Pain and Therapy最新文献

{"title":"Neuromodulation Techniques Alleviating Neuropathic Pain by Targeting Microglia: A Narrative Review.","authors":"Qinghua Mu, Xiaojin Li, Long Li, Shujun Sun, Juanjuan Xu, Guobin Song, Yifei Chen, Yang Lv, Zheng Gan, Dong Yang","doi":"10.1007/s40122-026-00848-5","DOIUrl":"10.1007/s40122-026-00848-5","url":null,"abstract":"<p><p>Neuropathic pain (NP) has attracted growing attention in recent years; however, its pathogenesis remains incompletely understood, and therapeutic options remain limited. Neuromodulation techniques have demonstrated considerable promise in managing NP, offering advantages including noninvasiveness, minimal discomfort, and precise anatomical targeting. Nevertheless, therapeutic parameters have yet to be standardized as a result of variability across multiple factors such as modality type, stimulation site, and treatment duration. Microglia, as the resident immune cells of the central nervous system, play a pivotal role in the development and maintenance of NP. Following nerve injury, microglia become activated and release various inflammatory mediators and signaling molecules that modulate pain transmission pathways. Importantly, emerging evidence indicates that neuromodulation can regulate microglial activation states and associated inflammatory cascades through either indirect or direct pathways. Indirect mechanisms involve modulating neuronal activity and downstream signaling, thereby influencing microglial functional phenotypes. Direct mechanisms act via microglia-specific properties such as electrophysiological sensitivity, receptor expression, or local field potential interactions. This review synthesizes current evidence on the mechanisms and recent advances in microglia-targeted neuromodulation strategies for NP relief, distinguishing between preclinical and clinically validated findings, and aiming to provide a theoretical foundation for future research.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"1023-1048"},"PeriodicalIF":4.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13369068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148252644","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":"Outcomes of Thermal Radiofrequency Ablation of Lumbar Medial Branches as Treatment for Chronic Low Back Pain.","authors":"Alaa Abd-Elsayed, Trevor N Johnson, Kylie K Ruprecht, Lukas J Henjum","doi":"10.1007/s40122-026-00845-8","DOIUrl":"10.1007/s40122-026-00845-8","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic pain, defined as pain that persists for longer than 3 months or recurs, is a significant health and economic burden in the USA associated with substantial healthcare costs and lost productivity. Radiofrequency ablation (RFA) is a minimally invasive procedure utilizing radiofrequency probes to provide precise thermal energy to targeted nociceptive pathways, thereby providing pain relief. This study examines whether patients undergoing RFA for chronic low back pain due to lumbar facet arthropathy experience decreased pain scores, longer pain relief, and greater pain reduction.</p><p><strong>Methods: </strong>This retrospective study analyzed data from UW-Health Electronic Medical Records (EMR) on lumbar RFA procedures performed between 2015 and April 2024. Collected patient data included diagnosis, pre-and postoperative pain scores, duration of relief, age, sex, and BMI. Pain scores were analyzed using a two-tailed paired t test; p ≤ 0.05 was considered significant.</p><p><strong>Results: </strong>A total of 195 lumbar RFA procedures were reviewed; 26 were excluded due to absent pre- or post-op pain scores, and four were excluded due to weekly lidocaine infusions between their procedure and reporting of their post-op score. A total of 148 patients were included, comprising of 95 women and 53 men, with an average age of 57.39 ± 12.24 years and a BMI of 32.24 ± 8.11. The average pre- and post-procedure VAS pain scores were 6.42 (6.42 ± 1.80, n = 165) and 3.61 (3.61 ± 2.37, n = 165), respectively. The difference between pre- and post-RFA was statistically significant (p < 0.0001). Improvement of pain symptoms was reported in 87.88% (n = 145) of patients, 6.67% (n = 11) of patients reported complete pain remission, 6.67% (n = 11) of patients reported no change, and 7.88% (n = 13) of patients reported worsening symptoms.</p><p><strong>Conclusion: </strong>This study supports the effectiveness of thermal RFA as a minimally invasive option for managing chronic lower back pain caused by lumbar facet arthropathy unresponsive to conventional treatments.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"1101-1107"},"PeriodicalIF":4.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13369069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147942521","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":"Cervical Erector Spinae Plane Block for Shoulder Arthroscopy: A Favorable Alternative to Interscalene Brachial Plexus Block? A Randomized Non-Inferiority Trial.","authors":"Tie-Shuai Liu, Jun Zhang, Yong-He Hu, Qian Hu, Qi-Hong Shen, Zi-Ming Zhang, Gang Chen","doi":"10.1007/s40122-026-00844-9","DOIUrl":"10.1007/s40122-026-00844-9","url":null,"abstract":"<p><strong>Introduction: </strong>Shoulder arthroscopy is associated with significant postoperative pain. Interscalene brachial plexus block (ISBPB) provides excellent analgesia but frequently causes hemidiaphragmatic paralysis (HDP) and respiratory impairment. Cervical erector spinae plane block (ESPB) has been proposed as a possible alternative approach, but its comparative efficacy, safety, and anatomical spread remain uncertain.</p><p><strong>Methods: </strong>In this randomized non-inferiority trial, 70 patients undergoing arthroscopic shoulder surgery received cervical ESPB or ISBPB with 20 ml 0.375% ropivacaine. The primary endpoint was resting visual analog scale (VAS) pain at 6 h. Secondary outcomes included static and dynamic VAS, diaphragm ultrasound, respiratory function, handgrip strength, opioid use, adverse events, and satisfaction.</p><p><strong>Results: </strong>The median between-group difference in resting VAS at 6 h was 0 (range 0-1), meeting the non-inferiority margin. VAS pain scores were lower with ISBPB at 1 and 3 h at rest (p = 0.008 and p = 0.003) and at 3 and 6 h during movement (p < 0.001 and p = 0.007); however, all 95% confidence intervals for median differences were < 1, confirming non-inferiority of ESPB. Cumulative sufentanil use and rescue analgesia were similar. ESPB was associated with greater diaphragmatic excursion and thickening fraction and a lower HDP incidence (RR 0.2 post-block; 0.4 in the PACU; both p < 0.001). Respiratory declines were smaller with ESPB for FVC (5.8% vs. 14.8%; p < 0.001), FEV₁ (4.9% vs. 18.8%; p < 0.001), MIP and MEP (both p < 0.001). Handgrip strength was better maintained and Horner syndrome was less frequent (8.6% vs. 34.3%; p = 0.018). Other adverse events and patient satisfaction were similar between groups.</p><p><strong>Conclusions: </strong>In this low-risk study population, cervical ESPB met the predefined non-inferiority criterion for postoperative analgesia compared with ISBPB and was associated with less diaphragmatic and respiratory impairment. However, cervical ESPB should not be considered risk-free, and further anatomical, dose-finding, and clinical studies are needed before any broader clinical role can be defined.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier no. ChiCTR2200060019.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"1085-1100"},"PeriodicalIF":4.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13369091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147931987","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":"A Multicenter Prospective Study to Develop a Prediction Model for Postherpetic Neuralgia Using Clinical and Laboratory Indicators.","authors":"Jiaqi Wang, Yanbing Yao, Honggeng Wang, Jiaxiong Chen, Shulin Huang, Shiyuan Li, Ziheng Xiao, Jiewei Huang, Chunmei Fan","doi":"10.1007/s40122-026-00836-9","DOIUrl":"10.1007/s40122-026-00836-9","url":null,"abstract":"<p><strong>Introduction: </strong>Postherpetic neuralgia (PHN) is the most common and difficult-to-treat complication of herpes zoster (HZ). This complication not only causes significant suffering but also imposes a substantial economic burden on patients. Early identification of patients at high risk and initiation of preventive interventions are crucial for reducing the burden of PHN. However, current clinical risk identification methods largely rely on subjective or semi-subjective clinical features and lack objective, easily accessible quantitative tools. This study aimed to develop and validate an efficient, objective, and clinically accessible prediction model for PHN risk by integrating routine clinical and laboratory indicators.</p><p><strong>Methods: </strong>This prospective, multicenter study consecutively enrolled 722 patients with acute HZ who presented at four hospitals in Quanzhou between September 2, 2024, and July 12, 2025. Clinical data were collected, and multiple laboratory indicators were obtained through centralized testing. In the training set, univariate and multivariate logistic regression analyses were performed to identify independent predictors significantly associated with PHN. Subsequently, based on these factors, multiple machine learning algorithms were evaluated for performance to select robust models, with their generalizability subsequently assessed on an independent test set.</p><p><strong>Results: </strong>The incidence of PHN was 18.84%. Multivariate analysis identified seven independent predictors of PHN: age, disease duration, prodromal pain, varicella-zoster virus immunoglobulin M (VZV-IgM), red cell distribution width-coefficient of variation (RDW-CV), urea, and serum sodium. The logistic regression model demonstrated the best predictive performance, achieving an area under the receiver operating characteristic curve (AUC) of 0.733 and accuracy of 0.765.</p><p><strong>Conclusion: </strong>This study provides the first report of PHN incidence among patients with HZ in Quanzhou. By integrating routine clinical and laboratory indicators, we successfully developed and validated a logistic regression model for predicting PHN risk. This model offers clinicians a practical tool for early identification of patients at high risk during the acute phase, thereby guiding timely preventive strategies.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"817-851"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778140","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":"Pain Relief and Multidimensional Outcomes of Fast-Acting Subperception Spinal Cord Stimulation Therapy for Chronic Pain: The FAST Prospective, Multicenter Study.","authors":"Magdalena Anitescu, Eric Loudermilk, James North, Sayed Wahezi, Ajay Antony, Tim Leier, Drew Trainor, John Noles, Gregory Moore, Jennifer Lee, Julio Paez, Derron Wilson, Virginie Van Belleghem, Edward Goldberg","doi":"10.1007/s40122-026-00823-0","DOIUrl":"10.1007/s40122-026-00823-0","url":null,"abstract":"<p><strong>Introduction: </strong>Fast-acting subperception therapy in spinal cord stimulation (FAST-SCS) uses low-frequency, subthreshold stimulation to engage the dorsal column-mediated surround inhibition mechanism and thereby relieve pain. Our study was performed to better characterize the multidimensional long-term clinical outcomes of FAST-SCS therapy in patients with chronic low back and/or leg pain.</p><p><strong>Methods: </strong>Our prospective, multicenter, single-arm, open-label trial, conducted at 12 pain management centers across the USA, included male and female patients with chronic low back pain with/without leg pain refractory to conservative therapy. All eligible patients received an SCS implant. Outcomes evaluated included pain relief, disability, mobility, health-related quality of life, sleep quality, depression, pain catastrophizing, and global impression of change.</p><p><strong>Results: </strong>Fifty-six patients received a permanent SCS implant and 55 were activated with FAST-SCS therapy. At 12 months, 89% and 59% of patients achieved ≥ 50% and ≥ 80% pain relief, respectively (p < 0.0001), and pain intensity (verbal numerical rating scale) decreased by 4.9 ± 2.2 points (p < 0.0001). Significant improvements were observed in disability (Oswestry Disability Index - 24 ± 16 points, p < 0.0001) and endurance (6-Minute Walk Test + 73 ± 96 m, p < 0.0001), while mobility and balance improved without reaching statistical significance (Timed Up-and-Go test - 7.5 ± 37.5 s, p = 0.17). All psychosocial measures improved significantly at 12 months compared to baseline, with an increase in the EQ5D-5L index (+ 0.200 ± 0.182, p < 0.0001) and decreases in the Pittsburgh Sleep Quality index (- 3.96 ± 4.31, p < 0.0001), Pain Catastrophizing Score (- 13.3 ± 11.4, p < 0.0001), and Beck Depression Index (- 7.9 ± 10.0, p < 0.0001). At 12 months, 87% of patients reported being \"much\" or \"very much\" improved. Responses to FAST-SCS were at or above the minimal clinically important differences across all measured clinical dimensions.</p><p><strong>Conclusion: </strong>This prospective study demonstrated that FAST-SCS provided statistically significant, multidimensional benefits across pain, disability, mobility, and psychosocial outcomes over 12 months in patients with chronic low back and/or leg pain. These findings support the use of FAST-SCS in this patient population.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (NCT04618471). https://www.</p><p><strong>Clinicaltrials: </strong>gov/study/NCT04618471 .</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"643-662"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147390712","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":"Impact of Selumetinib on Long-Term Pain Medication Utilization in Pediatric Patients: A Retrospective US Claims Database Study.","authors":"Genevieve Lyons, Theresa Dettling, Alyssa Bowling, Ashwin Anand, Michael Sicilia, Wouter van der Pluijm, Benjamin Guikema, Julia Meade","doi":"10.1007/s40122-026-00837-8","DOIUrl":"10.1007/s40122-026-00837-8","url":null,"abstract":"<p><strong>Introduction: </strong>Neurofibromatosis type 1 (NF1) is a heterogeneous, multisystem genetic condition associated with diverse clinical manifestations, including nerve sheath tumors called plexiform neurofibroma (PN), which can be extremely painful. Both chronic pain and regular pain medication use are associated with low overall quality of life in pediatric patients with NF1-PN. Previous short-term, real-world data demonstrate that selumetinib treatment reduces prescription pain medication utilization; however, there are no published long-term real-world data.</p><p><strong>Methods: </strong>This was a retrospective analysis of pediatric and young adult patients receiving selumetinib. Patients receiving selumetinib were investigated using a US retrospective claims database and were identified with relevant national drug codes. Patients were followed from selumetinib initiation to the end of available follow-up data (≤ 3 years). Patients had ≥ 3 selumetinib prescriptions filled, were aged 2-21 years at selumetinib initiation, and had ≥ 12 months (pre- and post-selumetinib initiation) of continuous enrollment and medical/pharmacy claims activity. Patients receiving selumetinib were indexed at the time of selumetinib initiation (April 1, 2020-January 31, 2025).</p><p><strong>Results: </strong>The primary cohort comprised 220 patients (female patients: 46%; male patients: 54%), 24% of whom were receiving prescription pain medication at baseline of selumetinib initiation. At 3 years post-selumetinib initiation, this decreased to 9%. At baseline, 26/220 (12%) of patients were receiving gabapentin, half of whom discontinued gabapentin during the first year post-selumetinib initiation. At baseline, 17/220 (8%) patients were receiving oxycodone; 14/17 (82%) patients discontinued oxycodone in the first year post-selumetinib initiation. There was a 20.3% reduction in prescription pain medication utilization per year for patients receiving selumetinib (odds ratio = 0.797; p = 0.039).</p><p><strong>Conclusion: </strong>Selumetinib treatment was associated with a significant, consistent, and durable decline in prescription pain medication utilization over 3 years. Patients who continued taking pain medications experienced nominal dose reductions, and patients who received selumetinib continuously experienced a decrease in prescription pain medication utilization.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"803-815"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717757","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":"Outcomes of Low Back Placement of Intrathecal Pumps for Patients with Chronic Pain.","authors":"Alaa Abd-Elsayed, Madelyn J Reilly, Nina Hashimoto, Kylie K Ruprecht","doi":"10.1007/s40122-026-00832-z","DOIUrl":"10.1007/s40122-026-00832-z","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic pain poses a significant challenge to quality of life throughout the USA. It is estimated that as much as 21% of the US population experiences chronic pain, and the incidence of new chronic pain cases is shockingly high, at 52.4 cases per 1000 persons per year. An intrathecal pump (ITP) consists of a small pump surgically implanted under the skin, along with a catheter inserted into the intrathecal space in the spine. Medication, usually in the form of opioids, local anesthetics, or muscle relaxants, is then delivered through the catheter into the spinal fluid, where it can act directly on nerves to provide pain relief or reduce spasticity. The use of intrathecal drug delivery has been established for decades and is used for various conditions, including chronic noncancer pain and cancer-related pain. ITPs are also employed for managing severe spasticity in conditions such as multiple sclerosis or spinal cord injury. Over the years, there has been a gradual increase in the use of ITPs, particularly as awareness of their benefits and technological advancements has increased. ITPs have been historically placed in the abdomen. However, more recently, some ITPs have begun to be placed in the lower back. Placing ITPs in the lower back has the potential to lower operative time and complication rates, but more research in this area is warranted. This study analyzes the outcomes of posterior ITP placement to evaluate their suitability and potential benefits.</p><p><strong>Methods: </strong>This study consisted of a retrospective review including data from 115 procedures completed between 2015 and 2025. Data collection included patient demographics, preoperative and postoperative pain scores, surgical time, needle and catheter locations, and adverse events. Pain scores were collected using the visual analog scale (VAS), and data were analyzed using SPSS 29. Two-tailed paired t-tests were used to determine the significance of the difference between preoperative and postoperative pain scores.</p><p><strong>Results: </strong>A total of 115 procedures from 103 patients were included in the statistical analysis. The average preoperative pain was 6.54 (6.54 ± 2.00, n = 114), and the average postoperative pain score in the first year following the procedure was 4.45 (4.45 ± 2.30, n = 114), with a p value of < 0.001. The average surgical time for the procedure was 49.00 ± 19.53 min (n = 113).</p><p><strong>Conclusions: </strong>In this study, ITPs implanted in the lower back were associated with greater pain relief, shorter surgical times, and fewer complications than those placed in the abdomen. These findings, while indirect, provide evidence for promoting ITP placement in the lower back as a safe and effective option for patients experiencing chronic pain.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"721-734"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147531838","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":"Long-Term Reductions in Headache Frequency, Severity, and Disability with Eptinezumab in Adults with Chronic Migraine: Results from the PREVAIL Trial.","authors":"Amaal J Starling, David Kudrow, Neha Kapur, Susanne F Awad, S Wald Grossman, Foram Patel, Jessica Ailani, Andrew Blumenfeld, Richard B Lipton","doi":"10.1007/s40122-026-00831-0","DOIUrl":"10.1007/s40122-026-00831-0","url":null,"abstract":"<p><strong>Introduction: </strong>Individuals with chronic migraine (CM) experience substantial headache-related disability. Post hoc analyses from the PREVAIL trial assessed the long-term impact of eptinezumab preventive treatment for CM on patient-centered measures of headache frequency, headache pain severity, disability, and quality of life.</p><p><strong>Methods: </strong>In the 104-week, open-label PREVAIL trial, which evaluated long-term safety and patient-reported outcomes, participants received eptinezumab 300 mg intravenously every 12 weeks to week 84 for preventive treatment of CM. The Migraine Disability Assessment (MIDAS) scale was used to evaluate proportions of participants with sustained ≥ 50% and ≥ 75% reductions in mean monthly headache days (MHDs) through 12-week dosing intervals to week 84 and changes in mean MHD frequency category (e.g., 0, 1- < 4 MHDs), Frequency-Severity Index (FSI) scores (composite of MIDAS-derived mean MHDs and headache pain severity), and days with headache-related disability through week 104.</p><p><strong>Results: </strong>Over half of participants with ≥ 50% or ≥ 75% reduction in mean MHDs after the first eptinezumab dose (weeks 1-12: 78% and 54%, respectively) or second dose (weeks 13-24: 83% and 69%, respectively) experienced sustained reductions in headache frequency through all subsequent dosing intervals until the last dose (week 84). At baseline, participants reported a mean (standard deviation [SD]) of 15.8 (7.6) MHDs. More than 60% of participants reported < 4 mean MHDs at week 12 and at all subsequent assessments through week 104 (20 weeks after last infusion) after initiating eptinezumab; 23% reported 0 mean MHDs by week 104. The mean FSI score decreased from baseline (11.4) to week 12 (3.5), with decreases maintained through week 104. Monthly days with headache-related impact also decreased from baseline to week 12, with improvements maintained through week 104.</p><p><strong>Conclusions: </strong>Treatment with eptinezumab 300 mg is associated with substantial early and long-term reductions in headache frequency, severity, and disability, indicating its ability to improve multiple aspects of the broader burden of CM. Graphical abstract available for this article.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT02985398.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"785-801"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717747","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":"Real-World Safety and Effectiveness of Mirogabalin in Chinese Adults with Diabetic Peripheral Neuropathic Pain: a Protocol of ReMIssion Study.","authors":"Lin Zhao, Botao Liu, Hong Chen, Bin Lu, Weimin Wang, Yiqian Shi, Min Li, Na Guo, Bifa Fan, Xiaoying Li","doi":"10.1007/s40122-026-00827-w","DOIUrl":"10.1007/s40122-026-00827-w","url":null,"abstract":"<p><strong>Introduction: </strong>Mirogabalin is an oral Ca²⁺ channel α₂δ ligand used for treating diabetic peripheral neuropathic pain (DPNP) in China. However, there is limited real-world evidence on its safety and effectiveness in treating adult patients with DPNP in China. This study aims to evaluate the safety and effectiveness of mirogabalin in patients with DPNP treated in a routine clinical practice in China.</p><p><strong>Methods: </strong>The ReMIssion study is a multicenter, prospective, observational study that aims to enroll 720 patients from around 36 centers. The study population will consist of patients aged ≥ 18 years, who are treatment-naïve, and have a visual analog scale (VAS) score of ≥ 40 mm. Patients will be observed for 15 weeks, including 14 weeks of mirogabalin treatment and a 1-week follow-up.</p><p><strong>Planned outcomes: </strong>The primary endpoint is to evaluate the real-world safety of mirogabalin, whereas the secondary endpoint is to evaluate the real-world effectiveness of mirogabalin in Chinese patients with DPNP. Exploratory endpoints will investigate the real-world usage pattern and patient-reported outcomes (PRO) associated with mirogabalin treatment in Chinese adult patients with DPNP. In China, this is the first observational study focusing on the safety and effectiveness of mirogabalin in real-world clinical practice. Mirogabalin may offer clinical benefits for DPNP management, including improved real-world effectiveness, tolerable safety, and favorable usage patterns, potentially enhancing patient-reported outcomes.</p><p><strong>Trial registration: </strong>Clinicaltrial.gov/NCT06812117.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"905-920"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147481302","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":"Magnetic Resonance Imaging-Based Radiomic Signatures for the Diagnosis of Zoster-Associated Pain: A Quantitative Imaging Approach.","authors":"Hao Jiang, Jiafang Chen, Hao Zeng, Zhangya Lin, Weibing Miao","doi":"10.1007/s40122-026-00833-y","DOIUrl":"10.1007/s40122-026-00833-y","url":null,"abstract":"<p><strong>Introduction: </strong>Accurate diagnosis and treatment of zoster-associated pain (ZAP) remains challenging because identifying the affected dorsal root ganglion (DRG) relies on subjective assessment and lacks objective imaging. We developed and validated a quantitative model using neurological magnetic resonance imaging (MRI) and radiomics, with the contralateral healthy DRG as an internal control. This study aimed to identify imaging biomarkers for precise localization, optimized treatment, and improved patient prognosis.</p><p><strong>Methods: </strong>Clinical data were retrospectively collected from patients with ZAP who underwent neuro-magnetic resonance imaging (MRI) at the Pain Department of the First Affiliated Hospital of Fujian Medical University (December 2023-December 2024). T2-weighted neuroimages were acquired for region-of-interest segmentation. Experienced radiologists manually segmented neuropathic DRG by using the Insight Segmentation and Registration Toolkit Segmentation and Neuroimaging Applications Platform (ITK-SNAP), and quantitative radiomic features were extracted via PyRadiomics. Feature selection was performed using the Mann-Whitney U test and least absolute shrinkage and selection operator. The selected features were used to train Logistic Regression, Support Vector Machine, Neural Network, XGBoost, and AdaBoost models. Performance metrics included area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, positive predictive value, and negative predictive value.</p><p><strong>Results: </strong>Overall, 408 DRGs from 68 patients (30 male, 38 female; mean age 68.25 ± 9.01 years) were analyzed. From 1316 radiomic features per region, 10 robust and discriminative features were retained for model construction. The neural network achieved the highest diagnostic performance in the training and validation set (AUC 0.818; 95% confidence interval: 0.719-0.916, p = 0.001). Decision curve and calibration analyses indicated moderate clinical utility in distinguishing affected from healthy DRGs.</p><p><strong>Conclusions: </strong>Magnetic resonance imaging-based radiomics using a neural network algorithm robustly discriminates lesioned dorsal root ganglia in zoster-associated pain. This approach provides an objective imaging tool to improve diagnostic precision and guide targeted therapy.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"735-750"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147593588","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}