European Journal of Pain最新文献

{"title":"Exploring the Spectrum of Temporal Summation and Conditioned Pain Modulation Responses in Pain-Free Individuals Using a Tonic Heat Pain and Cold Pressor Test Paradigms","authors":"M. Vincenot,&nbsp;G. Léonard,&nbsp;C. Cloutier-Langevin,&nbsp;M. Bordeleau,&nbsp;L. Gendron,&nbsp;F. Camirand Lemyre,&nbsp;S. Marchand","doi":"10.1002/ejp.70019","DOIUrl":"https://doi.org/10.1002/ejp.70019","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Temporal summation (TS) and conditioned pain modulation (CPM) are impaired in many chronic pain individuals, although typical TS and CPM responses remain unclear. Providing a quantile distribution of TS and CPM values could help determine whether TS and CPM responses fall outside the usual ranges, thereby informing pain management strategies. The objective of this study was to provide a response distribution for these mechanisms in a large, pain-free cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Pain-free participants (<i>n</i> = 347) were evaluated. TS was interpreted as the change in pain perception scores during a constant heat pain stimulus. CPM was assessed by the difference in pain perception scores induced by a tonic heat pain stimulus and a mechanical pain threshold, before and after a cold pressor test (CPT). Quantile regression was performed to identify the 5th to 95th percentiles, with a specific focus on the 75th, 90th and 95th percentiles and their confidence intervals, while considering age and sex.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Analyses revealed a particularly large range of TS and CPM responses, spanning from strong inhibition in CPM and strong summation in TS to moderate or even null effects. Notably, some responses deviated from the expected patterns, with certain individuals exhibiting hyperalgesic CPM effects and others displaying hypoalgesic TS responses. The highest percentiles of the TS distribution were influenced by age and gender, while CPM scores remained unchanged.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The results of this study provide an overview of the possible spectra of responses for TS and CPM, potentially paving the way for their incorporation into pain management strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>This study examines the spectrum and provides a distribution for TS and CPM values to better identify what may constitute a deficit in these mechanisms and enhance their clinical interpretation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>clinicaltrial.gov identifier: NCT03376867</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 5","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761857","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":"Correction to “Increased Behavioural Inhibition and Decreased Behavioural Activation in Whiplash-Associated Disorders: Associations With Health Outcomes”","authors":"","doi":"10.1002/ejp.70020","DOIUrl":"https://doi.org/10.1002/ejp.70020","url":null,"abstract":"","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 5","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761859","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":"Conversational Agents to Support Pain Management: A Scoping Review","authors":"Filipe L. Souza,&nbsp;Hannah Bowman,&nbsp;Francis Yang,&nbsp;Negin Hesam-Shariati,&nbsp;Jackson Linke,&nbsp;Yannick L. Gilanyi,&nbsp;Matthew D. Jones,&nbsp;Rafael Z-Pinto,&nbsp;James H. McAuley,&nbsp;Rodrigo R. N. Rizzo","doi":"10.1002/ejp.70016","DOIUrl":"https://doi.org/10.1002/ejp.70016","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Pain-related conditions are the leading cause of years lived with disability globally. Managing pain presents significant challenges, including the need to address multiple biopsychosocial factors and the difficulty in delivering evidence-based treatments. Digital health technologies, such as conversational agents, offer the potential for personalised and accessible pain management. However, the characteristics and effectiveness of these interventions are not yet fully understood. This scoping review aims to comprehensively evaluate the applications and effectiveness of conversational agents in supporting pain management in adults (i.e., healthy individuals at risk of developing pain, individuals currently experiencing pain and healthcare providers or students involved in managing pain conditions).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Searches were systematically conducted across six databases—MEDLINE PubMed, ACM Digital Library, CINAHL, Embase, PsycINFO, Cochrane CENTRAL—and five trial registries from inception.&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;Twenty-eight studies were included, focusing on capturing health information (&lt;i&gt;n&lt;/i&gt; = 8), providing emotional support (&lt;i&gt;n&lt;/i&gt; = 7), facilitating adherence to self-management exercises (&lt;i&gt;n&lt;/i&gt; = 6), delivering psychological treatment (&lt;i&gt;n&lt;/i&gt; = 5), offering organisational support (&lt;i&gt;n&lt;/i&gt; = 1) and educating healthcare providers (&lt;i&gt;n&lt;/i&gt; = 1). These studies addressed conditions with pain as a central or common symptom, including dementia (&lt;i&gt;n&lt;/i&gt; = 7), cancer (&lt;i&gt;n&lt;/i&gt; = 5) and musculoskeletal disorders (&lt;i&gt;n&lt;/i&gt; = 4), among others. None of the conversational agents on the market covered all four stages recommended for translational research (development, feasibility, effectiveness and implementation).&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 use of conversational agents in pain management is relatively new and involves diverse and promising appllications. However, evidence supporting their effectiveness in improving pain-related outcomes remains limited and heterogeneous. Future reseacrh should prioritise feasibility, reliability, and user experience studies to inform the design of robust randomised controlled trials.&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 scoping review comprehensively examines the use of conversational agents (CAs) in adult pain management. The study identified six applications of CAs to s","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 5","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143749821","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":"Association Between Interoceptive Accuracy and Pain Perception: Insights From Trained Musicians and Athletes","authors":"Boris Kleber,&nbsp;Carol Sitges,&nbsp;Elvira Brattico,&nbsp;Peter Vuust,&nbsp;Anna M. Zamorano","doi":"10.1002/ejp.70012","DOIUrl":"https://doi.org/10.1002/ejp.70012","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;The integration of concurrent endogenous and exogenous multisensory information throughout years of dedicated sensorimotor training is associated with enhanced interoceptive accuracy and altered pain perception in healthy individuals. However, this relationship remains inconclusive, with outcomes varying by training modality and pain stimulus. This study examines associations between distinct forms of sensorimotor training, interoception and pain perception.&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;Two groups of individuals performing extensive sensorimotor training, 17 musicians and 15 athletes, and 14 non-musicians/athletes were recruited. Participants completed a cardiac interoceptive accuracy (IAcc) task and quantitative sensory tests, including mechanical and electrical detection thresholds (MDTs and EDTs), pressure and heat pain thresholds (PPTs and HPTs), as well as music-related perceptual discrimination and self-reported physical activity assessments.&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;Results revealed superior IAcc and PPTs in athletes compared to controls. Musicians exhibited increased heat pain sensitivity. While IAcc in musicians did not reach significance, training duration significantly predicted IAcc across both groups. PPTs correlated positively with both IAcc and accumulated training, but mediation analyses revealed that training effects on PPTs occurred independently of IAcc, suggesting distinct pathways for interoception and pain modulation. Additionally, physical activity levels correlated positively with both IAcc and PPTs across participants.&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 findings support the emerging view that individuals engaging in sensorimotor training routines, which require embodied multisensory integration for optimal performance, enhance interoceptive accuracy. They also confirm that pain processing varies by training modality. Furthermore, they suggest that the type of acute pain stimulus may explain inconsistencies in the interoception–pain relationship in healthy populations.&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 advances our understanding of the interoception–pain-training nexus by revealing two distinct pathways: one linking sensorimotor training, interoceptive accuracy and pressure pain perception and another showing that accumulated sensorimotor training independently elevates pain thresholds. By ","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 5","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143749752","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 Painful Temporomandibular Disorders and Overlapping Primary Headaches Among Young Adults","authors":"Cristina Rocha Exposto,&nbsp;Mojdeh Mansoori,&nbsp;Bodil Hammer Bech,&nbsp;Lene Baad-Hansen","doi":"10.1002/ejp.70013","DOIUrl":"https://doi.org/10.1002/ejp.70013","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;Large population-based estimates of the prevalence of painful temporomandibular disorders (p-TMD) utilising standardised screening tools are scarce and have not investigated the prevalence of overlapping primary headaches. We aimed to estimate the prevalence of p-TMD in a large population of young adults (18 to 23 years) and to estimate the co-occurrence of p-TMD and two primary headaches, migraine and tension-type headache (TTH). The study also aimed to examine the extent of psychological (PHQ-4) and physical (PHQ-15) comorbidities and report prevalence across three gender categories (&lt;i&gt;women&lt;/i&gt;, &lt;i&gt;men&lt;/i&gt; and &lt;i&gt;other&lt;/i&gt;).&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;Survey data from the Danish National Birth Cohort were collected (&lt;i&gt;n&lt;/i&gt; = 11,982), in a cross-sectional observational design. A sensitivity analysis was conducted to address participation bias, revealing minimal impact on the estimates.&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 overall prevalence of p-TMD was 26.4% with gender-specific prevalence of &lt;i&gt;women:&lt;/i&gt; 31.5%, &lt;i&gt;other:&lt;/i&gt; 39.2% and &lt;i&gt;men:&lt;/i&gt; 16.8%. Among those with p-TMD, 80.5% reported headaches at least once a month, and 13.8% over 15 days monthly. For the p-TMD individuals with a medical headache diagnosis, 31.9% experienced TTH and 10.9% migraine. The study also identified a higher proportion of moderate/severe psychological distress and physical symptoms in the p-TMD group compared to the non-p-TMD group. Logistic regression revealed a positive association between PHQ-4 and p-TMD, modified by gender (&lt;i&gt;p&lt;/i&gt; = 0.016).&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;High overall prevalence of p-TMD and overlapping primary headaches was found in young adults. In addition, the study reports gender-specific associations between p-TMD, psychological distress and physical comorbidities indicating that this association is stronger for men than for women.&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 found a higher-than-expected prevalence of painful temporomandibular disorders in young adults. It is based on a large population cohort and used standardised and validated screening tools. The study also reported common co-occurrence of primary headaches and explored gender differences. The study raises awareness for a possibly underestimated health burden in young individuals, particularly among individuals experiencing psychological distres","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 5","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717028","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":"Two-Phase Inpatient Withdrawal Programme for Long-Term Opioid Use in Non-Cancer Pain","authors":"Konrad Streitberger,&nbsp;Michael A. Harnik,&nbsp;Anna Saliba,&nbsp;Nina Bischoff,&nbsp;Larissa T. Blättler,&nbsp;Kyrill Schwegler,&nbsp;Christine Baumgartner,&nbsp;Nora Sutter,&nbsp;Maria M. Wertli","doi":"10.1002/ejp.70010","DOIUrl":"10.1002/ejp.70010","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>High-dose long-term opioid treatment for chronic non-cancer pain (CNCP) has become an increasing burden in industrialised countries. Opioid tapering and withdrawal in patients with CNCP remain challenging. This study evaluated a two-phase inpatient opioid withdrawal (OW) programme aimed at safely discontinuing opioid use in CNCP patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective observational study was conducted from 2018 to 2023 at a Swiss tertiary care centre, involving CNCP patients on long-term opioid therapy (≥ 6 months, ≥ 100 mg morphine equivalent daily dose) who had failed outpatient withdrawal attempts. The programme consisted of a withdrawal phase (Phase 1) followed by multimodal pain rehabilitation (Phase 2). Outcomes included the proportion of patients opioid-free after Phase 2 (primary) and at 3 months, pain intensity changes, and adverse events (secondary).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 38 enrolled patients (58% female, median age 54 years [IQR 49, 62]), 34 (89%) completed both phases, and 32 (84%) were opioid-free at the end of Phase 2. At 3 months, 23 patients (61%) remained opioid-free, while 4 (11%) resumed opioids, and 11 (29%) were lost to follow-up. Median pain intensity remained stable after discharge. One patient died by suicide 10 days post-withdrawal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This two-phase inpatient withdrawal and rehabilitation programme enabled most CNCP patients to discontinue opioids without increased pain intensity, with a majority remaining opioid-free at 3 months. These findings highlight the importance of ongoing psychological support and careful patient selection in OW management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>This study introduces a structured inpatient opioid withdrawal model tailored for chronic non-cancer pain patients on high-dose opioid therapy, demonstrating that high cessation rates can be achieved without worsening pain intensity. By addressing the gap in care for patients who fail outpatient tapering, this research provides clinical insights into optimising withdrawal protocols and highlights the need for targeted resource allocation for intensive, multidisciplinary pain management. These findings support evidence-based decision-making in designing more effective opioid tapering strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 5","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669504","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":"Attachment in Young Adults With Chronic Pain: The Mediating Role of Cognitive Appraisals in the Relationship Between Attachment Security, Pain Coping and Functioning","authors":"Nicole Harte,&nbsp;Olivia Noon,&nbsp;Andreea Heriseanu,&nbsp;Blake F. Dear,&nbsp;Joanne Dudeney","doi":"10.1002/ejp.70008","DOIUrl":"10.1002/ejp.70008","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Attachment styles can influence how individuals perceive and cope with chronic pain. This study examined the relationships between attachment security, pain coping and functioning in young adults with chronic pain, focusing on the mediating role of cognitive appraisals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study included 206 young adults attending university aged 17–29 with chronic pain (<i>M</i>age = 19.24, <i>SD</i> = 2.03) and 346 without pain (<i>M</i>age = 19.11, <i>SD</i> = 1.79). Participants completed measures assessing pain characteristics, attachment security, pain coping strategies, physical and social functioning and cognitive appraisals relating to bodily and social threat bias and pain catastrophising. SPSS PROCESS macro was used to test mediational hypotheses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Young adults with chronic pain had greater insecure attachment than controls (Mann–Whitney <i>U</i> = 41639.50, <i>p</i> &lt; 0.001). Insecure attachment was significantly associated with poorer solution-focused coping and social functioning (<i>r</i> = −0.330 and − 0.355 respectively), and increased emotion-focused avoidance (<i>r</i> = 0.317). Social threat bias partially mediated the effects of attachment security on emotion-focused avoidance and social functioning. Pain catastrophising partially mediated the effects of attachment security on solution-focused coping and social functioning, and fully mediated its effects on emotion-focused avoidance. An indirect effect of attachment security on reframing and distraction was found via social threat and pain catastrophising.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Insecure attachment is heightened in young adults with chronic pain and may contribute to poorer pain coping and social functioning through cognitive appraisals, specifically social threat and pain catastrophising. These may be useful targets for intervention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 5","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669451","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":"HLA-Region Genetic Association Analysis of Breast Cancer Patients With and Without Persistent Postsurgical Neuropathic Pain","authors":"L. Mustonen,&nbsp;J. K. Nieminen,&nbsp;S. Koskela,&nbsp;M. Kaunisto,&nbsp;E. Kalso,&nbsp;P. J. Tienari,&nbsp;H. Harno","doi":"10.1002/ejp.70009","DOIUrl":"https://doi.org/10.1002/ejp.70009","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Surgical nerve injuries lead to persistent neuropathic pain (NP) in up to 30% of patients. Among many other factors, polymorphisms in the human leukocyte antigen (HLA) genes have been suggested to contribute to the development of neuropathic pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a genetic association analysis of HLA class I and class II alleles in women who had been operated on for breast cancer. Patients had a surgeon-confirmed perioperative nerve injury and were examined 4–9 years after their surgery. Patients with painful (cases, <i>n</i> = 27) and painless (controls, <i>n</i> = 30) intercostobrachial nerve resection were studied. Cases included patients with definite NP with worst pain intensity in the past week ≥ 4/10 on a numerical rating scale (NRS) and controls had the same nerve injury with no NP or other pains. Whole-genome single nucleotide polymorphism data were produced, and HLA class I (HLA-A, -B, -C) and class II (HLA-DRB1, -DQA1, -DQB1 and -DPB1) alleles were determined by imputation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>HLA-DRB1*03:01, DQA1*05:01 and DQB1*02:01 alleles appeared to be associated with painful nerve injury after breast cancer surgery (nominal <i>p</i> = 0.007 for all, carriership OR = 12.0, 95% CI 1.38–104; FDR corrected <i>p</i> &gt; 0.07). These alleles comprise the DR3-DQ2 haplotype, which is part of the ancestral haplotype AH8.1.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our results provide further support for the role of HLA genetic variation in the development of persistent post-surgical neuropathic pain, which indirectly implies a mechanism involving immunological memory in this process.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>We report a novel association between the HLA-DR3-DQ2 haplotype and the development of persistent neuropathic pain after breast cancer surgery. Our results provide further evidence for the role of HLA polymorphism in persistent neuropathic pain.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143612543","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":"Does Leptin and Insulin Levels Influence Pain and Disability in Subjects With Frozen Shoulder? A Cross-Sectional Study","authors":"José Javier Pérez-Montilla,&nbsp;Rafael Guzmán-García,&nbsp;Leo Pruimboom,&nbsp;Santiago Navarro-Ledesma","doi":"10.1002/ejp.70007","DOIUrl":"https://doi.org/10.1002/ejp.70007","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To investigate the relationship between leptin levels, insulin resistance (measured by HOMA), and clinical outcomes related to pain, disability, and shoulder range of motion (ROM) in patients with frozen shoulder (FS).&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;This cross-sectional study included 34 patients diagnosed with FS. Leptin and HOMA levels were measured and analysed in relation to pain and disability scores, as assessed by the Shoulder Pain and Disability Index (SPADI), along with shoulder ROM (flexion, extension, abduction, adduction, and internal/external rotation). Linear regression models were used to evaluate associations between leptin, HOMA, and clinical outcomes, adjusting for potential confounders such as age and sex.&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;Higher leptin levels were significantly associated with increased SPADI pain (&lt;i&gt;R&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.114, &lt;i&gt;β&lt;/i&gt; = 0.397, &lt;i&gt;p&lt;/i&gt; = 0.005) and disability scores (&lt;i&gt;R&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.110, &lt;i&gt;β&lt;/i&gt; = 0.425, &lt;i&gt;p&lt;/i&gt; = 0.006), as well as an inverse association with shoulder flexion (&lt;i&gt;R&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.074, &lt;i&gt;β&lt;/i&gt; = −1.088, &lt;i&gt;p&lt;/i&gt; = 0.025), indicating reduced ROM with higher leptin levels. Similarly, higher HOMA levels were associated with increased SPADI pain (&lt;i&gt;R&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.096, &lt;i&gt;β&lt;/i&gt; = 1.078, &lt;i&gt;p&lt;/i&gt; = 0.010) and disability scores (&lt;i&gt;R&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.081, &lt;i&gt;β&lt;/i&gt; = 1.517, &lt;i&gt;p&lt;/i&gt; = 0.017), as well as combined SPADI scores (&lt;i&gt;R&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.089, &lt;i&gt;β&lt;/i&gt; = 2.595, &lt;i&gt;p&lt;/i&gt; = 0.014). HOMA also showed a significant inverse relationship with shoulder flexion (&lt;i&gt;R&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.061, &lt;i&gt;β&lt;/i&gt; = −2.097, &lt;i&gt;p&lt;/i&gt; = 0.028), suggesting that insulin resistance may contribute to ROM limitations.&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;Elevated leptin and insulin resistance levels were linked to greater pain, disability, and decreased ROM in patients with FS. These findings underscore the potential role of metabolic and inflammatory pathways in FS pathogenesis and highlight the importance of considering lifestyle interventions targeting leptin and insulin regulation as adjuncts to traditional management strategies for this condition.&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;Elevated levels of leptin and HOMA (insulin resistance) are significantly associated with increased pain and disability in patients with frozen shoulder, as measured by SPADI scores. Higher leptin and HOMA levels are also associated with reduced range of motion, particularly in shoulder flexio","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595325","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":"Painful Mondays: Exploring Weekly Sleep Variations and Pain Perception in Healthy Women—An Experimental Study","authors":"Shima Rouhi,&nbsp;Natalia Egorova-Brumley,&nbsp;Amy S. Jordan","doi":"10.1002/ejp.70004","DOIUrl":"https://doi.org/10.1002/ejp.70004","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;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.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A 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.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A total of 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 (&lt;i&gt;M&lt;/i&gt; = 89.2 ± 5.42 min; &lt;i&gt;p&lt;/i&gt; = 0.022, lowest on Friday and Sunday nights), bedtime (&lt;i&gt;M&lt;/i&gt; = 00:56 &lt;i&gt;AM&lt;/i&gt; ± 0.29; &lt;i&gt;p&lt;/i&gt; = 0.038, latest on Friday vs. Sunday night) and wake-up time (&lt;i&gt;M&lt;/i&gt; = 07:04 &lt;i&gt;AM&lt;/i&gt; ± 0.30; &lt;i&gt;p&lt;/i&gt; = 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 (&lt;i&gt;B&lt;/i&gt; = −11.89; &lt;i&gt;p&lt;/i&gt; = 0.002) and increased heat pain summation (&lt;i&gt;B&lt;/i&gt; = 1.65; &lt;i&gt;p&lt;/i&gt; &lt; 0.001).&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 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.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Statement of Significance&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;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}