Pain Reports最新文献

{"title":"miR-374 family is a key regulator of chronic primary pain onset.","authors":"Nathaniel P Hernandez, Ashleigh Rawls, Jiegen Chen, Xin Zhang, Yaomin Wang, Xianglong Gao, Marc Parisien, Mohamad Karaky, Carolina Beraldo Meloto, Francesca Montagna, Hong Dang, Yue Pan, Ying Zhao, Samuel McLean, Sarah Linnstaedt, Luda Diatchenko, Andrea G Nackley","doi":"10.1097/PR9.0000000000001199","DOIUrl":"10.1097/PR9.0000000000001199","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic primary pain conditions (CPPCs) are linked to catecholamine activation of peripheral adrenergic receptors. Yet, catecholamine-dependent epigenetic mechanisms, such as microRNA (miRNA) regulation of mRNA transcripts, remain largely unknown.</p><p><strong>Objectives: </strong>We sought to identify RNA species correlated with case status in 3 pain cohorts, to validate RNAs found to be dysregulated in a mouse model of CPPC onset, and to directly test the role of adrenergic receptors in miRNA regulation. Furthermore, we tested antinociceptive effects of miR-374 overexpression.</p><p><strong>Methods: </strong>We used RNA-seq and quantitative reverse transcription polymerase chain reaction to measure RNA expression in 3 pain cohorts. Next, we validated identified RNAs with quantitative reverse transcription polymerase chain reaction in a mouse model of CPPC onset, measuring expression in plasma, peripheral (adipose, muscle, dorsal root ganglia [DRG]), and central (spinal cord) tissues. Then, we stimulated adrenergic receptors in primary adipocyte and DRG cultures to directly test regulation of microRNAs by adrenergic signaling. Furthermore, we used in vitro calcium imaging to measure the antinociceptive effects of miR-374 overexpression.</p><p><strong>Results: </strong>We found that one miRNA family, miR-374, was downregulated in the plasma of individuals with temporomandibular disorder, fibromyalgia syndrome, or widespread pain following a motor vehicle collision. miR-374 was also downregulated in plasma, white adipose tissue, and spinal cord from mice with multisite mechanical sensitivity. miR-374 downregulation in plasma and spinal cord was female specific. Norepinephrine stimulation of primary adipocytes, but not DRG, led to decreased miR-374 expression. Furthermore, we identified tissue-specific and sex-specific changes in the expression of predicted miR-374 mRNA targets, including known (HIF1A, NUMB, TGFBR2) and new (ATXN7, CRK-II) pain targets. Finally, we demonstrated that miR-374 overexpression in DRG neurons reduced capsaicin-induced nociceptor activity.</p><p><strong>Conclusions: </strong>Downregulation of miR-374 occurs between adrenergic receptor activation and mechanical hypersensitivity, and its adipocyte source implicates adipose signaling in nociception. Further study of miR-374 may inform therapeutic strategies for the millions worldwide who experience CPPCs.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"9 6","pages":"e1199"},"PeriodicalIF":3.4,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11487220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complex Regional Pain Syndrome: a cross-sectional study of physical symptoms, disability, and psychological health in long term.","authors":"Ellen Lyckegård Finn, Astrid Parinder, Erika Nyman, Lars B Dahlin","doi":"10.1097/PR9.0000000000001180","DOIUrl":"10.1097/PR9.0000000000001180","url":null,"abstract":"<p><strong>Introduction: </strong>Knowledge about long-time residual symptoms, disabilities, and psychological health in complex regional pain syndrome (CRPS) is limited.</p><p><strong>Objectives: </strong>The aim was to evaluate outcome, focusing on physical symptoms, disability, and psychological health, in individuals with CRPS through a cross-sectional survey study.</p><p><strong>Methods: </strong>Individuals with a confirmed diagnosis of CRPS were identified through medical charts and sent validated survey forms (Disabilities of the Arm, Shoulder and Hand-Quick version, Specific Hand Surgery Questionnaire-8 questions, EuroQol 5 Dimensions 3 levels, Life Satisfaction Questionnaire-11, Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale, and Sense of Coherence-29) and complementary questions.</p><p><strong>Results: </strong>Responders (response rate: 99/238, 42%; CRPS type 1: 72%; CRPS type 2: 28%; time since diagnosis median: 59 [34-94] months) reported remaining symptoms and disability (Disabilities of the Arm, Shoulder and Hand-Quick version score: 45 [20-70]) and more improvement in type 1 than in type 2. Only 9% of individuals with CRPS reported no residual pain or discomfort. Approximately 60% had problems in daily activities, 49% had sleeping problems, and 90% experienced moderate-extreme pain with 23% still on sick leave. The Hospital Anxiety and Depression Scale survey revealed significantly higher scores than a Swedish reference population. Individuals with a low Sense of Coherence and high pain catastrophizing had worse disability and were less satisfied with their lives and physical and psychological health. A lower level of education and more anxiety were associated with worsened disability over time.</p><p><strong>Conclusion: </strong>Individuals with CRPS suffer in the long term from pain, sleeping problems, and limitations in daily activities with occurrence of anxiety and depression, resulting in dissatisfaction with many aspects of their lives. A low Sense of Coherence and high pain catastrophizing are associated with a worse outcome. Biopsychosocial aspects should be addressed in clinical practice.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"9 5","pages":"e1180"},"PeriodicalIF":3.4,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11419548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustained nerve growth factor-induced C-nociceptor sensitization to electrical sinusoidal stimulation in humans.","authors":"Hans Jürgen Solinski, Martin Schmelz, Roman Rukwied","doi":"10.1097/PR9.0000000000001190","DOIUrl":"10.1097/PR9.0000000000001190","url":null,"abstract":"<p><strong>Introduction: </strong>Injection of recombinant human nerve growth factor (rhNGF) evokes acute heat and prolonged \"polymodal\" (mechanosensitive [CM]) and \"silent\" (mechano<i>in</i>sensitive [CMi]) C-nociceptor sensitization. Both nociceptor classes can be activated differentially using slowly depolarizing electrical sinusoidal stimuli.</p><p><strong>Objectives: </strong>To explore the temporal profile of nociceptor sensitization to heat and mechanical and electrical stimuli in humans after rhNGF.</p><p><strong>Methods: </strong>Recombinant human nerve growth factor (1 µg) and NaCl (0.9%) was injected into human forearm skin (n = 9, 50 µL/injection). Pain ratings (numeric rating scale) to transcutaneous electrical stimuli (1 ms 20 Hz rectangular pulses, 500-ms half-period sine wave [1 Hz] and 4 Hz sine wave pulses [2.5 and 60 seconds]) were assessed at days 3, 21, and 49 after injection, in addition to heat pain thresholds (HPTs, 9 × 9 mm thermode) and mechanical impact pain (4 and 8 m/second).</p><p><strong>Results: </strong>Suprathreshold sinusoidal stimulation for specific CM (1 Hz) and combined CM and CMi (4 Hz) activation resulted in enhanced pain from day 3 post rhNGF and lasted throughout 7 weeks. These temporal dynamics contrasted minimum HPTs at day 3 (normalized by day 49) or mechanical impact pain (developing slowly until day 21 before declining depending on stimulus intensity). Correlation analyses of electrical pain indicated diverging kinetics when assessed for CM with or without concomitant CMi activation at days 3 and 21, which converged 7 weeks post rhNGF.</p><p><strong>Conclusions: </strong>Exceptionally long sensitization of CM and CMi nociceptors by rhNGF, uncovered by suprathreshold electrical sinusoidal stimulation, indicates a signal transduction-independent long-lasting hyperexcitability of C-nociceptors that clinically may contribute to rhNGF-maintained chronic inflammatory pain.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"9 5","pages":"e1190"},"PeriodicalIF":3.4,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11419415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weight, height, waist circumference: association with knee osteoarthritis findings from the osteoarthritis initiative.","authors":"Lisa H Antoine, Kristen Allen Watts, Deanna D Rumble, Taylor Buchanan, Andrew Sims, Burel R Goodin","doi":"10.1097/PR9.0000000000001187","DOIUrl":"10.1097/PR9.0000000000001187","url":null,"abstract":"<p><strong>Introduction: </strong>Global prevalence of knee osteoarthritis is more than 300 million. Uncontrollable risk factors include age, sex, and height. Controllable risk factors include trauma, weight, and waist circumference.</p><p><strong>Objectives: </strong>Our goal was to determine the association between knee osteoarthritis and anthropometric measures that include weight, height, and waist circumference.</p><p><strong>Methods: </strong>Using 4,602 participants (45-79 years) from the Osteoarthritis Initiative, we analyzed the association between knee osteoarthritis and anthropometry collectively and by sex. We calculated female and male tertiles (3 groups) for anthropometry.</p><p><strong>Results: </strong>Anthropometric measures were correlated with knee osteoarthritis (<i>P</i> ≤ 0.05) except the correlation between height and activities and height and quality of life. When comparing female weight tertiles, there were associations (<i>P</i>'s < 0.001) between knee osteoarthritis and weight, but when comparing male weight tertiles, these associations were primarily between the lowest weight and highest weight groups. There were significant associations between knee osteoarthritis and height among female tertiles, with no differences among male tertiles. There were knee osteoarthritis/waist circumference tertile associations (<i>P</i>'s < 0.001) for the lowest and highest waist circumference groups.</p><p><strong>Conclusion: </strong>Higher weight in female participants was a stronger predictor of increases in knee osteoarthritis discomforts when compared to waist circumference, while weight and waist circumference were almost equivalent in predicting increases in knee osteoarthritis for male participants. Height did not predict increases in knee osteoarthritis with the exception of female symptoms and quality of life. Quality of life for both sexes was the most unfavorable with female participants reporting a more unfavorable quality of life than male participants.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"9 5","pages":"e1187"},"PeriodicalIF":3.4,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11419520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of immunosuppression after limb fracture in mice on nociceptive, cognitive, and anxiety-related outcomes.","authors":"Peyman Sahbaie, Tian-Zhi Guo, Xiao-You Shi, Wade S Kingery, J David Clark","doi":"10.1097/PR9.0000000000001179","DOIUrl":"10.1097/PR9.0000000000001179","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic pain is a common and problematic consequence of injuries with few proven methods for prevention or treatment. In addition to pain, functional limitations and neuropsychiatric changes such as cognitive impairment and anxiety worsen outcomes.</p><p><strong>Objectives: </strong>To determine whether inhibiting activation of the adaptive immune response after limb fracture would reduce pain, functional loss, memory changes, and anxiety.</p><p><strong>Methods: </strong>These experiments used a murine tibial fracture/cast immobilization model that develops these adverse outcomes. Adaptive immunity was blocked using the immunosuppressant FK506 beginning at the time of fracture.</p><p><strong>Results: </strong>The administration of FK506 reduced mechanical allodynia and hind limb unweighting for weeks after cast removal as well as nonevoked pain measures. Fracture was associated with working memory loss in the Y-maze assay in vehicle- but not FK506-treated mice. Object recognition memory was not improved with FK506 after fracture. Also, vehicle- but not FK506-treated mice developed an anxiety phenotype. Impaired running wheel performance after cast removal over the following 2 weeks was not improved with FK506 administration. In addition, FK506 treatment blocked Immunoglobulin M (IgM) accumulation in the skin of the fractured limbs, and hippocampal enhancement of matrix metalloproteinase-8 expression, a metalloproteinase associated with neuroplastic changes after injuries, was completely blocked.</p><p><strong>Conclusion: </strong>Taken together, our results show that blocking the adaptive immune response after limb trauma reduces the severity of nociceptive and biological changes. The same treatment may reduce the adverse consequences of anxiety and memory deficits using some measures, but other measures of memory are not affected, and activity is not enhanced.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"9 5","pages":"e1179"},"PeriodicalIF":3.1,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11390048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A myriad of methods to determine temporal summation of pain in people with musculoskeletal pain and healthy participants: a scoping review.","authors":"Sjoerd C Kielstra, Roland R Reezigt, Michel W Coppieters, Ralph de Vries, Lars Arendt-Nielsen, Kristian K Petersen, David Yarnitsky, Gwendolyne G M Scholten-Peeters","doi":"10.1097/PR9.0000000000001176","DOIUrl":"10.1097/PR9.0000000000001176","url":null,"abstract":"<p><p>Temporal summation of pain (TSP) is a human proxy for wind-up of dorsal horn neurons as assessed in animals. The common paradigm for eliciting TSP is evoked by repetitive nociceptive stimuli of equal intensity. Various stimulation and assessment protocols have been used. This scoping review aims to provide insight into key elements of TSP stimulation and assessment: modality, instruments, test location, familiarization, train characteristics, and calculations. PubMed, Embase, and Ebsco/CINAHL were searched for studies that measured TSP in adults with musculoskeletal conditions and healthy people. Four hundred six studies were included. Mechanical stimuli were the most commonly used modality (250 studies), followed by thermal stimuli (125 studies). Forty-six different instruments were used. Disregarding studies on widespread musculoskeletal pain and healthy participants, 40 studies evaluated TSP at painful sites, 77 in remote areas, and 66 in both locations. Of the 13 tested locations in patients, the hand (74 studies), lower leg (64 studies), and forearm (59 studies) were most commonly tested. A single practice round was the most common familiarization method (46 studies). Repeated stimuli were applied using 31 different frequencies (0.03-200 Hz) and sustained stimulations ranging from 5 to 1080 seconds were used. Twenty-two different train lengths, 63 different calculations (37 absolute, 19 relative, and 7 alternatives using data directly), and 14 different outcome measures (eg, self-reported pain rating scales and reflex thresholds) were used. Temporal summation of pain protocols vary excessively, hindering the comparison and pooling of results. None of the studies provided substantiation for their protocol choice.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"9 5","pages":"e1176"},"PeriodicalIF":3.4,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social health in young women with chronic pain.","authors":"Ian A Boggero, Linda Sangalli, Lauryn Brasch, Christopher D King","doi":"10.1097/PR9.0000000000001146","DOIUrl":"10.1097/PR9.0000000000001146","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic pain may negatively affect social functioning, but no study to date has examined the specific social impact of different chronic pain conditions in young women, and whether living with multiple chronic overlapping pain conditions (COPCs) differently influences social domains.</p><p><strong>Objectives: </strong>This study aimed to assess social functioning (social isolation, hostility, informational support satisfaction, social roles, emotional support, friendships, and family relationships) among young women with chronic pain compared with pain-free controls and to test whether the number of COPCs influenced the extent of social burden.</p><p><strong>Methods: </strong>Participants aged 18 to 30 years with a physician-confirmed diagnoses of migraine, fibromyalgia, or temporomandibular disorder (TMD) and pain-free controls were invited to participate from across the United States. After confirming eligibility, participants completed a 1-hour REDCap online questionnaire assessing social functioning.</p><p><strong>Results: </strong>One hundred four participants (mean age 24.54 ± 3.35 years) were included (n = 26 with TMD, n = 25 with fibromyalgia, n = 25 with migraine, and n = 28 controls). All 3 chronic pain groups combined reported worse functioning than controls on friendship (<i>P</i> = 0.038), social isolation (<i>P</i> = 0.002), and social roles (<i>P</i> < 0.001). There were no differences on social variables between the 3 chronic pain groups (all <i>P'</i>s > 0.05). Compared with those with 3 COPCs, participants with 1 condition reported better family relationships (<i>P</i> = 0.024).</p><p><strong>Conclusions: </strong>Experience of chronic pain-regardless of the specific pain condition-may negatively affect some areas of social functioning in young women.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"9 2","pages":"e1146"},"PeriodicalIF":3.4,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10950150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtually delivered Mindfulness-Oriented Recovery Enhancement (MORE) reduces daily pain intensity in patients with lumbosacral radiculopathy: a randomized controlled trial.","authors":"Ryan S Wexler, Devon J Fox, Danielle ZuZero, Melissa Bollen, Anand Parikshak, Hannah Edmond, Johnny Lemau, Diane Montenegro, Jillian Ramirez, Sophia Kwin, Austin R Thompson, Hans L Carlson, Lynn M Marshall, Thomas Kern, Scott D Mist, Ryan Bradley, Douglas A Hanes, Heather Zwickey, Courtney K Pickworth","doi":"10.1097/PR9.0000000000001132","DOIUrl":"10.1097/PR9.0000000000001132","url":null,"abstract":"<p><strong>Introduction: </strong>Lumbosacral radiculopathy (LR), also known as sciatica, is a common type of radiating neurologic pain involving burning, tingling, and numbness in the lower extremities. It has an estimated lifetime prevalence as high as 43%.</p><p><strong>Objectives: </strong>The objective of this randomized controlled trial was to evaluate the impact of virtually delivered Mindfulness-Oriented Recovery Enhancement (MORE) on patients with LR during the COVID-19 pandemic.</p><p><strong>Methods: </strong>Potentially eligible patients were identified using electronic health record queries and phone screenings. Participants were then randomized to MORE or treatment-as-usual (TAU) for 8 weeks, with pain intensity assessed daily. At baseline and follow-up visits, participants completed questionnaires assessing the primary outcome, disability, as well as quality of life, depression, mindful reinterpretation of pain, and trait mindfulness.</p><p><strong>Results: </strong>In our study, patients undergoing virtual delivery of MORE had greater improvements in daily pain intensity (<i>P</i> = 0.002) but not in disability (<i>P</i> = 0.09), depression (<i>P</i> = 0.26), or quality of life (<i>P</i> = 0.99 and <i>P</i> = 0.89, SF-12 physical and mental component scores, respectively), relative to TAU patients. In addition, patients in MORE experienced significantly greater increases in mindful reinterpretation of pain (<i>P</i> = 0.029) and trait mindfulness (<i>P</i> = 0.035).</p><p><strong>Conclusion: </strong>Among patients with lumbar radiculopathy, MORE significantly reduced daily pain intensity but did not decrease disability or depression symptoms. Given the long duration of symptoms in our sample, we hypothesize the discrepancy between changes in daily pain intensity and disability is due to fear avoidance behaviors common in patients with chronic pain. As the first trial of a mindfulness intervention in patients with LR, these findings should inform future integrative approaches to LR treatment, particularly when considering the increasing use of virtual interventions throughout the COVID-19 pandemic.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"9 2","pages":"e1132"},"PeriodicalIF":4.8,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10948133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140159566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review and meta-analysis of randomized controlled head-to-head trials of recommended drugs for neuropathic pain.","authors":"Ayda Asadizadeh Sadegh, Nina Lykkegaard Gehr, Nanna Brix Finnerup","doi":"10.1097/PR9.0000000000001138","DOIUrl":"10.1097/PR9.0000000000001138","url":null,"abstract":"<p><p>Neuropathic pain is a challenging chronic pain condition. Limited knowledge exists regarding the relative effectiveness of pharmacological treatments, and differences in trial design and impact of the placebo response preclude indirect comparisons of efficacy between drug classes. The purpose of this systematic review and meta-analysis of head-to-head trials was to compare the efficacy and tolerability of drugs recommended for neuropathic pain. We conducted a systematic review and meta-analysis of direct-comparison double-blind randomized trials. Primary outcomes were mean change in pain intensity and number of responders with a 50% reduction in pain intensity. Secondary outcomes encompassed quality of life, sleep, emotional functioning, and number of dropouts because of adverse events. We included 30 trials (4087 patients), comprising 16 crossover and 14 parallel-group design studies. All studies were conducted in adults, and the majority were investigator-initiated trials. We found moderate-quality evidence for equivalence (no clinically relevant difference) between tricyclic antidepressants (TCA) and gabapentin/pregabalin with a combined mean difference in pain score of 0.10 (95% CI -0.13 to 0.32). We could not document differences between TCA and serotonin-noradrenaline reuptake inhibitors (SNRI), between SNRI and gabapentin/pregabalin, or between opioids and TCA (low quality of evidence). We found more dropouts because of adverse events with SNRI and opioids compared with TCA (low quality of evidence). We did not identify any studies that included topical treatments. This systematic review of direct-comparison studies found evidence for equivalence between TCA and gabapentin/pregabalin and fewer dropouts with TCA than SNRI and opioids.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"9 2","pages":"e1138"},"PeriodicalIF":3.4,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11208104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability, validity, and responsiveness of a smartphone-based manikin to support pain self-reporting.","authors":"Sabine N van der Veer, S Mustafa Ali, Ziqiao Yu, John McBeth, Alessandro Chiarotto, Ben James, William G Dixon","doi":"10.1097/PR9.0000000000001131","DOIUrl":"10.1097/PR9.0000000000001131","url":null,"abstract":"<p><strong>Introduction: </strong>Many people worldwide suffer from chronic pain. Improving our knowledge on chronic pain prevalence and management requires methods to collect pain self-reports in large populations. Smartphone-based tools could aid data collection by allowing people to use their own device, but the measurement properties of such tools are largely unknown.</p><p><strong>Objectives: </strong>To assess the reliability, validity, and responsiveness of a smartphone-based manikin to support pain self-reporting.</p><p><strong>Methods: </strong>We recruited people with fibromyalgia, rheumatoid arthritis, and/or osteoarthritis and access to a smartphone and the internet. Data collection included the Global Pain Scale at baseline and follow-up, and 30 daily pain drawings completed on a 2-dimensional, gender-neutral manikin. After deriving participants' pain extent from their manikin drawings, we evaluated convergent and discriminative validity, test-retest reliability, and responsiveness and assessed findings against internationally agreed criteria for good measurement properties.</p><p><strong>Results: </strong>We recruited 131 people; 104 were included in the full sample, submitting 2185 unique pain drawings. Manikin-derived pain extent had excellent test-retest reliability (intraclass correlation coefficient, 0.94), moderate convergent validity (ρ, 0.46), and an ability to distinguish fibromyalgia and osteoarthritis from rheumatoid arthritis (F statistics, 30.41 and 14.36, respectively; <i>P</i> < 0.001). Responsiveness was poor (ρ, 0.2; <i>P</i>, 0.06) and did not meet the respective criterion for good measurement properties.</p><p><strong>Conclusion: </strong>Our findings suggest that smartphone-based manikins can be a reliable and valid method for pain self-reporting, but that further research is warranted to explore, enhance, and confirm the ability of such manikins to detect a change in pain over time.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"9 2","pages":"e1131"},"PeriodicalIF":3.4,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10876220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139906875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}