Pain and Therapy最新文献

{"title":"Plasma Lipoproteins as Key Regulators in Neuropathic Pain: A Comprehensive Review of Mechanisms and Clinical Potential.","authors":"Hao Wei, Jiahua Shi, Jiabin Fan, Xiongjuan Li, Xinping Yang, Zhiheng Liu","doi":"10.1007/s40122-026-00830-1","DOIUrl":"10.1007/s40122-026-00830-1","url":null,"abstract":"<p><p>Neuropathic pain (NP) is a complex chronic pain syndrome often secondary to conditions such as diabetic peripheral neuropathy and postherpetic neuralgia. It not only severely compromises patients' quality of life but also imposes a heavy burden on healthcare systems. Recent studies indicate that plasma lipoproteins play a significant role in its pathophysiology, with functions extending beyond lipid transport to include extensive involvement in inflammatory regulation, oxidative stress, and maintenance of neural function. This review aims to systematically elucidate the intricate relationship between NP and lipoproteins, analyze its pathophysiological mechanisms, and transcend conventional perspectives by conducting in-depth analyses of the specific mechanisms of action of high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL) in pain. Consequently, it explores potential therapeutic strategies based on lipoprotein metabolism. This review demonstrates that distinct lipoprotein types exert critical roles in the initiation and maintenance of NP through differentiated mechanisms involving regulation of neuroinflammation, oxidative stress, and ion channel function. These findings not only expand our understanding of pain mechanisms but also provide theoretical foundations for developing novel therapeutic strategies targeting lipoprotein metabolism. Future clinical research is essential to advance these insights into safe and effective personalized analgesic approaches.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"623-642"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729494","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":"Buprenorphine Products for the Treatment of Pain: Relative Risk of Abuse and Related Clinical Outcomes Compared to Full μ-Opioid Agonist Medications.","authors":"Jody L Green, Taryn Dailey-Govoni, Suzanne K Vosburg","doi":"10.1007/s40122-026-00835-w","DOIUrl":"10.1007/s40122-026-00835-w","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this study was to utilize real-world data from National Poison Data System (NPDS) to evaluate the relative risk of intentional use and subsequent outcomes following exposures to buprenorphine buccal film (BBF) compared to immediate-release (IR) and extended-release (ER) full agonist opioid (FAO) formulations, and buprenorphine transdermal patch (BTP).</p><p><strong>Methods: </strong>A cross-sectional study design compared exposures that involved BBF to those that involved IR FAO, ER FAO, and BTP using real-world data from NPDS. Data included individuals age 18 years and older involved in exposures managed by US poison centers from 2020 to 2023. Descriptive statistics were used to summarize study groups, exposures, and outcomes. Relative risk was calculated for exposure reasons and clinical outcomes using BBF as reference group.</p><p><strong>Results: </strong>Dataset included 276 BBF, 43,322 IR FAO, 2453 ER FAO, and 134 BTP exposures. Compared to BBF, significantly higher risks were found for both IR FAO and ER FAO for intentional abuse, intentional suspected suicide, significant medical outcome, hospital admission, and treated/evaluated and released level of care.</p><p><strong>Conclusion: </strong>Findings from this study suggest that, compared to FAO, exposures to BBF managed by US poison centers were less likely to involve intentional abuse or suspected suicide, have a decreased risk of resulting in a life-threatening effect or death, and have a lower likelihood of subsequent hospital admission and emergency department visits. Along with published guidelines and medication labels (including boxed warnings), relative risks of intentional exposures and associated clinical outcomes should be considered when determining opioid therapy for pain management.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"751-763"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691582","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":"The Association Between Body Mass Index and Acute Postoperative Pain in Bariatric Surgery Patients: A Prospective Cohort Study.","authors":"Chong Wang, Pin Zhang, Mengmeng Zhao, Shanshan Zuo, Xing Dong, Yangxi Hu, Qinjun Chu, Yan Wang","doi":"10.1007/s40122-026-00829-8","DOIUrl":"10.1007/s40122-026-00829-8","url":null,"abstract":"<p><strong>Introduction: </strong>The rising global prevalence of obesity has established bariatric surgery as a key therapeutic option; however, postoperative pain management remains a challenge. This study investigated the influence of body mass index (BMI) stratification on acute postoperative pain in patients undergoing bariatric surgery.</p><p><strong>Methods: </strong>Fifty-five patients aged 18-65 years with BMI ≥ 30 kg/m² scheduled for laparoscopic sleeve gastrectomy were categorized into the obesity group (O group; 30 kg/m² ≤ BMI < 40 kg/m²) and the severe obesity group (SO group; BMI ≥ 40 kg/m²). Preoperative pain threshold and pain tolerance threshold, perioperative inflammatory cytokines, Brief Pain Inventory (BPI) scores, Quality of Recovery-15 (QoR-15) scores, postoperative resting and movement numeric rating scale (NRS) scores, patient-controlled analgesia (PCA) pump usage, cumulative analgesic consumption, and analgesic satisfaction were assessed.</p><p><strong>Results: </strong>Compared with the O group, the SO group demonstrated a significantly higher pain tolerance threshold (4.1 ± 0.8 vs. 3.5 ± 1.0, P < 0.01), along with lower demand for PCA and reduced consumption of cumulative morphine milligram equivalents and flurbiprofen (P < 0.05). Notably, the primary outcome, the 24-h BPI score, showed no significant difference between the two groups. On postoperative days 1 and 3, tumor necrosis factor-α (TNF-α) levels were significantly lower in the O group, whereas no significant intergroup differences were observed in other inflammatory cytokines. No significant differences were observed in NRS or QoR-15 scores between the two groups.</p><p><strong>Conclusion: </strong>BMI may be considered as a factor for stratifying postoperative analgesia, favoring multimodal, opioid-sparing strategies in patients with severe obesity who demonstrate higher pain tolerance and lower analgesic requirements.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry, ChiCTR2400095080.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"697-710"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513785","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 Real-World Evidence Study on US Patients Demonstrating Safety of High-Frequency Use of the Remote Electrical Neuromodulation (REN) Wearable Device for Migraine Treatment.","authors":"Reena G Rastogi, Jason A Santiago, Alicia Chang, Eden Mama, Alit Stark-Inbar, Alon Ironi, Alan R Towne, Klaus Werner","doi":"10.1007/s40122-026-00828-9","DOIUrl":"10.1007/s40122-026-00828-9","url":null,"abstract":"<p><strong>Introduction: </strong>Remote electrical neuromodulation (REN) is an FDA-cleared, nonsignificant-risk, drug-free, prescribed wearable device (Nerivio^®) for the acute treatment of migraine and/or every other day for prophylactic treatment in patients aged 8 years and older. Despite established efficacy within labeled use parameters, some patients adopt more frequent treatment regimens, including multiple treatments within a single day, daily use, or both. This study assessed the safety and tolerability of REN when used at frequencies exceeding the labeled indication.</p><p><strong>Methods: </strong>Real-world observational data from patients with migraine using REN with frequent treatment patterns were collected. Safety assessments evaluated all adverse events (AE) reports, with emphasis on device-related AEs (dAEs), categorized by severity and seriousness per regulatory standards.</p><p><strong>Results: </strong>A total of 1863 patients with migraine (82.1% female, mean age of 38.8 ± 20.1 years) were eligible: (1) 1654 treated multiple times a day, at least once, (2) 310 treated daily; 101 patients met both patterns. Safety profile was favorable, with a total of 17 patients reporting dAEs (0.91% of patients, 0.02% of treatments). Of them, 16 dAEs reported in multiple treatments per day group (0.97% of patients, 0.05% of treatments), and 6 dAEs in daily treatment group (1.94% of patients, 0.01% of treatments) with 5 dAEs overlapping between the groups (reported by patients who met both criteria). dAEs were infrequent, negligible to moderate in severity, and resolved without medical intervention. No serious dAEs were observed, and the majority of patients continued to use REN after reporting the dAE.</p><p><strong>Conclusion: </strong>REN is a safe and well-tolerated treatment for migraine, even when used more frequently than the labeled indication. These findings support its use in real-world clinical practice, including for patients with severe or highly frequent attacks who may need additional treatments.</p><p><strong>Trial registration: </strong>ClinicalTrial.gov NCT07336056.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"711-720"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521641","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":"Effect of Transcranial Magnetic Stimulation in Patients with Postherpetic Neuralgia and Comorbid Depression: A Randomized Controlled Trial.","authors":"Huichan Xu, Junpeng Yuan, Chen Zhao, Liqun Huang, Panqi Wang, Youjia Yu, Xiaohong Jin","doi":"10.1007/s40122-026-00840-z","DOIUrl":"10.1007/s40122-026-00840-z","url":null,"abstract":"<p><strong>Introduction: </strong>Postherpetic neuralgia (PHN) frequently coexists with depression and remains associated with poor clinical outcomes despite interventional neuromodulation. Repetitive transcranial magnetic stimulation (rTMS) may lower the incidence of poor prognosis in this population. The aim of this trial was to evaluate the effect of perioperative rTMS in patients with PHN and comorbid depression undergoing neuromodulation.</p><p><strong>Methods: </strong>This randomized, single-center, sham-controlled trial was conducted at the First Affiliated Hospital of Soochow University in Jiangsu Province from February 2025 to November 2025. A total of 174 participants were randomly assigned, stratified by neuromodulation therapy, to receive either 10 Hz rTMS (n = 87) or sham stimulation (n = 87) targeting the primary motor cortex for five consecutive days. The primary outcome was the incidence of poor prognosis at 3 months.</p><p><strong>Results: </strong>The incidence of poor prognosis was significantly lower in the rTMS group compared with the sham group (27.4% versus 42.7%; odds ratio [OR] 0.51; 95% confidence interval [CI] 0.27-0.97; P = 0.039), corresponding to an absolute risk reduction of 15.3%. After adjusting for potential confounders, patients in the rTMS group were less likely to experience poor prognosis at 3 months than those in the sham group (adjusted OR, 0.47; 95% CI 0.23-0.95; P = 0.036).</p><p><strong>Conclusions: </strong>In this randomized controlled trial, perioperative rTMS reduced the risk of unfavorable clinical outcomes in patients with PHN and comorbid depression undergoing neuromodulation, without compromising safety. These findings support rTMS as a promising adjunctive therapeutic strategy in this population.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Register Identifier: ChiCTR2500096978.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"853-870"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778076","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":"Results from TRIUMPH [EUROPE], a Real-World Observational Study on the 3-Month Effectiveness of Galcanezumab Versus Traditional Oral Migraine Preventive Medications.","authors":"Cristina Tassorelli, Diego Novick, Saygin Gonderten, Maurice Vincent, Rebecca L Robinson, Georgia Martimianaki, Patricia Pozo Rosich","doi":"10.1007/s40122-026-00839-6","DOIUrl":"10.1007/s40122-026-00839-6","url":null,"abstract":"<p><strong>Introduction: </strong>Galcanezumab, a monoclonal antibody targeting calcitonin gene-related peptide, has shown efficacy in migraine prevention in clinical trials and has been included in clinical guidelines. Nonetheless, data on its real-world effectiveness are limited.</p><p><strong>Methods: </strong>TRIUMPH [Europe], an ongoing prospective study, enrolled patients ≥ 18 years old with migraine from Germany, Italy, Spain, and the UK who were initiating or switching to galcanezumab or traditional oral migraine preventive medications (TOMPs) between June 2020 and February 2023. The primary end point at 3 months was the percentage of patients achieving a response in monthly headache days (MHDs) as defined by a percentage reduction of ≥ 50% for episodic migraine and ≥ 30% for chronic migraine. The TRIUMPH [Europe] results are descriptive, as no alpha was allocated for comparative formal hypothesis testing between treatment groups.</p><p><strong>Results: </strong>A total of 717 patients were enrolled, with 46.0% in the galcanezumab and 40.9% in the TOMP groups. In the galcanezumab and TOMP groups, 85.8% and 85.3% of patients were women, respectively, and had a mean age of 44.4 and 36.8 years. Chronic migraine was more represented in the galcanezumab group than in the TOMP group (60.9% versus 32.4%). At baseline, mean (standard deviation [SD]) MHDs were 14.8 (7.2) for galcanezumab and 10.3 (5.2) days for TOMP. At 3 months, mean (SD) MHDs were 7.7 (7.4) and 6.8 (5.5) days for galcanezumab and TOMP, respectively. The 3-month weighted proportion of responders for galcanezumab and TOMP, respectively, was 63.1% and 34.9% overall, 60.7% and 29.9% for episodic migraines, and 65.0% and 42.6% for chronic migraines. Changes from baseline in the mean number of MHDs with acute medication use were -6.6 for galcanezumab and -2.9 for TOMP.</p><p><strong>Conclusions: </strong>After 3 months of migraine preventive treatment, the proportion of responders trended numerically higher among patients with migraine initiating/switching to galcanezumab than among those receiving TOMP.</p><p><strong>Trial registration: </strong>This study was registered through the European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (number EUPAS33068).</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"871-890"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778110","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":"Acetyl-L-Carnitine in the Treatment of Peripheral Neuropathies: A Narrative Review.","authors":"Diego Maria Michele Fornasari","doi":"10.1007/s40122-026-00826-x","DOIUrl":"10.1007/s40122-026-00826-x","url":null,"abstract":"<p><p>Acetyl-L-carnitine is an ester of L-carnitine, both endogenous molecules, with a vital role in lipid metabolism. Exogenously delivered acetyl-L-carnitine is endowed with neuroprotective and neurotrophic actions due to its antioxidant and metabolic properties. Moreover, acetyl-L-carnitine is an epigenetic regulator of genes involved in analgesia such as the metabotropic glutamate 2 receptor in the presynaptic neurons and of neurotrophic factors including nerve growth factor. Accordingly, its long-term neurotrophic and analgesic activity has been confirmed in animal models of chronic inflammatory and neuropathic pain and in clinical studies in patients with peripheral neuropathies. The aim of this narrative review was to summarise the available evidence on the usefulness of acetyl-L-carnitine in the treatment of peripheral neuropathies.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"601-622"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147459202","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 Triglyceride Glucose Index and Postherpetic Neuralgia in Patients with Acute Herpes Zoster: A Retrospective Study.","authors":"Ziwei Lu, Chengcheng Zhao, Tong Zhi, Huadong Ni, Ming Yao","doi":"10.1007/s40122-026-00824-z","DOIUrl":"10.1007/s40122-026-00824-z","url":null,"abstract":"<p><strong>Introduction: </strong>Insulin resistance (IR) is an important factor in the development of chronic pain. The triglyceride-glucose (TyG) index is a convenient measure of insulin resistance. However, as a common subtype of chronic pain, the relationship between postherpetic neuralgia (PHN) and the TyG index remains unclear. Through a retrospective analysis of the relationship between the TyG index and the incidence of PHN, we aim to determine whether the TyG index possesses predictive capability for PHN occurrence, thereby enabling the development of strategies to reduce the incidence of PHN.</p><p><strong>Methods: </strong>This retrospective study analyzed the medical records of patients diagnosed with acute herpes zoster (with a disease course of ≤ 1 month) in the Pain Department of Jiaxing University Affiliated Hospital from November 2024 to May 2025. Eligible patients were those who had available data on triglycerides and glucose, and no history of diabetes. Relevant clinical data were extracted from existing records and subjected to retrospective analysis. The numerical rating scale (NRS) score was utilized as the primary outcome measure to assess whether patients developed PHN. Those who still had pain (NRS ≥ 4) were classified as the PHN group, while those without pain symptoms (NRS < 4) were classified as the non-PHN group. The association between the TyG index and PHN was evaluated using multi-model logistic regression. In addition, the nonlinear relationship between these indicators and the results was studied using a restricted cubic spline plot. Subsequently, subgroup analyses were conducted on the sensitive population. The predictive value of the TyG index for PHN was evaluated using the receiver operating characteristic curve.</p><p><strong>Results: </strong>The retrospective study comprised 157 patients with acute herpes zoster, of whom 55 were male and 102 female, with a mean age of 64.87 ± 11.67 years. The TyG index in patients with acute herpes zoster exhibited a nonlinear relationship with PHN, with an odds ratio (OR) and 95% confidence interval (CI) of 4.32 (1.56-11.97). A linear correlation was found between the triglyceride-glucose-body mass index (TyG-BMI) and PHN, with OR and 95% CI of 1.07 (1.02-1.11). The TyG index and the TyG-BMI showed similar performance on the receiver operating characteristic (ROC) curve for evaluating PHN and have certain predictive value.</p><p><strong>Conclusion: </strong>Higher TyG index and TyG-BMI are associated with an increased risk of PHN.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier, ChiCTR2500113190 (retrospectively registered). Registration Date: November 26, 2025.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"663-679"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147459189","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":"Supraspinal Correlates of Patients with Chronic Pain Under Burst Spinal Cord Stimulation: A Proof-of-Concept Functional MRI Study.","authors":"Steffen Brenner, Achim Schilling, Patrick Krauss, Sherif Mohamed, Julia Fauth, Zohair Niroomand, Thomas Mehari Kinfe","doi":"10.1007/s40122-026-00841-y","DOIUrl":"10.1007/s40122-026-00841-y","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic pain is associated with central pain network-associated alterations. Functional MRI (fMRI) provides a powerful, non-invasive imaging technique to visualize such alterations. This feasibility study attempted to investigate the impact of BurstDR spinal cord stimulation (SCS) on fMRI correlates in patients with chronic pain.</p><p><strong>Methods: </strong>This proof-of-concept study included 11 patients (8 m/3 f; mean age 69.1 ± 11.2 years) with chronic back and/or leg pain with BurstDR SCS. Clinical outcomes were assessed at baseline and after 3 months BurstDR SCS (Numeric Rating Scale (NRS), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), Oswestry Disability Index (ODI)). fMRI (1.5 T) was obtained using a classic block-design motor with task and rest with single-subject and group analyses.</p><p><strong>Results: </strong>Pain decreased at follow-up (NRS: 7.3 ± 1.7 vs. 4.4 ± 1.5; p < 0.001) with improved functional capacity (PSQI: 10.2 ± 3.6 vs. 8.1 ± 2.7; p = 0.009; BDI: 16.9 ± 8.2 vs. 11.9 ± 6.3; p = 0.027; ODI: 56.5 ± 18.3 vs. 45.2 ± 16.4; p = 0.001). In the fMRI analyses, ten patients were included. Movement of the left foot led to significant activation in the medial region of the right precentral gyrus (Z > 3.1, p < 0.05). No differences at the predefined threshold for the entire brain were detected, although the uncorrected voxel-wise analysis showed several regions with increased activation post BurstDR SCS (bilateral middle temporal gyri (left: Z = 3.56, uncorrected p < 0.001; right: Z = 4.48, uncorrected p < 0.0001)). Functional connectivity analyses in 9 patients revealed no significant differences in task-modulated functional connectivity.</p><p><strong>Conclusions: </strong>BurstDR SCS reduced pain intensity and improved functional status associated with task-related activation of the motor cortex, which was reproducible across the entire cohort. Further randomized controlled studies are warranted to validate these findings and to elucidate the underlying mechanisms.</p><p><strong>Trial registration: </strong>German Clinical Trials Register (DRKS ID: DRKS00035826).</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"891-904"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147819308","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":"Efficacy of Transcutaneous Auricular Vagus Nerve Stimulation for Postoperative Pain Relief in Patients Undergoing Elective Laparoscopic Gastrointestinal Tumor Surgery.","authors":"Yu Yi, Yongjie Li, Ge Luo, Yiqi Fang, Lin He, Hongjin Ni, Hongming Wu, Meihui Li, Suyun Xia, Weidong Wu, Longfei Ma, Lina Yu","doi":"10.1007/s40122-026-00825-y","DOIUrl":"10.1007/s40122-026-00825-y","url":null,"abstract":"<p><strong>Introduction: </strong>Acute postoperative pain remains prevalent among patients undergoing gastrointestinal tumor surgery. The study was conducted to evaluate the efficacy of transcutaneous auricular vagus nerve stimulation (taVNS) in alleviating postoperative pain in this population.</p><p><strong>Methods: </strong>This patient- and assessor-blinded randomized controlled trial was conducted at the Second Affiliated Hospital of Zhejiang University School of Medicine. Eligible participants who underwent elective laparoscopic gastrointestinal tumor surgery were randomly assigned to the taVNS or control stimulation group. Both groups received the stimulation on the day before surgery and the day after surgery. The primary outcome was the change in visual analogue scale (VAS) scores at 24 h postoperatively.</p><p><strong>Results: </strong>The median reduction in VAS scores was 12.0 in the taVNS group, compared with 5.0 in the control stimulation group (median [interquartile range, IQR] 12.0 [10.0-13.3] mm vs 5.0 [2.0-8.0] mm; P < 0.001). Additionally, the taVNS group showed lower cumulative morphine milligram equivalents (MME) at 48 h (median [IQR] 0 [0-5] mg vs 5 [0-10] mg; P = 0.004) and 72 h (median [IQR] 0 [0-5] mg vs 5 [0-10] mg; P = 0.002), and shorter time to first flatus (median [IQR] 45 [40-60] h vs 75 [60-85] h; P < 0.001). The incidence of complications, length of hospital stay, and quality of recovery-15 (QoR-15) scores are similar between groups.</p><p><strong>Conclusion: </strong>TaVNS statistically alleviated postoperative pain in patients undergoing gastrointestinal tumor surgery, decreased analgesic requirements, and promoted gastrointestinal function recovery.</p><p><strong>Trial registration: </strong>NCT06763913.</p>","PeriodicalId":19908,"journal":{"name":"Pain and Therapy","volume":" ","pages":"681-695"},"PeriodicalIF":4.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147459216","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}