European Journal of Pain最新文献

{"title":"Neuropathic Pain in Nursing Homes","authors":"Gisèle Pickering,&nbsp;Marion Voute,&nbsp;Elise Sortais,&nbsp;Nicolas Macian,&nbsp;Leslie Goumy,&nbsp;Fatiha Giron,&nbsp;Bruno Pereira","doi":"10.1002/ejp.70035","DOIUrl":"https://doi.org/10.1002/ejp.70035","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In older persons, pain prevalence is estimated to range between 22% and 80%. In nursing home residents, underevaluated pain is common despite pain management quality indicators. This study aims to assess neuropathic pain (NP) prevalence, NP evaluation and treatment, and healthcare professionals’ practices and needs to optimise NP management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study received ethical approval [IRB number 2023-CF230]. In order to obtain data from healthcare professionals working in nursing homes, an online survey was conducted on REDCap software between 4 March 2024 and 28 June 2024. The survey was divided into 3 sections: (1) prevalence of NP, (2) assessment of the four steps of the NP management algorithm (detection, evaluation, treatment and re-evaluation), (3) awareness and needs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Responses to the survey came from nine nursing homes, for a total of 841 residents, half of them aged between 75 and 85 years The prevalence of NP was 8.5% [4.2; 12.7]. The clinical pertinence of each step of the algorithm showed good satisfaction (mean ± SD, 7.9 ± 1.5). A large majority of participants (96.8%) expressed the need to receive a specific training on NP management in their care setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The prevalence of NP is close to that described in the literature, but appears to be underestimated by the participants because of diagnostic issues. The decision-making algorithm proposed to the teams has shown good results in terms of its usefulness in current practice. The survey also highlighted the need for training in this field to optimise NP management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>This survey highlights the underestimated prevalence of neuropathic pain because of lack of diagnosis issues. A 4-step algorithm (detection, evaluation, treatment and re-evaluation) was proposed and validated by healthcare professionals for neuropathic pain management with good results in terms of its usefulness for current practice. Results unveils the still unmet needs for information and training of nursing homes healthcare professionals and medical/nursing students as regards neuropathic pain assessment and treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70035","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144100701","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":"Retrospective Assessment of Endometriosis Pain Over the Life Course: A Reliability Study Within the ComPaRe-Endometriosis Cohort","authors":"Solène Gouesbet,&nbsp;Sarah Lambert,&nbsp;Hélène Amazouz,&nbsp;Zélia Breton,&nbsp;Viet-Thi Tran,&nbsp;Stacey Missmer,&nbsp;Marina Kvaskoff","doi":"10.1002/ejp.70040","DOIUrl":"https://doi.org/10.1002/ejp.70040","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;Endometriosis may manifest through various pain symptoms, such as dysmenorrhea, dyspareunia, dyschezia, dysuria and abdominal pain. While retrospective evaluation of these pain symptoms is less expensive and time-consuming compared to a prospective evaluation, there is potential for recall bias, and the reliability of such data needs to be assessed. We aimed to evaluate the reliability of questions on past endometriosis-related pain.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We conducted a reliability study within ComPaRe-Endometriosis, an ongoing prospective e-cohort including patients with endometriosis. We assessed past endometriosis-related pain over a lifetime using the WERF-EPHect Patient Questionnaire—Standard (EPQ-S). Participants rated the worst intensity of dysmenorrhea, dyspareunia, dyschezia, dysuria and abdominal pain that they experienced at ≤ 15, 16–20, 21–30, 31–40 and &gt; 40 years using a numeric-rating scale (NRS). We asked the same questions about 1 year later and measured the agreement between participant responses by calculating intraclass correlation coefficients (ICC) (continuous NRS level) and weighted kappa coefficients (&lt;i&gt;κ&lt;/i&gt;&lt;sub&gt;w&lt;/sub&gt;) (pain intensity categories).&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 1752 participants completed both surveys. The global reliability was close to the ‘good’ and ‘substantial’ thresholds for dysmenorrhea (ICC = 0.74; &lt;i&gt;κ&lt;/i&gt;&lt;sub&gt;w&lt;/sub&gt; = 0.57) and dyspareunia (ICC = 0.72; &lt;i&gt;κ&lt;/i&gt;&lt;sub&gt;w&lt;/sub&gt; = 0.57), ‘moderate’ and close to the ‘substantial’ threshold for dysuria (ICC = 0.68; &lt;i&gt;κ&lt;/i&gt;&lt;sub&gt;w&lt;/sub&gt; = 0.59), and ‘moderate’ for dyschezia (ICC = 0.62; &lt;i&gt;κ&lt;/i&gt;&lt;sub&gt;w&lt;/sub&gt; = 0.54) and abdominal pain (ICC = 0.58; &lt;i&gt;κ&lt;/i&gt;&lt;sub&gt;w&lt;/sub&gt; = 0.49).&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;In this population, questions on worst pain intensity over the life course showed moderate-to-good reliability depending on the type of pain, with higher reliability when pain level was considered as a continuous variable.&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;While prospective measures are the most robust approach in epidemiological research, longitudinal data with pain recorded since childhood or adolescence are scarce. This study shows that the worst level of pelvic and abdominal pain over the life course are reliably reported by endometriosis patients after a 1-year interval. These findings suggest that retrospecti","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143938874","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":"Author's Reply to the Comment by Meira E Cruz M","authors":"Cristina Rocha Exposto","doi":"10.1002/ejp.70036","DOIUrl":"https://doi.org/10.1002/ejp.70036","url":null,"abstract":"","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143944477","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":"Author's Reply to the Comment by Anjum et al.","authors":"Cristina Rocha Exposto","doi":"10.1002/ejp.70037","DOIUrl":"https://doi.org/10.1002/ejp.70037","url":null,"abstract":"","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143944478","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":"Stress-Related Brain Alterations in Chronic Pain","authors":"Yann Quidé,&nbsp;Negin Hesam-Shariati,&nbsp;Nell Norman-Nott,&nbsp;James H. McAuley,&nbsp;Sylvia M. Gustin","doi":"10.1002/ejp.70034","DOIUrl":"https://doi.org/10.1002/ejp.70034","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;Stress symptoms are commonly experienced by people with chronic pain. Although stress and chronic pain are associated with similar effects on brain morphology, the present study aims to clarify the relationship between stress severity, chronic pain, and brain morphology.&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;Fifty-two people with chronic pain and 38 pain-free healthy controls (HC) underwent T1-weighted magnetic resonance imaging. Severity of stress symptoms was measured using the civilian version of the posttraumatic stress disorder checklist (PCL-C). A series of multiple linear regressions determined the main effects of group, stress symptom severity (PCL-C total score and symptom-specific scores) and their interaction on grey matter volume of selected regions of interest.&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 interaction term was significantly associated with variations in grey matter volume in the left and right putamen, the left middle cingulate cortex (MCC) and the right posterior insula. Results showed significantly smaller left and right putamen when reporting higher stress levels, and significantly larger left MCC and right posterior insula at lower stress levels in people with chronic pain compared to HCs. In addition, increasing stress severity was significantly associated with larger left and right putamen in HCs, and significantly associated with smaller left MCC and right posterior insula in people with chronic pain.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Severity of stress moderated chronic pain-related grey matter alterations. More severe stress, especially avoidance, was associated with smaller left MCC, a core region of the “pain matrix”. The MCC is strongly linked with the somatosensory network and critical for empathy, especially toward pain-related stimuli.&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;To our knowledge, this is the first study to show that stress severity differentially impacts grey matter integrity in people with chronic pain compared to pain-free healthy controls. Briefly, our results indicate that higher levels of stress were associated with larger putamen and right posterior insula in pain-free participants, potentially reflecting mechanisms of resilience to trauma in this group. Higher levels of stress, especially avoidance symptoms, were associated with smaller left middle cingulate cortex, a region with strong links to the somatos","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143930209","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":"Generalisation of Placebo and Nocebo Effects: Current Knowledge and Future Directions","authors":"Lingling Weng,&nbsp;Kaya J. Peerdeman,&nbsp;Antoinette I. M. van Laarhoven,&nbsp;Andrea W. M. Evers","doi":"10.1002/ejp.70018","DOIUrl":"https://doi.org/10.1002/ejp.70018","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objective</h3>\u0000 \u0000 <p>Placebo and nocebo effects are beneficial or adverse treatment outcomes upon administration of inert treatment components. These effects have been frequently studied on pain. It remains unclear to what extent generalisation occurs in these effects on pain and other somatic sensations. This review outlines the current knowledge on stimulus generalisation (i.e., generalisation over various stimuli) and response generalisation (i.e., generalisation over various responses) of placebo and nocebo effects on prevalent somatic sensations (i.e., pain, itch, dyspnea, nausea and fatigue).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Databases and Data Treatment</h3>\u0000 \u0000 <p>The databases PubMed, Web of Science and PsycINFO were systematically searched for peer-reviewed articles reporting on experimental studies in humans of the induction and generalisation of placebo and nocebo effects on prevalent somatic sensations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 2025 records identified, 23 studies were included. These studies indicated that placebo and nocebo effects can generalise over stimuli (at perceptual, categorical and treatment levels) and over responses within modalities. Most studies investigated pain; fewer studies investigated itch, dyspnea, nausea and fatigue. Generalisation effects tend to be larger when the generalisation stimuli and responses more closely resemble the initial stimulus or response. Generalisation was more likely if a combination of verbal suggestion and conditioning was employed to induce placebo or nocebo effects than if either suggestion or conditioning was employed alone. Response generalisation across modalities remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Placebo and nocebo effects can generalise over stimuli and responses. More experimental and clinical research is warranted to address carryover effects of placebo and nocebo effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>The current review provides an overview of the literature on the generalisation of placebo and nocebo effects to diverse stimuli and responses. This can ultimately benefit healthcare providers to prevent carryover effects of treatment failure and harness carryover effects of treatment success.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143919638","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":"Status and Opportunities for Improvement in Pain Education in Europe: A European Pain Federation EFIC Multiple-Methods Study","authors":"Nathan Skidmore,&nbsp;Zsófia Nagy,&nbsp;Felicia J. Cox,&nbsp;Frank J. P. M. Huygen,&nbsp;Edmund Keogh,&nbsp;Andreas Kopf,&nbsp;Bart Morlion,&nbsp;Harriët Wittink,&nbsp;Mary O'Keeffe,&nbsp;Brona M. Fullen","doi":"10.1002/ejp.70025","DOIUrl":"https://doi.org/10.1002/ejp.70025","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Pain is one of the most prevalent health issues in Europe, yet the quality of pain education for healthcare professionals remains unclear. This study assessed the status of undergraduate and postgraduate pain education for nurses, physicians, psychologists, and physiotherapists across Europe, identifying key strategies to enhance training and improve healthcare outcomes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A study using multiple methods was conducted, comprising a scoping review, an online survey of educators, and qualitative interviews with EFIC chapters and professional educational bodies.&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 scoping review of 11 studies revealed a paucity of evidence, with significant heterogeneity in the hours dedicated to pain training and inconsistencies in both content, teaching, and assessment methods across European curricula. The survey of educators (&lt;i&gt;n&lt;/i&gt; = 511) showed wide variability in pain education coverage, with psychology curricula particularly underrepresented compared to the more structured programmes in medicine and physiotherapy. The interviews highlighted curriculum constraints, lack of resources, and limited specialised staff as key barriers. They also underscored the importance of integrating pain education across all disciplines through international and interdisciplinary collaboration to enhance training efforts.&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;Significant gaps persist in the depth, consistency, and delivery of pain education for undergraduate and postgraduate health professionals across Europe. The absence of standardised, evidence-based curricula underscores the need for consistent pain education across all disciplines. Implementing targeted educational standards, increasing interdisciplinary training, and supporting qualified educators are essential to address this fragmented landscape. Standardising pain education has the potential to greatly improve patient outcomes by equipping healthcare professionals with more effective pain management skills.&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 multiple method study provides an updated and comprehensive overview of the current state of pain education for healthcare professionals in Europe at undergraduate and postgraduate levels. Substantial gaps remain in the depth, consistency, and delivery of pain education for both undergraduate and postgraduate h","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914123","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 Postsurgical Pain and Dementia Risk: Expanding the Horizon of Multifactorial Interactions","authors":"Junjian Zeng,&nbsp;Zhidong Zhou","doi":"10.1002/ejp.70031","DOIUrl":"https://doi.org/10.1002/ejp.70031","url":null,"abstract":"","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143905113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Intermittent Theta Burst Stimulation on Pain Relief and Brain Connectivity in Chronic Low Back Pain","authors":"Jiajia Yang,&nbsp;Xiaoyu Gao,&nbsp;Xue Cheng,&nbsp;Ruochen Fu,&nbsp;Hao Xie,&nbsp;Siyun Zhang,&nbsp;Zhenwen Liang,&nbsp;Xi Chen,&nbsp;Qiuhua Yu,&nbsp;Chuhuai Wang","doi":"10.1002/ejp.70033","DOIUrl":"https://doi.org/10.1002/ejp.70033","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This randomised clinical trial investigated the effect of intermittent theta burst stimulation (iTBS) over the dorsolateral prefrontal cortex (DLPFC) on pain alleviation in patients with chronic low back pain (CLBP) and its underlying mechanisms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Forty CLBP patients were randomly assigned to receive either active or sham iTBS combined with core stability exercise. Pain assessments were completed before and after the intervention. Eleven patients from each group underwent resting-state functional magnetic resonance imaging scans pre- and post-intervention to analyse DLPFC activation and connectivity with other brain regions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The active iTBS group had a greater pain reduction than the sham group (<i>p</i> = 0.05, 95% CI: −0.009 to 1.109). In the active and sham groups, 80% (16/20) and 40% (8/20) reached the minimal clinically important difference, respectively, with a number needed to treat of 2.5. For the Fear-Avoidance Beliefs Questionnaire, there was a significant difference between the two groups (<i>p</i> = 0.011, <i>r</i> = 0.40). The active iTBS group showed a significantly enhanced functional connectivity between the left DLPFC and the right cerebellum, as well as both occipital gyri (voxel-level, <i>p</i> &lt; 0.001; cluster-level familywise error rate, <i>p</i> &lt; 0.01). Spearman's correlation analysis showed a significant negative correlation between Numerical Rating Scale and the FC of the left DLPFC and the right cerebellum (rho = −0.55, <i>p</i> = 0.008), the right (rho = −0.439, <i>p</i> = 0.01), and left occipital gyri (rho = −0.45, <i>p</i> = 0.034).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>iTBS may alleviate pain in CLBP patients by enhancing DLPFC connectivity with the cerebellum and occipital gyrus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>This study showed a facilitatory effect of iTBS on alleviating CLBP, which might be modulated by brain functional connectivity.</p>\u0000 \u0000 <p>Trial Registration</p>\u0000 \u0000 <p>Chinese Clinical Trial Registry: ChiCTR2200064899</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143905114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Altered Intra-Network Functional Connectivity Predicts the 6-Month Prognosis in Patients With Medication Overuse Headache: A Case-Control Study","authors":"Changling Li,&nbsp;Yang Zhang,&nbsp;Chengmin Yang,&nbsp;Jinghuan Fang,&nbsp;Mengmeng Ma,&nbsp;Yanbo Li,&nbsp;Ning Chen,&nbsp;Su Lui,&nbsp;Li He","doi":"10.1002/ejp.70028","DOIUrl":"https://doi.org/10.1002/ejp.70028","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Previous studies suggested that changes in functional connectivity (FC) within intrinsic resting-state networks (RSNs) might be associated with treatment responses during withdrawal in patients experiencing medication overuse headache (MOH). This study examined alterations in intra- and internetwork FC in intrinsic RSNs among MOH patients and explored the relationship between neuroimage changes and six-month prognoses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This case–control study enrolled healthy controls and MOH patients. Six months after implementing a withdrawal and preventive strategy, patients who had successfully discontinued overusing acute medications and reduced headache days by at least 50% from baseline were classified as having ‘good outcome’ and those not reaching this outcome were classified as having a ‘poor outcome’. Changes in intra- and inter-network FC in intrinsic RSNs across groups at baseline were evaluated. Univariate and multivariate logistic regression analyses were conducted to identify independent alterations associated with good outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the MOH group, 16 patients had poor outcomes and 17 patients had good outcomes. Compared to 24 healthy controls, all patients showed significantly increased FC in the left middle temporal gyrus of the left frontoparietal network (FPN). Furthermore, those with good outcomes had significantly decreased FC in the left orbital inferior frontal gyrus (IFG) of the left FPN compared to both poor outcome patients and healthy controls. Altered FC in the left orbital IFG of the left FPN was significantly associated with good outcomes and positively correlated with baseline headache intensity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The altered FC in the left orbital IFG of the left FPN may be associated with MOH treatment prognosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>The present study provides evidence of the association between alterations of intra-network functional connectivity in intrinsic resting-state networks and six-month prognoses in patients with medication overuse headache. Our results imply potential neuroimaging biomarkers associated with the prognosis of medication overuse headache.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143900899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}