European Journal of Pain最新文献

{"title":"Chronic Postsurgical Pain and Dementia Risk: Expanding the Horizon of Multifactorial Interactions","authors":"Junjian Zeng, Zhidong Zhou","doi":"10.1002/ejp.70031","DOIUrl":"https://doi.org/10.1002/ejp.70031","url":null,"abstract":"","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143905113","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":"Impact of Intermittent Theta Burst Stimulation on Pain Relief and Brain Connectivity in Chronic Low Back Pain","authors":"Jiajia Yang,&nbsp;Xiaoyu Gao,&nbsp;Xue Cheng,&nbsp;Ruochen Fu,&nbsp;Hao Xie,&nbsp;Siyun Zhang,&nbsp;Zhenwen Liang,&nbsp;Xi Chen,&nbsp;Qiuhua Yu,&nbsp;Chuhuai Wang","doi":"10.1002/ejp.70033","DOIUrl":"https://doi.org/10.1002/ejp.70033","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This randomised clinical trial investigated the effect of intermittent theta burst stimulation (iTBS) over the dorsolateral prefrontal cortex (DLPFC) on pain alleviation in patients with chronic low back pain (CLBP) and its underlying mechanisms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Forty CLBP patients were randomly assigned to receive either active or sham iTBS combined with core stability exercise. Pain assessments were completed before and after the intervention. Eleven patients from each group underwent resting-state functional magnetic resonance imaging scans pre- and post-intervention to analyse DLPFC activation and connectivity with other brain regions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The active iTBS group had a greater pain reduction than the sham group (<i>p</i> = 0.05, 95% CI: −0.009 to 1.109). In the active and sham groups, 80% (16/20) and 40% (8/20) reached the minimal clinically important difference, respectively, with a number needed to treat of 2.5. For the Fear-Avoidance Beliefs Questionnaire, there was a significant difference between the two groups (<i>p</i> = 0.011, <i>r</i> = 0.40). The active iTBS group showed a significantly enhanced functional connectivity between the left DLPFC and the right cerebellum, as well as both occipital gyri (voxel-level, <i>p</i> &lt; 0.001; cluster-level familywise error rate, <i>p</i> &lt; 0.01). Spearman's correlation analysis showed a significant negative correlation between Numerical Rating Scale and the FC of the left DLPFC and the right cerebellum (rho = −0.55, <i>p</i> = 0.008), the right (rho = −0.439, <i>p</i> = 0.01), and left occipital gyri (rho = −0.45, <i>p</i> = 0.034).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>iTBS may alleviate pain in CLBP patients by enhancing DLPFC connectivity with the cerebellum and occipital gyrus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>This study showed a facilitatory effect of iTBS on alleviating CLBP, which might be modulated by brain functional connectivity.</p>\u0000 \u0000 <p>Trial Registration</p>\u0000 \u0000 <p>Chinese Clinical Trial Registry: ChiCTR2200064899</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143905114","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":"Altered Intra-Network Functional Connectivity Predicts the 6-Month Prognosis in Patients With Medication Overuse Headache: A Case-Control Study","authors":"Changling Li,&nbsp;Yang Zhang,&nbsp;Chengmin Yang,&nbsp;Jinghuan Fang,&nbsp;Mengmeng Ma,&nbsp;Yanbo Li,&nbsp;Ning Chen,&nbsp;Su Lui,&nbsp;Li He","doi":"10.1002/ejp.70028","DOIUrl":"https://doi.org/10.1002/ejp.70028","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Previous studies suggested that changes in functional connectivity (FC) within intrinsic resting-state networks (RSNs) might be associated with treatment responses during withdrawal in patients experiencing medication overuse headache (MOH). This study examined alterations in intra- and internetwork FC in intrinsic RSNs among MOH patients and explored the relationship between neuroimage changes and six-month prognoses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This case–control study enrolled healthy controls and MOH patients. Six months after implementing a withdrawal and preventive strategy, patients who had successfully discontinued overusing acute medications and reduced headache days by at least 50% from baseline were classified as having ‘good outcome’ and those not reaching this outcome were classified as having a ‘poor outcome’. Changes in intra- and inter-network FC in intrinsic RSNs across groups at baseline were evaluated. Univariate and multivariate logistic regression analyses were conducted to identify independent alterations associated with good outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the MOH group, 16 patients had poor outcomes and 17 patients had good outcomes. Compared to 24 healthy controls, all patients showed significantly increased FC in the left middle temporal gyrus of the left frontoparietal network (FPN). Furthermore, those with good outcomes had significantly decreased FC in the left orbital inferior frontal gyrus (IFG) of the left FPN compared to both poor outcome patients and healthy controls. Altered FC in the left orbital IFG of the left FPN was significantly associated with good outcomes and positively correlated with baseline headache intensity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The altered FC in the left orbital IFG of the left FPN may be associated with MOH treatment prognosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>The present study provides evidence of the association between alterations of intra-network functional connectivity in intrinsic resting-state networks and six-month prognoses in patients with medication overuse headache. Our results imply potential neuroimaging biomarkers associated with the prognosis of medication overuse headache.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143900899","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":"Letter to the Editor: Prevalence of Painful Temporomandibular Disorders and Overlapping Primary Headaches Among Young Adults","authors":"Ahmad Furqan Anjum,&nbsp;Shujaat Ali,&nbsp;Syed Mohib Ullah","doi":"10.1002/ejp.70032","DOIUrl":"https://doi.org/10.1002/ejp.70032","url":null,"abstract":"","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896884","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":"Opioid Therapy in Chronic Pain: Assessment of Clinical Outcomes and Relationships With Endocrine Biomarkers","authors":"Dalia Abou-Kassem,&nbsp;Pernille Døssing Kwateng Diasso,&nbsp;Per Sjøgren,&nbsp;Katharina Maria Main,&nbsp;Susanne Dam Nielsen,&nbsp;Geana Paula Kurita","doi":"10.1002/ejp.70027","DOIUrl":"https://doi.org/10.1002/ejp.70027","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;Long-term opioid treatment (L-TOT) may have consequences that are mediated by factors affecting functionality and health-related quality of life. This study aimed at investigating associations between L-TOT and clinical outcomes including sustained attention, short-term and working memory, worst pain intensity, sleep quality, mood, and health-related quality of life in patients with chronic non-cancer pain (CNCP). Additionally, the study aimed at exploring whether endocrine biomarkers mediate the relationship between L-TOT and these outcomes.&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;Cross-sectional study with 82 adult CNCP patients divided into two groups (opioid treated (&lt;i&gt;n&lt;/i&gt; = 38) and controls not treated with opioids (&lt;i&gt;n&lt;/i&gt; = 44)). Linear regression analyses assessed associations between L-TOT, outcome variables, and the mediating effects of endocrine biomarkers.&lt;/p&gt;\u0000 \u0000 &lt;p&gt;A Bootstrap approach with 95% confidence intervals was applied to analyse the natural indirect effect.&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;The opioid group had worse sleep quality (&lt;i&gt;p&lt;/i&gt; = 0.018), physical functioning (&lt;i&gt;p&lt;/i&gt; = 0.0186), social functioning (&lt;i&gt;p&lt;/i&gt; = 0.002), and higher pain intensity (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) compared with controls. Men in the L-TOT group experienced worse measures for the same variables, and additionally for anxiety (&lt;i&gt;p&lt;/i&gt; = 0.028), depression (&lt;i&gt;p&lt;/i&gt; = 0.040), role physical (&lt;i&gt;p&lt;/i&gt; = 0.038), role emotional (&lt;i&gt;p&lt;/i&gt; &lt; 0.001), fatigue (&lt;i&gt;p&lt;/i&gt; = 0.019), and emotional well-being (&lt;i&gt;p&lt;/i&gt; = 0.001). Only the association between L-TOT and anxiety in men was significantly mediated by total testosterone (β = 1.6, Bias-Corrected Bootstrap 95% CI: 0.1; 4.1, &lt;i&gt;p&lt;/i&gt; = 0.045).&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;CNCP patients in L-TOT showed significantly poorer outcomes than controls. Only testosterone mediated anxiety in men, indicating a natural indirect effect. Causality and mediating effects of endocrine biomarkers need to be further explored, but the associations are an alert to the potential effects of opioids.&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 study reveals the broader health impacts of opioid use, particularly the role of hormone-related factors in men, which may be linked to specific adverse effects and consequences. Investigating these hormonal dynamics could lead to improved treatment strategi","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143884062","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":"HOPE for Hypermobile Ehlers–Danlos Syndrome (hEDS) and Hypermobility Spectrum Disorder (HSD)—A Pilot Randomised Controlled Trial of Feasibility, Acceptability and Appropriateness","authors":"Min Tze Chew,&nbsp;Emre Ilhan,&nbsp;Leslie L. Nicholson,&nbsp;Sarah Kobayashi,&nbsp;Verity Pacey,&nbsp;Alan Hakim,&nbsp;Cliffton Chan","doi":"10.1002/ejp.70030","DOIUrl":"https://doi.org/10.1002/ejp.70030","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;Feasibility and effectiveness of online pain management programs for chronic widespread pain conditions have been shown; yet, there are no empirically evaluated programs for hypermobile Ehlers–Danlos syndrome (hEDS) or hypermobility spectrum disorder (HSD). Bridging this gap, the Hypermobile Online Pain managemEnt (HOPE) program was developed with stakeholder input to be pilot tested.&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;We conducted a randomised controlled trial of the HOPE program to assess Feasibility of Intervention Measure (FIM), Acceptability of Intervention Measure (AIM) and Intervention Appropriateness Measure (IAM) and eight clinical effectiveness outcomes. Intervention participants were given 8 weeks to complete 12 self-paced modules, while control participants continued treatment as usual. Participants were assessed at baseline, post-treatment and 3 months post-treatment using online surveys.&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;Seventy-two participants were recruited and randomised. Two control participants withdrew before starting, leaving 34 controls and 36 intervention participants for analysis. In all, 81%–91% agreed/completely agreed that the HOPE program was feasible with mean FIM score of 4.3/5 (SD 0.7), 62%–76% agreed/completely agreed that it was acceptable with mean AIM score of 3.9/5 (SD 0.96) and 67%–76% agreed/completely agreed that it was appropriate with mean IAM score of 4.0/5 (SD 0.9). Only two clinical effectiveness outcomes were significantly improved in the intervention group, with moderate and small effect sizes in worst pain intensity (Cohen's &lt;i&gt;d&lt;/i&gt; = 0.63) and impact of hypermobility (Cohen's &lt;i&gt;d&lt;/i&gt; = 0.32) at 3 months post-intervention, respectively.&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;The HOPE program seemed feasible, acceptable and appropriate, with preliminary improvements in worst pain intensity and impact of hypermobility. Our findings warrant a fully powered trial to further explore the clinical effectiveness of this online pain intervention.&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;Pain is of high concern among people with hypermobile Ehlers–Danlos syndrome (hEDS) or hypermobility spectrum disorder (HSD), yet there are limited online pain management resources for them. This pilot trial of the novel Hypermobile Online Pain managemEnt (HOPE) program is important in guiding the creation of evidence-based and stakeh","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143884063","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":"Temporal Associations of Physical Activity With Subsequent Knee Pain in Individuals With Knee Osteoarthritis: An Ecological Momentary Assessment Study","authors":"Alison H. Chang,&nbsp;Emma Hertel,&nbsp;Malene Kjær Bruun,&nbsp;Erika Maria Kristensen,&nbsp;Kristian Kjær-Staal Petersen,&nbsp;Michael Skovdal Rathleff","doi":"10.1002/ejp.70026","DOIUrl":"https://doi.org/10.1002/ejp.70026","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;Physical activity (PA) is a first-line treatment for knee osteoarthritis and provides benefits for functional improvement and pain relief. However, movement-evoked pain often hinders PA participation and long-term adherence. The relationship between PA and pain is not fully understood and may vary across individuals. We examined the temporal associations between PA and subsequent knee pain in individuals with knee osteoarthritis.&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 a 10-day ecological momentary assessment (EMA) cohort study, PA was recorded using an Actigraph accelerometer; momentary knee pain intensity was rated on a numeric rating scale in responses to four daily text prompts. Linear mixed-effects models examined within-day and between-day associations between PA and knee pain, adjusting for age, sex and BMI.&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;The sample included up to 454 observations across 10 days from 17 participants (age = 64 ± 7 years, BMI = 27 ± 4 kg/m&lt;sup&gt;2&lt;/sup&gt;, 61% women), each consisting of a temporal pair of PA minutes and subsequent momentary pain. Within-day, greater moderate-to-vigorous PA (MVPA) minutes were associated with a subsequent increase in knee pain (adjusted &lt;i&gt;β&lt;/i&gt; = 0.112, 95% CI: 0.023, 0.201, &lt;i&gt;p&lt;/i&gt; = 0.014); while light-intensity PA showed no association with subsequent pain (adjusted &lt;i&gt;β&lt;/i&gt; = −0.003, 95% CI: −0.011, 0.005, &lt;i&gt;p&lt;/i&gt; = 0.461). Current-day MVPA and light-intensity PA minutes were not associated with next-day knee pain.&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 MVPA may temporarily increase knee pain, its impact was transient. Light-intensity PA showed no association with pain, suggesting it may be a suitable alternative for those with movement-evoked pain. Understanding these temporal patterns can help guide tailored pain management and PA adherence strategies. Further research is needed to confirm these preliminary findings.&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;Understanding the dynamic relationship between PA and knee pain is crucial for optimising the management of knee OA. This exploratory study offers new insights by leveraging high-frequency data to examine the intra- and inter-day associations of MVPA and light-intensity PA with subsequent knee pain. The preliminary findings demonstrate that MVPA may lead to transient pain increases, while light-intensity PA is not associated with pain in","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143875507","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":"Comparative Analysis of Lysophosphatidic Acid Levels in Fibromyalgia and Other Painful Conditions in Female Patients","authors":"Joana Menezes,&nbsp;Jenny E. Jakobsson,&nbsp;Alex Bersellini Farinotti,&nbsp;Emerson Krock,&nbsp;Matthew A. Hunt,&nbsp;Nils Simon,&nbsp;Sigita Venckute Larsson,&nbsp;Lars Tanum,&nbsp;Kim Kultima,&nbsp;Eva Kosek,&nbsp;Camilla I. Svensson","doi":"10.1002/ejp.70022","DOIUrl":"https://doi.org/10.1002/ejp.70022","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Previous work found a decrease in lysophosphatidylcholines (LPCs) in fibromyalgia (FM) serum, prompting the hypothesis that this decrease could be due to increased conversion of LPC to lysophosphatidic acid (LPA) through autotaxin (ATX). LPA has pronociceptive functions, and increased LPA levels could modulate FM pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study quantified LPA levels in serum and lumbar cerebrospinal fluid (CSF) and serum ATX levels in FM patients, comparing with healthy controls (HCs), osteoarthritis (OA), degenerative disc disease (DDD) and lumbar disc herniation (LDH) patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We found increased serum LPA levels in FM and OA patients, with no changes in FM lumbar CSF. Unexpectedly, a positive correlation between serum LPA and conditioned pain modulation was observed in FM patients, while LPA levels were correlated with pain intensity and Knee Injury and Osteoarthritis Outcome Scores in OA. Serum ATX levels in FM patients were comparable to those in HC but correlated significantly with FM LPA levels (in one cohort), as well as with pain duration and the maximal weekly pain intensity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study suggests that increased LPA levels play distinct roles in FM and OA patients. In FM, LPA levels were linked to less impaired inhibitory pain pathways, while LPA levels in OA correlated with pain intensity and knee-related impairment. ATX levels in FM serum are associated with pain intensity and duration. These findings underscore the complex role of LPA and ATX in FM pathophysiology. Future studies are essential to clarify LPA's specific roles and to develop therapies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>This study provides novel insights into the role of LPA in FM and other chronic pain conditions. Although ATX levels were unchanged in FM, a positive correlation between serum ATX and LPA supports the role of ATX in LPA conversion. These findings suggest complex lipid dysregulation in FM, with LPA potentially modulating pain pathways. Further research is needed to clarify LPA's role and its potential as a biomarker or therapeutic target.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865991","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":"The Effect of Information on the Time Course of Pain During an Episode of Acute Experimentally Induced Low Back Pain—A Randomised Experiment","authors":"M. Travers,&nbsp;B. M. Wand,&nbsp;D. Hince,&nbsp;W. Gibson,&nbsp;S. Meldgaard Hansen,&nbsp;T. Sigurðsson,&nbsp;S. Sorensen,&nbsp;T. Skuli Palsson","doi":"10.1002/ejp.70011","DOIUrl":"https://doi.org/10.1002/ejp.70011","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We compared the time course of pain intensity ratings between two groups who were given different information during an episode of acute experimentally induced LBP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fifty weight-training naive and pain-free people participated in this randomised clinical experiment. Immediately after performing a back exercise intended to cause delayed onset muscle soreness, one group was told that their muscles had been damaged and advised they needed to protect their back over the coming days. The other group's symptoms were described in terms of tissue sensitisation, and they were advised to keep moving.</p>\u0000 \u0000 <p>The primary outcome was movement-evoked low back pain intensity measured using an 11-point numeric rating scale (NRS 0–10). Pain intensity was recorded at baseline, immediately after the intervention and then daily for 7 days. The method of generalised estimating equations (GEE) was used to estimate treatment effects for average daily pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Movement-evoked pain intensity scores changed over time in both groups (main effect of time: χ^2(7) = 246.2, <i>p</i> &lt; 0.001). However, the intervention did not affect movement-evoked pain intensity scores (main effect of group: χ^2(1) = 0.02, <i>p</i> &lt; 0.895). The adjusted mean difference between the groups was only −0.05/10 (95% CI –0.72 to 0.63, <i>p</i> = 0.895) when averaged across all time points.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We simulated an episode of low back pain and found that information based on tissue sensitivity and advice to remain active did not improve pain compared to information referencing tissue damage and advice to rest and protect the back.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>Contemporary clinical guidelines and models of care recommend avoiding pathoanatomical diagnostic labels and encourage clinicians to advise patients to stay active during an episode of acute low back pain (LBP).</p>\u0000 \u0000 <p>We simulated an episode of acute LBP and found that information based on tissue sensitivity and advice to remain active did not improve pain compared to information referencing tissue damage and advice to rest and protect the back. The results could be different if repeated in a clinical population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 5","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143853030","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":"Nocebo Effect on Pain-Related Autonomic Responses in a State of Experimentally-Induced Sensitization","authors":"Florin Allmendinger,&nbsp;Jan Rosner,&nbsp;Thomas Egger,&nbsp;Paulina Simonne Scheuren,&nbsp;Michèle Hubli","doi":"10.1002/ejp.70029","DOIUrl":"https://doi.org/10.1002/ejp.70029","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;Enhanced pain-related autonomic responses were reported after experimentally-induced secondary mechanical hyperalgesia (SMH) in healthy individuals as well as in a variety of chronic pain cohorts. Stimulus-induced autonomic responses can also be modulated by positive and negative expectations towards the applied stimulus. This study aimed to investigate the influence of negative expectations on pain-related autonomic responses after experimentally-induced SMH.&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;Forty healthy participants (20 females) were recruited and assigned to a NOCEBO or a NAïVE group. Phasic skin conductance responses (SCR) and tonic background skin conductance level (SCL) were recorded in response to 10 pinprick stimuli applied to both volar forearms. On one arm, all stimuli were applied (EXP-arm) before (PRE) and after (POST) an experimental heat pain model to induce SMH. The other arm served as the control (CTRL-arm). The NOCEBO group was instructed that the stimuli will be ‘more intense and painful’ in the POST-assessment. The NAïVE group did not receive any instructions. Pain ratings were matched to a numeric rating scale 4 across all assessments to control for subjective pain perception.&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;Only the combination of induced SMH and negative expectation (i.e., EXP-arm in the NOCEBO group) increased the pinprick-evoked phasic SCRs (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) from PRE to POST. Tonic background SCL increased from PRE to POST (&lt;i&gt;p&lt;/i&gt; &lt; 0.01) independent of stimulation area (i.e., EXP-arm or CTRL-arm) or group (i.e., NOCEBO or NAïVE).&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;These results demonstrate facilitatory effects of top-down modulatory processes (i.e., negative expectations) on pain-related autonomic responses after experimentally-induced SMH.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Significance&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study showed a facilitatory effect of negative expectation on enhanced pain-related autonomic responses in a state of experimentally-induced sensitisation in healthy participants. Hence, pain-related autonomic responses are shaped by both bottom-up (nociceptive input) and top-down (expectation) modulatory processes. This leads to the clinical implication that increased pain-related autonomic responses reported in individuals with chronic pain might not solely reflect pain hypersensitivities through nociceptive sensitisation, but also exaggera","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 5","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143849170","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}