PAIN®最新文献

{"title":"Early codevelopment of pain, sleep disturbance, and hyperarousal after traumatic injury.","authors":"Michele Sterling, Jenna Liimatainen, Nigel Armfield, Shu-Kay Ng, Samuel McLean, Wanyun Huang, Richard Tawiah","doi":"10.1097/j.pain.0000000000004105","DOIUrl":"10.1097/j.pain.0000000000004105","url":null,"abstract":"<p><strong>Abstract: </strong>Chronic pain after traumatic injury likely reflects interacting processes rather than isolated recovery pathways, yet longitudinal evidence examining the joint development of pain, sleep disturbance, and hyperarousal from the acute postinjury stage is limited. We analysed data from the AURORA cohort of emergency department trauma survivors recruited within 72 hours of injury (n = 2834) to characterise trajectories of pain, sleep discontinuity, and hyperarousal over 12 months, identify shared multitrajectory profiles, and examine factors associated with adverse outcomes. Smartphone-based surveys assessed symptoms repeatedly from 1 to 5 days postinjury to one year. Group-based trajectory modelling identified 5 pain (n = 1635), 6 sleep discontinuity (n = 1635), and 5 hyperarousal (n = 1820) trajectories, ranging from rapid recovery to persistent high symptoms. Persistent high pain occurred in 35.1% of participants, while 23.5% followed persistently high or worsening sleep trajectories and 27.2% followed high hyperarousal trajectories. Multitrajectory modelling (n = 1800) identified 6 joint profiles, with 10.6% experiencing persistently high symptoms across all domains and 25.7% showing medium symptom levels. Older age and higher pretrauma pain were associated with adverse trajectories, whereas resilience and better prior mental health were protective. Baseline sleep discontinuity showed the strongest association with persistent high pain (adjusted odds ratio 3.31; 95% confidence interval 2.61-4.18), while physical activity was associated with a lower likelihood of medium-to-high pain trajectories. Female sex and lower income were associated with the most adverse multidomain profile. These findings highlight early postinjury sleep disruption, hyperarousal, and pain as interconnected processes. Targeting multiple domains may offer a promising strategy to prevent chronic pain after injury.</p>","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":"2554-2563"},"PeriodicalIF":5.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal associations between pain intensity and disturbed body perception after total knee arthroplasty: a random-intercept cross-lagged panel model analysis.","authors":"Yuta Tomooka, So Tanaka, Akira Mibu, Masahiro Manfuku, Hirofumi Yamashita, Shuhei Ishida, Keiko Yamada, Masami Tokunaga, Benedict M Wand, Tasha R Stanton, Tomohiko Nishigami","doi":"10.1097/j.pain.0000000000004107","DOIUrl":"10.1097/j.pain.0000000000004107","url":null,"abstract":"<p><strong>Abstract: </strong>Disturbed body perception is associated with chronic musculoskeletal pain, but its temporal relationship with pain after total knee arthroplasty (TKA) is unclear. We examined whether within-person fluctuations in knee-specific body perception are prospectively associated with pain intensity after TKA, beyond stable between-person differences. A total of 285 people undergoing primary TKA completed the Fremantle Knee Awareness Questionnaire (FreKAQ) and 100-mm visual analogue scales for pain during movement and resting pain preoperatively and at 1, 3, 6 months, and 1 year postoperatively. Random-intercept cross-lagged panel models (RI-CLPMs) were estimated across 5 waves. Model fit was evaluated with the standardized root-mean-square residual (SRMR), comparative fit index (CFI), and root mean square error of approximation (RMSEA). Pain intensity and FreKAQ scores decreased over 1 year. In both RI-CLPMs, higher FreKAQ scores at 6 months were associated with greater pain intensity at 1 year (pain during movement: β = 0.262, P = 0.004; resting pain: β = 0.359, P = 0.003). Resting pain intensity at 3 months was associated with FreKAQ at 6 months (β = 0.179, P = 0.033), whereas no other paths from pain to subsequent FreKAQ scores were significant. Model fit was mixed, with acceptable SRMR and CFI values, but RMSEA values exceeding recommended thresholds. These results highlight a later recovery period warranting further assessment. Disturbed knee-specific body perception at 6 months may be associated with subsequent pain after TKA; however, these observational findings do not establish causality and warrant further longitudinal and interventional research before body-perception-focused rehabilitation can be recommended.</p>","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":"2593-2603"},"PeriodicalIF":5.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of blinding in pharmacotherapy and noninvasive neuromodulation randomized controlled trials for neuropathic pain in adults.","authors":"Landon T Montag, Nadia Soliman, Xavier Moisset, Michael C Ferraro, Daniel Ciampi de Andrade, Ralf Baron, Joletta Belton, David L H Bennett, Margarita Calvo, Patrick M Dougherty, Aki J Hietaharju, Koichi Hosomi, Peter R Kamerman, Harriet Kemp, Elena K Enax-Krumova, Ewan McNicol, Theodore J Price, Srinivasa N Raja, Andrew S C Rice, Blair H Smith, Fiona Talkington, Andrea Truini, Jan Vollert, Nadine Attal, Nanna B Finnerup, Simon Haroutounian, Luana Colloca, Lene Vase, Tim V Salomons, Bethany Gwyther, David Hohenschurz-Schmidt, Jules Phalip, Tjokorda Istri Pramitasuri, Nina Taule-Lim, Quyen V Than, Jan D Wandrey, Md Zunaid, Ian Gilron","doi":"10.1097/j.pain.0000000000004120","DOIUrl":"10.1097/j.pain.0000000000004120","url":null,"abstract":"<p><strong>Abstract: </strong>In randomized controlled trials (RCTs), study participants and research personnel are often blinded to minimize biases related to knowing treatment allocation. To determine if blinding was effective, participants may be asked which treatment they believe they received (\"treatment guess\"). This descriptive review characterized blinding assessment (BA) reporting in pharmacotherapy and neuromodulation neuropathic pain RCTs. Of 288 papers, 36 (12.5%) reported a BA. One paper reported the results of 2 studies, so in total 37 studies with a BA were assessed. Of these, 19 were crossover, 17 parallel, and 1 partial crossover in design. All 37 studies assessed participant blinding, and 10 also assessed investigator blinding. Approximately 27% included an \"unsure\" answer option for treatment guess, and 38% asked the reason for the guess. There were no clear patterns in BA reporting across time nor based on treatment type. Seventeen trials provided sufficient data to calculate Bang Blinding Index (BI) to determine blinding success. Participants remained blinded (BI = 0 ± 0.2) in 10/17 placebo and 10/17 treatment arms, 6 placebo and 5 treatment arms had a BI > 0.2 suggesting possible unblinding, whereas 1 placebo and 2 treatment arms had a BI < -0.2 suggesting misinformed guessing. Overall, we found that BAs are done in a minority of published neuropathic pain trials and with variable methodology. Given the importance of minimizing risk of bias because of treatment unblinding, future studies should consider including BAs, and further consensus building is necessary to determine if and how BAs should be conducted and interpreted in analgesic clinical trials.</p>","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":"2661-2671"},"PeriodicalIF":5.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived pleasantness mediates the effects of high-arousal and emotionally complex music on pain.","authors":"Elise Desbarats, Darius Valevicius, Anaïs Lépine Lopez, Todd A Vogel, Robert J Zatorre, David M Greenberg, Mathieu Roy","doi":"10.1097/j.pain.0000000000004108","DOIUrl":"10.1097/j.pain.0000000000004108","url":null,"abstract":"<p><strong>Abstract: </strong>Music effectively reduces pain, yet the mechanisms underlying music-induced hypoalgesia remain poorly understood. We investigated how latent perceptual dimensions of music influence pain by examining both stimulus properties and subjective evaluations of those properties in 2 experiments. One hundred thirty-four participants listened to unfamiliar musical excerpts during thermal pain stimulation. Musical stimuli were systematically selected using the validated Arousal, Valence, Depth (AVD) model, which quantifies 3 key latent perceptual dimensions of music based on groups of descriptors such as \"forceful\" or \"calming.\" Study A (n = 74) demonstrated that high arousal music increased pain unpleasantness, whereas high depth music provided relief, but crucially, these effects were completely mediated by participants' subjective ratings of musical pleasantness. Study B (n = 60) replicated the beneficial effect of musical depth and confirmed that participants' perceptions aligned with loadings of the AVD model dimensions. Individual differences in trait systemizing moderated the analgesic effect of depth in one study. Complete mediation by pleasantness ratings indicates that experiences of reward and subjective aesthetic evaluation, rather than perceived musical dimensions themselves, drives music-induced hypoalgesia. This suggests that musical pain interventions should prioritize deep and relaxing music that is well liked by the participant.</p>","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":"2571-2581"},"PeriodicalIF":5.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A computational account of perceptual uncertainty in paradoxical heat sensation.","authors":"Jesper Fischer Ehmsen, Alexandra G Mitchell, Camilla E Krænge, Arthur S Courtin, Cyprien Simonnet, Francesca Fardo","doi":"10.1097/j.pain.0000000000004094","DOIUrl":"10.1097/j.pain.0000000000004094","url":null,"abstract":"<p><strong>Abstract: </strong>Paradoxical heat sensation (PHS) is conventionally described as the perception of warmth elicited by innocuous cooling, yet the qualitative nature of this experience remains largely uncharacterised. To describe potential differences in how PHS is perceived, we compared 2 a priori profiles: \"true perceivers,\" who experience PHS as a clear, warm percept, and \"unsure perceivers,\" who experience it as an ambiguous sensation. Seventy-five healthy adults (21-80 years old) performed a perceptual decision-making task designed to elicit PHS by manipulating the thermal contrast between warm and cold temperatures. To test the PHS experience across the lifespan, we applied hierarchical multivariate Bayesian modelling in which perceptual choices, response times, and confidence ratings were expected to vary systematically across the 2 hypothesised perceptual profiles. At the group level, behaviour was best accounted for by the unsure perceiver model, indicating that PHS is most often an uncertain experience, rather than a categorical misperception. Both profiles were present across individuals, demonstrating substantial interindividual variability in perceptual patterns. Older adults reported PHS more frequently, and at lower thermal contrasts, but their perceptual profiles did not differ from those of younger participants. This suggests that ageing increases the likelihood of experiencing PHS without changing its qualitative nature. These findings show that PHS is a heterogeneous perceptual phenomenon defined by variability in certainty and subjective quality across individuals.</p>","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":"2543-2553"},"PeriodicalIF":5.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinct connectivity patterns subserve 2 dimensions of the chronic pain experience.","authors":"Natalie J McLain, Chelsea M Kaplan, Bruce D Naliboff, Larissa Rodriguez, Robert Moldwin, David A Williams, John T Farrar, Richard E Harris, Theresa Spitznagle, Daniel Clauw, J Quentin Clemens, Steven E Harte, Jason J Kutch, Andrew Schrepf","doi":"10.1097/j.pain.0000000000004114","DOIUrl":"10.1097/j.pain.0000000000004114","url":null,"abstract":"<p><strong>Abstract: </strong>Identifying the neural correlates of chronic pain and their relationship to clinically relevant measures of disease has proven challenging due to high variability in individual patterns of functional brain connectivity and the rarity of ecologically valid scanning paradigms. Here, we address these limitations using data from the Multidisciplinary Approach to the Study of Pelvic Pain Symptom Patterns Study, which recruited a large sample of urologic chronic pain patients (n = 382) imaged repeatedly (range = 2-4) over 36 months. Intrinsic brain connectivity was recorded before and after a naturalistic challenge designed to elicit symptomatic pain and discomfort. Linear mixed-effects models revealed 2 neuroanatomically distinct patterns: pain at the time of scan was linked to connectivity within sensory-discriminative regions, while past-week recalled pain was associated with distributed patterns across regions implicated in memory, salience, and affective processing. These findings emphasize the dynamic roles of brain regions for different aspects of chronic pain.</p>","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":"2625-2636"},"PeriodicalIF":5.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacological modulation of peripheral nerve excitability: a novel way to investigate sodium channel subtypes in humans.","authors":"Trine Andresen, Jenny Tigerholm, Johan Røikjer, Carsten Dahl Mørch","doi":"10.1097/j.pain.0000000000004117","DOIUrl":"10.1097/j.pain.0000000000004117","url":null,"abstract":"<p><strong>Abstract: </strong>Despite considerable progress in pain management, recommended systemic pharmacotherapy often comes with a high risk of serious side effects adversely affecting quality of life. Hence, topical routes of drug administration are currently gaining popularity in painful conditions such as diabetic peripheral neuropathy. Voltage-gated sodium channels (Nav) are expressed in peripheral nerves and are crucial for development and maintenance of neuropathic pain. Subtypes Nav1.7, 1.8, and 1.9 are highly expressed in nociceptors and are therefore interesting targets for topical pharmacotherapeutics. The aim of this study was to assess pharmacologically modulated excitability of peripheral sensory nerves using the human experimental perception threshold tracking technique, an indirect method for measuring the excitability of peripheral nerves. This randomized, placebo-controlled, and double-blinded study included 20 healthy participants. A novel electrical stimulation protocol-the Sodium channel Excitability Nociceptor Testing protocol-was used to identify alterations in Nav1.7, 1.8, and 1.9 after applying 3 (5% lidocaine, 10% phenytoin, and 2% mepyramine) topical pharmacological drugs. There was a significant difference in the relative increase in the perception threshold after drug application between drugs ( P < 0.01) and between drugs and placebo ( P < 0.01), except for phenytoin ( P = 0.22). The computational model suggests that lidocaine and mepyramine caused different alterations of the Nav1.7, 1.8, and 1.9 currents. The Sodium channel Excitability Nociceptor Testing protocol can be used to investigate differential pharmacological alterations of specific Nav subtypes. This may lead to better insight of neurophysiological mechanisms of sensory afferents, forming the basis for targeted drug development, leading the way to stratified treatment regimens of peripheral pain.</p>","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":"2564-2570"},"PeriodicalIF":5.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GLP-1 receptor agonists: a role in the treatment of neuropathic pain?","authors":"Xavier Moisset, Nadine Attal","doi":"10.1097/j.pain.0000000000004103","DOIUrl":"10.1097/j.pain.0000000000004103","url":null,"abstract":"","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":"2467-2468"},"PeriodicalIF":5.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Noninvasive and objective near-real-time detection of pain changes during tonic fluctuating noxious heat stimulation.","authors":"Leonard Visser, Christian Büchel","doi":"10.1097/j.pain.0000000000004118","DOIUrl":"10.1097/j.pain.0000000000004118","url":null,"abstract":"<p><strong>Abstract: </strong>Chronic pain involves natural intensity fluctuations that patients cannot control, contributing to learned helplessness and functional impairment. Detecting spontaneous pain decreases could enable precisely timed interventions that enhance perceived control. However, existing research on objective pain assessment has focused primarily on estimating static intensity from short, predictable stimuli rather than detecting moment-to-moment changes in ongoing pain. This study investigated whether pain decreases can be detected objectively using easily obtainable physiological signals during fluctuating pain. We recorded multiple physiological signals (8-channel electroencephalography, electrodermal activity, heart rate, pupil diameter, and facial expressions) from 42 healthy participants (mean age = 26.2 years, SD = 5.1) during calibrated tonic noxious heat stimulation on the left forearm with unpredictable intensity fluctuations (0-70 on visual analogue scale; twelve 3-minute trials). Temperature changes lasted 5 to 20 seconds. Using minimal preprocessing suitable for real-time applications, we trained deep learning models to classify pain decreases vs nondecreases from brief temporal windows, evaluated on a held-out test set (9 participants). Combining electrodermal activity, heart rate, and pupil diameter yielded optimal classification performance using a transformer-based architecture (area under the receiver operating characteristic curve = 0.854, accuracy = 76.8%). Electrodermal activity emerged as the most informative single predictor. Continuous stream analysis demonstrated median detection latency of 5.75 seconds with 70.4% sensitivity, reducible to 4.25 seconds at the cost of increased false positives. Results indicate that electrodermal activity and heart rate enable straightforward practical deployment, while highly variable signals such as electroencephalography and facial expressions require personalized fine-tuned models. These findings establish a basis for closed-loop interventions targeting spontaneous pain changes.</p>","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":"2637-2649"},"PeriodicalIF":5.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting A3 adenosine receptor signaling to enhance analgesia in nonresponders to spinal cord stimulation in male nerve-injured rats.","authors":"Zhaoli Luo, Jing Liu, Xiang Cui, Ankit Uniyal, Jieru Wan, Qin Zheng, Yun Guan","doi":"10.1097/j.pain.0000000000004106","DOIUrl":"10.1097/j.pain.0000000000004106","url":null,"abstract":"<p><strong>Abstract: </strong>Spinal cord stimulation (SCS) is a clinically approved therapy for neuropathic pain (NP), yet a substantial subset of patients fails to respond or shows minimal efficacy, so-called nonresponders. It remains unclear how to resolve this SCS nonresponsiveness. Using a NP model induced by tibial-sparing nerve injury (SNI-t) in male rats, we investigated whether targeting the A3 adenosine receptor (A3AR), which is enriched in microglial cells, could convert nonresponders into responders. The dose-response relationship of 2-Cl-IB-MECA (a highly selective A3AR agonist) to inhibit mechanical hypersensitivity in male SNI-t rats after intraperitoneal injection was first established by measuring the paw withdrawal thresholds. Responders and nonresponders were classified based on the degree of reduction in mechanical hypersensitivity induced by conventional SCS (50 Hz, 0.2 milliseconds, 80% motor threshold, 30 minutes). A subtherapeutic dose of 2-Cl-IB-MECA (0.3 mg/kg, intraperitoneal) was subsequently combined with either acute or repeated SCS in nonresponders. Repeated SCS reduced microglial activation but produced limited analgesia in nonresponders. Subtherapeutic-dose 2-Cl-IB-MECA by itself induced minimal pain inhibition; however, when combined with SCS, it restored analgesic responses to both acute and repeated SCS. Notably, the pain reduction from repeated SCS was accompanied by a shift toward an anti-inflammatory microglial phenotype. These findings suggest that persistent microglial activation in male SNI-t rats may contribute to SCS nonresponsiveness, and that engaging A3AR signaling represents a promising strategy to convert nonresponders into SCS responders in NP conditions.</p>","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":"2604-2613"},"PeriodicalIF":5.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}