. In study 2, assimilation of pain experiences appeared regardless of precision level, while no significant effects on EMG eyeblink startle responses were observed. Moreover, under- and overpredictions caused disappointment and relief, respectively, with greater disappointment upon precise than imprecise predictions.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The influence of pain predictions on pain might be more complex than assumed in simple instantiations of current theoretical frameworks, with no systematically stronger assimilation of pain experiences to larger and more precise predictions. Since overpredictions are associated with relief, but underpredictions with disappointment, these findings underline the importance of providing correct predictions when preparing for upcoming painful procedures.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Significance Statement&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Our work supports, challenges, and extends the application of Bayesian and predictive processing frameworks to the influence of pain predictions on pain. Under- and overpredictions of pain yielded assimilation of pain experiences, but assimilation was not systematically stronger with larger prediction errors or greater precision. Moreover, under- and overpredictions resulted in disappointment and relief, respectively. This research signifies the impo","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11639048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Different ways to reach the same goal: Are the analgesic effects of different types of tactile stimuli similar?","authors":"Rachel B. Zauberman,&nbsp;Simone Shamay-Tsoory,&nbsp;Irit Weissman-Fogel","doi":"10.1002/ejp.4772","DOIUrl":"10.1002/ejp.4772","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Tactile-induced analgesia (TIA) is a phenomenon in which different types of tactile stimulation alleviate pain via different mechanisms including empathy. As TIA plays an essential role in therapeutic situations and clinical conditions, it is crucial to determine whether specific tactile stimulations confer distinct benefits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fifty-two subjects (31 females; 21–47 years) were exposed to four distinct experimental conditions involving three types of touch provided within a simulated supportive therapeutic setting. First, a contact heat (70 s) at a pain intensity of 60/100 Numerical Pain Scale (NPS) was applied to the forearm. The pain stimulus was then given simultaneously with vibration, gentle stroking, or handholding in random order. Pain ratings were reported at 5 and 65 s of each stimulation. Given the role of empathy in TIA, we also assessed the levels of empathy experienced by the subjects and the experimenter.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Handholding and vibration conditions were associated with a more rapid decrease in pain ratings compared to pain-alone (B values: handholding = −150.94 vs. pain-alone = −99.38, <i>p</i> = 0.01; vibration = −163.54 vs. pain-alone = −99.38, <i>p</i> &lt; 0.001). Higher levels of the experimenter's empathy toward the subjects were associated with greater pain alleviation during vibration vs. pain-alone condition (B values: vibration = −56.42 vs. B pain-alone = −9.57, <i>p</i> = 0.04).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Vibration's potent analgesic effects may be attributed to its multi-channel analgesic mechanisms, including the therapist's empathy toward the participant. On the other hand, for handholding establishing an empathic interaction should be considered in a therapeutic setting to enhance its analgesic efficacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>This article explores the effectiveness of touch-based pain relief methods and their association with empathetic therapeutic interactions. The study emphasizes the significance of positive therapeutic interactions in facilitating tactile-induced analgesia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11639264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain sensitization in fibromyalgia. Cross-sectional associations between quantitative sensory testing of pain sensitization and fibromyalgia disease burden","authors":"Pernille Steen Pettersen,&nbsp;Trond Haugmark,&nbsp;Inger Jorid Berg,&nbsp;Hilde Berner Hammer,&nbsp;Tuhina Neogi,&nbsp;Heidi Zangi,&nbsp;Ida K. Haugen,&nbsp;Sella Aarrestad Provan","doi":"10.1002/ejp.4771","DOIUrl":"10.1002/ejp.4771","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Whether fibromyalgia burden is related to measures of sensitization, assessed by quantitative sensory testing (QST), is not clear. We examine the associations between sensitization and fibromyalgia disease burden as measured by the polysymptomatic sistress scale (PDS) and the fibromyalgia impact questionnaire (FIQ) (range 0–100).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Participants were recruited from referrals to a rheumatology outpatient clinic and the fibromyalgia diagnosis was verified by a rheumatologist. They completed the PDS and FIQ and underwent QST of pressure pain threshold (PPT) at five sites, temporal summation (TS), and conditioned pain modulation (CPM) estimated as post-stimuli/pre-stimuli PPT. The associations between QST and disease burden were analysed in linear regression models adjusted for age, sex, and body mass index.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 78 individuals with clinically verified fibromyalgia (90% women, mean age 40.9 years (SD 7.3)) were recruited. Overall mean PPT was associated with the FIQ total score (<i>β</i>-2.1, 95% CI-4.3, −0.0) and the function component (<i>β</i>-2.1, (−4.3, −0.0)). When examining the associations between PPT at individual sites and fibromyalgia disease severity, PPTs at the distal interphalangeal joint and tibialis anterior muscle were associated with both FIQ total score and the FIQ fatigue component. All associations were weak and insignificant after Bonferroni corrections.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this cohort of individuals with fibromyalgia, sensitization was not significantly associated with self-reported disease burden. Our results point to the multifactorial nature of fibromyalgia disease severity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>In patients with fibromyalgia, commonly used measures of sensitization do not explain the symptom burden or the functional impact.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11639049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fibromyalgia severity and symptoms are associated with the disorders of gut–brain interaction","authors":"Sharon Erdrich,&nbsp;Joanna E. Harnett","doi":"10.1002/ejp.4766","DOIUrl":"10.1002/ejp.4766","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Fibromyalgia remains an idiopathic common disorder characterised by widespread pain with no universally accepted treatment. Irritable bowel syndrome is prevalent among women living with fibromyalgia. The prevalence of other disorders of gut–brain interaction (DGBI) and associations with fibromyalgia symptoms and severity is unknown.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To evaluate the prevalence of the range of DGBI and associations with the symptoms and severity of fibromyalgia in women.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A prospective observational study was conducted in New Zealand in 2022. A comprehensive survey included validated measures to identify DGBI (Rome IV) and items assessing the severity of fibromyalgia and pain symptoms, sleep quality, quality of life, mental health and migraine. Analysis was conducted employing Spearman's rho, Mann–Whitney &lt;i&gt;U&lt;/i&gt;, Kruskal–Wallis and chi-square tests.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A total of 111 adult women with fibromyalgia enrolled in the study. Of these, 98 (93%) met the criteria for at least one DGBI, and 67 (68%) satisfied criteria for more than one. All groups of DGBI, and 11 specific DGBI were significantly associated with measures of pain, fibromyalgia severity, sleep problems and migraine (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Severity of pain and symptoms associated with fibromyalgia, including sleep problems, were also significantly associated with the functional bowel disorder severity index.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study demonstrated that the prevalence of DGBI in women with fibromyalgia extends beyond irritable bowel syndrome. Presence of multiple DGBI correlates with pain, severity indices of fibromyalgia and sleep problems. Further research is required to examine the aetiology of DGBI in this population.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Significance Statement&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This observational study has identified important relationships between the broader DGBI, fibromyalgia pain and associated symptoms, particularly migraine and sleep disturbance. Notable correlations between the severity indices of each are demonstrated, suggesting that improvements in one domain may reduce pain and improve overall well-being. These findings highlight the importance of addressing each clinical feature of the condi","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of multiple transcranial magnetic stimulation sessions on pain relief in patients with chronic neuropathic pain: A French cohort study in real-world clinical practice","authors":"Joy Thomas,&nbsp;Camille Fauchon,&nbsp;Nicolas Oriol,&nbsp;François Vassal,&nbsp;Christelle Créac'h,&nbsp;Charles Quesada,&nbsp;Roland Peyron","doi":"10.1002/ejp.4763","DOIUrl":"10.1002/ejp.4763","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Current clinical trials indicate that repetitive transcranial magnetic stimulation (rTMS) is effective in reducing drug-resistant neuropathic pain (NP). However, there is a lack of studies evaluating the long-term feasibility and clinical efficacy of rTMS in large patient cohorts in real-world conditions.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In this retrospective cohort study, we analysed 12 years of clinical data to assess the long-term analgesic effects of 20 Hz rTMS over the primary motor cortex in patients with NP. Subgroup analyses were conducted to identify predictive factors and assess the potential role of epidural motor cortex stimulation (eMCS) as a sustained solution.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In total, 193 patients completed test period of 4 rTMS sessions and 42% of them reported a pain relief (PR) greater than 30%, with concurrent improvement in their most disabling symptom. Iterative rTMS sessions maintained analgesic effects over 10 years in certain patients identified as responders (≥10% PR) without adverse effects. Success probability was higher in patients with central NP compared to peripheral NP (OR = 2.03[1.04;4.00]), and among those with central post-stroke pain, this probability was higher in ischemic versus hemorrhagic strokes (OR = 3.36[1.17;10.05]). PR obtained with iterative rTMS sessions was an excellent predictor of eMCS efficacy.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;While rTMS shows promise as a therapeutic option for some patients with drug-resistant NP, it does not benefit all patients. Efficacy varies by NP aetiology, aiding patient selection. For responders, eMCS may offer a permanent solution. These findings support a tailored approach to rTMS in NP management, while recognizing both its potential and limitations across diverse patient profiles.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Significance Statement&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Multiple rTMS sessions demonstrate long-term efficacy and safety in treating drug-resistant neuropathic pain. Extending session numbers for the test period can enhance responder identification, especially in patients with initial low pain relief. This identification refines patient selection for neurosurgery, reducing non-responders. Central neuropathic pain shows higher success rates than peripheral. For post-stroke central pain, patients with ischemic stroke are more likely to respond than those with hemorrhagic stroke. These resu","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A pain research strategy for Europe: A European survey and position paper of the European Pain Federation EFIC","authors":"Gisèle Pickering,&nbsp;Mary O'Keeffe,&nbsp;Kirsty Bannister,&nbsp;Susanne Becker,&nbsp;Sonia Cottom,&nbsp;Felicia J. Cox,&nbsp;Elon Eisenberg,&nbsp;David P. Finn,&nbsp;Patrice Forget,&nbsp;Thomas Graven-Nielsen,&nbsp;Eija Kalso,&nbsp;Magdalena Kocot-Kepska,&nbsp;Hugo Leite-Almeida,&nbsp;Jose Antonio Lopez-Garcia,&nbsp;Mira Meeus,&nbsp;André Mouraux,&nbsp;Bruno Pereira,&nbsp;Livia Puljak,&nbsp;Michiel F. Reneman,&nbsp;Iben Rohde,&nbsp;Ioannis Sotiropoulos,&nbsp;Nathan Skidmore,&nbsp;Thomas R. Tölle,&nbsp;Snezana Tomasevic Todorovic,&nbsp;Andrea Truini,&nbsp;Kevin E. Vowles,&nbsp;Esther Pogatzki-Zahn,&nbsp;Luis Garcia-Larrea,&nbsp;Brona M. Fullen","doi":"10.1002/ejp.4767","DOIUrl":"10.1002/ejp.4767","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Pain is the leading cause of disability and reduced quality of life worldwide. Despite the increasing burden for patients and healthcare systems, pain research remains underfunded and under focused. Having stakeholders identify and prioritize areas that need urgent attention in the field will help focus funding topics, reduce ‘research waste’, improve the effectiveness of pain research and therapy and promote the uptake of research evidence. In this study, the European Pain Federation (EFIC) developed a Pain Research Strategy for Europe.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The study used multiple methods, including literature searches, multidisciplinary expert debate, a survey and a final consensus meeting. The cross-sectional survey was conducted among 628 European pain researchers, clinicians, educators and industry professionals to obtain the rating and hierarchy of pain research priorities.&lt;/p&gt;\u0000 \u0000 &lt;p&gt;The final consensus meeting involved a multidisciplinary expert panel including people with lived experience from 23 countries. The survey results guided discussions where top priorities were agreed.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Content analysis identified nine survey themes, of which five emerged as top priorities: (i) understand the pathophysiology of pain; (ii) understand and address comorbidities; (iii) critically assess current therapies; (iv) develop new treatments; and (v) explore the biopsychosocial impacts of pain. Physical, psychological and social approaches were prioritized at the same level as pharmacological treatments. The top priorities were endorsed by a multidisciplinary expert panel. The panel emphasized the importance of also clearly communicating the concepts of prediction, prevention self-management and personalized pain management in the final strategy.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The content of the final top research priorities' list reflects a holistic approach to pain management. The equal importance given to physical, psychological and social aspects alongside pharmacological treatments highlights the importance of a comprehensive biopsychosocial-orientated research strategy. The expert panel's endorsement of five top priorities, coupled with an emphasis on communicating the concepts of prediction, prevention, self-management and personalized pain management, provides a clear direction for future basic, translational and clinical research.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 ","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative susceptibility to developing secondary hyperalgesia is associated with post-thoracotomy pain at 2 months","authors":"Solenn Gousset,&nbsp;Maximilien Cappe,&nbsp;Cedric Lenoir,&nbsp;Arnaud Steyaert,&nbsp;Patricia Lavand'homme,&nbsp;André Mouraux,&nbsp;Valérie Lacroix,&nbsp;Emanuel N. van den Broeke","doi":"10.1002/ejp.4768","DOIUrl":"10.1002/ejp.4768","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Identifying the subset of patients at risk for developing persistent pain after surgery is clinically important as they could benefit from targeted prevention measures. In this prospective study, we investigated if the preoperative assessment of the individual susceptibility to developing experimentally induced secondary hyperalgesia is associated with post-thoracotomy pain at 2 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Forty-one patients scheduled to undergo a posterolateral thoracotomy were recruited before surgery and followed prospectively for 2 months. The day before surgery, we experimentally induced secondary hyperalgesia at one of the two forearms and measured the change of perception to mechanical pinprick stimuli and the area of hyperalgesia. On postoperative Day 4, Day 15 and at the 2-month follow-up, patients were asked about their pain intensity at rest and during coughing and the area of secondary hyperalgesia around the scar as well as the change in perception to mechanical pinprick stimuli was measured.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 41 patients that were recruited only 20 could be analysed. Forty per cent reported pain at the 2-month follow-up. All of them reported cough-evoked pain and 10 per cent also reported pain at rest. A binary logistic regression model with both the magnitude and extent of experimentally induced secondary hyperalgesia was statistically significant (chi-squared = 12.439, <i>p</i> = 0.002, McFadden <i>R</i>² = 0.462) and showed excellent discriminative power (AUC = 0.938) for the presence or absence of cough-evoked pain at the 2 month follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings indicate that the individual susceptibility to developing experimentally induced secondary hyperalgesia preoperatively may identify patients who are potentially vulnerable to develop persistent post-thoracotomy pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>Our data suggests that preoperatively assessed experimentally induced secondary hyperalgesia displays excellent discriminative power for the presence or absence of cough-evoked pain 2 months after thoracotomy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11627004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of health trajectories of patients with persistent spinal pain syndrome type 2 using latent class trajectory methods","authors":"Amine Ounajim,&nbsp;Maxime Billot,&nbsp;Etienne Babin,&nbsp;Lisa Goudman,&nbsp;Maarten Moens,&nbsp;Manuel Roulaud,&nbsp;Bertille Lorgeoux,&nbsp;Sandrine Baron,&nbsp;Kevin Nivole,&nbsp;Mathilde Many,&nbsp;Lucie Lampert,&nbsp;Sarah Borel,&nbsp;Romain David,&nbsp;Philippe Rigoard","doi":"10.1002/ejp.4762","DOIUrl":"10.1002/ejp.4762","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Persistent spinal pain syndrome Type 2 (PSPS-T2) is a long-lasting condition that consists of persistent pain following spinal surgery. Although this condition has long-term effects, it is currently studied at a given time point or over a limited period of time, which does not reflect the true impact of pain patients. To bridge this gap, we used latent class trajectory models to extract clusters with different trajectories of patients with PSPS-T2.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Data from the PREDIBACK study, an observational, multicentric, and longitudinal investigation carried out prospectively, were used. This study focuses on patients with PSPS-T2, tracking their outcomes at 3-month intervals over a one-year period. Health status was evaluated using a novel multidimensional clinical response index (MCRI). The trajectories of patients' health status were extracted using mixture of mixed effect models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two hundred (200) PSPS-T2 patients were included. Two clusters were identified, including ‘persistent low health’ trajectories (63.1%) and ‘improving health’ trajectories (36.9%). Regarding the factors associated with these trajectories, our results showed that lower age, lower body mass index, lower pain intensity, lower functional disability, lower anxiety and less extended pain surface were associated with improving health status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Clustering methods provide an opportunity to identify two distinct clusters of pain-related health trajectories of PSPS-T2 patients. Persistence of the symptoms was not observed in one third of the PSPS-T2 study patients, who belong to the improving pain-related health cluster, while the other two thirds did not achieve improved health over a 1-year follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>Our study findings suggest that the use of trajectory-based methods could improve patient evaluation and pain management as it allows for obtaining a global view of patients during their care pathway compared to conventional methods, which only focus on specific visits. Our study also advocates for multidimensional assessment and management of pain by targeting not only pain intensity but also the psychological distress, functional capacity and pain surface at an early stage of pain onset after spine surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}