European Journal of Pain最新文献

{"title":"Evaluating multiplicity reporting in analgesic clinical trials: An analytical review","authors":"Maaz S. Khan,&nbsp;Lori F. Zarmer,&nbsp;Jie Liang,&nbsp;Sepideh Saroukhani,&nbsp;Anthony R. Lucas,&nbsp;Colin J. L. McCartney,&nbsp;Rabail Chaudhry","doi":"10.1002/ejp.4756","DOIUrl":"10.1002/ejp.4756","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>Analgesia trials often demands multiple comparisons to assess various treatment arms, outcomes, or repeated assessments. These multiple comparisons risk inflating the false positive rate. Multiplicity correction in recent analgesic randomized controlled trials (RCTs) remains unclear despite statistical method advancements and regulatory guidelines. Our study aimed to identify reporting inadequacies in multiple analysis adjustments and explanations to understand these deficiencies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Databases and Data Treatment</h3>\u0000 \u0000 <p>This review analysed RCTs from the <i>European Journal of Pain</i>, the <i>Journal of Pain</i>, and <i>PAIN</i>, published between January 2018 and December 2022. We included randomized, double-blind trials focusing on pain outcomes. Data extraction, managed by three researchers using predefined criteria, included trial characteristics, multiplicity presence, and correction methods. Descriptive statistical analyses included Fisher's exact, and Holm method for multiple comparisons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of 112 articles, 48 pre-specified a primary analysis plan. Multiple analyses were observed in 65 articles, with 60% adjusting for all comparisons, primarily using the Bonferroni method. Compared with previous studies, no significant changes in multiplicity correction practices were noted when stratified by trial type, size, and sponsor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The study reveals a persistent reliance on multiple comparisons in analgesic clinical trials without a corresponding increase in multiplicity corrections emphasizing a need for enhanced reporting and implementation of statistical adjustments. We acknowledge limitations in categorizing studies, the use of a surrogate for the trial stage, and sourcing data from journal webpages rather than a database.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>This study flags inadequate reporting on multiplicity correction in analgesic trials, stressing the risk of false positives and the urgent need for enhanced reporting to boost reproducibility.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709602","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":"Beyond intensity: A commentary on stretch-induced hypoalgesia","authors":"Zhu Binbin,&nbsp;Zhao Rui,&nbsp;Huang Changshun,&nbsp;Zhang Yiwei","doi":"10.1002/ejp.4759","DOIUrl":"10.1002/ejp.4759","url":null,"abstract":"<p>We read with great interest the recent study by Støve et al., examining stretching intensity and pain sensitivity which demonstrated that both low- and high-intensity stretching produced similar hypoalgesic effects (Støve et al., <span>2024</span>). This finding raises two important questions: Why would anyone need to perform high-intensity stretching if lower intensities achieve comparable pain modulation? And more fundamentally, how does body position—a question raised by Apostolopoulos et al. almost 10 years ago (Apostolopoulos et al., <span>2015</span>) still unanswered—influence these stretching effects?</p><p>Their results showed that stretching exercises activate ‘endogenous modulation of somatosensory input’, with more pronounced effects at regional sites compared to distant sites. While their standardized protocol using a seated position in the Biodex system provided good experimental control, it may limit generalizability to clinical practice where stretching is performed in various positions. The interaction between body position, gravitational effects and pain modulation pathways could significantly influence both local and systemic responses (Cooper et al., <span>2023</span>).</p><p>The clinical implications extend beyond simple stretching exercises. Traditional movement practices like yoga and Chinese exercises (e.g. Baduanjin) incorporate various stretching intensities, potentially activating similar pain-modulating pathways (Wang et al., <span>2021</span>). Understanding whether the intensity-independent hypoalgesic effect holds true across different positions and delivery methods would advance therapeutic applications. This is particularly relevant given that the mechanical loading and proprioceptive input may vary significantly with body position.</p><p>These findings could guide clinicians in prescribing stretching exercises, suggesting that gentler approaches might be equally effective for pain management. However, future research should examine not only the effects in diverse populations but also how different body positions might influence stretching intensity and subsequent pain modulation outcomes.</p>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.4759","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709592","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":"Cycling sensitivity across migraine phases: A longitudinal case–control study","authors":"Kuan-Po Peng,&nbsp;Arne May","doi":"10.1002/ejp.4761","DOIUrl":"10.1002/ejp.4761","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;Functional neuroimaging studies indicate that central transmission of trigeminal pain may commence up to 48 h prior to the onset of headache. Whether these cyclic changes are associated with somatosensory alteration remains incompletely understood.&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 present study aimed to investigate the temporal progression of somatosensory alterations preceding the onset of a migraine attack. Patients with menstrually related migraine (&lt;i&gt;n&lt;/i&gt; = 10) and matched healthy controls (&lt;i&gt;n&lt;/i&gt; = 13) underwent consecutive daily quantitative sensory tests, commencing 6 days prior to the expected onset of the migraine attack and menstruation. Each subject was investigated for 7–11 consecutive days, resulting in 85 and 91 days of experimentation for the respective cohorts.&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;Electrical/heat/cold pain thresholds showed a phase-dependent decline towards the spontaneous migraine attack, which had commenced 48 h prior to the onset of the headache. The pain thresholds further declined towards the ictal phase, with only the electrical pain threshold reaching statistical significance (ictal vs. preictal). In healthy controls, the pain thresholds remained stable and unaltered during the consecutive daily measurements. In an exploratory analysis, the pain thresholds at baseline (interictal phase) were comparable between both cohorts.&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 data suggest the existence of a trigeminal somatosensory alteration in the preictal phase of migraine, occurring up to 48 h prior to the onset of the headache. This change occurred in a chronologically synchronous manner with the brain activation in the preictal phase in functional neuroimaging studies. It will be important to combine pain threshold measurement and functional neuroimaging in future studies.&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;Our data suggest the existence of a somatosensory behavioural correlate of the functional neuroimaging changes starting 48 h before the onset of headache. Despite the concurrence of the behavioural and functional neuroimaging changes in a chronological sequence, the next step in elucidating the cause of migraine is to combine the behavioural and functional neuroimaging changes in a temporal sequence, i.e. to identify the generator behind the cyclic sensory fluctuation.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 &lt;/di","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.4761","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692826","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 resting-state electrophysiological signals predict acute but not chronic postoperative pain","authors":"Qi Han,&nbsp;Hailu Wang,&nbsp;Xuejing Lu,&nbsp;Yaru Li,&nbsp;Yutong Guo,&nbsp;Xiangyue Zhao,&nbsp;Yi Feng,&nbsp;Li Hu","doi":"10.1002/ejp.4757","DOIUrl":"10.1002/ejp.4757","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The prevalence of postoperative pain is notably high among the elderly population, which poses significant challenges for their postoperative recovery. In this study, we aimed to identify preoperative predictors for acute and chronic postoperative pain in patients undergoing lumbar spinal surgery through a longitudinal investigation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We recruited 75 patients (mean age 68.29 ± 5.60 years) and collected their resting-state electroencephalography (EEG) data two hours before the surgery. The aperiodic and periodic signal components were extracted from the resting-state EEG using the Fitting Oscillations and One-Over-F algorithm. We also collected the preoperative pain ratings, demographic information and the Hospital Anxiety and Depression Scale from all patients. The postoperative pain ratings were collected ten times from Day 1 to Week 12 after surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We observed a high incidence of postoperative acute and chronic pain among older patients. Preoperative pain and peak alpha frequency in resting-state EEG were the primary predictors of acute postoperative pain. Although age is a significant predictor of chronic postoperative pain, its predictive performance is poor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Overall, our study provides valuable insights into the complex pattern of preoperative EEG features, preoperative pain and age in predicting postoperative pain at different stages. Our findings highlight the significance of exploring preoperative features to identify patients who are at a higher risk of developing severe postoperative pain, which can aid in the development of more personalized and effective pain management strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>The heightened occurrence of postoperative pain among the elderly presents formidable obstacles to their recuperation. This study delves into identifying preoperative factors influencing acute and chronic postoperative pain. Our findings indicate that preoperative pain and peak alpha frequency are crucial predictors of acute postoperative pain. However, the predictive performance for chronic postoperative pain is limited, although age was a significant predictor of chronic postoperative pain. These insights contribute to the identification of patients at elevated risk for severe acute and chronic postoperative pain, offering valuable guidance for pre-surgical risk assessment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692827","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":"Expectation of analgesia increases the inhibitory response of conditioned pain modulation in healthy participants who at baseline have a non-inhibitory profile","authors":"Allen Matheus S. Nascimento,&nbsp;Soraya S. Ardestani,&nbsp;Isabela C. Novaes,&nbsp;Paulo César R. Conti,&nbsp;Leonardo R. Bonjardim,&nbsp;Fernando G. Exposto,&nbsp;Peter Svensson,&nbsp;Yuri M. Costa","doi":"10.1002/ejp.4747","DOIUrl":"10.1002/ejp.4747","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study assessed the effect of expectation of analgesia on conditioned pain modulation (CPM) in healthy participants stratified into inhibitors and non-inhibitors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A parallel CPM protocol was assessed on 21 women and 22 men across two sessions: baseline and expectation of analgesia, which was induced by a standardized audiovisual suggestion. The CPM assessment involved two different test stimuli (TS): mechanically controlled palpation and the pressure pain threshold, applied to two different regions: anterior temporalis and thenar eminence of the hand. The conditioning stimulus (CS) involved immersing the non-dominant forearm in cold water. The order of the TS and regions was randomized for each participant. The CPM protocol was performed three times, with a 1-min interval between TS/region sequences. After a 20-min rest, the CPM assessment was repeated (two blocks in total). The standard error of measurement (SEM) was computed to identify inhibitors (inhibitory responses) and non-inhibitors (including non-inhibitors and facilitatory responses). Cochran's <i>Q</i>, ANOVA and ANCOVA were applied to the data (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was a significant decrease in the proportion of non-inhibitors during the expectation of analgesia session (32.6%–44.2%) when compared with the baseline session (51.2%–72.1%). The non-inhibitors exhibited a lower inhibitory CPM magnitude than the inhibitors only in block 1 of the baseline session. The expectation of analgesia resulted in an increased magnitude of the inhibitory CPM solely in non-inhibitors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Expectation of analgesia can increase the inhibitory response of the CPM beyond the measurement error in healthy participants with a baseline non-inhibitory profile.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>Several studies have investigated whether cognitive modulation can alter the magnitude of the inhibitory response of conditioned pain modulation (CPM), yet some gaps remain. This study accounted for measurement error to accurately determine changes in CPM influenced by expectation of analgesia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 3","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647193","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":"Correction to ‘Systematic review and co-ordinate based meta-analysis to summarize the utilization of functional brain imaging in conjunction with human models of peripheral and central sensitization’","authors":"","doi":"10.1002/ejp.4744","DOIUrl":"10.1002/ejp.4744","url":null,"abstract":"<p>Clarke, S., Rogers, R., Wanigasekera, V., Fardo, F., Pia, H., Nochi, Z., Macian, N., Leray, V., Finnerup, N. B., Pickering, G., Mouraux, A., Truini, A., Treede, R.-D., Garcia-Larrea, L., &amp; Tracey, I. (2024). Systematic review and co-ordinate based meta-analysis to summarize the utilization of functional brain imaging in conjunction with human models of peripheral and central sensitization. <i>European Journal of Pain</i>, <i>28</i>, 1069–1094.</p><p>The Funding Information ‘This project has received funding from the Innovative Medicines Initiative 2 Joint undertaking under grant agreement No 777500. This Joint Undertaking receives support from the European Union's Horizon 2020 research and innovation program and EFPIA (www.imi.europa.eu; www.imi-paincare.eu). The statements and opinions presented here reflect the author's view and neither IMI nor the European Union, EFPIA, or any Associated Partners are responsible for any use that may be made of the information contained therein. This research was also partly supported by the NIHR Oxford Health Biomedical Research Centre (NIHR203316) and by the Wellcome Trust (203139/Z/16/Z and 203139/A/16/Z). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.’ was incomplete.</p><p>This should have read: ‘This project has received funding from the Innovative Medicines Initiative 2 Joint undertaking under grant agreement No 777500. This Joint Undertaking receives support from the European Union's Horizon 2020 research and innovation program and EFPIA (www.imi.europa.eu; www.imi-paincare.eu). The statements and opinions presented here reflect the author's view and neither IMI nor the European Union, EFPIA or any associated partners are responsible for any use that may be made of the information contained therein. This research was also partly supported by the NIHR Oxford Health Biomedical Research Centre (NIHR203316), by the Wellcome Trust (203139/Z/16/Z and 203139/A/16/Z) and by the European Research Council (ERC-2020-StG-948838). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care’.</p><p>We apologize for this missing information.</p>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.4744","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142617235","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":"Exploring signs of central sensitization in adolescents with hypermobility Spectrum disorder or hypermobile Ehlers-Danlos syndrome","authors":"Elke Schubert-Hjalmarsson,&nbsp;Anders Fasth,&nbsp;Kelly Ickmans,&nbsp;Ann-Charlott Söderpalm,&nbsp;Mari Lundberg","doi":"10.1002/ejp.4754","DOIUrl":"10.1002/ejp.4754","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;Hypermobility Spectrum Disorder (HSD) and Hypermobile Ehlers-Danlos Syndrome (hEDS) are two overlapping heritable connective tissue disorders characterized by joint hypermobility, chronic pain, impaired body perception, and musculoskeletal symptoms. Central sensitization has been proposed as a plausible explanation for symptoms like widespread pain, fatigue, mood disorders, and sleep disturbances in patients with HSD/hEDS.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The aim of this study was to investigate signs of central sensitization, including exercise-induced hypoalgesia (EIH), and fatigue severity in adolescents with HSD/hEDS.&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 prospective, experimental, case–control study, thirty-seven adolescents with HSD/hEDS and 47 healthy adolescents (all aged 13–17 years) were included. Pressure pain thresholds (PPTs) were measured at four muscle groups using a pressure algometer. EIH was evaluated by measuring PPTs on two muscle groups immediately after an exercise test on a bicycle ergometer. Participants also completed questionnaires on fatigue and cognitive/emotional factors.&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 study demonstrated significantly lower PPTs in four different muscle groups in adolescents with HSD/hEDS compared to the healthy control group. Both groups achieved a significantly higher PPTs after exercise in the muscle involved in the activity. Adolescents with HSD/hEDS reported higher fatigue levels and more cognitive/emotional difficulties than the control group.&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;Adolescents with HSD/hEDS showed generalized hyperalgesia measured through PPTs at different body sites. EIH was partly affected in adolescents with HSD/hEDS, presenting as unchanged pain sensitivity in the remote muscle. Pain should be considered as a phenomenon that is influenced by different biopsychosocial factors, including possible central sensitization, which increase its complexity.&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 breaks new ground by showing signs of central sensitization, including diminished EIH, in adolescents with HSD or hEDS. Given that exercise is a key element in pain management, these findings offer valuable insights when developing treatment plans for adolescents w","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.4754","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142617240","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":"Moving towards the use of artificial intelligence in pain management","authors":"Ryan Antel,&nbsp;Sera Whitelaw,&nbsp;Genevieve Gore,&nbsp;Pablo Ingelmo","doi":"10.1002/ejp.4748","DOIUrl":"10.1002/ejp.4748","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objective</h3>\u0000 \u0000 <p>While the development of artificial intelligence (AI) technologies in medicine has been significant, their application to acute and chronic pain management has not been well characterized. This systematic review aims to provide an overview of the current state of AI in acute and chronic pain management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Databases and Data Treatment</h3>\u0000 \u0000 <p>This review was registered with PROSPERO (ID# CRD42022307017), the international registry for systematic reviews. The search strategy was prepared by a librarian and run in four electronic databases (Embase, Medline, Central, and Web of Science). Collected articles were screened by two reviewers. Included studies described the use of AI for acute and chronic pain management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From the 17,601 records identified in the initial search, 197 were included in this review. Identified applications of AI were described for treatment planning as well as treatment delivery. Described uses include prediction of pain, forecasting of individualized responses to treatment, treatment regimen tailoring, image-guidance for procedural interventions and self-management tools. Multiple domains of AI were used including machine learning, computer vision, fuzzy logic, natural language processing and expert systems.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There is growing literature regarding applications of AI for pain management, and their clinical use holds potential for improving patient outcomes. However, multiple barriers to their clinical integration remain including lack validation of such applications in diverse patient populations, missing infrastructure to support these tools and limited provider understanding of AI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>This review characterizes current applications of AI for pain management and discusses barriers to their clinical integration. Our findings support continuing efforts directed towards establishing comprehensive systems that integrate AI throughout the patient care continuum.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 3","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142617158","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":"Chronic pain among primary fentanyl users: The concept of self-medication","authors":"Jane J. Kim,&nbsp;Dianah Hayati,&nbsp;Milad Zamany,&nbsp;Fiona Choi,&nbsp;Kerry Jang,&nbsp;Martha Ignaszewski,&nbsp;Pouya Azar,&nbsp;Michael Krausz","doi":"10.1002/ejp.4753","DOIUrl":"10.1002/ejp.4753","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic pain is among the leading causes of disability worldwide, of which only a small percentage of patients receive adequate treatment for. Non-prescribed opioid analgesics are commonly sought out in effort to alleviate unrelieved pain. This study assesses the prevalence and correlates of chronic pain among primary fentanyl users.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional and structured survey was conducted with 200 adults who reported fentanyl as their drug of choice from a Vancouver acute care hospital. Presence and levels of chronic pain were determined through self-report.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The majority of participants (<i>n</i> = 130, 72.6%) reported having chronic pain in the past 6 months, with the mean level of pain on a typical day to be 7.6 out of a scale of 10 (<i>SD</i> = 1.9). Majority (<i>n</i> = 85, 65.4%) reported using street opioids to self-medicate, while only 9 (6.9%) reported that their chronic pain was unrelated. Regression analysis indicated that increasing age and co-use of cannabis and opioids were independent associated factors of chronic pain. Higher levels of reported pain on a typical day were further associated with age and self-medication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings of this study demonstrate a significant association between self-medication and chronic pain among primary fentanyl users in British Columbia. For these individuals, inadequate pain relief may drive continued opioid use, which in turn may increase risks of treatment discontinuation and overdose. Appropriate pain management strategies are crucial to avoid opioid misuse and decrease the large societal burden caused by chronic pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>Our work points to the high prevalence of self-reported chronic pain among individuals who primarily use fentanyl. Among those with self-reported fentanyl use and chronic pain, self-medication with street opioids was found to be common and associated with higher reported pain levels on a typical day. This highlights the need for pain management strategies to be integrated into opioid dependence treatment and more research in the overlap of pain and fentanyl use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.4753","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582552","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":"Plasma neurofilament light chain in fibromyalgia: A case control study exploring correlation with clinical and cognitive features","authors":"Maddalena Ruggieri,&nbsp;Giulia Paparella,&nbsp;Livio Clemente,&nbsp;Giuseppe Libro,&nbsp;Concetta Domenica Gargano,&nbsp;Marina de Tommaso","doi":"10.1002/ejp.4752","DOIUrl":"10.1002/ejp.4752","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Plasma neurofilament light chain (NFL) has been measured as a biomarker of neuronal damage in various neurological disorders. Elevated tau and β-amyloid levels have been found in patients with fibromyalgia (FM). The aim of the present study was to compare plasma neurofilament levels in fibromyalgia patients with normal controls and to investigate the correlation with clinical features and cognitive tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Plasma NFL levels were assessed in 33 FM patients and compared with 22 age-matched controls. All patients were also assessed with clinical scales examining fibromyalgia disability, sleep quality and duration, fatigue, anxiety, and depression, and a neuropsychological battery examining executive function, verbal short-term memory, and working memory, as well as attentional executive function and selective attention, interference sensitivity, and inhibition of automatic responses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>NFL levels were higher in FM patients (controls 6.19± 1.92; FM 17.28± 15.94 pg/mL ANOVA <i>p</i> 0.002). Working memory was the most impaired cognitive function significantly correlated with high NFL scores (Pearson <i>p</i> 0.034). Short sleep times also correlated with higher NFL scores (Pearson <i>p</i> 0.02) and poorer working memory performance (Pearson <i>p</i> 0.02). No correlation was found with indices of disease severity and duration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Plasma NFL levels are elevated in fibromyalgia patients, suggesting neuronal damage and correlating with a slight decrease in working memory and short sleep duration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>Plasma neurofilament levels are elevated in patients with fibromyalgia, regardless of disease severity and duration. Neurofilament levels are higher in patients with mild working memory impairment and sleep disorders. Subgroups of patients with primary neuronal damage phenomena could be individualized for prospective evaluation with regard to the possible development of cognitive decline and sleep disturbances, which would justify a tailored therapeutic approach.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 3","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568156","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}