Journal of Pain最新文献

{"title":"Transgenic mice with a global depletion of toll-like receptor type 4 are largely protected from peripheral and central posttraumatic neuroinflammation","authors":"Silke Hirsch ,&nbsp;Theodora Kalpachindou ,&nbsp;Tanja Schlereth ,&nbsp;Michaela Kress ,&nbsp;Frank Birklein","doi":"10.1016/j.jpain.2025.105340","DOIUrl":"10.1016/j.jpain.2025.105340","url":null,"abstract":"<div><div>Experimental bone fracture induces a posttraumatic inflammatory reaction which is characterized by local swelling, increased temperature, tenderness, thermal hypersensitivity and pain at the lesion site. As a consequence, some patients develop complex regional pain syndrome (CRPS), a chronic pain condition which often starts with exacerbating inflammation of the limb. The transmembrane receptor Toll-like receptor type 4 (TLR4) plays a central role in the innate immune response and not only engages with extracellular but also intracellular ligands, initiating intricate intracellular signaling cascades promoting inflammation. Depletion of TLR4 specifically in microglia attenuates posttraumatic pain, especially in males. Here, it is shown that male mice lacking TLR4 develop less inflammation after distal bone fracture, with attenuated swelling, local warming, macrophage invation into the dorsal root ganglion and spinal activation of microglia. Furthermore, expression of neuroinflammatory markers such as NGF, TNFα, ATF3 and Il4rα, is reduced in dorsal root ganglia. Together, the results support a proinflammatory role of TLR4 after distal bone fracture possibly initiating mechanisms leading to complex regional pain syndrome development in some patients which may be a promising novel for analgesic drug development.</div></div><div><h3>Perspective</h3><div>TLR4 is causally involved in the development of posttraumatic neuroinflammation characterised by upregulation of inflammatory mediators, invasion of macrophages into the dorsal root ganglion, as well as activation of microglia changes in the spinal dorsal horn in a murine model of human complex regional pain syndrome.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"29 ","pages":"Article 105340"},"PeriodicalIF":4.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442714","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":"Effects of manual therapy combined with therapeutic exercise on brain structure in patients with chronic nonspecific neck pain: A randomized controlled trial","authors":"Rungtawan Chaikla ,&nbsp;Munlika Sremakaew ,&nbsp;Suwit Saekho ,&nbsp;Suchart Kothan ,&nbsp;Sureeporn Uthaikhup","doi":"10.1016/j.jpain.2025.105336","DOIUrl":"10.1016/j.jpain.2025.105336","url":null,"abstract":"<div><div>This trial aimed to investigate the effects of 10-week manual therapy combined with exercise compared to routine physical therapy on brain structure and clinical outcomes in patients with neck pain. Fifty-two participants with chronic nonspecific neck pain were randomized into either an intervention group or a control group (a 1:1 ratio). The intervention group received cervical mobilization and cervical and scapular exercises. The control group received routine physical therapy. The primary outcomes were cortical thickness and volume. Secondary outcomes were neck pain intensity, disability, psychological symptoms, cervical range of motion and cervical flexor muscle strength. Outcome measures were taken at baseline and post-treatment. There was no loss to follow-up. Compared to baseline, significant differences in cortical thickness were observed at post-treatment in both groups, including prefrontal cortex (PFC), anterior cingulate cortex (ACC), primary somatosensory cortex (S1), primary motor cortex (M1) and precuneus (<em>p</em>&lt;0.05). The intervention group exhibited greater increases in cortical thickness in the ACC and M1 compared to controls (<em>p</em>&lt;0.05). The secondary outcomes were improved in both groups (<em>p</em>&lt;0.05). There were differences in brain structure (S1, PFC and insula) between participants who experienced ≥50% reduction in pain intensity and those with &lt;50% reduction (<em>p</em>&lt;0.05). Changes in brain structure were correlated with changes in pain intensity and neck disability (r =−0.31 to −0.44, <em>p</em>&lt;0.05). The study suggests that patients with chronic nonspecific neck pain who experienced significant improvements in pain intensity exhibited greater changes in cortical structure following a 10-week intervention, particularly with a combination of manual therapy and exercise.</div></div><div><h3>Perspective</h3><div>A combination of manual therapy and exercise results in greater improvements in clinical outcomes and substantially alters cortical thickness compared to routine physical therapy in patients with chronic nonspecific neck pain. These findings highlight the potential impact of this intervention on both brain structure and clinical recovery.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"29 ","pages":"Article 105336"},"PeriodicalIF":4.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429334","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":"Associations of ethnic identity, religiosity, discrimination, and injustice appraisal with pain-related outcomes in arab americans with chronic back pain.","authors":"Albatool H Alnojeidi, Carmen E Capo-Lugo, John A Sturgeon, Zina Trost","doi":"10.1016/j.jpain.2025.105337","DOIUrl":"10.1016/j.jpain.2025.105337","url":null,"abstract":"<p><p>This study sought to examine the moderating roles of ethnic identity, acculturation, and religiosity on the relationship between pain-related injustice appraisal and chronic low back pain (CLBP) outcomes among a sample of Arab-Americans, who are an underrepresented population in prior pain research. The study also aimed to examine the mediating effect of pain-related injustice appraisal in the relationship between discrimination and CLBP outcomes. The sample included 96 Arab-American adults who completed an online survey concerning their CLBP. Multiple regression was used to examine the moderating role of ethnic identity, acculturation, and religiosity on the relationship between injustice appraisal and disability and depression. Findings showed that ethnic identity (β = 0.43, p = 0.03) and religiosity (β = 0.28, p = 0.04), but not acculturation, buffered the relationship between pain-related injustice appraisal and CLBP-related depressive symptoms. Perceived discrimination predicted higher pain intensity (β = 0.28), disability (β = 0.56), and depressive symptoms (β = 0.51). Pain-related injustice appraisal significantly mediated the relationship between discrimination and CLBP-related disability (β = 0.24, p < 0.0001), and depressive symptoms (β = 0.22, p < 0.0001). The current study is the first to examine the role of unique ethnic characteristics, namely ethnic identity, acculturation, and religiosity, within the context of pain-related injustice appraisal. The results support the role of broader sociocultural and societal factors, such as ethnic-based discrimination, within the context of pain-related injustice appraisal as well as the influence of intra- and interpersonal factors and their interactions on pain-related injustice appraisal. PERSPECTIVE: This study is the first to demonstrate the unique role of ethnic identification, acculturation, and religiosity within the concept of pain-related injustice appraisal, specifically among Arab-Americans with chronic low back pain. This understanding could potentially help basic researchers, clinical scientists, as well as clinicians.</p>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":" ","pages":"105337"},"PeriodicalIF":4.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442701","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":"Chronic musculoskeletal pain and its association with cognitive function and sarcopenia in older adults: Characterization and change over three months","authors":"David Oliveira MSc ,&nbsp;Júlia Costa PhD ,&nbsp;Maria H. Marques MSc ,&nbsp;Anabela G. Silva PhD","doi":"10.1016/j.jpain.2025.105341","DOIUrl":"10.1016/j.jpain.2025.105341","url":null,"abstract":"<div><div>Pain, cognitive impairment, and sarcopenia share common risk factors and neurophysiological processes, but studies investigating cognition and sarcopenia in older adults with pain are scarce. This study's main aim was to compare cognition and sarcopenia between older adults with and without chronic pain. A secondary aim was to investigate predictors of cognition and sarcopenia at baseline and 3 months while adjusting for confounders. Participants (67 older adults with pain and 67 asymptomatic older adults) were assessed for sociodemographic and clinical information, pain (number of painful body sites – body chart, pain phenotype – PainDETECT, severity and disability – BPI, pain catastrophizing – PCS, and kinesiophobia – Tampa Scale), cognition (MoCA), sarcopenia (risk of sarcopenia - SARC-F, hand grip strength, and calf circumference) and physical activity (RAPA) at baseline and 3 months after. Older adults with and without pain did not differ in cognition (Mean (95% CI): Pain = 21.47 (20.60; 22.34); Asymptomatic = 21.75 (20.89; 22.61)), but older adults with pain had greater signs of sarcopenia than asymptomatic older adults, including higher risk of sarcopenia (Mean (95%CI): Pain=2.89 (2.41; 3.37); Asymptomatic=0.50 (0.32; 0.68)) and lower hand grip strength (Pain=24.01 (21.74; 26.29); Asymptomatic=27.98 (25.80; 30.16)). No between-group differences were found for calf circumference (Pain=35.03 (34.26; 35.79); Asymptomatic=34.55 (33.86; 35.24)). Pain phenotype (baseline) and kinesiophobia (3 months) contributed to poorer cognition. Kinesiophobia and catastrophizing (baseline), and pain severity (3 months) contributed to sarcopenia. Despite no differences in cognition between older adults with and without pain, pain-related variables contributed to explaining sarcopenia and cognition.</div></div><div><h3>Perspective</h3><div>This study compared cognition and sarcopenia between older adults with and without pain and explored the association between pain, cognition, and sarcopenia. Groups were similar for cognition, but older adults with pain showed higher signs of sarcopenia. Kinesiophobia and pain severity partially explained cognition and sarcopenia among those with pain.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"29 ","pages":"Article 105341"},"PeriodicalIF":4.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429228","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":"Self-rated pain and observed pain behavior in Black and White Americans with chronic low back pain","authors":"Matthew B. Jennings ,&nbsp;John W. Burns ,&nbsp;Benita Jackson ,&nbsp;Kristine M. Molina ,&nbsp;Mark A. Lumley","doi":"10.1016/j.jpain.2025.105338","DOIUrl":"10.1016/j.jpain.2025.105338","url":null,"abstract":"<div><div>Black Americans report more intense and disabling pain than White Americans, but differences in pain behavior have rarely been studied. The Structured Pain Behavior Test (SPBT), a standardized, video-recorded series of pain-inducing movements, assesses the behavioral expression of pain. We conducted the first test of whether Black Americans with chronic low back pain (CLBP) have greater pain behavior and increased self-reported pain intensity during the SPBT, compared to White Americans. Adults (<em>N</em> = 267) with CLBP (174 Black, 93 White; 57% female) rated their clinical pain severity and interference (Multidimensional Pain Inventory; MPI) and their current pain intensity (Numerical Rating Scale; NRS) both before and after engaging in the SPBT, which was coded for observed pain behavior. Consistent with prior research, Black participants reported greater MPI clinical pain severity and interference (large effect). More importantly, during the SPBT, Black participants had greater pain behavior (medium effect) and reported a greater increase in pain intensity (NRS; small-medium effect) than did Whites. Racialized differences in all pain measures remained significant after controlling for multiple variables (including depressive symptoms and pain catastrophizing), and differences in observed pain behavior remained after also controlling for self-reported pain intensity (NRS) or MPI clinical pain severity. We conclude that greater self-reported pain severity and interference among Black Americans is accompanied by greater pain behavior and increased pain intensity in response to pain-inducing movements. Research should examine possible mechanisms of this racialized difference, including differential access and care, racism as pain exacerbator, and the social communication of pain.</div></div><div><h3>Perspective</h3><div>Black Americans with chronic back pain have greater self-reported pain severity than White Americans and greater pain behavior during the Structured Pain Behavior Test, even after controlling for self-reported pain and other variables. Black Americans’ elevated pain may reflect poorer health care, racism-induced pain exacerbation, and/or social communication of need.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"29 ","pages":"Article 105338"},"PeriodicalIF":4.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425800","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":"Experimentally induced pain and paresthesia respond differently to parameter changes of cuff-based compression in pain-free young individuals","authors":"Jacek Skalski ,&nbsp;Sylwia Swoboda ,&nbsp;Tibor M. Szikszay ,&nbsp;Piotr Wodarski ,&nbsp;Andrzej Bieniek ,&nbsp;Kerstin Luedtke ,&nbsp;Wacław M. Adamczyk","doi":"10.1016/j.jpain.2025.105339","DOIUrl":"10.1016/j.jpain.2025.105339","url":null,"abstract":"<div><div>Neuropathic pain is a significant therapeutic challenge due to the co-occurrence with other neurological symptoms such as paresthesia. Human-based models such as cuff algometry can enhance our understanding of pain-paresthesia relationships. This experiment aimed to characterize (psychophysically) pain and paresthesia evoked by stimuli of different temporal and intensity parameters and to demonstrate the reliability of experimental induction of these two symptoms using cuff algometry. Forty participants, aged 18–35, were exposed to mechanical pressure stimuli at three intensities (100, 150, 200 mmHg) and three durations (90, 120, 150 s). Skin Conductance (SC) was continuously monitored, and participants rated pain and paresthesia in real-time using a computerized visual analog scale. The General Linear Model analysis revealed significant differences in paresthesia across all durations (p&lt;0.01), but not all intensities, as paresthesia did not increase from 150 to 200 mmHg (p&gt;0.05). Conversely, pain responses showed significant differences across all pressure intensities (p&lt;0.05) but not durations, as pain did not increase from 90 to 120 and from 120 to 150 s (p&gt;0.05). No interaction effects were found for either symptom. SC analysis showed no significant main or interaction effects. Intraclass correlation coefficients (ICCs) indicated moderate to excellent reliability for pain and paresthesia induction across different durations and intensities (ICC: 0.51–0.91), while SC showed poor to good reliability (ICC: 0.17–0.79). In conclusion, computerized cuff algometry seems to be an effective and reliable method for simultaneously inducing and assessing pain and paresthesia, revealing that these symptoms follow different patterns based on pressure duration and intensity.</div></div><div><h3>Perspective</h3><div>This study demonstrates that pain and paresthesia respond differently to varying intensities and durations of mechanical pressure, revealing their distinct psychophysical characteristics. This model can advance the understanding of neuropathic conditions and aid the development of more targeted therapeutic approaches for both pain and paresthesia.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"29 ","pages":"Article 105339"},"PeriodicalIF":4.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425774","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":"Using intensive longitudinal assessment to study mechanisms of the Native American pain inequity among persons experiencing depression and/or anxiety: The role of interpersonal discrimination and stress","authors":"Jamie L. Rhudy PhD ,&nbsp;Joanna O. Shadlow PhD ,&nbsp;Travis S. Lowe PhD ,&nbsp;Lancer D. Stephens PhD ,&nbsp;Michael J. Zvolensky PhD ,&nbsp;Lorra Garey PhD ,&nbsp;Darla E. Kendzor ,&nbsp;Michael S. Businelle PhD","doi":"10.1016/j.jpain.2025.105329","DOIUrl":"10.1016/j.jpain.2025.105329","url":null,"abstract":"<div><div>Native Americans (NA) experience higher rates of chronic pain than other U.S. racial/ethnic groups. Our research has indicated discrimination and stress play a role in chronic pain onset. However, chronic pain research has mostly relied on retrospective reports that may be impacted by recall bias. The current study was a secondary analysis of data from 208 NA, 206 Black, 202 Latinx, and 206 non-Hispanic White (NHW) participants from an efficacy trial of a mobile health intervention for depression and anxiety. Participants were prompted to complete 6 months of twice daily ecological momentary assessments (EMAs) that included stress and pain. Discrimination was assessed at baseline. Pain EMAs were used to reduce recall bias and estimate chronic pain prevalence. Dynamic structural equation modeling assessed the impact of race/ethnicity and discrimination on stress-pain relationships, as well as pain and stress dynamics. To assess chronic pain (pain ≥3-months), participants had to complete ≥3-months of consecutive EMAs, leaving 578 participants available for primary analyses (there were no racial/ethnic differences in EMA completion). Results showed NAs had the highest rate of chronic pain that was statistically significantly higher than NHW and Black participants. Controlling discrimination eliminated the NA-NHW, but not the NA-Black, pain inequity. Moreover, a reciprocal stress-pain relationship was found and was stronger in NAs than other groups. Discrimination did not exacerbate stress-pain relationships but was associated with higher rates of chronic pain and greater pain fluctuations, regardless of race/ethnicity. These findings indicate that targeting stress and discrimination could help reduce the NA pain inequity.</div></div><div><h3>Perspective</h3><div>Native Americans experienced a self-reinforcing stress-pain cycle in which stress predicted future pain and pain predicted future stress. This cycle was stronger than Black, Latinx, and non-Hispanic White groups. Discrimination was associated with chronic pain but not stronger stress-pain relationships. These findings have implications for treatment.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"29 ","pages":"Article 105329"},"PeriodicalIF":4.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425970","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":"Living successfully with chronic pain: Identifying the pivotal conditions needed to make it happen","authors":"Mélanie Bérubé ,&nbsp;Lesley Norris Singer ,&nbsp;Line Guénette ,&nbsp;Laurence Bourque ,&nbsp;Suzy Ngomo ,&nbsp;Anne Hudon","doi":"10.1016/j.jpain.2025.105332","DOIUrl":"10.1016/j.jpain.2025.105332","url":null,"abstract":"<div><div>Chronic pain is associated with many negative consequences for individuals and society. Given the burden it represents, many studies have focused on the risk factors involved, but very few have aimed to explain why some people live well with chronic pain, beyond the psychological realm. Thus, this study collected and analyzed different individual experiences to identify the pivotal conditions that help some individuals achieve quality of life despite chronic pain, with an emphasis on social considerations. We conducted a qualitative study using a narrative inquiry approach to unpack the participants’ stories on these pivotal conditions. We carried out 25 individual interviews with persons who considered they had been living well with their pain for a minimum of 6 months. Data were analyzed using the inductive narrative method. Most participants were women (64%), White (88%), with a high level of education, and having low back or generalized pain (56%). Three main themes were identified: 1) a care partnership, 2) a nurturing environment, and 3) breaking free from previous life to move forward. These themes were then divided into 11 sub-themes, providing an in-depth understanding of the pivotal conditions needed to live well with chronic pain. The data collected suggest that to enable people to have a favorable evolution in the presence of chronic pain, a socio-ecological approach could be necessary to counteract painogenic environments. However, these results need to be validated and adapted to different populations.</div><div>Perspective</div><div>This study highlights the importance of a socio-ecological approach to living well with chronic pain, emphasizing that care partnerships, a nurturing environment and the ability to break with the past are essential to improve the quality of life of those affected.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"29 ","pages":"Article 105332"},"PeriodicalIF":4.0,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374916","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":"Risks and familial coaggregation of suicide, accident mortality, and psychiatric disorders in first-degree relatives of individuals with migraine","authors":"Ju-Wei Hsu M.D. ,&nbsp;Shih-Jen Tsai M.D. ,&nbsp;Wen-Han Chang M.S. ,&nbsp;Chih-Ming Cheng M.D. ,&nbsp;Ya-Mei Bai M.D., PH.D. ,&nbsp;Tung-Ping Su M.D. ,&nbsp;Tzeng-Ji Chen M.D., PH.D. ,&nbsp;Mu-Hong Chen M.D., PH.D.","doi":"10.1016/j.jpain.2025.105335","DOIUrl":"10.1016/j.jpain.2025.105335","url":null,"abstract":"<div><div>Studies have revealed a comorbidity to be common between patients with migraine and those with psychiatric disorders, such as bipolar disorder (BD) and major depressive disorder (MDD). However, considering the substantial epidemiological differences in the prevalence of migraine between Western and Asian countries, further investigation was required to determine whether findings regarding familial coaggregation of migraine and psychiatric disorders can be generalized to Asian populations. Using the Taiwan National Health Insurance Database, we included 822,773 first-degree relatives (FDRs) of individuals with migraine and 3,291,092 FDRs of individuals without migraine. We investigated the prevalence of nine psychiatric disorders—schizophrenia, BD, MDD, autism, attention deficit hyperactivity disorder (ADHD), alcohol use disorder (AUD), substance use disorder (SUD), generalized anxiety disorder (GAD), and panic disorder (PD)—in addition to suicide and accidental death in these individuals. Poisson regression models with robust error variance revealed that the FDRs of individuals with migraine were at higher risks of suicide (relative risk: 1.11) as well as BD (1.09), MDD (1.16), autism (1.08), ADHD (1.23), AUD (1.20), SUD (1.14), GAD (1.23), and PD (1.26) than were those of individuals without migraine. The concurrent presence of psychiatric disorders, migraine, and suicide within families suggests a shared pathomechanism across these medical conditions. Thus, clinicians should closely monitor the mental health of FDRs of individuals with migraine.</div></div><div><h3>Perspective</h3><div>First-degree relatives of migraine probands had an increased risk of being diagnosed with psychiatric disorders, including schizophrenia, bipolar disorder, major depressive disorder, anxiety disorders, and alcohol or substance use disorders. They also died by suicide, regardless of the individual migraine and psychiatric comorbidities.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"29 ","pages":"Article 105335"},"PeriodicalIF":4.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143378986","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":"Transition of care readiness among adolescents with chronic pain between 2021-2022 in a Nationally representative sample","authors":"Daron M. Vandeleur MD ,&nbsp;Tonya M. Palermo PhD","doi":"10.1016/j.jpain.2025.105333","DOIUrl":"10.1016/j.jpain.2025.105333","url":null,"abstract":"<div><div>Chronic pain impacts 11–33% of children and will continue into adulthood for over half of them. Transition of pain management to adult care is crucial given high risk of interruption of care which is associated with subsequent poor medical, social, and vocational outcomes. Yet the transition experience for these youth is poorly characterized. Using a sample from the 2021 and 2022 National Survey of Children’s Health (conducted by parent report), we aimed to determine the prevalence of transition readiness among adolescents with chronic pain in the U.S. and estimate the association of readiness with biopsychosocial-cultural and health system characteristics. Of the 2584 adolescents aged 14–17 with chronic pain, 23.9% of adolescents met criteria for transition readiness. Using Poisson regression, we determined those more likely to meet criteria were older (PR 1.8 95%CI: 1.3, 2.6), female (PR 1.6 95% CI: 1.2, 2.2), White (Asian PR 0.4, 95% CI: 0.2, 0.9, Multi-racial PR 0.6 95% CI: 0.4, 0.9), and experienced shared decision making (aPR 1.7 95% CI: 1.1, 2.8). Fewer than half met criteria for medical home, effective care coordination, and adequate insurance. Poor mental health emerged as a concern with high levels of anxiety and/or depression (48%) and low levels of flourishing (42%). This is an important first step in demonstrating low transition readiness among adolescents with chronic pain and identifying mental health and healthcare continuity concerns. Future research should incorporate stakeholder perspectives and investigate pain specific factors relevant to transition readiness and investigate how readiness relates to transition outcomes.</div></div><div><h3>Perspective</h3><div>This article establishes low readiness to transition from pediatric to adult healthcare among adolescents with chronic pain and identifies disparities in readiness. Poor mental health and inadequate healthcare access were identified as factors which may impact transition intervention delivery. These findings can guide development and implementation of a transition intervention.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"29 ","pages":"Article 105333"},"PeriodicalIF":4.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392462","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}