Current Pain and Headache Reports最新文献

{"title":"Perioperative Pain Assessment and Medication Safety in Office-Based Dental Anesthesia: A Practical Review.","authors":"Aidan McCarthy, Fred E Shapiro, Richard D Urman","doi":"10.1007/s11916-026-01577-2","DOIUrl":"https://doi.org/10.1007/s11916-026-01577-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>We examined perioperative pain assessment, medication documentation, toxicity preparedness, emergency medications and preparedness, and discharge readiness in office-based dental practices. By bringing these considerations together, the goal is to provide a practice overview of what providers should consider incorporating into their office-based dental and other similar anesthesia practices.</p><p><strong>Recent findings: </strong>Office- based dental anesthesia consistently delivers care to children and patients who cannot tolerate hospital treatment. Effective perioperative pain management is critically important for safe patient care in the dental office. Age-appropriate pain assessment, local-anesthetic safety, emergency preparedness, and recovery and discharge criteria are important components of office-based dental anesthesia practices. Dental offices are an important setting for patients who require sedation or general anesthesia; A practical framework may help clinicians consistently integrate safeguard elements into daily office-based care.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"30 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149327079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional Anesthesia in Low- and Middle-Income Countries: Current Landscape and Future Directions.","authors":"Taylie Sargent, Fung Holgar Mua, Andrew Dobrowski, Candace Chang","doi":"10.1007/s11916-026-01572-7","DOIUrl":"10.1007/s11916-026-01572-7","url":null,"abstract":"<p><strong>Purpose of review: </strong>Regional anesthesia (RA) is increasingly promoted as a strategy for expanding safe surgical and obstetric anesthesia access in low- and middle-income countries (LMICs), where general anesthesia (GA) carries disproportionate risk. This review examines current RA utilization patterns, recent advances in training and implementation, persistent barriers, and the evidence linking RA to clinical outcomes in LMICs, in order to identify what is needed for durable, system-wide scale-up.</p><p><strong>Recent findings: </strong>Large observational analyses show lower perioperative and maternal mortality with regional or neuraxial anesthesia compared with GA. Hybrid training models combining online instruction, simulation, and mentored clinical practice have improved provider knowledge and peripheral nerve block competence, and portable ultrasound has expanded point-of-care applications. However, workforce shortages, inconsistent equipment and medication supply, limited capacity to manage local anesthetic systemic toxicity, and fragmented, single-center safety data continue to constrain reliable implementation. RA offers a safe, lower-resource alternative to GA in LMICs, but sustainable expansion depends on addressing underlying workforce, supply, and monitoring deficits rather than isolated procedural training. Embedding RA within National Surgical, Obstetric, and Anesthesia Plans, supported by multicenter outcome registries and economic evaluation, should guide future research and implementation efforts.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"30 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149301616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomarkers for Post-Traumatic Headache in Youth.","authors":"Carlyn Patterson Gentile, Ramon Diaz-Arrastia","doi":"10.1007/s11916-026-01571-8","DOIUrl":"10.1007/s11916-026-01571-8","url":null,"abstract":"<p><strong>Purpose of review: </strong>Traumatic brain injury is a highly prevalent condition impacting youth that commonly results in persist headache. However, current management is limited by our ability to differentiate youth who will recover with little intervention from those who will develop a potentially debilitating headache lasting months to years. The aim of this review is to highlight promising biomarkers for identifying youth who will develop persistent post-traumatic headache.</p><p><strong>Recent findings: </strong>Multiple candidate genetic, protein, imaging, electrophysiological, and digital biomarkers have been identified to help differentiate youth who will develop persistent headache from traumatic brain injury from those who will recover. Promising directions include biomarkers that overlap between traumatic brain injury and migraine. However, no biomarkers are ready for standard use in clinical care. While further work is needed to develop and validate clinically reliable biomarkers of post-traumatic headache in the pediatric population, myriad candidate biomarkers hold promise and warrant further study.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"30 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13722807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149301625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Epigenomics of Migraine.","authors":"Yi-Chia Liaw","doi":"10.1007/s11916-026-01574-5","DOIUrl":"10.1007/s11916-026-01574-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>To review current evidence on epigenetic mechanisms in migraine, offering insights into diagnosis, disease classification, and future therapeutic management.</p><p><strong>Recent findings: </strong>Recent research has focused on three primary epigenetic mechanisms: DNA methylation, non-coding RNAs, and histone modifications. Altered methylation patterns have been identified in CALCA and RAMP1, both critical components of the CGRP signaling pathway. Furthermore, recent research on non-coding RNA data has enabled the development of composite risk scores to distinguish endophenotypes and support clinical diagnosis. Lastly, the therapeutic efficacy of valproic acid may be mediated via its endogenous histone deacetylase-inhibiting effect and chromatin remodeling. As our understanding of epigenetic modulation in migraine expands, these molecular insights can be integrated with genomic profiles to advance precision medicine, adding value to the interaction between genetic and environmental factors.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"30 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13719745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149301614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Needed Approaches for Dietary Research in Migraine.","authors":"Margaret Slavin, Maryann Greenfield, Anjali Pendala, Valentina A Andreeva, Ali Ozmeral, Elizabeth Seng","doi":"10.1007/s11916-026-01573-6","DOIUrl":"10.1007/s11916-026-01573-6","url":null,"abstract":"<p><strong>Purpose of review: </strong>Diet is frequently cited among the lifestyle interventions important to managing migraine disease, but existing evidence informing dietary recommendations is hindered by limited and heterogeneous dietary study designs and results. Here, we review recent literature on migraine and diet with attention toward study designs needed to better inform dietary recommendations for migraine.</p><p><strong>Recent findings: </strong>Numerous recent observational studies agree that dietary intake of individuals with migraine is slightly different than their counterparts without migraine, and the disparity appears to be greater with more severe symptoms. The cross-sectional nature of the data prevents determination of causality. Meanwhile, mechanistic evidence is mounting that the relationship between dietary intake and migraine is bidirectional, yet little has been observed about the direct influence of migraine on dietary intake. Increasingly rigorous controlled dietary feeding studies demonstrate the ability of dietary modifications to impact migraine outcomes, and the strongest evidence exists for diets that diverge substantially from typical eating patterns. The implications of long-term dietary intake on migraine prognosis are also not yet known due to lack of prospective data. Multidimensional evidence supports the existence of a bidirectional relationship between diet and migraine, but data are lacking on how this interplay actually impacts dietary intake and what it means for dietary recommendations. Future research needs include: expanded study designs to better elucidate how migraine influences diet, clinical trials evaluating interventions that support healthy eating behaviors in the presence of migraine symptoms, and prospective cohorts with longitudinal assessments of migraine and dietary intake, to provide data on the reduction of risk for migraine, its exacerbation and co-morbid diet-related chronic diseases.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"30 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13710641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149276677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Pain Management in the Intensive Care Unit.","authors":"Carolyn Thai, Anis Dizdarevic","doi":"10.1007/s11916-026-01570-9","DOIUrl":"10.1007/s11916-026-01570-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review summarizes current approaches to pain assessment and pharmacologic therapy in the intensive care unit (ICU) and evaluates the expanding role of regional anesthesia (RA).</p><p><strong>Recent findings: </strong>Contemporary ICU analgesia emphasizes systematic pain assessment and multimodal therapy while avoiding unnecessary deep sedation. RA provides targeted, opioid-sparing analgesia for localized pain but is limited by coagulopathy, infection, altered anatomy, and practical considerations. Fascial-plane blocks may provide useful alternatives in selected patients. Thoracic epidural and paravertebral techniques remain options for selected patients but may cause hypotension and clinically significant bleeding. Ultrasound-guided techniques, including erector spinae, serratus anterior, parasternal, rectus sheath, and transversus abdominis plane blocks, expand analgesic options. Continuous catheter techniques may extend analgesia when prolonged pain is anticipated. However, evidence in heterogeneous ICU populations remains limited, and much of the current evidence is derived from perioperative or trauma populations rather than general medical ICU cohorts. Further ICU-specific comparative trials are needed to define patient selection and clinically meaningful outcomes.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"30 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149247185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral Nerve Stimulation for Essential Tremor: a Systematic Review and Meta-Analysis of Effectiveness and Safety.","authors":"Mohamed El-Moslemani, Abdallah Abbas, Haneen Sabet, Abdullah Almarfadi, Mohammad Mahadin, Ro'ya Khanfar, Obai Yousef, Amna Hussein, Alaa Abd-Elsayed, Julie G Pilitsis","doi":"10.1007/s11916-026-01549-6","DOIUrl":"10.1007/s11916-026-01549-6","url":null,"abstract":"<p><strong>Background: </strong>Essential tremor (ET) is the most prevalent movement disorder worldwide. There are limited current pharmacological therapies, and their side effects often preclude adequate doses. Surgical therapies, such as Deep Brain Stimulation (DBS) and Focused Ultrasound (FUS), are reserved for patients with tremor that debilitates activities of daily living (ADLs). Peripheral nerve stimulation (PNS), including transcutaneous afferent patterned stimulation (TAPS) and transcutaneous peripheral nerve stimulation (TPNS), has emerged as a promising non-invasive neuromodulatory approach for many patients with intermediate symptoms.</p><p><strong>Methods: </strong>A systematic review and meta-analysis following PRISMA 2020 guidelines was conducted, with searches across PubMed, Scopus, Cochrane, and Web of Science. Studies enrolling patients with ET assessing TAPS and TPNS were included. Primary outcomes were tremor severity (TETRAS performance scale, total TETRAS) and tremor amplitude. Secondary outcomes included functional disability (BF-ADL, TETRAS-mADL) and safety.</p><p><strong>Results: </strong>Nineteen studies (2,541 patients) were included. Sham-controlled analyses showed statistically significant improvement in TETRAS performance scale scores (MD = - 1.00; p = 0.002; I² = 0%). BF-ADL scores improved significantly in sham-controlled analyses (MD = - 1.69; p < 0.0001) and single-arm pre-post analyses (MD = - 3.22; p < 0.0001). Tremor amplitude and total TETRAS outcomes were inconsistent, with high heterogeneity (I² up to 94%) driven mainly by differences in assessment timing; the pooled total TETRAS estimate was not statistically significant (p = 0.16). Adverse events were mostly mild and transient; skin irritation was the most frequently reported (7.88%), and no serious adverse events were attributed to the intervention.</p><p><strong>Conclusions: </strong>PNS consistently improved functional outcomes with a favorable safety profile in ET patients. These findings support PNS as a viable adjunctive or on-demand non-invasive therapeutic option, particularly for medication-refractory patients or those unsuitable for surgery.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"30 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Evidence on the Use of Calcitonin Gene-Related Peptide-Targeting Therapies in Children and Adolescents.","authors":"Lauren Shin, Ryan Moon, Amy Gelfand","doi":"10.1007/s11916-026-01567-4","DOIUrl":"10.1007/s11916-026-01567-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>This is a narrative review to summarize current evidence on use of therapies targeting calcitonin gene-related peptide (CGRP) for children and adolescents with headache disorders.</p><p><strong>Recent findings: </strong>The CGRP-targeting therapies have been used in adults for prevention of migraine since 2018. There is one randomized controlled trial (RCT) published on fremanezumab in children age 6-17 years old which showed favorable outcome as a preventive treatment for episodic migraine. Several real-world evidence (RWE) studies report on use of CGRP-targeting therapies in patients younger than 18 years old. Several clinical trials are pending for other CGRP-targeting therapies.</p><p><strong>Conclusion: </strong>There is a small number of RWE studies and one RCT study that shows that CGRP-targeting therapies have potential to be beneficial and safe to use in children and adolescents with headache disorders. Future clinical trials, once completed, will further shed light on efficacy and safety of CGRP-targeting therapies.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"30 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacological and Non-Pharmacological approaches to manage Tension-Type Headache: a Systematic Review.","authors":"Chloé Barreira, Bruno Daniel Carneiro, Carlos Faria, Daniel Humberto Pozza","doi":"10.1007/s11916-026-01566-5","DOIUrl":"10.1007/s11916-026-01566-5","url":null,"abstract":"<p><strong>Introduction: </strong>Tension-Type Headaches (TTH), particularly in its chronic form, constitutes a persistent pain syndrome that can substantially impair physical, cognitive, emotional, and social functioning. Although this is the most common type of headache, there is a lack of clear consensus on the optimal long-term treatment strategy.</p><p><strong>Objectives: </strong>A systematic review was conducted to evaluate the evidence for the effectiveness of pharmacological and non-pharmacological treatments in patients diagnosed with episodic or chronic TTH, focusing on improvements in headache pain and related clinical outcomes.</p><p><strong>Methods: </strong>A search across five electronic databases (PubMed, Scopus, Web of Science, Cochrane CENTRAL, and PsycNET) was conducted to identify randomized clinical trials (RCTs). The review was registered in PROSPERO, followed PRISMA guidelines and used the Cochrane Risk of bias 2 tool. Due to significant clinical and methodological heterogeneity, a narrative synthesis was performed following the Synthesis Without Meta-analysis (SWiM) framework, and the certainty of evidence was appraised using the GRADE approach.</p><p><strong>Results and conclusions: </strong>Ninety-three RCTs were included, most of which had a moderate to low risk of bias. Based on the findings of this systematic review, the evidence suggests that pharmacological, manual, and behavioral therapies each have specific indications. These approaches can be combined in an individualized manner according to each patient's needs, with the aim of maximizing long-term symptom reduction, minimizing side effects, and ultimately improving quality of life in individuals with TTH.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"30 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Behavioral and Psychological Interventions in Chronic Ocular Pain.","authors":"Radhika S Amin, Eliot N Haddad, Raghavan Gopalakrishnan, Sara McCormick, Pavan Tankha, Sara Davin, Rony R Sayegh","doi":"10.1007/s11916-026-01565-6","DOIUrl":"https://doi.org/10.1007/s11916-026-01565-6","url":null,"abstract":"<p><strong>Purpose of review: </strong>Chronic ocular pain (COP) is a debilitating condition in which patients experience pain in or around the eyes. It is strongly associated with other pain and psychological conditions. Management options remain limited and available ocular therapies are rarely effective, particularly in patients with central sensitization. As in other pain conditions, psychological and behavioral interventions are important, yet understudied and underutilized in the management of COP. This review explores the literature pertaining to such interventions for COP.</p><p><strong>Recent findings: </strong>COP, while previously thought of as dry eye disease, is now accepted as a separate pain entity. It overlaps with other chronic pain conditions and is also associated with depression, anxiety, post-traumatic stress disorder, sleep disturbance, pain catastrophizing, fear avoidance, and somatic symptom burden, which can be conceptualized through a biopsychosocial model. In broader chronic pain populations, cognitive behavioral therapy, mindfulness-based interventions, acceptance and commitment therapy, pain neuroscience education, emotional awareness and expression therapy, and behavioral interventions have demonstrated benefit for pain-related distress, coping, function, and disability. However, evidence supporting such interventions for COP remains limited, and no formal investigation of psychological interventions for COP has been published to date. The reviewed literature provides supportive evidence for psychological and behavioral interventions as mechanism-based adjuncts for COP management within a biopsychosocial framework. Integrating these approaches through multidisciplinary care models emphasizing pain psychology may help address central pain contributors and functional disability. COP-specific trials are needed to define which patients will most benefit, optimal interventions, and implementation models in practice.</p>","PeriodicalId":50602,"journal":{"name":"Current Pain and Headache Reports","volume":"30 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}