IF 5.9 1区医学

PAIN® Pub Date : 2025-04-01 Epub Date: 2024-11-07 DOI: 10.1097/j.pain.0000000000003442

Jamie L Rhudy, Parker A Kell, Taylor V Brown, Hayden M Ventresca, Claudia N Vore, Kayla Trevino, Brandon W Jones, Travis S Lowe, Joanna O Shadlow

{"title":"Mechanisms of the Native American pain inequity: predicting chronic pain onset prospectively at 5 years in the Oklahoma Study of Native American Pain Risk.","authors":"Jamie L Rhudy, Parker A Kell, Taylor V Brown, Hayden M Ventresca, Claudia N Vore, Kayla Trevino, Brandon W Jones, Travis S Lowe, Joanna O Shadlow","doi":"10.1097/j.pain.0000000000003442","DOIUrl":"10.1097/j.pain.0000000000003442","url":null,"abstract":"Abstract: A pain inequity exists for Native Americans (NAs), but the mechanisms are poorly understood. The Oklahoma Study of Native American Pain Risk (OK-SNAP) addressed this issue and recruited healthy, pain-free NAs and non-Hispanic Whites (NHWs) to attend 2 laboratory visits and assessed mechanisms consistent with the biopsychosocial model of pain: demographics, physical variables, psychosocial factors, and nociceptive/pain phenotypes. Then participants were surveyed every 6 months to assess for chronic pain onset. Results at the 2-year follow-up found that NAs were ∼3x more likely than NHWs to develop chronic pain. Moreover, psychosocial factors (discrimination, stress, pain-related anxiety), cardiometabolic load (higher body mass index and blood pressure, lower heart rate variability), and impaired inhibition of spinal nociception partly mediated the pain inequity. The present study examined mechanisms of chronic pain at the 5-year follow-up for OK-SNAP. Results found that the NA pain inequity worsened-NAs were 4x more likely to develop chronic pain (OR = 4.025; CI = 1.966, 8.239), even after controlling for baseline age, sex assigned at birth, income, and education. Moreover, serial mediation models replicated paths from the 2-year follow-up that linked psychosocial variables, cardiometabolic load, and impaired inhibition of spinal nociception to chronic pain onset. Further, 2 new significant paths were observed. One linked discrimination, stress, sleep problems, and facilitated pain perception to increased pain risk. The other linked discrimination with higher spinal nociceptive threshold and pain risk. These results provide further evidence for a NA pain inequity and identify multiple psychosocial, cardiometabolic, and pronociceptive targets for primary interventions.","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":"936-955"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11919569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605299","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}

引用次数: 0

Reply to Key and Brown.

IF 5.9 1区医学

PAIN® Pub Date : 2025-04-01 Epub Date: 2025-01-30 DOI: 10.1097/j.pain.0000000000003533

Robert R Edwards, Claudia M Campbell, Jennifer A Haythornthwaite

引用次数: 0

The value of equity, diversity, and inclusion principles and sex/gender considerations in pain research.

IF 5.9 1区医学

PAIN® Pub Date : 2025-04-01 Epub Date: 2025-02-19 DOI: 10.1097/j.pain.0000000000003569

Karen Deborah Davis

引用次数: 0

Effects of sleep and circadian rest-activity rhythms on daily pain severity in women with temporomandibular disorders.

IF 5.9 1区医学

PAIN® Pub Date : 2025-03-28 DOI: 10.1097/j.pain.0000000000003578

Chung Jung Mun, Siny Tsang, Matthew J Reid, Howard Tennen, Jennifer A Haythornthwaite, Patrick H Finan, Michael T Smith

{"title":"Effects of sleep and circadian rest-activity rhythms on daily pain severity in women with temporomandibular disorders.","authors":"Chung Jung Mun, Siny Tsang, Matthew J Reid, Howard Tennen, Jennifer A Haythornthwaite, Patrick H Finan, Michael T Smith","doi":"10.1097/j.pain.0000000000003578","DOIUrl":"https://doi.org/10.1097/j.pain.0000000000003578","url":null,"abstract":"Abstract: Although a robust connection between sleep and pain is established, the extent to which circadian rest-activity rhythms contribute toward unique variations in pain, beyond what is elucidated by sleep, remains uncertain. Furthermore, it is largely unknown whether sleep and circadian rest-activity rhythms have interactive effects on daily pain severity. Using wrist actigraphy and daily pain diaries, data from 140 women with temporomandibular disorders and insomnia symptoms were analyzed over a 14-day period. Sleep duration and continuity were quantified by using total sleep time (TST) and wake after sleep onset (WASO), and circadian rest-activity rhythms were characterized with the Relative Amplitude (indicating strength/robustness of rest-activity rhythm) and Intradaily Variability metrics (representing rhythm fragmentation). Linear mixed-effects modeling revealed that both TST (b = -0.11, P = 0.006) and WASO (b = 0.18, P = 0.006) from the previous night, along with Relative Amplitude (b = -2.56, P = 0.001) from the past 24 hours, predicted next-day pain severity. Among the 4 interaction effects tested, both Intradaily Variability (b = 1.52, P = 0.034) and Relative Amplitude (b = -1.52, P = 0.003) moderated the relationship between WASO and next-day pain severity; on days characterized by less robustness (lower Relative Amplitude) or greater fragmentation (higher Intradaily Variability) in the circadian rest-activity rhythm, the positive association between previous night WASO and next-day pain severity intensified. These findings highlight the complex interplay among sleep, circadian rest-activity rhythms, and pain. While preliminary, our findings indicate that interventions aimed at improving both sleep and restoring circadian rhythms may provide enhanced benefits for managing chronic pain.","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812114","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}

引用次数: 0

What you don't know can hurt others. A systematic review on calibration of stimulus intensity in pain research.

IF 5.9 1区医学

PAIN® Pub Date : 2025-03-27 DOI: 10.1097/j.pain.0000000000003588

Julia Badzińska, Magdalena Żegleń, Łukasz Kryst, Przemysław Bąbel

{"title":"What you don't know can hurt others. A systematic review on calibration of stimulus intensity in pain research.","authors":"Julia Badzińska, Magdalena Żegleń, Łukasz Kryst, Przemysław Bąbel","doi":"10.1097/j.pain.0000000000003588","DOIUrl":"https://doi.org/10.1097/j.pain.0000000000003588","url":null,"abstract":"Abstract: Calibration of pain stimuli is critical in experimental pain research because it makes it possible to adjust stimulus intensity to match individual pain sensitivity. Despite its importance, precise descriptions of calibration procedures are lacking in the literature, thus hindering the ability to replicate studies. The aim of this systematic review is to fill this gap by evaluating and categorizing calibration methods used in pain studies involving electrodermal stimuli in healthy adult volunteers. A search of 9 databases identified 51 relevant articles published between 2018 and 2024, which were analyzed regarding calibration methods and their effectiveness. The review identified 2 main calibration methods, namely the method of limits and the staircase method, along with 3 techniques, namely ascending, descending, and random calibration. The findings reveal that 69% of studies did not verify the effectiveness of their calibration processes. Among those that did, varying degrees of success were observed. The ascending calibration technique was less precise, while combined ascending and pseudorandom calibration offered better matching of stimulus intensity but still required optimization. However, the data were insufficient to definitively determine which method was the most accurate. There is still a lack of consistent approaches to reporting calibration in the literature, which can lead to difficulties in interpreting results and comparing different studies. Future research should focus on comparing these methods to identify the most effective approaches and explore factors influencing calibration success.","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721032","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}

引用次数: 0

Trajectories of cold but not mechanical sensitivity correspond with disability trajectories after whiplash injury. 冷敏感性轨迹与鞭打伤后的残疾轨迹一致，但与机械敏感性无关。

IF 5.9 1区医学

PAIN® Pub Date : 2025-03-25 DOI: 10.1097/j.pain.0000000000003461

Scott F Farrell, Nigel R Armfield, Eythor Kristjansson, Ken Niere, Steffan Wittrup McPhee Christensen, Michele Sterling

{"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":"Abstract: 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.","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-25","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}

引用次数: 0

Pain Commentary on Spinal hyperexcitability in patients with chronic musculoskeletal pain or headache as evidenced by alterations in the nociceptive withdrawal reflex: a systematic review and meta-analysis.

IF 5.9 1区医学

PAIN® Pub Date : 2025-03-25 DOI: 10.1097/j.pain.0000000000003567

Michele Sterling, Paul Hodges

引用次数: 0

Impacts of opioid stewardship in surgical settings: a scoping review.

IF 5.9 1区医学

PAIN® Pub Date : 2025-03-20 DOI: 10.1097/j.pain.0000000000003594

Dereje Zewdu Assefa, Ting Xia, Yonas Getaye Tefera, Monica Jung, Suzanne Nielsen

{"title":"Impacts of opioid stewardship in surgical settings: a scoping review.","authors":"Dereje Zewdu Assefa, Ting Xia, Yonas Getaye Tefera, Monica Jung, Suzanne Nielsen","doi":"10.1097/j.pain.0000000000003594","DOIUrl":"https://doi.org/10.1097/j.pain.0000000000003594","url":null,"abstract":"Abstract: Opioid stewardship programs have been implemented in many countries to reduce harms related to prescription opioid use. Yet, there is an evidence gap on the impact of these programs in surgical settings. This systematic scoping review aimed to examine the impact of opioid stewardship on opioid use and clinical outcomes, alongside assessing adherence, and barriers to its implementation in surgical settings. A systematic search strategy was developed and applied among 7 electronic databases for published literature. In total, 100 eligible articles were included in the review. Most studies showed that opioid stewardship reduced the quantity of opioid use (in 83/88 studies; 94%) and the number of days of opioid supplied (15/18; 83%). No effect was seen on the rate of opioid refills (34/44; 78%), postoperative pain scores (22/23; 96%), and length of hospital stay (12/15; 80%). The adherence rates ranged from 32% to 100%, with considerable heterogeneity in the indicators used to measure the quality use of opioids. Logistical issues, patients' demand for analgesics, clinicians' uncertainty regarding the efficacy of nonopioid analgesics, and a lack of role allocation were reported as major barriers to implementation. Opioid stewardship can improve the quality use of opioids without adversely affecting clinical outcomes. The variety of opioid stewardship types, measurement metrics, study designs, and different surgeries pose challenges in determining causal relationships. Future prospective studies using standardized approaches are needed to develop more robust evidence.","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670466","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}

引用次数: 0

Differential pain perception among females with or without nonspecific chronic low back pain and comorbid insomnia: a quantitative sensory testing analysis. 患有或不患有非特异性慢性腰背痛和合并失眠症的女性对疼痛的感知差异：定量感觉测试分析。

IF 5.9 1区医学

PAIN® Pub Date : 2025-03-20 DOI: 10.1097/j.pain.0000000000003591

Jeremy R Chang, Rachel L C Kwan, Eliza R Sun, Shirley X Li, Ping Liang, Jae Q J Liu, Daniel K Y Zheng, Zhixing Zhou, Frank F Huang, Dino Samartzis, Siu Ngor Fu, Arnold Y L Wong

{"title":"Differential pain perception among females with or without nonspecific chronic low back pain and comorbid insomnia: a quantitative sensory testing analysis.","authors":"Jeremy R Chang, Rachel L C Kwan, Eliza R Sun, Shirley X Li, Ping Liang, Jae Q J Liu, Daniel K Y Zheng, Zhixing Zhou, Frank F Huang, Dino Samartzis, Siu Ngor Fu, Arnold Y L Wong","doi":"10.1097/j.pain.0000000000003591","DOIUrl":"https://doi.org/10.1097/j.pain.0000000000003591","url":null,"abstract":"Abstract: Sleep disturbance is a prevalent condition in individuals with chronic low back pain (CLBP). Despite a strong association between the 2 conditions, the potential mechanisms underlying the role of sleep disturbance in CLBP remain unclear. This case-control study aimed to examine pain perception among females with or without nonspecific CLBP and comorbid insomnia. One hundred females were recruited (mean age: 34.3 ± 11.4 years), with 25 individuals with concomitant CLBP and insomnia (CLBP+I), 25 with CLBP (CLBP+), 25 with insomnia (Insomnia+), and 25 healthy controls. All participants completed self-report questionnaires and quantitative sensory testing (QST). Our study found that CLBP+I exhibited lower mechanical pain and pressure pain thresholds (PPT) in both painful and nonpainful areas and impaired conditioned pain modulation (CPM) as compared to healthy controls. Similar findings were found in PPT at the back and CPM when compared to CLBP+. However, no significant differences were noted in thermal pain thresholds and temporal summation of pain across the 4 groups. Furthermore, CLBP+I and Insomnia+ displayed higher levels of functional disability, maladaptive beliefs, and negative mood than CLBP+ or healthy controls. There were significant increases in pain sensitivity to pressure stimuli, decreases in descending pain inhibitory effects, and higher levels of maladaptive psychological status in CLBP+I compared to CLBP+. These findings underscore the importance of incorporating sleep assessments as a routine practice in treating CLBP cases. Future studies are warranted to validate our findings in males, establish the diagnostic and prognostic value of QST, and probe the neurophysiological mechanisms in comorbid conditions.","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670332","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}

引用次数: 0

Spontaneous pain dynamics characterized by stochasticity in neural recordings of awake humans with chronic pain.

IF 5.9 1区医学

PAIN® Pub Date : 2025-03-20 DOI: 10.1097/j.pain.0000000000003592

Jihye Ryu, Jonathan C Kao, Ausaf Bari

{"title":"Spontaneous pain dynamics characterized by stochasticity in neural recordings of awake humans with chronic pain.","authors":"Jihye Ryu, Jonathan C Kao, Ausaf Bari","doi":"10.1097/j.pain.0000000000003592","DOIUrl":"https://doi.org/10.1097/j.pain.0000000000003592","url":null,"abstract":"Abstract: Chronic pain is characterized by spontaneous fluctuations in pain intensity, a phenomenon that remains poorly understood. The aim of this study is to elucidate the neural mechanisms underlying pain fluctuations in patients with chronic pain undergoing deep brain stimulation surgery. We recorded local field potentials (LFPs) from pain-processing hub structures, including the ventral posteromedial nucleus of the thalamus, subgenual cingulate cortex, and periventricular and periaqueductal gray, while patients continuously reported their pain levels. Using novel auto-mutual information metrics to analyze LFP stochastic patterns, we found that pain intensity correlated with both increased regularity of spike-like events and greater past-dependency of neural oscillations in the 4- to 15-Hz frequency band. In addition, during periods of higher pain states, we observed enhanced functional connectivity between the examined hub structures and the prefrontal cortex, suggesting a more focused flow of pain-related information within the pain circuit. By characterizing the dynamic nature of pain fluctuations, this study bridges the gap in understanding moment-to-moment pain variations and their underlying neural mechanisms, paving the way for improved chronic pain management strategies.","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670449","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}

引用次数: 0

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