Clinical Journal of Pain最新文献

{"title":"Interdisciplinary Multimodal Pain Treatment for Patients with Chronic Musculoskeletal, Neuropathic, Primary Chronic, and tumor-related Pain at an University Outpatient Clinic - two Years follow-up in Four Symptom Domains.","authors":"Rupert Hölzl, Boo-Young Chung, Justus Benrath","doi":"10.1097/AJP.0000000000001312","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001312","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with chronic pain should receive specialist treatment in outpatient, day-care or inpatient clinics by \"interdisciplinary multimodal pain therapy\" recommended by scientific pain associations. Existing structural requirements, however, can often not support a full IMPT program for diverse indications. We report on a modified IMPT program implemented at the Pain Center of the University Hospital Mannheim which is readily adaptable for other regional pain centers seeing a similar broad spectrum of pain diagnoses and variable chronicities.</p><p><strong>Methods: </strong>The retrospective study on 106 day-care patients with chronic pain investigated the effects on four major pain domains, i.e., pain characteristics, function and impairment, well-being and quality of life, and mental health including depression two years after program entry. Patients were categorized according to referral ICD-10 diagnoses into musculoskeletal, neuropathic and persistent pain with psychosocial factors plus a small group with tumor-related pain.</p><p><strong>Results: </strong>Most markers of the major pain domains had significantly improved including function and well-being. The improvements were reproduced in the major pain clusters with best results for specific neuropathic and tumor pain and lesser but significant effects on musculoskeletal pain. Patients with persistent pain disorders responded least.</p><p><strong>Discussion: </strong>The results show that an individualized IMPT can be put in effect in an outpatient clinic seeing a diversity of chronic pain diagnoses. The success and failure rates for different pain pictures delineate the scope and the limits of generic IMPTs.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency and Correlates of Physical Activity among Young Adults with Chronic Pain.","authors":"Laura E Laumann, Katherine E Gnall, Sinead M Sinnott, Crystal L Park, Dean G Cruess","doi":"10.1097/AJP.0000000000001314","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001314","url":null,"abstract":"<p><strong>Objectives: </strong>Chronic pain affects an estimated 8.5% of young adults in the United States. Physical activity is a promising strategy for behavioral pain management, yet research characterizing prevalence and correlates of physical activity among young adults with chronic pain is scant. The present study sought to characterize physical activity patterns and identify psychosocial predictors of physical activity in this population.</p><p><strong>Methods: </strong>Participants were 129 young adults with self-reported chronic pain. Fear-avoidance (experiential avoidance, kinesiophobia), mental health (depression, anxiety) and energy-related (sleep disturbance, fatigue) factors were examined as correlates and predictors of moderate-to-vigorous physical activity (MVPA), walking, and sedentary behavior using generalized linear models.</p><p><strong>Results: </strong>Participants reported an average of 51.0 (IQR=16.75, 100.75) minutes of MVPA and 90.0 (IQR=43, 153) minutes of walking per day. Nearly three-quarters (72.9%) of participants met recommended MVPA guidelines. At baseline, experiential avoidance (95% CI [-0.019, -0.007]), depression (95% CI [-0.100, -0.017]), and fatigue (95% CI [-0.042, -0.007]) were negatively associated with MVPA; depression (95% CI [1.37, 13.71]) was positively associated with sedentary behavior. Experiential avoidance at baseline predicted MVPA at two-week follow-up (95% CI [-0.015, -0.001]). No psychosocial factors were significantly associated with or predictive of walking.</p><p><strong>Discussion: </strong>On average, young adults with chronic pain in our sample met recommended physical activity guidelines. Experiential avoidance was associated with MVPA at baseline and predicted less MVPA two weeks later. Findings suggest that while pain itself may not prevent engagement in MVPA among this population, a desire to prevent discomfort may be prohibitive.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Combined Lidocaine Transdermal Patch and Lidocaine Subcutaneous Injection Versus Lidocaine Subcutaneous Injection Alone for Trans-distal Radial and Trans-Radial Arterial Access Pain and Cost-Effectiveness: A Single-Blind Randomized Study.","authors":"Arata Hagikura, Kazuki Moriwaki, Hayato Tanaka, Yu Kawai, Miko Hosoi, Maya Kashimoto, Yuki Satani, Shumpei Yao, Yutaro Nagase, Kana Nagasawa, Atsushi Miyajima, Naoto Inoue, Eitaro Umehara, Takanori Kusuyama, Daiju Fukuda","doi":"10.1097/AJP.0000000000001308","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001308","url":null,"abstract":"<p><strong>Objectives: </strong>The optimal local anesthetic for trans-distal radial (TDRA) and trans-radial arterial (TRA) catheterization is unclear and not standardized. This study compared the efficacy and cost-effectiveness of adding a lidocaine patch to standard lidocaine subcutaneous lidocaine injection for TDRA and TRA procedures.</p><p><strong>Methods: </strong>This was a prospective, single-blind study conducted between September 2021 and December 2023. With written consent, consecutive patients undergoing TDRA or TRA catheterization in patients with ischemic heart and peripheral arterial disease were randomized to receive either a lidocaine patch (Lidocaine group, n=41) or a placebo patch (Placebo group, n=43) at the planned arterial access site at least 30 minutes before the procedure, followed by lidocaine subcutaneous anesthesia using a 27-gauge needle. The primary outcome was access site pain measured by visual analog scale (VAS) at predetermined three points. Secondary outcomes included drug-related costs.</p><p><strong>Results: </strong>VAS scores at all three points were comparable (Lidocaine vs. Placebo: at the point of lidocaine infusion 20 mm vs. 19 mm, P=0.55; during the procedure 17 mm vs. 14 mm, P=0.67; after the procedure 9 mm vs. 12 mm, P=0.71). The Lidocaine group incurred significantly higher costs, even when considering only the lidocaine patch (0.43 USD vs. 0.00 USD, P<0.001) and the total amount of lidocaine patch and lidocaine subcutaneous infusion (0.62 USD vs. 0.21 USD, P<0.001).</p><p><strong>Discussion: </strong>The addition of a lidocaine patch to standard lidocaine subcutaneous injection for TDRA or TRA catheterization did not improve pain relief or cost-effectiveness.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuropathic Pain in Female Patients with Fibromyalgia Syndrome: Clinical, Electrodiagnostic and Genetic Aspects.","authors":"Noha A Elsawy, Marwa Hassan, Rasha A Ghazala, Riham Hamed, Rehab Elnemr","doi":"10.1097/AJP.0000000000001311","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001311","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to explore the potential contribution of small fiber pathology (SFP) and COMT enzyme gene Val/158/Met functional polymorphism to neuropathic pain (NP) in FMS female patients.</p><p><strong>Methods: </strong>This case-control study was conducted on 60 women with FMS and 60 matched healthy women. All patients were subjected to detailed clinical assessment. Sympathetic skin response (SSR) and cutaneous silent period (CSP) were performed to assess small fiber neuropathy (SFN). Catechol-Omethyl-transferase (COMT) SNP, rs4680 (A/G, missense158Val/Met),) were genotyped for all studied subjects.</p><p><strong>Results: </strong>FMS patients had significantly longer latency and lower amplitude of foot and hand SSR (P<0.001), with seven patients having unobtainable foot SSR. Also, they had significantly earlier onset latency, longer duration, and more delayed offset latency of CSP (P<0.001, from most of them). Regarding the relation between COMT genotypes and different disease characteristics, patients with A/A genotypes had a statistically significant increase in pain severity scores compared to those with G/G genotypes (P=0.013 for McGill and 0.019 for the visual analogue scale). Moreover, there was a significant increase in NP scores (P=0.004 and 0.001, for pain DETEDT and SFNL, respectively) of A/A and A/G compared to G/G genotypes.</p><p><strong>Conclusion: </strong>It can be concluded that moderate to severe neuropathic pain was experienced by all the studied patients with fibromyalgia syndrome, and small fiber pathology was suggested to be a significant contributor to neuropathic pain. Moreover, the COMT A/A genotype was found to be associated with the NP as well as pain severity.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presence of Neuropathic-Like Symptoms in Individuals With Painful Tendinopathy/Overuse Injuries: A Systematic Review and Meta-Analysis.","authors":"Ignacio Cancela-Cilleruelo, Jorge Rodríguez-Jiménez, José L Arias-Buría, Marcos J Navarro-Santana, Lars Arendt-Nielsen, César Fernández-de-Las-Peñas","doi":"10.1097/AJP.0000000000001292","DOIUrl":"10.1097/AJP.0000000000001292","url":null,"abstract":"<p><strong>Objective: </strong>This meta-analysis evaluated the prevalence of neuropathic-like symptoms in individuals with painful tendinopathies/overuse injuries.</p><p><strong>Methods: </strong>Electronic literature searches on MEDLINE, CINAHL, PubMed, SCOPUS, and Web of Science databases were conducted up to January 20th, 2025. Studies reporting the prevalence of neuropathic-like symptoms in painful tendinopathy/overuse injury were included. The methodological quality was assessed with the Newcastle-Ottawa Quality Assessment Scale in cohort/case-control studies or the Physiotherapy Evidence Database (PEDro) in clinical trials. Random-effects models were used for meta-analytical pooled prevalence of neuropathic-like symptoms.</p><p><strong>Results: </strong>From 1285 studies identified, 8 (1 case-control, 5 cohorts, and 2 clinical trials) met inclusion criteria. The sample included 920 participants with painful tendinopathy/overuse injury (47.6% female, age: 51, SD: 12.5 y). All studies included self-reported questionnaires for evaluating neuropathic-like symptomatology. The methodological quality was moderate-high. The overall prevalence of neuropathic-like symptoms in painful tendinopathies was 30% (95% CI: 22%-38%, n=8, I2 =79%). The prevalence by each tendinopathy was: plantar heel pain (44%, 95% CI: 17%-75%, n=2, I2 =96%), lateral epicondylalgia (42%, 95% CI: 30%-56%, n=2, I2 =30%), insertional Achilles tendinopathy (38%, 95% CI: 20%-60%, n=2, I2 = 71%), greater trochanteric pain syndrome (32%, 95% CI: 26%-39%, n=2, I2 =0%), patellar-quadricipital tendinopathy (16%, 95% CI: 5%-41%, n=3, I2 =29%), noninsertional Achilles tendinopathy (11%, 95% CI: 2%-41%, n=5, I2 =86%).</p><p><strong>Conclusion: </strong>The results of this meta-analysis suggests the presence of neuropathic-like symptoms in 30% of participants with painful tendinopathy, although this prevalence rate depends on specific condition. Identification of neuropathic symptoms in musculoskeletal pain conditions is important for diagnosis as it impacts its management.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Individual Psychological Factors and Cumulative Psychological Distress on Prospective Pain Quality in Older Adults With Chronic Low Back Pain.","authors":"Patrick J Knox, Corey B Simon, Ryan T Pohlig, Jenifer M Pugliese, Peter C Coyle, Jaclyn M Sions, Gregory E Hicks","doi":"10.1097/AJP.0000000000001294","DOIUrl":"10.1097/AJP.0000000000001294","url":null,"abstract":"<p><strong>Objective: </strong>Although pain quality may be a component of the geriatric chronic pain experience that influences disability, no research has investigated the psychological underpinnings of pain quality in any geriatric chronic pain population. We sought to address this knowledge gap by examining associations between both general (ie, depressive symptoms) and pain-specific psychological risk factors (ie, fear-avoidance beliefs, pain catastrophizing, and kinesiophobia) and prospective pain quality in older adults with chronic low back pain.</p><p><strong>Methods: </strong>Questionnaires for each psychological factor were collected at baseline, while pain quality was measured by the McGill Pain Questionnaire at baseline and 12 months. Preliminary analyses identified pain catastrophizing as the individual factor with the highest correlation to future pain quality for subsequent analyses. To assess if baseline psychological factors were cumulatively associated with 12-month pain quality, questionnaire values were entered into principal component analysis to yield a combined psychological component score. Robust regression models with HC3 standard errors were used to examine associations between baseline psychological risk factors (both individually and cumulatively) and prospective pain quality.</p><p><strong>Results: </strong>In adjusted analyses, higher baseline pain catastrophizing independently predicted worse pain quality at 12 months ( b =0.342, t =4.225, P <0.001). Similarly, higher baseline psychological component scores were independently associated with worse prospective pain quality after adjustment ( b =3.816, t =4.518, P <0.001).</p><p><strong>Discussion: </strong>The combined psychological component score had comparatively stronger predictive ability than pain catastrophizing alone; however, overall model prediction was modest, suggesting that future research is needed to identify other biopsychosocial variables that may impact pain quality in the geriatric chronic LBP population.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12369281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engagement in Digital Self-management Interventions for Chronic Pain: A Systematic Review.","authors":"R Ross MacLean, Rachel Shor, Erin D Reilly, Lillian Reuman, Chelsey Solar, Allison M Halat, Diana M Higgins","doi":"10.1097/AJP.0000000000001289","DOIUrl":"10.1097/AJP.0000000000001289","url":null,"abstract":"<p><strong>Objectives: </strong>Digital interventions promise to increase access to non-pharmacological chronic pain treatment and reduce burden for both individuals seeking care and pain providers/clinics. Unfortunately, despite early evidence of efficacy, engagement in self-management digital interventions for chronic conditions is typically low. A comprehensive analysis into how engagement in these programs is measured and reported is warranted. The current systematic review evaluated engagement in digital self-management interventions for chronic pain and identified gaps to improve reporting of engagement data.</p><p><strong>Methods: </strong>We conducted a pre-registered systematic review using Boolean search terms to identify digital chronic pain self-management interventions that did not include clinician support. After removal of duplicates and screening, 150 full-text manuscripts were assessed, and 43 studies met inclusion criteria. Data was extracted and examined from included manuscripts.</p><p><strong>Results: </strong>Of the 43 included articles, five articles were based on 2 separate datasets, resulting in a final sample of 41 unique datasets representing 4205 participants that were mostly non-Hispanic White, female, and with at least some college education. Approximately 10% of studies did not report any data related to system use or self-reported engagement. Most engagement data consisted of mean system use variables, with a handful of studies describing self-reported use of skills and very few studies examining demographic variables associated with engagement.</p><p><strong>Discussion: </strong>To address identified gaps in the reviewed literature, we suggest guidelines for collecting and reporting engagement in digital chronic pain interventions. Consistent reporting of engagement data will improve evaluation, efficacy, and improvement of interventions designed to assist individuals who may otherwise not receive non-pharmacological pain treatment.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Psychological Factors Explain the Persistence of Symptoms in Individuals With Rotator Cuff-related Shoulder Pain? A Prospective Cohort Study.","authors":"Dayana Patricia Rosa, Marc-Olivier Dubé, Simon Beaulieu-Bonneau, Alex Scott, Hugo Masse-Alarie, Jean-Sébastien Roy","doi":"10.1097/AJP.0000000000001280","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001280","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether psychosocial factors, such as resilience, perceived stress, catastrophizing, anxiety, depression, pain self-efficacy, and social support, explain the persistence of pain and disability in individuals with rotator cuff-related shoulder pain (RCRSP) following an education program.</p><p><strong>Methods: </strong>One hundred forty-three individuals with persistent RCRSP were included in this prospective cohort study. At baseline, participants completed self-reported questionnaires related to pain, disability, and psychosocial constructs, including resilience, stress, catastrophizing, anxiety and depressive symptoms, pain self-efficacy, and social support. Thereafter, participants took part in an educational program aimed at promoting self-management of RCRSP that included 2 meetings with a physiotherapist. After 12 and 24 weeks, participants filled out pain and disability questionnaires and, based on their scores, were classified as having persistent shoulder pain or as recovered.</p><p><strong>Results: </strong>A univariable modified Poisson regression showed that higher perceived stress (RR adjusted : 1.02; 95% CI: 1.01-1.04), catastrophizing (RR adjusted : 1.01; 95% CI: 1.01-1.02), symptoms of depression (RR adjusted : 1.03; 95% CI: 1.01-1.06) and anxiety (RR adjusted : 1.03; 95% CI: 1.01-1.06), along with lower resilience (RR adjusted : 0.90; 95% CI: 0.81-1.00), were associated with ongoing RCRSP at 12 weeks. In addition, reduced pain self-efficacy was associated with persistent pain at both 12 weeks (RR adjusted : 0.98; 95% CI: 0.97-0.99) and 24 weeks (RR adjusted : 0.99; 95% CI: 0.98-1.00). Multivariable regression indicated that only pain self-efficacy served as a protective factor against persistent RCRSP (RR adjusted : 0.98; 95% CI: 0.97-0.99).</p><p><strong>Discussion: </strong>This study sheds light on the impact of psychosocial factors on persistent RCRSP, underscoring the importance of positive beliefs in pain management. Importantly, pain self-efficacy emerges as a key factor in recovery.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":"41 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Effectiveness of Noninvasive Brain Stimulation for the Treatment of Pain, Fatigue, and Sleep Quality in Fibromyalgia. A Systematic Review With Network Meta-Analysis.","authors":"Ishtiaq Ahmed, Rustem Mustafaoglu, Aamir R Memon, Rubab Zafeer, Huanyu Xiong, Sofia Straudi, Nils Runge","doi":"10.1097/AJP.0000000000001282","DOIUrl":"10.1097/AJP.0000000000001282","url":null,"abstract":"<p><strong>Objectives: </strong>There is tentative evidence to support the analgesic effects of noninvasive brain stimulation (NiBS) in fibromyalgia (FM), but a comprehensive synthesis is lacking. This systematic review with network meta-analysis (NMA) aimed to determine the relative effectiveness of different NiBS techniques, such as transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) in FM, and to identify the optimal stimulation location and intensity/frequency.</p><p><strong>Methods: </strong>Four databases were searched until July 9, 2023 for randomized trials (RCTs) comparing NiBS in FM. Pain was the primary outcome, while fatigue and sleep were secondary outcomes. A frequentist NMA calculated standardized-mean-differences (SMDs) for pain, with pairwise meta-analysis for fatigue and sleep. Bias was assessed with the Cochrane-risk-of-bias-tool (RoB-2.0), and evidence certainty through confidence-in-NMA.</p><p><strong>Results: </strong>Forty-three RCTs with 2120 participants were included. NMA showed that low frequency (LF)-rTMS (SMD: -1.20, 95% CI: -1.82 to -0.58), dual tDCS (SMD: -0.91, 95% CI: -1.82 to -0.58), and high frequency (HF)-rTMS (SMD: -0.58, 95% CI: -1.00 to -0.17) likely results in a reduction in pain intensity at the end of intervention compared with sham stimulation. For stimulation location, right dorsolateral prefrontal cortex (DLPFC)(SMD: -1.42, 95% CI: -2.69 to -0.15), bilateral DLPFC (SMD: -0.94, 95% CI: -1.82 to -0.05), and left primary motor cortex (M1)(SMD: -0.49, 95% CI: -0.85 to -0.14) likely results in reduction in pain intensity at the end of intervention, with DLPFC maintaining effects in short-term. LF-rTMS over DLPFC (SMD: -1.42, 95% CI: -2.69 to -0.15) and HF-rTMS over M1 (SMD: -0.78, 95% CI: -1.39 to -0.18) likely results in the reduction in pain intensity at the end of intervention, with LF-rTMS over right DLPFC maintaining effects in the short term. NiBS appears to be safe and may reduce fatigue and improve sleep quality.</p><p><strong>Discussion: </strong>Excitatory stimulation like HF-rTMS over M1 and inhibitory like LF-rTMS over DLPFC may yield better results.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Analgesic Efficacy of Different Regional Blocks After Single-incision Video-assisted Thoracoscopic Surgery.","authors":"Gu-Yue Liu, Fu-Shan Xue, Mu Jin","doi":"10.1097/AJP.0000000000001287","DOIUrl":"10.1097/AJP.0000000000001287","url":null,"abstract":"","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}