Journal of Pain最新文献

{"title":"Altered breathing pattern and thoracic mobility in women with fibromyalgia: A case-control study","authors":"Kent Jonsson ,&nbsp;Andreas Pikwer ,&nbsp;Erik MG Olsson ,&nbsp;Magnus Peterson","doi":"10.1016/j.jpain.2025.105508","DOIUrl":"10.1016/j.jpain.2025.105508","url":null,"abstract":"<div><div>The objective of this study was to investigate respiratory parameters, including minute ventilation, tidal volume, and respiratory rate, and the role of thoracic mobility in women with FM compared to healthy controls. This case-control study included 38 women with fibromyalgia and 44 age-matched healthy women. Respiratory rate was measured using a portable monitor and tidal volume was assessed through spirometry. The minute ventilation was calculated by multiplying tidal volume by respiratory rate. Thoracic mobility was evaluated by measuring chest expansion. Pressure pain threshold was assessed over paraspinal muscles between C7-T7 by algometry to evaluate pain sensitivity. Perceived stress was assessed using the questionnaire Perceived Stress Scale −10. Women with fibromyalgia exhibited significantly higher minute ventilation (p&lt;0.032), respiratory rate (p&lt;0.001), and lower tidal volume (p&lt;0.001) compared to healthy controls. Thoracic mobility was reduced in participants with fibromyalgia. Group differences in minute ventilation disappeared when adjusting for perceived stress, suggesting a psychological influence on respiratory parameters. However, differences in respiratory rate and tidal volume were still significant. Fibromyalgia is associated with altered breathing function, including higher respiratory rate and lower tidal volume. Thoracic mobility and stress may contribute to these changes.</div></div><div><h3>Perspective</h3><div>Compared to healthy controls, women with fibromyalgia exhibit an altered breathing pattern which consists of higher minute ventilation due to increased respiratory rate. Reduced thoracic mobility and perceived stress may contribute to this condition<strong>.</strong> Including the respiratory system in the evaluation and treatment may optimize the effects of rehabilitation.</div></div><div><h3>Trial registration number</h3><div>ClinicalTrials.gov: NCT04098731.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"35 ","pages":"Article 105508"},"PeriodicalIF":4.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703548","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":"I expect therefore I avoid? The effects of negative expectancy learning on pain and pain-related avoidance behavior","authors":"Putu Gita Nadinda ,&nbsp;Antoinette I.M. van Laarhoven ,&nbsp;Johan W.S. Vlaeyen ,&nbsp;Madelon L. Peters ,&nbsp;Andrea W.M. Evers","doi":"10.1016/j.jpain.2025.105506","DOIUrl":"10.1016/j.jpain.2025.105506","url":null,"abstract":"<div><div>Expectancies and avoidance behavior are key factors influencing pain perception and its maintenance, but few empirical studies have investigated their relationship. Thus, two separate studies with a two-fold primary aim were conducted. The first part of the primary aim was to investigate whether negative expectancies lead to hyperalgesia. The second part of the primary aim was to investigate whether negative expectancies lead to more costly pain avoidance. The studies included a total of 116 and 98 participants respectively. In both studies, participants were randomly assigned to either the experimental or the control group. Pain expectancies were induced verbally and via conditioning, and avoidance was measured through a novel pain avoidance task in which participants could choose between avoiding a more painful stimulus by playing a difficult game or enduring a more painful stimulus by playing an easy game. In Study 2, adjustments were made to the conditioning procedure and the novel pain avoidance task based on the results of Study 1. Both studies demonstrated that negative expectancies led to hyperalgesia, indicating that the negative expectancy paradigm produces robust effects. However, negative expectancies did not lead to more pain avoidance suggesting that other factors may be at play in avoiding more pain. Further studies are needed to fully unravel the interplay between expectancies and avoidance in pain.</div></div><div><h3>Perspective</h3><div>This article found that negative expectancies can lead to hyperalgesia but not necessarily to more pain avoidance behavior in individuals without chronic pain. Findings from this article support the ample studies indicating that expectancies provide a strong target for pain treatment.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"35 ","pages":"Article 105506"},"PeriodicalIF":4.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700305","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":"Psilocybin as a psychophysical adaptogen in chronic pain rehabilitation","authors":"Nicholas P. Cherup PhD, MS ,&nbsp;Patrick H. Finan PhD","doi":"10.1016/j.jpain.2025.105507","DOIUrl":"10.1016/j.jpain.2025.105507","url":null,"abstract":"<div><div>Those living with chronic pain and comorbid functional disabilities are often confronted by a physically and emotionally transformative experience, impacting their identity and ability to derive meaning in life. Despite the use of various pharmacological and non-pharmacological treatments to moderate symptoms, the degree of analgesia and functional recovery are far from optimal. Psychological disorders including depression and anxiety, and maladaptive cognitive-affective states such as pain catastrophizing and fear of movement collectively impact participant engagement with rehabilitation services, leading to further deteriorations in functional status while perpetuating pain symptoms into a continuous and distressing cycle of avoidance and sedentary behavior. Psilocybin is known to produce altered states of consciousness through altered functional connectivity among key brain regions responsible for self-referential and sensorimotor processing. While preliminary evidence suggests drastic and favorable therapeutic effects among those with psychiatric disorders and unhelpful coping skills, there is limited research examining its analgesic potential and ability to foster participation in structured rehabilitation programs through changes in self-perception and meaning-making processes. The current focus article examines the application of psilocybin as a psychophysical adaptogen among those suffering from chronic pain. We propose psilocybin may be used to simultaneously improve illness identity and neuromotor outcomes through a reframing of perceived barriers to exercise engagement.</div></div><div><h3>Perspective</h3><div>This focus article examines the potential of psilocybin to enhance patient engagement in chronic pain rehabilitation by modulating self-perception and meaning-making processes—two underexplored yet critical barriers to successful pain management. We also propose a novel integrative framework embedding targeted movement therapy sessions into psilocybin study protocols.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"34 ","pages":"Article 105507"},"PeriodicalIF":4.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700306","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":"Transitions in psychosocial phenotypes in older adults with pain","authors":"Ashleigh Holmes PhD, MSN, RN, AGPCNP-BC ,&nbsp;Yu-Ping Chang PhD, RN, FGSA, FIAAN, FAAN","doi":"10.1016/j.jpain.2025.105503","DOIUrl":"10.1016/j.jpain.2025.105503","url":null,"abstract":"<div><div>Although pain is prevalent in older adults, there are gaps in the existing literature regarding multivariable psychosocial contributors to pain outcomes. Identifying psychosocial phenotypes, or patterns of psychological and social characteristics, can help predict outcomes; however, further longitudinal analysis is required. This study explores the stability of psychosocial phenotypes longitudinally in older adults with pain, along with the predictors of transitions in phenotypes over time. Using 2018–2022 annual National Health and Aging Trends Study data, 813 older adults consistently reported pain. Psychosocial variables used in the analysis included depression, anxiety, affect, self-realization, resilience, self-efficacy, and social participation. Latent transition analysis was used to identify optimal psychosocial phenotypes and proportions of participants transitioning to different phenotypes longitudinally. Baseline variables (pain characteristics, physical, cognitive) associated with longitudinal transitions in psychosocial phenotypes were determined via logistic regression. Latent transition analysis resulted in three psychosocial phenotypes (Adverse, Favorable, and Intermediate) based on scores on psychosocial variables. Longitudinally, phenotype membership remained generally stable with a trend towards increased psychosocial adversity. Baseline cognition and physical performance were predictors of transitions to less adverse phenotypes longitudinally. In contrast, baseline sleep, physical performance, pain limitations, and self-rating of general health were predictors of transitions to more adverse phenotypes. There is stability in psychosocial well-being longitudinally in older adults with pain and a remarkable ability to rebound despite major stressors. Future research should explore interventions that promote transitions to more favorable psychosocial phenotypes, develop point-of-care clinical insights, and advance precision pain medicine.</div></div><div><h3>Perspective</h3><div>This study analyzed psychosocial phenotypes in older adults with chronic pain using latent transition analysis. It identified stable phenotypes (Adverse, Intermediate, Favorable) and tracked changes over time. Findings highlight the impact of cognitive and physical health on psychosocial well-being, supporting personalized interventions and advancing precision pain medicine in older adults.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"35 ","pages":"Article 105503"},"PeriodicalIF":4.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660968","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":"Advancing equity in pain care through education, strategic partnerships, and advocacy.","authors":"Amber K Brooks, Janki Patel","doi":"10.1016/j.jpain.2025.105505","DOIUrl":"10.1016/j.jpain.2025.105505","url":null,"abstract":"<p><p>This article highlights three key pathways to advancing equitable pain care: education, strategic partnerships, and advocacy. Education remains foundational, emphasizing both provider training in cultural competency and bidirectional patient education to improve pain management outcomes. Strategic partnerships between the private sector, academia, and the community are needed to advance pain care and research in an increasingly challenging sociopolitical climate. Moreover, community-based participatory research (CBPR) and patient advisory boards ensure that research remains patient-centered and impactful. Finally, advocacy is crucial in mitigating legislative and policy shifts that threaten equitable pain care. While institutional constraints may limit public advocacy efforts, individual researchers and clinicians can engage policymakers, promote equitable funding structures, and advocate for high-quality pain care. By integrating action research principles with community-driven solutions, the pain research community can move beyond identifying disparities to actively implementing strategies that improve outcomes for marginalized populations, ensuring that pain care remains inclusive, responsive, and effective amidst ongoing challenges.</p>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":" ","pages":"105505"},"PeriodicalIF":4.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668982","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":"Heightened protective decision-making related to physical, but not cognitive, effort in individuals with fibromyalgia","authors":"Aleksandra M. Herman ,&nbsp;Carolyn Berryman ,&nbsp;Tasha R. Stanton","doi":"10.1016/j.jpain.2025.105504","DOIUrl":"10.1016/j.jpain.2025.105504","url":null,"abstract":"<div><div>Fibromyalgia is a chronic condition involving widespread pain, fatigue, and cognitive dysfunction. Evidence-based interventions for fibromyalgia, such as education and exercise, often require prolonged, cognitive and/or physical effort, involving immediate costs (effort) for delayed benefits (improved pain/function). Initiation of, and adherence to, these interventions is often difficult, which may reflect pain-related alterations in an individual’s attitudes towards effortful and delayed rewards. Here we explored whether individuals with fibromyalgia differed from age- and sex-matched pain-free controls in such attitudes. In cross-sectional Study 1, individuals with fibromyalgia (N=19) and controls (N=19) completed tasks offering real rewards for performing actual physical or cognitive effort or enduring real delays. Despite individualizing task difficulty to each participant’s unique capacity, those with fibromyalgia required higher incentives to engage in the physical effort task (treadmill walking), especially at higher effort intensities (OR=1.077, 95%CI [1.003, 1.156]), but showed no differences in the cognitive effort task, indicating no general motivation deficit but rather a shift in attitudes toward physical exertion. Additionally, participants with fibromyalgia showed a greater willingness to wait for rewards (OR=0.726, 95%CI [0.533, 0.990]), particularly at lower reward levels, suggesting an increased motivation driven by rewards. Study 2, conducted online (N=43 fibromyalgia, N=139 controls), replicated the findings regarding physical effort (t=3.36, 95%CI [0.08, 0.29]), reinforcing that fibromyalgia does not involve a broad motivational deficits. Instead, we found specific changes in physical effort discounting and indications of heightened sensitivity to rewards in delay discounting. These insights may help inform tailored intervention strategies for individuals with fibromyalgia.</div></div><div><h3>Perspective</h3><div>This article identifies altered attitudes toward physical effort and delayed rewards in individuals with fibromyalgia. These findings suggest that difficulties with treatment adherence may stem from over-protective physical effort-related decision-making rather than low motivation, offering a potential target for personalized education and intervention strategies in clinical care.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"34 ","pages":"Article 105504"},"PeriodicalIF":4.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633589","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":"Mixed methods family-centered study of acute post-surgical pain experience in non-hispanic white and black children","authors":"Julia Kumar MD ,&nbsp;Dylan Atkinson DO ,&nbsp;Adaora Chima MBBS, MPH ,&nbsp;Laura McLaughlin MA, CRC III ,&nbsp;Rajvi Parikh MHA, CCRC III ,&nbsp;Jiwon Lee MS. ,&nbsp;Lili Ding PhD ,&nbsp;Jennifer Allen ,&nbsp;Peter Mende-Siedlecki PhD ,&nbsp;Monica Mitchell PhD., MBA ,&nbsp;Vidya Chidambaran MD, MS, MMM","doi":"10.1016/j.jpain.2025.105502","DOIUrl":"10.1016/j.jpain.2025.105502","url":null,"abstract":"<div><div>Racial and neighborhood disparities in pediatric pain management are well-documented. This mixed-methods study engaged 19 Non-Hispanic Black (NHB) and 19 White (NHW) children with recent acute pain, along with their caregivers, to gain comprehensive insight into sociocultural factors and healthcare interactions impacting acute pediatric pain experiences. All children had acute post-surgical pain managed in tertiary care settings. Four focus groups per cohort (NHB and NHW) explored satisfaction with pain management, factors shaping pain experiences, and sociocultural beliefs surrounding pain and analgesia. Quantitative assessments included child measures of psychosocial factors, adverse childhood experiences (ACEs), pain coping, and resilience, alongside caregiver measures of socioeconomic status, pain catastrophizing, ACEs, racial and ethnic microaggressions (REMS), and responses to their child’s pain. Qualitative data were analyzed using thematic coding (NVivo©) and integrated with quantitative analyses. Several key shared themes emerged: empathetic care, shared decision-making, and healthcare provider responsiveness enhanced satisfaction/trust in pain care, while insurance-related delays detracted from satisfaction. Among NHB dyads, additional negative influences included lack of pain validation, racial discrimination, and socioeconomic constraints. Both cohorts expressed opioid hesitancy, stoicism, and use of distraction-based pain coping strategies. These themes aligned with quantitative findings of higher deprivation index (p=.005), elevated REMS subscale scores—Assumptions of Inferiority (p=.01) and Similarity (p=.02), and greater ACEs (p=.02) in NHB vs. NHW caregivers. Personal adverse experiences potentially shaped higher protective responses to their child’s pain (p=.005) in NHB (vs. NHW) caregivers. Our study sheds light on system-level factors that need to be addressed for an equitable pediatric pain experience.</div></div><div><h3>Perspective</h3><div>This mixed-methods study in NHB and NHW children with recent pain experiences and their caregivers highlights socioeconomic factors, racial bias, trust and healthcare provider interactions are important factors determining acute post-surgical pain experiences. Satisfaction with pain management, stoicism, distraction-based pain coping and hesitancy towards opioids were identified in both cohorts.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"35 ","pages":"Article 105502"},"PeriodicalIF":4.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627689","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":"Development and validation of the Pain Awareness Scale (PAS) for autistic adults: A mixed-methods study","authors":"Merry Kalingel Levi PhD ,&nbsp;Yelena Granovsky ,&nbsp;Irit Weissman-Fogel ,&nbsp;Tami Bar Shalita ,&nbsp;Tseela Hoffman ,&nbsp;Eynat Gal","doi":"10.1016/j.jpain.2025.105491","DOIUrl":"10.1016/j.jpain.2025.105491","url":null,"abstract":"<div><div>This study aimed to develop and validate the Pain Awareness Scale (PAS), a novel self-report questionnaire designed to assess pain awareness in autistic adults. Using a mixed-methods approach, the PAS was developed through literature review, expert consultation, and cognitive interviews with nine autistic adults (5 females, mean age= 29.1, SD= 7.9). The questionnaire was then administered to 59 autistic (24 females, mean age=26.8, SD=7.4) and 73 neurotypical adults (19 females, mean age=27.8, SD=6.7). Principal Axis Factoring revealed four distinct subscales: Pain Recognition, Pain Characterization, Nonverbal Pain Communication, and Verbal Pain Communication. The PAS demonstrated good internal consistency across all subscales (Cronbach's α=0.71–0.92) and strong construct validity, with autistic adults scoring significantly higher than neurotypical adults’ total score and on three out of four subscales (p &lt; 0.001). Convergent validity was supported by significant correlations between the PAS and the Toronto Alexithymia Scale-20 (TAS-20) total scores (ρ= 0.69, p&lt; 0.01). The PAS offers a reliable and valid tool for assessing pain awareness difficulties in autistic adults.</div></div><div><h3>Perspective</h3><div>This article introduces the Pain Awareness Scale (PAS), a psychometrically validated measure of pain awareness in autistic adults. The PAS may enhance clinical assessment and deepen understanding of pain processing differences in autism, offering insight into underlying mechanisms relevant for both clinical and basic science research.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"34 ","pages":"Article 105491"},"PeriodicalIF":4.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621117","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":"Assessing pain intensity in people from non-western countries: A multicenter study comparing four pain scales in adults with musculoskeletal pain in Bhutan","authors":"Monu Tamang ,&nbsp;Mark P. Jensen ,&nbsp;Anupa Pathak ,&nbsp;Karma Phuentsho ,&nbsp;Saurab Sharma","doi":"10.1016/j.jpain.2025.105492","DOIUrl":"10.1016/j.jpain.2025.105492","url":null,"abstract":"<div><div>Although the Numerical Rating Scale (NRS) is commonly recommended for use in research and clinical practice internationally, recent research in non-western countries questions its utility in some countries. We aimed to evaluate validity and utility of four commonly used pain intensity measures in a sample of participants with musculoskeletal pain in Bhutan. Two hundred forty-seven adults with musculoskeletal pain visiting three hospitals rated their one-week recalled worst and average pain using all four scales, and indicated their preferred scale. For analysis, participant responses were classified as being a correct or an incorrect response, where an “incorrect response” was defined as a response that did not meet pre-defined criteria. All four scales demonstrated adequate construct validity. The VAS and NRS had significantly higher incorrect response rates (9% each) than the other scales. Participants who were older and with less education had higher rates of incorrect responses on the NRS and VAS. The FPS-R (45%) was the most preferred scale, followed by the NRS (26%); there were no significant differences in preference rates between the VRS (15%) and VAS (5%). The findings suggest that the FPS-R should be used to assess pain intensity in Bhutanese people with musculoskeletal pain, especially in individuals with no formal education.</div></div><div><h3>Perspective</h3><div>This study evaluated the utility and validity of four commonly used pain intensity scales in Bhutan. The findings could help clinicians and researchers select the most appropriate scale for measuring pain intensity in Bhutanese individuals.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"34 ","pages":"Article 105492"},"PeriodicalIF":4.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610264","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":"Neurophysiological effects of high-frequency spinal cord stimulation on cortico-sensory areas in large ovine animal model","authors":"Vishal Bharmauria ,&nbsp;Hiroyuki Oya ,&nbsp;Yarema Bezchlibnyk ,&nbsp;Nour Shaheen ,&nbsp;Amirhossein Ghaderi ,&nbsp;Karim Johari ,&nbsp;Arun Singh ,&nbsp;Alexander L. Green ,&nbsp;Hiroto Kawasaki ,&nbsp;Can Sarica ,&nbsp;Brian Dalm ,&nbsp;Andres M. Lozano ,&nbsp;Matthew A. Howard III ,&nbsp;Oliver Flouty","doi":"10.1016/j.jpain.2025.105493","DOIUrl":"10.1016/j.jpain.2025.105493","url":null,"abstract":"<div><div>Spinal Cord Stimulation (SCS) has been a cornerstone in managing chronic pain since the late 1960s. However, traditional SCS is often associated with variable efficacy and side effects, driving the development of advanced techniques like high-frequency SCS (hSCS). Previous studies have demonstrated that the power of high-frequency cerebral oscillations increases as a function of stimulus intensity and plays a critical role in local neural processing of peripheral sensory stimuli. Extending from the current body of literature, we hypothesized that hSCS could selectively influence stimulus-triggered neural oscillations involved in sensory processing and perception. Using electrocorticography (ECoG) in sheep (n = 4), we investigated the effects of 8.2 KHz hSCS on low-frequency (4–30 Hz) and high-frequency (70–150 Hz) oscillations in ovine somatosensory and association cortices. Neural signals were recorded before, and after hSCS application to assess frequency-specific modulation of cortical activity. Our findings reveal that hSCS induces broad suppression of high-frequency oscillations across both cortical regions. In contrast, low-frequency oscillations were selectively suppressed or enhanced in both cortices. Furthermore, a linear mixed model analysis revealed that low-frequency oscillations better predict high-frequency modulation in the association than the somatosensory cortex, highlighting a reciprocal low-/high-frequency relationship between cortices. These distinct effects on cortical oscillations suggest potential supraspinal mechanisms through which hSCS may exert its analgesic effects. Our findings provide new insights for optimizing neuromodulation strategies in pain management, emphasizing the role of frequency-specific modulation in sensory and cognitive pain processing.</div></div><div><h3>Perspective</h3><div>This study demonstrates that high-frequency spinal cord stimulation modulates cortical oscillations in a frequency- and region-specific manner, suggesting a supraspinal mechanism of pain. These findings advance our understanding of how neuromodulation influences sensory components of pain, with implications for optimizing stimulation protocols in chronic pain management.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"34 ","pages":"Article 105493"},"PeriodicalIF":4.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605238","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}