Schmerz最新文献

{"title":"[Sequence variants of unknown significance in small fiber neuropathy : Characterization of a heterogeneous patient population].","authors":"Caren Meyer Zu Altenschildesche, Nadine Egenolf, Annette Lischka, Nurcan Üçeyler","doi":"10.1007/s00482-024-00811-3","DOIUrl":"10.1007/s00482-024-00811-3","url":null,"abstract":"<p><strong>Background: </strong>In almost half of patients suffering from small fiber neuropathies (SFN), the etiology remains elusive. For these patients with \"idiopathic SFN\", symptomatic analgesic therapy is the only option. Reports on a potential genetic background of neuropathic pain syndromes are increasing and particularly in SFN patients, several genetic variants were found mainly located in genes encoding voltage-gated sodium channels. Although up to 30% of SFN patients show genetic alterations, most of these remain of \"unknown pathogenic significance\" and little is known about \"genetic SFN\".</p><p><strong>Objectives: </strong>The study aimed to determine clinical characteristics of SFN patients carrying a rare genetic variant of unknown significance in pain-associated genes.</p><p><strong>Materials and methods: </strong>From 2015 to 2020, 66 patients with primarily idiopathic SFN were examined and rare gene variants of unknown significance detected in 13/66 (20%) of these. A detailed medical history with focus on pain was recorded and patients filled in standardized questionnaires to assess physical and emotional burden due to pain.</p><p><strong>Results: </strong>The authors found 13/66 (20%) patients with rare variants of unknown significance located in pain-associated genes who reported pain refractory to analgesic treatment, a higher number of external factors influencing clinical symptoms, and a higher level of physical impairment and emotional stress due to pain compared with patients without such genetic variants.</p><p><strong>Conclusions: </strong>Early genetic assessment is recommended to optimize the management of patients with potentially hereditary SFN. Early access to rehabilitation and mental support as well as a consequent elimination of external triggering factors should be granted.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"204-210"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12098409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Biomarkers in complex regional pain syndrome].","authors":"Michael Alexander Harnik, Gudrun Kindl, Frank Birklein, Heike L Rittner","doi":"10.1007/s00482-024-00856-4","DOIUrl":"10.1007/s00482-024-00856-4","url":null,"abstract":"<p><p>Complex regional pain syndrome (CRPS) is a severe pain disorder with an unclear pathophysiology. Biomarkers offer opportunities to enhance diagnosis, stratification, prognosis, and monitoring. Serum markers such as cytokines and microRNAs show potential but require further research. Local skin markers, particularly pro-inflammatory cytokines, are elevated in the acute stage and correlate with disease activity. Imaging techniques such as skeletal scintigraphy and functional magnetic resonance imaging provide valuable insights into structural and functional changes, despite inconsistent results to date. Psychosocial factors, including pain intensity and psychological comorbidities, are important prognostic indicators. Future research should focus on specific biomarkers to develop mechanism-based treatments. A multidisciplinary approach remains crucial for effective treatment.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"221-231"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The headache questionnaire of the German Migraine and Headache Society (DMKG) : A new tool to improve headache care].","authors":"Ruth Ruscheweyh, Charly Gaul, Thomas Dresler, Tim Patrick Jürgens, David Lewis, Torsten Kraya, Lars Neeb, Victoria Ruschil, Gudrun Goßrau","doi":"10.1007/s00482-025-00870-0","DOIUrl":"10.1007/s00482-025-00870-0","url":null,"abstract":"<p><p>To enable state-of-the-art diagnosis, therapy and monitoring of headache disorders, comprehensive history taking is necessary and can be time-consuming. This is facilitated substantially if the patient gathers the needed information beforehand, using a specialized questionnaire. To this end, experts of the German Migraine and Headache Society (DMKG) have developed the DMKG headache questionnaire. It assesses central information such as headache frequency, characteristics, accompanying symptoms and medication, as well as comorbidities and validated scales for psychological cofactors, disability and quality of life. The complete version for a first visit is complemented by a shorter version for follow-up visits and a specialized cluster headache module. For headache care professionals, the DMKG headache questionnaire is free after registration ( https://www.dmkg.de/dmkg-kopfschmerzfragebogen ). It is available for a printout or as fillable PDF and can be combined with the included PDF headache diary or with the DMKG-App (smartphone headache diary). A digital version is in the planning. The DMKG headache questionnaire is an important step towards quality assurance of headache care in Germany.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"169-176"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12098179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[European Medicines Agency checks metamizole: stronger focus on agranulocytosis but also established use in treatment].","authors":"Claudia Bausewein, Frank Petzke","doi":"10.1007/s00482-025-00882-w","DOIUrl":"https://doi.org/10.1007/s00482-025-00882-w","url":null,"abstract":"","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":"39 3","pages":"165-166"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[On \"collecting\" migraine attacks].","authors":"Peter Kropp","doi":"10.1007/s00482-025-00874-w","DOIUrl":"10.1007/s00482-025-00874-w","url":null,"abstract":"","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"167-168"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Using electricity to combat headache : Electrotherapy and tDCS in the 1870s/1880s and today].","authors":"Zhenya Wagner, Holger Steinberg","doi":"10.1007/s00482-023-00746-1","DOIUrl":"10.1007/s00482-023-00746-1","url":null,"abstract":"<p><p>Headache can be a widespread symptom as well as a disorder in itself. Headache syndromes such as migraine cause a lot of distress, disability and overall socioeconomic costs. Pharmacological treatments are often limited in their efficacy as well as due to side effects. The therapeutic application of electricity for this medical indication was a relevant field of research in the 19th century and-in the form of transcranial direct current stimulation (tDCS)-is still widely studied today. This paper provides an overview of publications from the late 19th century (as the era of discovery and success of electrotherapy) as well as contemporary studies investigating the usage of weak currents for the treatment or prophylaxis of headache. Our results show a large number of highly favorable reports of treatment successes. However, the number of cases analysed is often rather small and the forms of electric stimulation applied were often highly heterogeneous. In summary, electric stimulation appears to be a promising field of research and a possible therapeutic agent for the treatment of headaches; however, further research is necessary, especially into the details of the stimulation techniques applied and the various indications in which it may be of use.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"185-193"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12098203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10123600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[An instrument to assess biopsychosocial pain concepts in adults : Development and evaluation by experts].","authors":"L Wickering, C Lautwein, A Fiegler, L Allerdißen, T Kloos, M Schneider, T Hechler","doi":"10.1007/s00482-024-00793-2","DOIUrl":"10.1007/s00482-024-00793-2","url":null,"abstract":"<p><strong>Background: </strong>The biopsychosocial model is fundamental for the understanding and treatment of chronic pain; however, little research has focused on whether those affected show a biopsychosocial understanding. The multidimensional questionnaire Biopsychosocial Pain Concept Matrix (BiPS matrix) is presented. The conception of the BiPS matrix is based on the biological, psychological and social areas as well as on the common sense model of self-regulation with five dimensions: (1) type of disorder, (2) assumptions on the causes, (3) consequences, (4) duration of the disease and (5) possibilities for control and treatment.</p><p><strong>Objective: </strong>The present study aims to examine the content relevance and comprehension of the areas, dimensions and items, including the use of the BiPS matrix with children by interdisciplinary expert ratings. The questionnaire can be perspectively used by treating professionals for diagnostic purposes.</p><p><strong>Method: </strong>In an online study 17 experts were questioned. In addition to descriptive statistics, comments were evaluated using qualitative content analysis according to Mayring.</p><p><strong>Results: </strong>All experts rated the assessment of pain concepts with the BiPS matrix as well as the areas and dimensions as very relevant. With respect to the items, suggestions were made mainly regarding the wording of the items and adjustments for children.</p><p><strong>Discussion: </strong>From an expert point of view the BiPS matrix represents a relevant instrument. Further research on the psychometric properties of the BiPS matrix in adults and children is indicated. In addition, the BiPS matrix can also be used to investigate pain concepts of medical and psychotherapeutic professional groups to demonstrate the biopsychosocial understanding of pain and the associated treatment options.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"194-203"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12098183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139730358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Status survey of Austrian pain clinics 2023 : Impact of the COVID-19 pandemic on pain management services].","authors":"Sascha Hammer, Anna Krawczyk, Brigitte Messerer, Stefan Neuwersch-Sommeregger, Patrick Reinbacher, Gregor Schittek, Andreas Sandner-Kiesling","doi":"10.1007/s00482-025-00871-z","DOIUrl":"10.1007/s00482-025-00871-z","url":null,"abstract":"<p><strong>Background: </strong>According to a 2020 report by the Austrian Pain Society (ÖSG), between 1.5 and 1.8 million people in Austria suffer from chronic pain. For the treatment of these patients, multimodal pain therapy in specialized pain therapy facilities should be considered. This study aimed to analyze the actual postpandemic state of care in pain clinics in 2022 and to show how it has changed in recent years.</p><p><strong>Methods: </strong>In our survey, the heads or employees of all anesthesiology departments in Austria were asked via SurveyMonkey (SurveyMonkey Inc., San Mateo, CA, USA) using an access code to compare the pre- to postpandemic status of their pain clinics. Only anesthesiology departments were contacted, as pain clinics in Austria are almost entirely run by them. This survey was sent online by email to the heads of Austrian hospitals with an existing pain clinic and was open for completion from autumn 2022 to May 2023.</p><p><strong>Results: </strong>Of the 109 surveyed clinics, 92 participated in our study. Only 51 currently operate a pain clinic, seven of which are full-time. Nine pain clinics had closed since 2014, while seven new ones have opened. According to our data, only one specialized hospital and two basic care hospitals offer multimodal pain therapy. Invasive procedures were used more often compared to multimodal pain therapy.</p><p><strong>Conclusion: </strong>Despite the nominal increase of pain clinics in Austria, there is a multifactorial discrepancy between the recommendation of the Austrian Pain Society and the actual care of patients with chronic pain in Austria. Administrative and personnel obstacles must be overcome to meet the needs of this patient group. In addition, efforts to increase the interest of physicians in chronic pain management are needed. Greater support from healthcare policies and effective integration of pain clinics into the healthcare system could help improve the care situation.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"211-220"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12098487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Fear of migraine attacks: diagnosis and treatment].","authors":"Timo Klan, Anke Diezemann-Prößdorf, Anna-Lena Guth, Charly Gaul, Michael Witthöft","doi":"10.1007/s00482-023-00711-y","DOIUrl":"10.1007/s00482-023-00711-y","url":null,"abstract":"<p><p>In the field of headache disorders, the term \"fear of attacks\" refers to the fear of a headache attack occurring. Excessive fear of attacks may worsen the course of a migraine and lead to an increase in migraine activity. In the assessment of attack-related fear, a categorical (fear of attacks as a specific phobia) and a dimensional approach (measuring the extent of fear using a questionnaire) are available. The 29-item Fear of Attacks in Migraine Inventory (FAMI) is an economic self-report questionnaire for the assessment of attack-related fear, and it has good psychometric properties. The treatment of attack-related fear includes behavioral interventions as well as pharmacological therapy. Behavioral interventions have few side effects and are based on the treatment of common anxiety disorders (e.g., agoraphobia). Although the evidence of existing treatments is sparse, attack-related fear should be considered in routine care.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":"177-184"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10112828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9419482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The Bidirectional relationship between chronic pain and traumatic life events : Mechanisms and therapeutic implications].","authors":"Michelle Hermes, Sebastian Wieland, Jonas Tesarz","doi":"10.1007/s00482-025-00883-9","DOIUrl":"https://doi.org/10.1007/s00482-025-00883-9","url":null,"abstract":"<p><p>There is a close bidirectional relationship between chronic pain and psychological trauma disorders, which frequently results in more intense suffering and greater impairment for those affected. This article elucidates the intricate interrelationships between chronic pain, early childhood stress, and traumatic experiences as well as the underlying neurobiological, neuroimmunological and psychosocial mechanisms. Early childhood trauma, such as abuse or neglect, has a significant impact on individuals during particularly vulnerable phases of development, leading to long-lasting changes at various levels. The influence of trauma on pain perception is twofold: it increases the prevalence of chronic pain and intensifies pain and suffering. Therapeutically, interventions that target the hyperactive threat system and strengthen the hypoactive soothing system are essential. The article discusses evidence-based models of pain-trauma interaction and presents therapeutic approaches such as Eye Movement Desensitization Reprocessing (EMDR), Emotional Awareness and Expression Therapy (EAET), and psychodynamic interventions that are promising in the treatment of trauma-associated chronic pain.</p>","PeriodicalId":21572,"journal":{"name":"Schmerz","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}