PAIN®最新文献

{"title":"Trajectories of cold but not mechanical sensitivity correspond with disability trajectories after whiplash injury.","authors":"Scott F Farrell, Nigel R Armfield, Eythor Kristjansson, Ken Niere, Steffan Wittrup McPhee Christensen, Michele Sterling","doi":"10.1097/j.pain.0000000000003461","DOIUrl":"10.1097/j.pain.0000000000003461","url":null,"abstract":"<p><strong>Abstract: </strong>Developmental trajectories for neck disability after whiplash injury have been identified. Their relationship to cold and mechanical sensitivity trajectories is not known. We aimed to (1) identify recovery trajectories of cold and mechanical sensitivity, (2) explore their codevelopment with disability trajectories, (3) identify predictors of sensitivity trajectories, and (4) explore codevelopment of cold and mechanical sensitivity trajectories. Participants (n = 233) were assessed at <1, 3, 6, and 12 months after whiplash injury. Outcomes were cold pain detection threshold (CPT at neck), pressure pain detection thresholds (PPT, neck C5, and tibialis anterior), and the Neck Disability Index. We used group-based trajectory models to identify postinjury recovery trajectories and multinominal logistic regression to explore associations between baseline characteristics and trajectory membership. We identified the following trajectory groups: CPT (low [50.0%], moderate [29.7%], and high [20.4%] sensitivity); PPT C5 (low [10.8%] and high [89.2%] sensitivity); and PPT tibialis anterior (low [23.9%], moderate [39.0%], and high [37.1%] sensitivity); all were stable over the 12 months. There was good correspondence between disability and cold sensitivity trajectory groups but not for mechanical sensitivity; cold and mechanical sensitivity trajectories were not well associated. Higher baseline pain predicted membership of the high cold sensitivity trajectory (RR 1.27, 95% CI 1.01-1.59) and hyperarousal symptoms predicted membership of the moderate cold sensitivity trajectory (RR 1.17, 95% CI 1.01-1.36). We found no associations between baseline characteristics and mechanical sensitivity. There is an interplay between cold allodynia, pain, and hyperarousal symptoms in development of ongoing disability after whiplash injury. Different mechanisms likely underlie cold and mechanical sensitivity.</p>","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":"1328-1342"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546667","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":"Long-term impact of physiotherapy attendance on rehabilitation of workers with low back pain.","authors":"Liangping Zhang,Lei Pan","doi":"10.1097/j.pain.0000000000003525","DOIUrl":"https://doi.org/10.1097/j.pain.0000000000003525","url":null,"abstract":"","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":"25 1","pages":"1457"},"PeriodicalIF":7.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945505","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":"Complementary, integrative, and standard rehabilitative therapies in a military population with chronic predominantly musculoskeletal pain: a pragmatic clinical trial with SMART design.","authors":"Diane M Flynn, Jeffrey C Ransom, Alana D Steffen, Kira P Orr, Honor M McQuinn, Tyler J Snow, Larisa A Burke, Dahee Wi, Ardith Z Doorenbos","doi":"10.1097/j.pain.0000000000003462","DOIUrl":"10.1097/j.pain.0000000000003462","url":null,"abstract":"<p><strong>Abstract: </strong>There is growing acceptance for combining complementary and integrative health (CIH) therapies with standard rehabilitative care (SRC) for chronic pain management, yet little evidence on the best sequence of therapies. We investigated whether starting with CIH therapies or SRC is more effective in reducing pain impact. Participants were 280 service members with predominantly (88%) musculoskeletal chronic pain referred to an interdisciplinary pain management center who were randomized to a twice weekly program of either CIH therapies (n = 140) or SRC (n = 140) for the 3-week first stage of treatment. The composition of a second 3-week treatment stage depended upon response to the first stage. The primary outcome measure was the impact score (range 8-50) from the NIH Task Force on Research Standards for Chronic Low-Back Pain. Outcomes were measured after 3 and 6 weeks of treatment and at 3- and 6-month follow-ups. Most participants were men (76.8%) and mean age was 34.7 years (SD 8.0). At end of stage 1, pain impact decreased significantly more in the CIH group (29.8 points [SD 7.2] at baseline to 26.3 points [SD 7.9], change of -3.3 points [95% confidence interval, -4.2 to -2.5]) than in the SRC group (30.8 [SD 7.6] to 29.4 [SD 7.8], change of -0.9 points [95% confidence interval, -1.8 to -0.1]; P < 0.001). No significant between-group differences were observed after 6 weeks of treatment nor at 3- or 6-month follow-ups. Complementary and integrative health therapies may provide earlier improvement in pain impact than SRC, but this difference is not sustained.</p>","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":"1343-1353"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic associations of neuropathic pain and sensory profile in a deeply phenotyped neuropathy cohort.","authors":"Mikael Åkerlund, Georgios Baskozos, Wenqianglong Li, Andreas C Themistocleous, Mathilde M V Pascal, N William Rayner, Nadine Attal, Ralf Baron, Sophie Baudic, Kristine Bennedsgaard, Didier Bouhassira, Maddalena Comini, Geert Crombez, Catharina G Faber, Nanna B Finnerup, Janne Gierthmühlen, Yelena Granovsky, Sandra Sif Gylfadottir, Harry L Hébert, Troels S Jensen, Jishi John, Harriet I Kemp, Giuseppe Lauria, Helen Laycock, Weihua Meng, Kristian Bernhard Nilsen, Colin Palmer, Andrew S C Rice, Jordi Serra, Blair H Smith, Solomon Tesfaye, Leah Shafran Topaz, Abirami Veluchamy, Jan Vollert, David Yarnitsky, Natalie van Zuydam, John Anker Zwart, Mark I McCarthy, Valeriya Lyssenko, David L Bennett","doi":"10.1097/j.pain.0000000000003463","DOIUrl":"10.1097/j.pain.0000000000003463","url":null,"abstract":"<p><strong>Abstract: </strong>We aimed to investigate the genetic associations of neuropathic pain in a deeply phenotyped cohort. Participants with neuropathic pain were cases and compared with those exposed to injury or disease but without neuropathic pain as control subjects. Diabetic polyneuropathy was the most common aetiology of neuropathic pain. A standardised quantitative sensory testing protocol was used to categorize participants based on sensory profile. We performed genome-wide association study, and in a subset of participants, we undertook whole-exome sequencing targeting analyses of 45 known pain-related genes. In the genome-wide association study of diabetic neuropathy (N = 1541), a top significant association was found at the KCNT2 locus linked with pain intensity (rs114159097, P = 3.55 × 10 -8 ). Gene-based analysis revealed significant associations between LHX8 and TCF7L2 and neuropathic pain. Polygenic risk score for depression was associated with neuropathic pain in all participants. Polygenic risk score for C-reactive protein showed a positive association, while that for fasting insulin showed a negative association with neuropathic pain, in individuals with diabetic polyneuropathy. Gene burden analysis of candidate pain genes supported significant associations between rare variants in SCN9A and OPRM1 and neuropathic pain. Comparison of individuals with the \"irritable\" nociceptor profile to those with a \"nonirritable\" nociceptor profile identified a significantly associated variant (rs72669682, P = 4.39 × 10 -8 ) within the ANK2 gene. Our study on a deeply phenotyped cohort with neuropathic pain has confirmed genetic associations with the known pain-related genes KCNT2 , OPRM1 , and SCN9A and identified novel associations with LHX8 and ANK2 , genes not previously linked to pain and sensory profiles, respectively.</p>","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":"1354-1368"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"N-methyl-D-aspartate receptor activation is downstream coupled to pannexin 1 opening by Src kinase in dorsal horn neurons: an essential link for mechanical hyperalgesia in nerve-injured rats.","authors":"Katherine Zepeda-Morales, David Bravo, Jonathan Aránguiz-Barrera, Estibaliz Ampuero, Georgina M Renard, Teresa Pelissier, Alejandro Hernández, Jeffri S Retamal, Luis Constandil","doi":"10.1097/j.pain.0000000000003476","DOIUrl":"10.1097/j.pain.0000000000003476","url":null,"abstract":"<p><strong>Abstract: </strong>A well-recognized molecular entity involved in pain-related neuroplasticity is the N-methyl-D-aspartate receptor (NMDAR), which is crucial for developing chronic pain. Likewise, the pannexin 1 (Panx1) channel has been described as necessary for initiating and maintaining neuropathic pain, driving nociceptive signals dependent on spinal NMDAR through several possible mechanisms. Through behavioral, pharmacological, and molecular approaches, our study in male rats has revealed several key findings: (1) neurons located in spinal cord laminae I and II express functional Panx1 channels in both neuropathic and sham rats. These channels can open (indicated by YOPRO-1 uptake) through the stimulation of NMDARs with intrathecal NMDA; (2) intrathecal NMDA leads to increased expression of pSrc and pPanx1 in dorsal horn neurons. This elevation exacerbates existing mechanical hyperalgesia in nerve-injured rats; (3) inhibition of Src with intrathecal PP2 or blockade of Panx1 with intrathecal 10 Panx effectively mitigates NMDA-induced effects and reduces the spontaneous mechanical hyperalgesia of nerve-injured rats. Notably, while 10 Panx successfully alleviates hyperalgesia, it does not alter pSrc expression; and (4) NMDA-stimulated YOPRO-1 uptake in neurons of laminae I-II of spinal cord slices were prevented by the NMDAR antagonist D-AP5, the Src inhibitor PP2 (but not PP3), as well as with the 10 Panx and carbenoxolone. Therefore, NMDAR activation in dorsal horn neurons triggers an NMDAR-Src-Panx1 signaling pathway, where Panx1 acts as an enhancing effector in neuropathic pain. This implies that disrupting the NMDAR-Panx1 communication (eg, through Src inhibitors and/or Panx1 blockers) may offer a valuable strategy for managing some forms of chronic pain.</p>","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":"1369-1381"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Wang et al.","authors":"Emma Fisher, Fergal Monsell, Jacqui Clinch, Christopher Eccleston","doi":"10.1097/j.pain.0000000000003539","DOIUrl":"https://doi.org/10.1097/j.pain.0000000000003539","url":null,"abstract":"","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":"166 6","pages":"1460"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038046","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":"Social determinants of health in pediatric chronic postsurgical pain research.","authors":"Wendy Gaultney, Nathalia Jimenez, Abraham Correa-Medina, Claudia M Campbell, Jennifer Anne Rabbitts","doi":"10.1097/j.pain.0000000000003510","DOIUrl":"10.1097/j.pain.0000000000003510","url":null,"abstract":"","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":"1223-1229"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A realist review of rural pain management: comprehensive and practical.","authors":"Michael Di Donato","doi":"10.1097/j.pain.0000000000003483","DOIUrl":"10.1097/j.pain.0000000000003483","url":null,"abstract":"","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":"1217-1218"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009668","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":"Chronic widespread musculoskeletal pain shares a highly heritable latent pathway with atherosclerosis and arterial stiffness.","authors":"Maryam Kazemi Naeini, Marina Cecelja, Maxim B Freidin, Isabelle Granville Smith, Pirro Hysi, Christopher Sivert Nielsen, Frances M K Williams","doi":"10.1097/j.pain.0000000000003486","DOIUrl":"10.1097/j.pain.0000000000003486","url":null,"abstract":"<p><strong>Abstract: </strong>Chronic widespread pain (CWP) is prevalent and associated with reduced life expectancy. Cardiovascular disease is one possible mechanism for this. The purpose of this study was to examine the association of CWP with arterial stiffness and carotid plaque measured using ultrasound to determine if shared environmental or genetic factors might account for any observed association. Around 3000 participants from the TwinsUK with CWP information and measures of carotid-femoral pulse wave velocity (cfPWV), carotid intima-media thickness (cIMT), and plaque were considered. The relationship between CWP and cfPWV, cIMT, and plaque was determined. UK Biobank data were used to replicate the association. Cholesky decomposition and multivariate pathway twin models were examined. Using a 2-sample Mendelian randomisation approach, the causal association between CWP and coronary artery disease was assessed. TwinsUK participants demonstrated a significant association between CWP and increased cfPWV consistent with arterial stiffening (OR = 1.35, P -value = 0.012), as well as the presence of carotid plaque (OR = 1.45, P -value = 0.8e-5). The twin modelling showed a common latent component and pathway underlying CWP, cfPWV, and carotid plaque, with genetic factors accounting for 68% and 90% of the latent factor variation, respectively. The 2-sample MR revealed a potential causal association between CWP and coronary artery disease. This study found that those with CWP have increased the risk of arterial stiffness and atherosclerosis and suggests that CWP leads to an increased risk of cardiovascular disease through genetic factors.</p>","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":"1425-1435"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Bhatt and Forget.","authors":"Chihua Li, Peiyi Lu","doi":"10.1097/j.pain.0000000000003576","DOIUrl":"https://doi.org/10.1097/j.pain.0000000000003576","url":null,"abstract":"","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":"166 6","pages":"1462-1463"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987306","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}