IF 7.4 1区医学

PAIN® Pub Date : 2025-08-27 DOI: 10.1097/j.pain.0000000000003804

Rima El-Sayed,Vaidhehi Veena Sanmugananthan,Joshua C Cheng,Anton Rogachov,Natalie R Osborne,Ariana Besik,Kasey S Hemington,Junseok A Kim,Rachael L Bosma,Emily P Mills,Benjamin T Dunkley,Karen D Davis

{"title":"Individual differences in conditioned pain modulation are associated with alpha oscillations.","authors":"Rima El-Sayed,Vaidhehi Veena Sanmugananthan,Joshua C Cheng,Anton Rogachov,Natalie R Osborne,Ariana Besik,Kasey S Hemington,Junseok A Kim,Rachael L Bosma,Emily P Mills,Benjamin T Dunkley,Karen D Davis","doi":"10.1097/j.pain.0000000000003804","DOIUrl":"https://doi.org/10.1097/j.pain.0000000000003804","url":null,"abstract":"Conditioned pain modulation (CPM), the change in pain evoked by a test stimulus at 1 body site by a conditioning stimulus at another site, varies across individuals, ranging from inhibition (pain decreases) to no CPM to facilitation (pain increases). Given the role of alpha oscillations in pain, we examined the relationship between CPM and peak alpha frequency (PAF) and power in the dynamic pain connectome (DPC). In 68 healthy individuals who underwent resting-state magnetoencephalography and a heat-based CPM evaluation, 32% had inhibitory CPM, 49% had facilitatory CPM, and 19% had no CPM. The facilitatory subgroup had lower alpha power in the medial prefrontal cortex (mPFC) compared with the inhibitory subgroup and across the DPC (mPFC, right thalamus, bilateral dorsolateral prefrontal cortex [dlPFC]) compared with the noCPM subgroup. Peak alpha frequency in the thalamus bilaterally was strongly correlated with inhibitory CPM (higher PAF with stronger inhibitory CPM). The subgenual anterior cingulate cortex (sgACC) PAF was correlated with inhibitory CPM in males and females in opposite directions, but not at the whole subgroup level. The pressure-based CPM evoked inhibitory CPM in 87% of the 45 individuals tested; the relationship with PAF in the right dlPFC and sgACC had medium-strong effect sizes driven by males (higher PAF with weaker inhibitory CPM). This study indicates that the role of alpha oscillations in CPM is paradigm- and sex-dependent. Our findings that healthy individuals exhibit an alpha-CPM relationship, particularly in the prefrontal regions and sgACC, provide insight into the potential therapeutic use of targeted neuromodulation for pain.","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":"65 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144960055","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

Individual differences in conditioned pain modulation are associated with alpha oscillations. 条件性疼痛调节的个体差异与α振荡有关。

IF 5.5 1区医学

PAIN® Pub Date : 2025-08-27 DOI: 10.1097/j.pain.0000000000003804

Rima El-Sayed, Vaidhehi Veena Sanmugananthan, Joshua C Cheng, Anton Rogachov, Natalie R Osborne, Ariana Besik, Kasey S Hemington, Junseok A Kim, Rachael L Bosma, Emily P Mills, Benjamin T Dunkley, Karen D Davis

{"title":"Individual differences in conditioned pain modulation are associated with alpha oscillations.","authors":"Rima El-Sayed, Vaidhehi Veena Sanmugananthan, Joshua C Cheng, Anton Rogachov, Natalie R Osborne, Ariana Besik, Kasey S Hemington, Junseok A Kim, Rachael L Bosma, Emily P Mills, Benjamin T Dunkley, Karen D Davis","doi":"10.1097/j.pain.0000000000003804","DOIUrl":"https://doi.org/10.1097/j.pain.0000000000003804","url":null,"abstract":"Abstract: Conditioned pain modulation (CPM), the change in pain evoked by a test stimulus at 1 body site by a conditioning stimulus at another site, varies across individuals, ranging from inhibition (pain decreases) to no CPM to facilitation (pain increases). Given the role of alpha oscillations in pain, we examined the relationship between CPM and peak alpha frequency (PAF) and power in the dynamic pain connectome (DPC). In 68 healthy individuals who underwent resting-state magnetoencephalography and a heat-based CPM evaluation, 32% had inhibitory CPM, 49% had facilitatory CPM, and 19% had no CPM. The facilitatory subgroup had lower alpha power in the medial prefrontal cortex (mPFC) compared with the inhibitory subgroup and across the DPC (mPFC, right thalamus, bilateral dorsolateral prefrontal cortex [dlPFC]) compared with the noCPM subgroup. Peak alpha frequency in the thalamus bilaterally was strongly correlated with inhibitory CPM (higher PAF with stronger inhibitory CPM). The subgenual anterior cingulate cortex (sgACC) PAF was correlated with inhibitory CPM in males and females in opposite directions, but not at the whole subgroup level. The pressure-based CPM evoked inhibitory CPM in 87% of the 45 individuals tested; the relationship with PAF in the right dlPFC and sgACC had medium-strong effect sizes driven by males (higher PAF with weaker inhibitory CPM). This study indicates that the role of alpha oscillations in CPM is paradigm- and sex-dependent. Our findings that healthy individuals exhibit an alpha-CPM relationship, particularly in the prefrontal regions and sgACC, provide insight into the potential therapeutic use of targeted neuromodulation for pain.","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964755","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

Dyspareunia: a novel clinical approach for diagnosis based on pain mechanisms. 性交困难：一种基于疼痛机制的新型临床诊断方法。

IF 7.4 1区医学

PAIN® Pub Date : 2025-08-27 DOI: 10.1097/j.pain.0000000000003807

Orna Reichman,Tali Sahar,Yoni K Ashar

引用次数: 0

Task-specific vs general measures of pain-related fear relative associations with spinal motor behaviour: a systematic review and meta-analysis. 与脊柱运动行为相关的疼痛相关恐惧的任务特异性测量与一般测量：系统回顾和荟萃分析。

IF 7.4 1区医学

PAIN® Pub Date : 2025-08-27 DOI: 10.1097/j.pain.0000000000003797

Alexis F Homs,Raphael Pionnier,Gabriel Cohen-Aknine,Kjerstin Torre,Willy Fagart,Arnaud F Dupeyron

{"title":"Task-specific vs general measures of pain-related fear relative associations with spinal motor behaviour: a systematic review and meta-analysis.","authors":"Alexis F Homs,Raphael Pionnier,Gabriel Cohen-Aknine,Kjerstin Torre,Willy Fagart,Arnaud F Dupeyron","doi":"10.1097/j.pain.0000000000003797","DOIUrl":"https://doi.org/10.1097/j.pain.0000000000003797","url":null,"abstract":"Musculoskeletal pain, particularly low back and neck pain, is associated with maladaptive changes in spinal motor behaviour (SMB). Psychological factors such as pain-related fear play a role in driving these adaptations. While previous research found weak associations between general psychological measures and SMB, task-specific measures may provide more precise insights into movement avoidance. This systematic review and meta-analysis aimed to compare the relative associations of general and task-specific pain-related fear measures with SMB. Following PRISMA guidelines, we included 13 studies (651 participants) assessing both general (Tampa Scale of Kinesiophobia and Pain Anxiety Symptoms Scale) and task-specific measures alongside objective spinal motor outcomes (eg, amplitude, velocity, muscle activity, coordination, variability). A three-level meta-analytic model revealed a weak but significant association between general measures and SMB (r = 0.12, 95% CI: 0.04-0.21, P = 0.007), whereas task-specific measures showed a stronger association (r = 0.29, 95% CI: 0.18-0.40, P < 0.001). The difference between these correlations (Δr(task-specific - general) = 0.16, 95% CI: 0.04 to 0.27, P = 0.008) was statistically significant, indicating that task-specific measures better capture the relationship between perceived fear and movement alterations. Despite methodological heterogeneity, our findings highlight the importance of task-specific assessments in understanding motor impairments associated with pain-related fear. These results support the integration of task-specific evaluations in clinical and research settings. To further elucidate the mechanisms linking psychological factors to SMB, future studies should use longitudinal designs, improve the contextual validity of the motor tasks studied, and explore new approaches of movement analysis.","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":"24 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144960053","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

Task-specific vs general measures of pain-related fear relative associations with spinal motor behaviour: a systematic review and meta-analysis. 与脊柱运动行为相关的疼痛相关恐惧的任务特异性测量与一般测量：系统回顾和荟萃分析。

IF 5.5 1区医学

PAIN® Pub Date : 2025-08-27 DOI: 10.1097/j.pain.0000000000003797

Alexis F Homs, Raphael Pionnier, Gabriel Cohen-Aknine, Kjerstin Torre, Willy Fagart, Arnaud F Dupeyron

{"title":"Task-specific vs general measures of pain-related fear relative associations with spinal motor behaviour: a systematic review and meta-analysis.","authors":"Alexis F Homs, Raphael Pionnier, Gabriel Cohen-Aknine, Kjerstin Torre, Willy Fagart, Arnaud F Dupeyron","doi":"10.1097/j.pain.0000000000003797","DOIUrl":"https://doi.org/10.1097/j.pain.0000000000003797","url":null,"abstract":"Abstract: Musculoskeletal pain, particularly low back and neck pain, is associated with maladaptive changes in spinal motor behaviour (SMB). Psychological factors such as pain-related fear play a role in driving these adaptations. While previous research found weak associations between general psychological measures and SMB, task-specific measures may provide more precise insights into movement avoidance. This systematic review and meta-analysis aimed to compare the relative associations of general and task-specific pain-related fear measures with SMB. Following PRISMA guidelines, we included 13 studies (651 participants) assessing both general (Tampa Scale of Kinesiophobia and Pain Anxiety Symptoms Scale) and task-specific measures alongside objective spinal motor outcomes (eg, amplitude, velocity, muscle activity, coordination, variability). A three-level meta-analytic model revealed a weak but significant association between general measures and SMB (r = 0.12, 95% CI: 0.04-0.21, P = 0.007), whereas task-specific measures showed a stronger association (r = 0.29, 95% CI: 0.18-0.40, P < 0.001). The difference between these correlations (Δr(task-specific - general) = 0.16, 95% CI: 0.04 to 0.27, P = 0.008) was statistically significant, indicating that task-specific measures better capture the relationship between perceived fear and movement alterations. Despite methodological heterogeneity, our findings highlight the importance of task-specific assessments in understanding motor impairments associated with pain-related fear. These results support the integration of task-specific evaluations in clinical and research settings. To further elucidate the mechanisms linking psychological factors to SMB, future studies should use longitudinal designs, improve the contextual validity of the motor tasks studied, and explore new approaches of movement analysis.","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964103","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

Dyspareunia: a novel clinical approach for diagnosis based on pain mechanisms. 性交困难：一种基于疼痛机制的新型临床诊断方法。

IF 5.5 1区医学

PAIN® Pub Date : 2025-08-27 DOI: 10.1097/j.pain.0000000000003807

Orna Reichman, Tali Sahar, Yoni K Ashar

引用次数: 0

Trends and factors associated with opioid prescribing from 2017 to 2023. 2017年至2023年阿片类药物处方的趋势和相关因素。

IF 7.4 1区医学

PAIN® Pub Date : 2025-08-27 DOI: 10.1097/j.pain.0000000000003806

Wenyu Song,Kenneth J Mukamal,Joji Suzuki,Jorge A Rodriguez,Michael Sainlaire,Scott G Weiner,Patricia C Dykes,David W Bates

{"title":"Trends and factors associated with opioid prescribing from 2017 to 2023.","authors":"Wenyu Song,Kenneth J Mukamal,Joji Suzuki,Jorge A Rodriguez,Michael Sainlaire,Scott G Weiner,Patricia C Dykes,David W Bates","doi":"10.1097/j.pain.0000000000003806","DOIUrl":"https://doi.org/10.1097/j.pain.0000000000003806","url":null,"abstract":"Widespread misuse of prescription opioids has resulted in large numbers of opioid-related overdose deaths. It is critical to have a better understanding of the temporal patterns of opioid prescribing practices and associated clinical scenarios. We examined opioid prescription trends over 7 years in a large medical system using electronic health record data. Between 2017 and 2023, we identified 1,019,706 patients from 13 hospitals within a large health system in the northeastern United States, who had at least 1 opioid prescription. In total, there were 3,877,281 associated encounters with 18,225 prescribers. We examined the overall monthly opioid prescription rates and observed an average decrease during the 84 months of study period and discovered 4 distinct stages. A decrease was seen between January 2017 and January 2020 (monthly rate change: -0.70%, 95% CI: -0.89% to -0.41%), followed by a sharp decrease and a fast rebound between February 2020, April 2020, and July 2020 (monthly rate change: -10.60%, 95% CI: -14.73% to -2.52%; 13.06%, 95% CI: 3.42%-18.47%), then back to a gradual decrease from August 2020 to December 2023 (monthly rate change: -0.46%, 95% CI: -0.67% to -0.29%). When prescriptions were further classified by prescribing setting, patient demographics, and patient visit encounter types, we observed variations among these subgroups. We also identified significant associations between patient characteristics and provider specialty with high morphine milligram equivalent dose prescriptions. These results highlight the complexity of opioid prescription practice trends indicating that all these issues need to be considered in developing prescription guidance.","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":"35 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144960054","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

Trends and factors associated with opioid prescribing from 2017 to 2023. 2017年至2023年阿片类药物处方的趋势和相关因素。

IF 5.5 1区医学

PAIN® Pub Date : 2025-08-27 DOI: 10.1097/j.pain.0000000000003806

Wenyu Song, Kenneth J Mukamal, Joji Suzuki, Jorge A Rodriguez, Michael Sainlaire, Scott G Weiner, Patricia C Dykes, David W Bates

{"title":"Trends and factors associated with opioid prescribing from 2017 to 2023.","authors":"Wenyu Song, Kenneth J Mukamal, Joji Suzuki, Jorge A Rodriguez, Michael Sainlaire, Scott G Weiner, Patricia C Dykes, David W Bates","doi":"10.1097/j.pain.0000000000003806","DOIUrl":"https://doi.org/10.1097/j.pain.0000000000003806","url":null,"abstract":"Abstract: Widespread misuse of prescription opioids has resulted in large numbers of opioid-related overdose deaths. It is critical to have a better understanding of the temporal patterns of opioid prescribing practices and associated clinical scenarios. We examined opioid prescription trends over 7 years in a large medical system using electronic health record data. Between 2017 and 2023, we identified 1,019,706 patients from 13 hospitals within a large health system in the northeastern United States, who had at least 1 opioid prescription. In total, there were 3,877,281 associated encounters with 18,225 prescribers. We examined the overall monthly opioid prescription rates and observed an average decrease during the 84 months of study period and discovered 4 distinct stages. A decrease was seen between January 2017 and January 2020 (monthly rate change: -0.70%, 95% CI: -0.89% to -0.41%), followed by a sharp decrease and a fast rebound between February 2020, April 2020, and July 2020 (monthly rate change: -10.60%, 95% CI: -14.73% to -2.52%; 13.06%, 95% CI: 3.42%-18.47%), then back to a gradual decrease from August 2020 to December 2023 (monthly rate change: -0.46%, 95% CI: -0.67% to -0.29%). When prescriptions were further classified by prescribing setting, patient demographics, and patient visit encounter types, we observed variations among these subgroups. We also identified significant associations between patient characteristics and provider specialty with high morphine milligram equivalent dose prescriptions. These results highlight the complexity of opioid prescription practice trends indicating that all these issues need to be considered in developing prescription guidance.","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964581","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

Sensory neuron PIEZO1 deletion inhibits dynamic light touch sensitivity in uninjured mice, prevents neuropathic light touch hypersensitivity, and drives compensatory changes in dorsal root ganglia. 感觉神经元PIEZO1缺失抑制未损伤小鼠动态光触敏感性，防止神经性光触超敏反应，驱动背根神经节代偿性改变。

IF 5.5 1区医学

PAIN® Pub Date : 2025-08-26 DOI: 10.1097/j.pain.0000000000003781

Vanessa L Ehlers, Anvitha Sriram, Bradey A R Stuart, Christina M Mecca, Cheryl L Stucky

{"title":"Sensory neuron PIEZO1 deletion inhibits dynamic light touch sensitivity in uninjured mice, prevents neuropathic light touch hypersensitivity, and drives compensatory changes in dorsal root ganglia.","authors":"Vanessa L Ehlers, Anvitha Sriram, Bradey A R Stuart, Christina M Mecca, Cheryl L Stucky","doi":"10.1097/j.pain.0000000000003781","DOIUrl":"https://doi.org/10.1097/j.pain.0000000000003781","url":null,"abstract":"Abstract: Mechanotransduction is vital for sensing various mechanical stimuli, including blunt force and dynamic light touch. The sensation of a punctate mechanical force is very different from that of a brush swept across the skin, yet both involve mechanical stimulation of the skin and embedded sensory afferent endings. However, the sensory neuron mechanisms contributing to punctate vs light touch somatosensation, and how they might become dysregulated in nerve injury to cause pain, remain unclear. Here, we use mice with sensory neuron-specific PIEZO1 deletion to demonstrate sensory neuron PIEZO1 is required for dynamic light mechanical touch, and possibly punctate mechanical force, in healthy animals. These mice are also protected from acute and chronic tibial spared nerve injury-induced dynamic light touch hypersensitivity. However, dorsal root ganglia neurons from uninjured mice with sensory neuron PIEZO1 deletion displayed evidence of developmental compensation, including sensitized mechanically evoked inward currents. Dorsal root ganglia from these mice also exhibit transcriptional and functional compensation of other ion channels, including PIEZO2, TRPV1, and TRPV4. Thus, the behavioral phenotype of mice with sensory neuron-specific PIEZO1 knockout likely reflects these and possibly other forms of genetic compensation resulting from PIEZO1 absence throughout development, in addition to functional sensory neuron PIEZO1 deletion. Research using this transgenic mouse model must account for these caveats to facilitate accurate data interpretation. Furthermore, this article serves as a call for researchers to critically investigate possible genetic compensation in their mice. Such scrutiny is crucial to prevent replication crises and for advancement of scientific knowledge more broadly.","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964766","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

To do no harm, we must first "know harms". The challenge of measuring and reporting adverse events in interventions for pain. 要做到无害化，首先要“知害”。测量和报告疼痛干预中不良事件的挑战。

IF 5.5 1区医学

PAIN® Pub Date : 2025-08-26 DOI: 10.1097/j.pain.0000000000003796

Neil E O'Connell, Christina Abdel-Shaheed, Riaz Qureshi, Georgia C Richards, Nadia Soliman, Emma Fisher, Aidan G Cashin, Michael C Ferraro

引用次数: 0

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