Journal of Pain Research最新文献

{"title":"A Pharmacovigilance Study from 2004 to 2024 Utilizing the FDA Adverse Event Reporting System (FAERS) Examines Ischemic Adverse Events Linked to Triptan Use in Migraine Therapy.","authors":"Nuo Xu, Xiaowen Lu","doi":"10.2147/JPR.S551333","DOIUrl":"10.2147/JPR.S551333","url":null,"abstract":"<p><strong>Background: </strong>Triptans are commonly employed for acute migraine relief, yet concerns remain regarding their potential association with ischemic adverse events (IAEs). This study aimed to evaluate the association between triptan use and IAEs using real-world data from the FDA Adverse Event Reporting System (FAERS).</p><p><strong>Methods: </strong>We performed a retrospective pharmacovigilance analysis utilizing FAERS data spanning from Q1 2004 to Q3 2024. Reports of IAEs (stroke, including myocardial infarction, and other ischemic events) in patients using triptans were analyzed. The signal strength of triptan-associated IAEs was evaluated using disproportionality analysis with the reporting odds ratio (ROR) and Bayesian confidence propagation neural network (BCPNN).</p><p><strong>Results: </strong>Analysis of the FAERS database (2004-2024) identified 1305 ischemic adverse events (AEs) linked to triptans, accounting for 6.60% of all triptan-related AEs. The report proportion varied among triptans, with naratriptan (12.23%) and almotriptan (12.15%) showing the highest rates, while sumatriptan (4.74%) had the lowest. Females comprised 69.4% of cases, and 20.4% of reports involved life-threatening outcomes or death. Disproportionality analysis revealed significant signals for almotriptan (ROR=3.34), naratriptan (ROR=2.96), and rizatriptan (ROR=2.41), with almotriptan exhibiting the strongest association. The most frequent ischemic AEs included arteriospasm coronary (ROR=33.59), reversible cerebral vasoconstriction syndrome (ROR=63.92), and coronary artery dissection (ROR=93.17). Mortality rates exceeded 6% for ischemic stroke and acute myocardial infarction. Time-to-onset analysis showed frovatriptan had the earliest median onset (3.5 days), while almotriptan had the longest (284 days). Serious AEs were more frequently reported for cerebral vasoconstriction, cerebral ischemia, and coronary artery disease (p<0.05). These findings suggest notable ischemic safety signals associated with triptans, particularly specific drug subtypes.</p><p><strong>Conclusion: </strong>This pharmacovigilance study suggests a potential association between triptan use and ischemic adverse events, particularly in high-risk patients. Clinicians should carefully evaluate cardiovascular risk factors before prescribing triptans and consider alternative treatments for susceptible individuals. Additional prospective studies are required to validate these findings.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"5331-5345"},"PeriodicalIF":2.5,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12523564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Evidence of Acupoint Stimulation for Primary Dysmenorrhea: A Systematic Review and Updated Meta-Analysis [Letter].","authors":"Haixu Jin, Wenqing Xu, Chuanlong Zhou","doi":"10.2147/JPR.S571264","DOIUrl":"10.2147/JPR.S571264","url":null,"abstract":"","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"5357-5358"},"PeriodicalIF":2.5,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12523611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Efficacy and Plasma Metabolomics Analysis of Acupuncture for Migraine Treatment.","authors":"Lei Gao, Ying Chen, Chaorong Xie, ZhiYang Zhang, Qinyi Yan, Qi Xuan Fu, Mingsheng Sun, Ling Zhao","doi":"10.2147/JPR.S546838","DOIUrl":"10.2147/JPR.S546838","url":null,"abstract":"<p><strong>Purpose: </strong>Migraine, a prevalent neurological disorder characterized by recurrent, debilitating headaches, poses significant challenges due to limited understanding of its pathophysiology and variable treatment outcomes. Acupuncture has emerged as a promising intervention, yet its clinical efficacy and underlying metabolic mechanisms remain underexplored. This study aimed to evaluate the therapeutic effects of true acupuncture (TA) compared to sham acupuncture (SA) in migraine patients and to elucidate associated metabolic changes using non-targeted plasma metabolomics.</p><p><strong>Patients and methods: </strong>Fifty-two migraine patients were randomized into TA and SA groups, receiving 12 sessions of acupuncture over four weeks, with clinical assessments and plasma sample collection at baseline and week 4.</p><p><strong>Results: </strong>The TA group exhibited a significant reduction in migraine attack frequency (p<0.05) compared to baseline, while the SA group showed no significant change (p>0.05). Additionally, the TA group demonstrated greater improvements in attack frequency, duration, visual analog scale (VAS) scores, and migraine-specific quality of life (MSQ) emotional and dysfunction subscales compared to the SA group (p<0.05). Metabolomic analysis identified distinct metabolic profiles. TA was associated with five key metabolites, including the lipid regulators 1-oleoyl-sn-glycero-3-phosphoethanolamine (LysoPE) and Pe (16:0/19,20-epdpe), which correlated with reduced attack duration and improved quality of life scores. In contrast, metabolic changes in the SA group were less pronounced. Pathway analysis revealed that TA predominantly modulated amino acid and pyrimidine metabolism.</p><p><strong>Conclusion: </strong>These findings indicate that TA is more effective than SA in alleviating migraine symptoms, likely through specific regulation of metabolic pathways. The identified metabolites offer potential biomarkers for evaluating treatment response, though further validation is required.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"5283-5301"},"PeriodicalIF":2.5,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12517202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Factors of Acute Pain After Day Surgery: A Meta-Analysis.","authors":"Hanqing Zhang, Xinglian Gao","doi":"10.2147/JPR.S538046","DOIUrl":"10.2147/JPR.S538046","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to provide evidence-based recommendations for optimizing postoperative pain management and enhancing recovery efficiency by identifying key predictors of acute postoperative pain in day surgery patients.</p><p><strong>Background: </strong>As day surgery becomes more widespread, effective management of acute postoperative pain is crucial for successful recovery. A variety of studies have explored factors influencing postoperative acute pain. This study synthesizes existing evidence through a meta-analysis to clarify the primary predictors.</p><p><strong>Methods: </strong>A comprehensive search was performed across multiple databases, including PubMed, CINAHL, Scopus, Web of Science, EMBASE, the Cochrane Library, and CNKI, to identify clinical studies examining factors associated with acute postoperative pain following day surgery. The search encompassed all relevant publications up to January 30, 2025. The systematic review and meta-analysis employed a fixed-effects model to analyze the data, with a random-effects model applied in cases of significant heterogeneity.</p><p><strong>Results: </strong>Ten studies involving 11,865 patients were included. Significant predictors of acute postoperative pain, including: insufficient use of analgesics (OR = 2.12, <i>P</i> < 0.00001), age < 45 years (OR = 2.88, <i>P</i> < 0.00001), open surgery (OR = 5.05, <i>P</i> < 0.00001), education level ≤ middle school (OR = 2.06, <i>P</i> = 0.0001), preoperative fear and anxiety (OR = 2.18, <i>P</i> < 0.00001), higher preoperative pain expectation (OR = 1.74, <i>P</i> < 0.00001), and general anesthesia (OR = 1.91, <i>P</i> < 0.0001).</p><p><strong>Conclusion: </strong>This study identified the main predictors of acute postoperative pain in day surgery, suggesting these factors should be incorporated into clinical assessments to optimize pain management and recovery. The main risk factors include analgesic usage, age, surgery type, education level, preoperative fear and anxiety, pain expectation, and anesthesia type. Effective preoperative management of these factors may reduce postoperative pain and enhance recovery.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"5249-5263"},"PeriodicalIF":2.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Definition Transcranial Direct Current Stimulation Improves Pain Empathy: A Randomized, Double-Blind, and Sham-Controlled Study Based on Event-Related Potentials (ERPs).","authors":"Zhengyu Hu, Yurong Wen, Beibei Feng, Yafei Wang, Yangyang Lin, Jian Shi, Chen Gong, Yuling Wang","doi":"10.2147/JPR.S540255","DOIUrl":"10.2147/JPR.S540255","url":null,"abstract":"<p><p>The impact of transcranial direct current stimulation (tDCS) on pain empathy is a subject of debate and controversy. The variations in the results could be attributed to differences in the stimulus parameters. This study aimed to examine the impact of high-definition transcranial direct current stimulation (HD-tDCS) with different intensities on pain empathy through event-related potentials (ERPs). Thirty-nine participants were recruited for the experiment, and a parallel control design was used. The participants were randomly assigned to the sham group, 1 mA stimulation group, or 2 mA stimulation group. Before the experiment, all the participants provided basic information, completed relevant questionnaires and then wore an EEG cap for the first pain empathy task. After completing the task, each group received 20 minutes of HD-tDCS stimulation over the left DLPFC region at different intensities (2 mA, 1 mA, or sham), followed by a second pain empathy task. The findings from the pain-judgment and hands-counting tasks (task 1) demonstrated that both 1- and 2-mA stimulation increased Δ-N1 amplitudes, suggesting that anodal stimulation enhances early empathic responses. The results of the pain rating task (task 2) indicate that HD-tDCS stimulation did not improve the ratings of others' pain. However, the application of 2-mA tDCS significantly increased the Δ-intensity of unpleasantness compared with that of the other two groups. This suggests that 2-mA tDCS stimulation had a notable effect on the affective dimension of empathy, specifically the perception of unpleasantness. This finding indicates that 2mA stimulation primarily enhances affective empathy, whereas its influence on cognitive empathy appears to be limited. By employing different intensities of HD-tDCS, our findings build upon and extend previous findings in the field of pain empathy. These results have the potential to offer dose recommendations for future studies employing tDCS as an intervention to increase pain empathy.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"5223-5234"},"PeriodicalIF":2.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Epidemiology and Burden of Migraine in Children and Adolescents from 1990 to 2021: Insights from the Global Burden of Disease Study 2021.","authors":"Quan Sun, Hongting Xie, Longchao Hao, Jiayi Ding, Jiaming Hong, Xingdong Lin, Zhenhu Chen, Jun Lyu, Nanbu Wang","doi":"10.2147/JPR.S542845","DOIUrl":"10.2147/JPR.S542845","url":null,"abstract":"<p><strong>Purpose: </strong>Migraine is the most disabling neurological disorder in children and adolescents. This study aimed to comprehensively assess the global burden of migraine in children and adolescents.</p><p><strong>Methods: </strong>Utilizing the latest data from the Global Burden of Disease (GBD) 2021, trends and disparities in incidence, prevalence, and disability-adjusted life years (DALYs) for migraine among children and adolescents were quantified by sex, age, socio-demographic index (SDI), region, and country. Decomposition analysis and frontier analyses were applied to investigate the underlying factors for changes in burden and the potential for future improvements, respectively.</p><p><strong>Results: </strong>In 2021, there were 36,794,858 new cases, 205,729,235 prevalent cases, and 7,515,775 DALYs caused by migraine in children and adolescents. From 1990 to 2021, age-standardised incidence rates (ASIR), age-standardised prevalence rates (ASPR), and age-standardised rates of DALYs (ASDR) for migraine in children and adolescents have risen, particularly among males, adolescents aged 15-19 years, regions with middle and higher SDI, East Asia, and Norway. Overall, the burden was higher in females than in males. In 2021, adolescents aged 10-14 exhibited the highest ASIR, whereas adolescents aged 15-19 had the highest ASPR and ASDR. The highest ASPR and ASDR were in low-middle SDI regions, while the highest ASIR was in high SDI regions. Tropical Latin America and Brazil had the highest ASRs regionally and nationally, respectively. Population growth and epidemiological changes drove the increase in DALYs. Regions with middle and higher SDIs hold the greatest improvement potential.</p><p><strong>Conclusion: </strong>The global burden of migraine in children and adolescents has increased substantially, disproportionately affecting females, adolescents aged 15-19 years, and low-middle SDI regions, while the greatest potential for improvement lies in middle and higher SDI regions, especially Brazil. These findings underscore the need for targeted public health policies and interventions tailored to pediatric migraine across diverse settings.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"5265-5281"},"PeriodicalIF":2.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Tobacco Exposure on Low Back Pain-Related Disability-Adjusted Life Years in China: Trends From 1990-2021 and Projections for the Next 15 years Using ARIMA Modeling.","authors":"Shilei Song, Shengyi Feng, Haiming Lu, Bo Li","doi":"10.2147/JPR.S544871","DOIUrl":"10.2147/JPR.S544871","url":null,"abstract":"<p><strong>Background: </strong>Low back pain (LBP) is a leading cause of disability - adjusted life years (DALYs) globally. Tobacco exposure has been linked to LBP, but critical research gaps remain in quantifying its impact on LBP-related DALYs in China.</p><p><strong>Objective: </strong>This study aims to analyze the disease burden of tobacco - related LBP among the Chinese population across all age groups from 1990 to 2021 using the latest Global Burden of Disease (GBD) 2021 data and project trends for the next 15 years.</p><p><strong>Methods: </strong>We utilized data from the GBD 2021 study, applying joinpoint regression and age - period - cohort analysis to assess the disease burden of tobacco - related LBP among the Chinese population across all age groups. The autoregressive integrated moving average (ARIMA) model was employed to forecast future trends.</p><p><strong>Results: </strong>From 1990 to 2021, the total DALYs attributed to tobacco - related LBP in China showed an increasing trend, while the age - standardized rate (ASR) significantly declined. Specifically, the ASR for females decreased more sharply than that for males. The joinpoint regression analysis revealed a significant overall downward trend in the disease burden. The age - period - cohort analysis indicated that age significantly impacts the ASR, which is high in middle - to - old age groups. The ARIMA model forecast predicts a continued decline in the ASR of DALYs over the next 15 years.</p><p><strong>Conclusion: </strong>The findings highlight the positive impact of tobacco - control measures in reducing the disease burden of tobacco - related LBP in China. However, the persistent high burden among males and older age groups remains a challenge. Continued and targeted tobacco - control efforts are essential to further reduce the disease burden. The findings of this study provide critical evidence for formulating targeted tobacco control policies, supporting the enhancement of tobacco intervention measures for high-risk populations (eg, males and older adults) and the implementation of tobacco control strategies to reduce the LBP-related disease burden and improve population health outcomes.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"5303-5320"},"PeriodicalIF":2.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Intravenous Esketamine on Rebound Pain Following Single-Shot Brachial Plexus Block in Patients Undergoing Shoulder Arthroscopic Surgery: A Prospective, Randomized, Placebo-Controlled Study.","authors":"Jiale Chen, Zhihao Pan, Jinwei Zheng","doi":"10.2147/JPR.S533774","DOIUrl":"10.2147/JPR.S533774","url":null,"abstract":"<p><strong>Purpose: </strong>Rebound pain (RP) often occurs after the resolution of peripheral nerve blocks. Studies suggest that perineural esketamine prolongs block duration and reduces RP incidence. This study aimed to determine whether intravenous esketamine reduces RP incidence following single-shot interscalene brachial plexus block (ISBPB) in shoulder arthroscopic surgery.</p><p><strong>Patients and methods: </strong>In this randomized controlled trial, 200 patients scheduled for shoulder arthroscopy received ultrasound-guided single-shot ISBPB preoperatively and were randomized to receive either intravenous esketamine (0.5 mg/kg bolus + 0.25 mg/kg/h infusion) or placebo. Primary outcomes included RP incidence, onset time, duration, and pain scores. Secondary outcomes included block duration, postoperative pain scores, and hemodynamic parameters (heart rate [HR], mean arterial pressure [MAP]).</p><p><strong>Results: </strong>The incidence rates of rebound pain (RP) were comparable between groups, with no significant differences in RP duration or pain scores (<i>P></i>0.05). However, the Numeric Rating Scale at rest (NRS-R) scores at 8h, 12h, and 24h postoperatively were significantly higher in the C-group compared to the E-group <i>(P<</i>0.05). Hemodynamic stability was superior in the E-group during immediately post-administration (T4) to skin incision (T8), with higher MAP at T6-T10 (<i>P</i><0.05). Sensory/motor block onset and duration showed no intergroup differences (<i>P</i>>0.05). Adverse events (dizziness, nausea) were comparable, with one transient hallucination in the E-group.</p><p><strong>Conclusion: </strong>Patients undergoing arthroscopic rotator cuff repair under combined single-shot interscalene brachial plexus block and general anesthesia exhibit a rebound pain incidence of approximately 25%. Intravenous administration of esketamine (0.5 mg/kg bolus followed by continuous infusion at 0.25 mg/kg/h) during the operation failed to significantly reduce the incidence of rebound pain post-block (<i>P</i>>0.05). However, it demonstrated significant reductions in pain scores at 8h, 12h, and 24h postoperatively (<i>P</i><0.05), with enhanced hemodynamic stability observed from anesthetic induction to pre-incision periods. No severe adverse events were reported.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"5235-5248"},"PeriodicalIF":2.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lipid Transporter ABCA1 in Diabetic Polyneuropathy: Potential Mediation by Circulating Metabolites.","authors":"Yan Cao, Yuyan Pan, Yan Yan, Yichen Yao, Simin Lu, Liba Gei, Wenqi Jiang, Weian Zeng, Dongtai Chen","doi":"10.2147/JPR.S535866","DOIUrl":"10.2147/JPR.S535866","url":null,"abstract":"<p><strong>Background: </strong>Diabetic polyneuropathy (DPN) is a complication of diabetes characterized by peripheral sensory deficits or neuropathic pain. Emerging evidence suggests that DPN is associated with dyslipidemia. Probucol has shown promise in the treatment of diabetes and alleviation of neuropathic pain. However, the influence of probucol on DPN or dyslipidemia incidence is unclear. The study examined the mediating effects of circulating metabolites on the relationship between probucol target gene ATP-binding cassette subfamily A member 1 (ABCA1) and DPN.</p><p><strong>Methods: </strong>A positive control analysis was done on low density lipoprotein (LDL) to validate genetic instruments. A two-step Mendelian randomization (MR) study was conducted to assess the correlation between the probucol target gene ABCA1 and DPN, focusing on the mediation effects of circulating metabolites connecting them. MR analysis was mainly estimated using Inverse-variance weighted (IVW) and MR-Egger regression conducting SNP heterogeneity and sensitivity analysis.</p><p><strong>Results: </strong>Predicted based on genetics, the ABCA1 gene is associated with increased risk of LDL and four circulating metabolites. The direct effect of the Probucol target gene ABCA1 on DPN was 0.3006, and the mean diameter for high-density lipoprotein (HDL) particles, total cholesterol in medium LDL, triglycerides in medium very low-density lipoprotein (VLDL), and free cholesterol in very large HDL had partial mediating effects on the association between ABCA1 and DPN incidence.</p><p><strong>Conclusion: </strong>This study supports an association between genetically predicted Probucol target ABCA1, circulating metabolites, and DPN. Our observations indicate a direct effect of ABCA1 on DPN and a mediating pathway through four blood circulation metabolites. Our findings offer genetic evidence for the mechanisms of Probucol in preventing, alleviating, and treating DPN pain.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"5203-5222"},"PeriodicalIF":2.5,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12513255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Influence of Preoperative Central Sensitization on the Postoperative Prognosis of Pilon Fractures: A Retrospective Study.","authors":"Jiachen Liang, Qiang Zan, Shihang Cao, Hongze Wang, Geng Liu, Weijie Yang, Shaokang Zhang, Yi Li, Junkui Xu","doi":"10.2147/JPR.S542473","DOIUrl":"10.2147/JPR.S542473","url":null,"abstract":"<p><strong>Purpose: </strong>Although surgical techniques have improved, chronic pain, functional impairment and psychological effects still occur after pilon fracture surgery. The aim of this study is to evaluate the clinical efficacy after pilon fracture surgery and to explore the impact of preoperative patients with central sensitization (Central Sensitization, CS) on the improvement of postoperative pain, function, anxiety/depression.</p><p><strong>Patients and methods: </strong>In this single-center retrospective study, we collected adult (≥18 years old) patients with pilon fractures who underwent open reduction and internal fixation at Xi'an Honghui Hospital from January 2020 to July 2024 and had the cognitive ability to complete the questionnaire. Exclusion criteria included incomplete medical records, concurrent other foot fractures, or severe mental disorders. The preoperative central sensitization (CS) determination criteria were a score of ≥18 on the Chinese version of the 9-item Central Sensitization Inventory (CSI-9). The assessment indicators at baseline and the last follow-up included the Visual Analogue Scale (VAS) for pain, the American Orthopaedic Foot & Ankle Society Hindfoot Score (AOFAS), and the Hospital Anxiety and Depression Scale (HADS). Patients were divided into the CS group and the non-CS group based on whether they had a preoperative central sensitization state, and the differences in baseline characteristics, pain severity, functional performance, and psychological state between the two groups were compared.</p><p><strong>Results: </strong>At the final follow-up, the performance of the CS group was worse than that of the non-CS group, VAS was 20.04±6.87 compared to 14.15±6.34 (P < 0.001); AOFAS was 77.71±9.55 compared to 86.21±6.57 (P < 0.001); HADS-A was 6.39±2.87 compared to 3.00 (2.00, 4.00); HADS-D was 6.39±3.06 compared to 3.00 (2.00, 3.00). In terms of improvement degree, there were significant differences between the two groups in the improvement of pain and anxiety/depression (p < 0.05).</p><p><strong>Conclusion: </strong>Both groups of patients showed significant improvement in pain relief, functional activity, and psychological state postoperatively compared to preoperatively. However, patients with preoperative CS showed less improvement in pain relief, functional recovery, and psychological state compared to those without CS. Therefore, foot and ankle surgeons should further investigate the impact of preoperative interventions for CS on postoperative outcomes in future studies.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"5191-5201"},"PeriodicalIF":2.5,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12513248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}