European Journal of Pain最新文献

{"title":"Painful Mondays: Exploring Weekly Sleep Variations and Pain Perception in Healthy Women—An Experimental Study","authors":"Shima Rouhi, Natalia Egorova-Brumley, Amy S. Jordan","doi":"10.1002/ejp.70004","DOIUrl":"https://doi.org/10.1002/ejp.70004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Acute experimental sleep deprivation induces pain hypersensitivity, particularly in females. While the impact of extreme sleep loss on pain perception has been largely studied, how subtle sleep fluctuations, for example, sleep variations across the week, affect pain perception remains unclear. This study investigated how weekly sleep variations affect pain perception in young healthy women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A sleep-monitoring headband and self-reported questionnaire were used to assess sleep. Quantitative sensory testing was conducted on Monday and Friday, including heat, cold, pressure pain thresholds, tonic pain summation and conditioned pain modulation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 26 healthy young (23.9 ± 0.9 years) women were included. Repeated measures ANOVAs revealed significant sleep variation across the week, including differences in N3 sleep stage duration (<i>M</i> = 89.2 ± 5.42 min; <i>p</i> = 0.022, lowest on Friday and Sunday nights), bedtime (<i>M</i> = 00:56 <i>AM</i> ± 0.29; <i>p</i> = 0.038, latest on Friday vs. Sunday night) and wake-up time (<i>M</i> = 07:04 <i>AM</i> ± 0.30; <i>p</i> = 0.007 latest on Saturday vs. Monday morning). With most changes affecting Sunday night and Monday morning, pain sensitivity was higher on Monday compared to Friday, with a lower heat pain threshold (<i>B</i> = −11.89; <i>p</i> = 0.002) and increased heat pain summation (<i>B</i> = 1.65; <i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The results showed higher heat pain hyperalgesia on Mondays due to weekly sleep variation. Since sleep is a modifiable factor, maintaining a consistent sleep schedule throughout the week could benefit pain management, particularly in chronic pain patients with less effective pain modulatory pathways.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Statement of Significance</h3>\u0000 \u0000 <p>How weekly sleep variations in real life between weekends and weekdays affect pain perception has not been studied before. This paper provides the first evidence that natural weekend–weekday sleep alterations, including shifts in bedtime and wake-up time over the weekend and the transition back on Sunday night, heighten pain sensitivity on Monday—known as the ‘Monday effect’. The compromised pain pathways on Monday underscore the importance of maintaining a consistent sleep schedule throughout the week, potentially benefiting patients with","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143554570","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":"Subgrouping People With Acute Low Back Pain Based on Psychological, Sensory, and Motor Characteristics: A Cross-Sectional Study","authors":"Patrick Ippersiel, Claudia Côté-Picard, Jean-Sébastien Roy, Hugo Massé-Alarie","doi":"10.1002/ejp.70006","DOIUrl":"https://doi.org/10.1002/ejp.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Clustering helps identify patient subgroups with similar biopsychosocial profiles in acute low-back pain (LBP). Motor factors are common treatment targets and are associated with disability but have not been included in acute LBP cluster development. This study aimed to identify subgroups of individuals with acute LBP based on motor, sensory and psychological characteristics and to compare these subgroups regarding clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Ninety-nine participants with acute LBP were recruited, and motor (bending range of motion [ROM], flexion relaxation), pain sensitivity (pressure-pain thresholds, temporal summation of pain) and psychological factors (pain catastrophising, kinesiophobia, self-efficacy) were measured, along with pain, disability and demographics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Principal component analysis accounted for 66.03% of the variance. Four component scores were entered in a hierarchical linear clustering model, deriving 3 subgroups (‘mild features’ <i>n</i> = 39, ‘sensorimotor’ <i>n</i> = 35 and ‘psychomotor’ <i>n</i> = 25). Between-cluster comparisons revealed significant differences in motor, sensory and psychological variables (<i>p</i> < 0.05). Sensorimotor and psychomotor clusters had higher flexion–relaxation ratios (mean difference: > 0.2), greater disability (mean difference: > 7/100) and smaller ROM (mean difference: 7 cm) compared to the ‘mild’ group. The sensorimotor cluster mostly exhibited higher temporal summation of pain (mean difference: > 1.3/10) and lower pressure-pain thresholds (mean difference: > 1.2 kg/cm<sup>2</sup>) than ‘mild’ and psychomotor clusters. The psychomotor cluster showed higher kinesiophobia (mean difference: > 6/44) and pain catastrophising (mean difference: > 12/52) than ‘mild’ and sensorimotor groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Findings indicate 3 subgroups, suggesting that motor factors may add granularity to acute LBP clusters. Stratified care based on these subgroups may help refine treatment pathways for acute LBP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>Including motor factors in cluster development adds a clinically relevant metric to describe people with acute LBP and generates insight into underlying mechanisms of motor adaptation. Longitudinal testing is required to see if these subgroups are differentially related to ","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535773","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":"Assessing Child Pain-Related Injustice Appraisals: A Discriminant Content Analysis Study","authors":"F. Daenen,&nbsp;F. Baert,&nbsp;D. Van Ryckeghem,&nbsp;Z. Trost,&nbsp;T. Vervoort","doi":"10.1002/ejp.70005","DOIUrl":"https://doi.org/10.1002/ejp.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Child pain-related injustice appraisals, associated with adverse pain-related functioning, are commonly assessed using the Injustice Experience Questionnaire (IEQ). However, the IEQ was initially developed for adults. Recent qualitative phenomenological work highlighted pain-related injustice themes among children that are seemingly not captured by the IEQ. Furthermore, research in adults and children has shown strong associations between the IEQ and both pain catastrophising and disability. These issues raise concerns regarding the content validity and discriminant content validity of the IEQ for paediatric populations. This study assessed the content validity and discriminant content validity of the IEQ items and a set of novel items generated through previous qualitative work.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Content and discriminant content validity of the items was assessed by 96 adult judges rating items as measuring child injustice appraisals, as well as measuring competing constructs: pain catastrophising, disability and negative affect. Wilcoxon signed-rank tests were applied to assess content and discriminant content validity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four of 12 IEQ items displayed content validity as well as discriminant content validity against pain catastrophising and disability. Eight of 13 newly generated items displayed content validity as well as discriminant content validity against pain catastrophising and disability. Only two of all 25 items displayed discriminant content validity against negative affect.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study revealed the IEQ to lack discriminant content validity for use in a paediatric context. An item pool was created to assess child pain-related injustice appraisals, displaying both content validity and discriminant content validity against the competing constructs of pain catastrophising and disability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>The current study both reveals issues in applying the IEQ to assess child pain-related injustice appraisals and advances research on child pain-related injustice appraisals by providing an item pool displaying both content validity and discriminant content validity against the competing constructs of child pain catastrophising and child disability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143513876","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":"The Efficacy and Safety of Botulinum Neurotoxin Type A in Treating Chronic Low Back Pain: A Systematic Review, Meta-Analysis, Trial Sequential Analysis, and Meta-Regression","authors":"Waseem Wagrees,&nbsp;Hesham Kelani,&nbsp;Hazem Mohamed Salamah,&nbsp;Abdelrahman Mahmoud,&nbsp;Yehya Khlidj,&nbsp;Mohamed R. Abdelraouf,&nbsp;Bahaa Sharaf,&nbsp;Moustafa Elnewishy,&nbsp;Nadia Albaramony,&nbsp;Ahmed Naeem,&nbsp;Ahmed Abd Elazim,&nbsp;Mohammad El-Ghanem,&nbsp;Diana Greene-Chandos,&nbsp;Mohammad Jadidi,&nbsp;David P. Lerner,&nbsp;Arthur D. Kay,&nbsp;Lisa R. Merlin,&nbsp;Charles Brock","doi":"10.1002/ejp.4796","DOIUrl":"https://doi.org/10.1002/ejp.4796","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic low back pain (CLBP) is a leading cause of disability. Botulinum neurotoxin type A (BoNT-A) has strong anti-spasmodic and analgesic effects, suggesting that its local muscular injection can reduce CLBP compared to other therapies. In this systematic review and meta-analysis, we investigated the efficacy and safety of BoNT-A on patients with CLBP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched PubMed, Scopus, Cochrane, and Web of Science databases for studies comparing BoNT-A to other therapies in terms of functional improvement and pain improvement as measured by visual analog scale (VAS) and clinically significant improvement in pain (50% or greater reduction in VAS score). We employed trial sequential analysis (TSA) to confirm the findings. The GRADE approach was employed to assess the overall quality of the evidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The search yielded nine studies, seven randomised clinical trials (RCTs), and two prospective observational studies. Compared to the control, BoNT-A increased the incidence of clinically significant improvement in pain (RR = 4.82, 95% CI (3.00, 7.76), <i>p</i> &lt; 0.00001) and functional improvement (RR = 3.81, 95% CI (2.40, 6.04), <i>p</i> &lt; 0.00001) (low-certainty evidence), and reduced VAS score (MD = −1.62, 95% CI (−3.13, −0.11), <i>p</i> = 0.04) (very low-certainty evidence). Subgroup analysis showed that BoNT-A is effective against normal saline (moderate-certainty evidence), and it was comparable to steroids and local anaesthetics (very low-certainty evidence). TSA confirmed the findings regarding clinical improvement in pain and functional improvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>BoNT-A is a tolerable and effective treatment for CLBP with a longer duration of action. Future high-quality studies are needed to confirm our findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>This paper provides good evidence that BoNT-A may be employed in patients suffering from resistant chronic low back pain not responding to normal saline injection due to its higher efficacy and longer duration of action. Compared to steroids and local anaesthetics injections, there is not enough data to draw a firm conclusion and future studies are needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466096","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":"Chronic Postsurgical Pain Raises Risk of Dementia","authors":"Mingyang Sun,&nbsp;Xiaolin Wang,&nbsp;Zhongyuan Lu,&nbsp;Yitian Yang,&nbsp;Shuang Lv,&nbsp;Mengrong Miao,&nbsp;Wan-Ming Chen,&nbsp;Szu-Yuan Wu,&nbsp;Jiaqiang Zhang","doi":"10.1002/ejp.70002","DOIUrl":"https://doi.org/10.1002/ejp.70002","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aimed to investigate the association between chronic postsurgical pain (CPSP) and the risk of dementia, addressing a significant gap in the existing literature and highlighting potential implications for clinical practice and public health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>Utilising data from Taiwan's National Health Insurance Research Database, a propensity score-matched cohort study was conducted involving 142,682 patients who underwent major surgery between 2004 and 2018. CPSP was defined as prolonged analgesic use post-surgery, and dementia diagnosis was tracked until December 31, 2022. Multivariable Cox regression models were employed to calculate adjusted hazard ratios (aHRs) for dementia risk in CPSP versus non-CPSP groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Before propensity score matching, the CPSP cohort (<i>n</i> = 37,438) exhibited a higher risk of dementia, with aHRs of 1.35 (95% CI: 1.30–1.40). After matching, the aHR remained elevated at 1.31 (95% CI: 1.26–1.37), indicating a significant association between CPSP and dementia risk. Subgroup analysis confirmed this association across various demographic and clinical factors, with sensitivity analysis reinforcing the robustness of the findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study establishes CPSP as an independent predictor of dementia risk, highlighting the importance of postoperative pain management in mitigating long-term cognitive outcomes. Approximately 30% of dementia risk post-CPSP presents an opportunity for risk reduction through effective CPSP management strategies, emphasising the need for targeted interventions to address this critical healthcare issue.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>This study provides compelling evidence that chronic postsurgical pain (CPSP) significantly increases the risk of dementia, highlighting a critical and previously underexplored connection between postoperative pain and long-term cognitive decline. By establishing CPSP as an independent predictor of dementia, our findings underscore the importance of effective pain management strategies in surgical patients, particularly to mitigate the heightened risk of dementia and improve long-term outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455921","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":"The Effect of a Single Session Rubber Hand Illusion on Pressure Pain Is Not Long-Lasting","authors":"Hatice Ceylan,&nbsp;Nagihan Acet,&nbsp;Zafer Günendi","doi":"10.1002/ejp.70003","DOIUrl":"https://doi.org/10.1002/ejp.70003","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Rubber hand illusion (RHI) is an experience that causes changes in body perception and awareness as a result of the integration of simultaneous perceived visual and tactile stimuli. After synchronous brush strokes with rubber and real hands, the person perceives the rubber hand as their own. RHI is known to alter pain perception. In this study, it was aimed to evaluate the effects of RHI on pressure pain threshold and continuity of this effect.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-three volunteers who developed RHI were included in our study and two conditions, illusion (synchronous) and control (asynchronous), were applied. The illusion condition was created by synchronous brush strokes, while the control condition was created by asynchronous brush application using different frequency and different finger areas in the same individuals. In both conditions, pressure pain threshold measurements with an algometer were performed at four times: baseline/1st measurement, during the brush stroke/2nd measurement, at the end of the brush stroke/3rd measurement and after the hand was removed from the environment/4th measurement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>It was shown that RHI increased the pressure-pain threshold (<i>p</i> = 0.004) in healthy volunteers. Asynchronous brush strokes arranged as a control trial significantly decreased the pressure pain threshold (<i>p</i> = 0.002).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>It was found that the threshold values that change during the brush strokes return to the initial state after the brush strokes are terminated and the rubber hand is removed from the environment so that the effect of the illusion does not last for a long time with a single session application.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439252","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":"The Impact of Pain on Everyday Activities of People With Hypermobility Spectrum Disorders or Hypermobility Ehlers Danlos Syndrome","authors":"Susanne Lindholm,&nbsp;Suzanne Petersson,&nbsp;Peter Molander,&nbsp;Mathilda Björk","doi":"10.1002/ejp.70000","DOIUrl":"https://doi.org/10.1002/ejp.70000","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study describes aspects of pain and how pain affects everyday life and examines the relation between chronic pain and activity limitations in people with hypermobility spectrum disorders (HSD) or hypermobility Ehlers Danlos syndrome (hEDS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study used data from 2016 to 2021 obtained from the Swedish quality registry for pain rehabilitation (SQRP), comparing those with HSD/hEDS with the larger group of people with mixed chronic pain conditions as a reference group (RG).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 43,801 people registered in the SQRP, 1211 (2.8%) were diagnosed with HSD/hEDS (88.9% women). The mean age of the HSD/hEDS group was younger (36.3 ± 11.8) than the RG (45.7 ± 12.8). The HSD/hEDS group had a statistically significant (<i>p</i> &lt; 0.001) earlier onset of pain (calculated in years) in contrast to the RG. In the HSD/hEDS group, 80.1% had persistent pain; in the RG, 74.2% had persistent pain. The HSD/hEDS group reported more pain locations (20.0 ± 7.9) than the RG (14.8 ± 8.8). The HSD/hEDS group reported more problems performing leisure, social, and household activities than the RG; however, pain intensity was statistically significantly lower (<i>p</i> &lt; 0.001) in the HSD/hEDS related to the RG.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There were indications that pain affected daily activities for people with HSD/hEDS, who had earlier onset of pain, marked more pain locations, and had more persistent pain, but pain intensity was not as decisive in contrast to the RG.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>In a comparison yielding statistically significant results (<i>p</i> &lt; 0.001), persons with hypermobility spectrum disorder (HSD) or hypermobility Ehlers-Danlos syndrome (hEDS) reported earlier pain onset, longer pain durations, and a greater number of pain locations but surprisingly, lower pain intensity than the reference group which consisted of a mixed group of pain conditions. These pain characteristics affected daily activities, indicating a substantial impact on daily life for those with HSD/hEDS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 3","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397029","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":"Hypercapnia Reduces Perceived Heat Pain in Healthy Subjects","authors":"A. Guekos,&nbsp;M. Hau,&nbsp;S. Grob,&nbsp;G. Sharvit,&nbsp;P. Schweinhardt","doi":"10.1002/ejp.70001","DOIUrl":"https://doi.org/10.1002/ejp.70001","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Danger signals modulate pain perception. Both amplification and attenuation of perceived pain are observed in healthy subjects exposed to danger signals, such as transient threats of an imminent electrical shock. However, exposure to danger signals in real life typically is not transient but constant over minutes to hours. Here, this was experimentally achieved by administering hypercapnic air (7.5% CO₂). The primary objective was to investigate whether perceived heat pain would be differentially modulated during this intervention compared to regular air administration. The secondary objective assessed the potential differences of such a modulation with respect to heat intensity level.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirty-eight participants (19 women) received two air mixtures (hypercapnic and regular air) for 13 min each, during which 18 (6 × 3) noxious heat stimuli of three different intensities were applied to the calf and rated on two scales (intensity and pleasantness/unpleasantness). Psychological and physiological states were compared between conditions using the body sensations questionnaire, self-assessment manikins, heart rate, and galvanic skin response. Statistical analyses were performed using Bayesian estimation testing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between-condition differences were statistically meaningful for all heat intensity levels, always showing reduced pain perception during <i>hypercapnia</i> compared to <i>normocapnia</i>. The magnitude of the observed hypoalgesia did not depend on heat intensity levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The presence of a continuous physiological danger signal results in hypoalgesia. Future studies need to determine whether the present results only hold for hypercapnia in healthy subjects or are generalisable to interactions between pain perception and continuous physiological danger signals in clinical pain populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>It was shown that hypercapnia leads to reduced perception of noxious heat stimuli. If confirmed by neural data in future studies this could help to better understand the interaction of pain perception and continuous physiological danger signals in clinical pain conditions, potentially allowing for improved treatment of affected individuals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 3","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397028","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":"Development and Validation of a Short Version (PAIC6) of the Pain Assessment in Impaired Cognition Scale","authors":"Vivien Schreiber,&nbsp;Miriam Kunz,&nbsp;Wilco Achterberg,&nbsp;Jenny T. van der Steen,&nbsp;Frank Lobbezoo,&nbsp;Bernhard Langner,&nbsp;Stefan Lautenbacher","doi":"10.1002/ejp.4795","DOIUrl":"https://doi.org/10.1002/ejp.4795","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Observer pain scales are commonly used to assess pain in individuals with impaired cognition. However, nursing staff have highlighted that extremely tight time schedules and increasing workload demands prevent regular use. With the development of a short version of the Pain Assessment in Impaired Cognition (PAIC15), we aimed to reduce implementation barriers in everyday clinical practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We developed a new 6-item short version (PAIC6) in a first sample (<i>N</i> = 59) and validated its psychometric properties in a second sample (<i>N</i> = 250) of older individuals with cognitive impairments. The item reduction and evaluation involved four steps. First, we used Sample 1 to exclude items based on item quality statistics (e.g., difficulty, reliability). Second, the Partial Credit Model (PCM) was utilised for further reduction using again Sample 1. Third, an expert panel evaluated the preceding steps and suggested a draft short version with six items (PAIC6). Fourth, psychometric properties of the short version were evaluated in the independent Sample 2. Thereafter, the final short version was approved.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The new PAIC6 showed a high correlation with the total scale PAIC15 (<i>r</i> = 0.870), good reliability (Cronbach's <i>α</i> = 0.684), and high convergent construct validity, as observed by a high correlation with the established Pain Assessment in Advanced Dementia (<i>r</i> = 0.602).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Overall, we developed a valid, reliable, and clinically valuable PAIC6 that allows a more time-efficient pain assessment, by reducing the assessment time from 5 min to approximately 2 min (60% time saving).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>Observer pain scales are commonly used to assess pain in individuals with impaired cognition. However, nursing staff have highlighted that extremely tight time schedules and increasing workload demands prevent regular use. To address this, we developed PAIC6, a short version of the Pain Assessment in Impaired Cognition 15 (PAIC15). PAIC6 includes six items and takes 2 min for completion after training, realising a 60%-time reduction compared to the original scale while keeping the psychometric quality high.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 3","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.4795","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370088","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":"Prevalence of Temporomandibular Disorder Symptoms After Whiplash Trauma—A Systematic Review and Meta-Analysis","authors":"Birgitta Häggman-Henrikson,&nbsp;Anna Lövgren,&nbsp;Wendy Yi-Ying Wu,&nbsp;Christopher Peck,&nbsp;Hans Westergren,&nbsp;Thomas List","doi":"10.1002/ejp.4792","DOIUrl":"https://doi.org/10.1002/ejp.4792","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>Temporomandibular disorders (TMDs) is an umbrella term for pain and dysfunction involving jaw muscles and/or the temporomandibular joint, with whiplash trauma suggested to be one risk factor. The aim was to evaluate prevalence and relative risk of TMDs in the acute and chronic stages after whiplash trauma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Databases and Data Treatment</h3>\u0000 \u0000 <p>This review was registered in Prospero (CRD42023407091) and followed the PRISMA guidelines. A literature search in PubMed, Scopus and Web of Science on 10 March 2023 and updated 29 April 2024 identified studies reporting prevalence of TMD after whiplash trauma. Risk of bias was assessed with Joanna Briggs Institute Prevalence Critical Appraisal Tool. A random effect meta-analysis was performed for prevalence of TMD pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After screening of 671 identified studies, 96 articles were assessed in full text. Fourteen studies, with 840 cases in the acute and 8293 cases in the chronic stage (i.e., &gt; 3 months post-trauma) were included in a qualitative analysis together with 1591 controls. Nine studies, including 449 cases in the acute and 7912 individuals in the chronic stage after trauma, together with 515 controls, were included in the meta-analysis. Mean prevalence for TMD pain was 18.9% (95% CI 9.71–29.98) in the acute case group, 26.8% (95% CI 15.07–38.79) in the chronic case group, and 5.7% (95% CI 3.08–8.96) in the control group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The higher prevalence of TMD pain already in the early stage after whiplash trauma, emphasises the need for early comprehensive clinical assessment as well as targeted research to understand underlying mechanisms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>The prevalence of Temporomandibular disorder pain was high already in the acute stage after whiplash trauma, and there was no evidence of any decrease from the acute to the chronic stage. This finding suggests that early assessment and management rather than a 'wait-and see' approach should be recommended when patients present with orofacial pain related to whiplash trauma.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 3","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.4792","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362961","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}