Pain Reports最新文献

{"title":"Electroencephalography during acute painful procedures in neonates: a scoping review.","authors":"Patricia Y Gunawan, Luke Baxter, Maria M Cobo, Marianne van der Vaart, Samyuktha Iyer, Vaneesha Monk, Kanwaljeet J S Anand, Charles B Berde, Caterina Coviello, Mohammad Reza Daliri, Guy Dumont, Vineta Fellman, Behnood Gholami, Caroline Hartley, Pierre Kuhn, Nathalie L Maitre, Roshni C Mansfield, Simon Marchant, Sofie Nilsson, Elisabeth Norman, Safa Talebi, Sonya Wang, Karel Allegaert, Jonathan M Davis, Mark A Turner, Robert M Ward, Edress Darsey, James P Sheppard, Aomesh Bhatt, John van den Anker, An N Massaro, Kanwaljit Singh, Rebeccah Slater","doi":"10.1097/PR9.0000000000001437","DOIUrl":"10.1097/PR9.0000000000001437","url":null,"abstract":"<p><p>Although electroencephalography (EEG) is used to assess neonatal pain in research settings, EEG assessments have not been sufficiently characterized for use as end points to assess the efficacy of analgesics in regulatory-endorsed, industry-sponsored trials. We aimed to identify all studies conducted in neonates with EEG recordings during acute somatic nociceptive skin-breaking procedures, and to create a network of authors who will be invited to contribute their individual participant data (IPD) to an IPD meta-analysis to establish the validity, reliability, and clinical interpretability of an EEG-based neonatal pain measure. To identify literature, we searched MEDLINE, Embase, CINAHL, Web of Science, Scopus, Google Scholar, ClinicalTrials.gov, and the WHO ICTRP from database inception to July 2, 2025. Eligible studies were primary empirical studies that included neonates with EEG recordings during acute skin-breaking procedures. We identified 55 studies across 11 countries. Heel lance was the most common painful procedure; others included venipuncture, immunization, and lumbar puncture. The impact of 12 analgesic interventions has been studied to date, mostly nonpharmacological interventions. Individual-electrode EEG is more common than EEG caps. We noted relatively high data loss due to EEG data-quality concerns. A wide range of non-EEG pain-relevant measures have been recorded alongside EEG (eg, behavior, vital signs). Coauthorship network analysis highlighted that authors commonly work within discrete authorship hubs, with limited coauthorship across hubs. The predominance of studies was from European and American institutions, which limits generalizability. We conclude that sufficient data are available to undertake an IPD meta-analysis.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"11 3","pages":"e1437"},"PeriodicalIF":4.3,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13068459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678529","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":"Stellate ganglion block causing reproducible improvement of allergic rhinitis and asthma: a case report.","authors":"Azeem Ahmad, Efrain Perez-Bravo","doi":"10.1097/PR9.0000000000001431","DOIUrl":"10.1097/PR9.0000000000001431","url":null,"abstract":"<p><strong>Introduction: </strong>Stellate ganglion block (SGB) is hypothesized to influence immunologic and physiologic processes through autonomic modulation. Though similar effects of SGB on atopic disease have been intermittently observed over the past century, methodological concerns limit the internal and external validity of these prior efforts.</p><p><strong>Objectives: </strong>To describe a case of simultaneous and reproducible improvement in allergic rhinitis and asthma after SGB, and to contextualize this observation within the existing literature.</p><p><strong>Methods: </strong>A 35-year-old woman with Complex Regional Pain Syndrome (CRPS) following a radial head fracture underwent SGB as a part of routine CRPS management. Her incidentally-observed changes in allergic rhintis and asthma were assessed longitudinally using validated clinical outcome measures in a retrospective fashion.</p><p><strong>Results: </strong>The patient demonstrated improvement of her allergic rhinitis and asthma after SGB, exceeding MCID thresholds for meaningful clinical improvement of each condition. These benefits persisted for 9 months before a partial recurrence of her atopic airway disease. A second SGB was able to reproduce these improvements, again exceeding MCID thresholds for both allergic rhinitis and asthma.</p><p><strong>Conclusions: </strong>SGB's effects on atopic disease warrant reappraisal of SGB as a potential adjunct for atopic airway disease, particularly in light of recent experimental evidence suggesting that SGB may exert an immunomodulatory effect. This case therefore highlights a meaningful gap in the literature and underscores the need for systematic investigation of SGB as a potential adjunctive treatment for atopic airway disease.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"11 3","pages":"e1431"},"PeriodicalIF":4.3,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13061519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647111","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":"White matter microstructure of sensorimotor projection fibers in chronic low back pain.","authors":"John R Gilliam, Jennifer M C Vendemia, Zachary Baty, Sheri P Silfies, Stephen A Coombes","doi":"10.1097/PR9.0000000000001435","DOIUrl":"10.1097/PR9.0000000000001435","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic low back pain (cLBP) is linked to altered cortical sensorimotor structure and function, yet white matter microstructure in sensorimotor projection fibers remains poorly characterized. <b>Objective:</b> To address this gap, we used diffusion MRI to comprehensively characterize sensorimotor projection fibers in 44 patients with cLBP and 41 matched healthy controls.</p><p><strong>Methods: </strong>We estimated an array of microstructural measures, including fractional anisotropy (FA), extracellular free water fraction (FW), free water-corrected FA (fwcFA), and neurite orientation dispersion and density imaging (NODDI) metrics.</p><p><strong>Results: </strong>General linear models identified significantly higher FA and fwcFA and lower orientation dispersion index (ODI) in cLBP vs HC within projection fibers emanating from the primary somatosensory and motor cortices (all corrected <i>P</i>-values <0.05). Conjunction analyses indicated spatial overlap between increased anisotropy and reduced ODI, suggesting a reduction in geometric complexity of neurites underlies this group difference. Partial correlations revealed significant relationships between diffusion metrics and anxiety and depressive symptoms (FA: r = -0.41, <i>P</i> < 0.01; fwcFA: r = -0.38, <i>P</i> = 0.01; ODI: r = 0.38, <i>P</i> = 0.01). The relationships between anxiety and depressive symptoms and diffusion MRI metrics are consistent with work outside of chronic pain.</p><p><strong>Conclusion: </strong>Our results align differences in white matter microstructure with previous neurophysiological evidence that identifies the primary sensorimotor cortices as relevant in cLBP and emphasizes the interrelatedness of anxiety and depressive symptoms and sensorimotor structure.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"11 3","pages":"e1435"},"PeriodicalIF":4.3,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13061524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647241","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":"Youth experiences with discrimination and the association with multisite pain.","authors":"Madeeha Malik, Tristin Smith, Dan Clauw, Olubukola O Nafiu, Rachel S Bergmans, Chelsea Kaplan, Michael P Puglia","doi":"10.1097/PR9.0000000000001432","DOIUrl":"10.1097/PR9.0000000000001432","url":null,"abstract":"<p><strong>Introduction: </strong>Childhood experiences with pain and discrimination can have lasting negative impacts on short- and long-term health outcomes, yet the association between pain and discrimination remains incompletely understood.</p><p><strong>Objective: </strong>This study examined the association between childhood experiences of discrimination and multisite pain in a large longitudinal cohort of 7,979 children aged 9 to 10 years from the Adolescent Brain Cognitive Development Study.</p><p><strong>Methods: </strong>The primary outcome was self-reported multisite pain determined from a body map at year 2 follow-up. Discrimination was assessed at the year 2 follow-up with the Perceived Discrimination Scale (PDS).</p><p><strong>Results: </strong>The prevalence of multisite pain in the cohort was 13.8%. Children experiencing higher levels of perceived discrimination had increased odds of reporting multisite pain (OR = 2.28, 95% CI 1.9-2.72; <i>P</i> < 0.001). All 4 subtypes of discrimination assessed by the Adolescent Brain Cognitive Development study (weight, sexuality, country of origin, and race/ethnicity) were significant and independent predictors of multisite pain. Children experiencing discrimination based on weight had the highest odds of multisite pain (OR = 3.22, 95% CI 2.40-4.33; <i>P</i> < 0.001). Discrimination was also associated with higher self-reported average pain severity (0.48-point increase for every one-unit increase on the PDS, 95% CI 0.28-0.68; <i>P</i> < 0.001) and interference with daily activities (1.18 times higher for every one-unit increase on the PDS, 95% CI 1.06-1.32; <i>P</i> = 0.004).</p><p><strong>Conclusion: </strong>These findings suggest that childhood discrimination is associated with multisite pain and greater pain severity and interference. Healthcare providers should consider assessing discrimination experiences in children presenting with pain.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"11 3","pages":"e1432"},"PeriodicalIF":4.3,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13056464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647281","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":"Validation of a self-report measure for diagnostic screening and assessment in complex regional pain syndrome.","authors":"Stephen Bruehl, Alexandra Sideris, Tina Chen, Semih Gungor, Storm Horine, Vladimir Kramskiy, Frederic T Billings, Sara Anderson, R Norman Harden","doi":"10.1097/PR9.0000000000001410","DOIUrl":"10.1097/PR9.0000000000001410","url":null,"abstract":"<p><strong>Introduction: </strong>Complex regional pain syndrome (CRPS) is an orphan condition with no interventions proven effective in large-scale clinical trials. In-person clinical evaluations are required to make a CRPS diagnosis and determine study eligibility, making recruitment for CRPS trials challenging.</p><p><strong>Objectives: </strong>We developed and validated a self-report measure of CRPS symptoms suitable for remote administration.</p><p><strong>Methods: </strong>We evaluated diagnostic accuracy of a self-report version of the CRPS Severity Score (CSS-SR) and assessed its validity relative to the original clinician-completed CSS (CSS-Clinician) in two samples: 112 postsurgical patients with total knee arthroplasty and 80 patients with CRPS and non-CRPS limb pain attending a chronic pain clinic. All patients completed the CSS-SR and underwent a semi-structured history and physical examination from which the CSS-Clinician was scored and a criterion-based Budapest CRPS diagnosis was determined.</p><p><strong>Results: </strong>There was good to excellent correspondence (intraclass correlations [ICCs]) between CSS-Clinician and CSS-SR total scores (postsurgical sample: ICCs = 0.86-0.92; pain clinic sample: ICC = 0.76). In the postsurgical sample, the 2 measures displayed good agreement regarding changes in CRPS features across 2 assessments 4 months apart (ICC = 0.84). The CSS-SR exhibited high diagnostic accuracy in receiver operating characteristic analyses (area under the curve = 0.84-0.94). In the pain clinic sample, a CSS-SR cutoff of ≥8 had a 79% probability of correctly predicting a Budapest CRPS diagnosis after full evaluation (sensitivity = 0.79, specificity = 0.79).</p><p><strong>Conclusion: </strong>The CSS-SR appears valid as a self-report measure of CRPS status and displays good accuracy as a remote diagnostic screening tool.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"11 3","pages":"e1410"},"PeriodicalIF":4.3,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13056463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647278","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":"Psychological determinants and predictors of outcomes in spinal cord stimulation: a systematic review.","authors":"Caro Edelbroek, J W Kallewaard, Frank Huygen, Jitske Tiemensma","doi":"10.1097/PR9.0000000000001429","DOIUrl":"10.1097/PR9.0000000000001429","url":null,"abstract":"<p><p>Spinal cord stimulation (SCS) has been proven to be an effective therapy for chronic persistent pain conditions. In addition to somatic and technical variables, the effectiveness of this therapy is also influenced by psychological factors. Despite the growing number of studies, there is currently no consensus on which factors predict outcomes of SCS treatment. The existence of this knowledge gap underscores the need for a systematic review to consolidate the current knowledge about the role of psychological factors in the efficacy of SCS. A comprehensive literature search was conducted for this systematic review. The protocol for this review was registered at the International Database of Systematic Reviews (PROSPERO, CRD42024572349). The data from the included studies were synthesized using an Excel overview. The Newcastle-Ottawa Scale was used to evaluate the quality of the included studies. After duplicate removal, 1733 studies were identified; 29 studies met the inclusion criteria. The multiple questionnaires used in the included articles to measure psychological factors were divided into 7 domains: fear/anxiety, depressive feelings, catastrophizing, sleep, social functioning, pain, and psychiatric problems. The results were subjected to analysis on a per-domain basis. The domains of fear/anxiety, catastrophizing, and depressive feelings were classified as partially predictive, meaning that the reviewed articles provided mixed evidence regarding their predictive value for SCS outcome. The remaining 4 domains were either inconclusive or nonpredictive of SCS outcome. These psychological factors should not be used in isolation for selection, but they can contribute to a comprehensive assessment before SCS.</p><p><strong>Significance statement: </strong>In current practice, the predictive value of psychological factors within the scope of outcome in Spinal Cord Stimulation therapy is not always clear. This systematic review aimed to synthesize existing evidence to determine the extent to which psychological factors influence both short- and long-term SCS outcomes, thereby informing clinical decision-making and future research.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"11 3","pages":"e1429"},"PeriodicalIF":4.3,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635277","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":"Demographic patterns in quantitative sensory testing and clinical pain among former professional American-style football players.","authors":"Samantha M Meints, Robert R Edwards, Can Ozan Tan, Inana Dairi, Alicia J Whittington, Julius Dewayne Thomas, Heather DiGregorio, Cheyenne Brown, Claudia M Campbell, Elizabeth Nolan, Edgar Ross, Herman A Taylor, Adam S Tenforde, Meagan M Wasfy, Marc Weisskopf, Ross Zafonte, Aaron L Baggish, Rachel Grashow","doi":"10.1097/PR9.0000000000001428","DOIUrl":"10.1097/PR9.0000000000001428","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic pain is highly prevalent yet heterogeneous among former American-style football (ASF) players. Pain sensitivity, which differs by age and race, contributes to individual differences in clinical pain in the general population but has not been examined among elite athletes.</p><p><strong>Objectives: </strong>The aim of the current cross-sectional study was to (1) assess pain sensitivity using quantitative sensory testing (QST); (2) examine the impact of age and race on pain sensitivity; and (3) identify the extent to which pain sensitivity is associated with clinical pain intensity and whether this varies across age and race among former ASF players.</p><p><strong>Methods: </strong>Former players (N = 110; N_Black = 59; N_White = 51; M_age = 49) completed questionnaires and underwent QST.</p><p><strong>Results: </strong>Results of Wilcoxon rank-sum and Fisher exact tests indicate age- and race-related differences in QST whereby older and Black players reported greater painful temporal summation aftersensations (M_older = 2.89; SD_older = 6.89; M_Black = 18.03; SD_Black = 20.85) than younger and White players (M_younger = 0.32; SD_younger = 1.16; <i>P</i> < 0.01; M_White = 9.19; SD_White = 12.70; <i>P</i> = 0.03), and Black players demonstrated a lower tolerance for cold pain (M = 105.79; SD = 68.95) than White players (M = 144.66; SD = 57.15; <i>P</i> < 0.01). Results of multivariate linear and logistic regression models indicate the relationship between QST and clinical pain intensity differed by age and race. Greater cold pain tolerance was associated with less clinical pain but only for older players. Race differences in the relationship between QST and clinical pain varied across pain modalities.</p><p><strong>Conclusion: </strong>Results demonstrate that age- and race-related pain disparities persist among former ASF players. Moreover, age and race differences in pain sensitivity may be contributing to these disparities.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"11 3","pages":"e1428"},"PeriodicalIF":4.3,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635116","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":"Serum neurofilament light chain in fibromyalgia: comparative evidence of neuronal injury across chronic pain conditions.","authors":"Joel Fundaun, Eoin Kelleher, Lydia Coxon, Amanda Wall, Jishi John, Kurtis Garbutt, Andreas C Themistocleous, Yuki Terajima, David L Bennett, Katy Vincent, Anushka Irani, Annina B Schmid","doi":"10.1097/PR9.0000000000001423","DOIUrl":"10.1097/PR9.0000000000001423","url":null,"abstract":"<p><strong>Introduction: </strong>Evidence increasingly shows small nerve fibre pathology in subsets of people with fibromyalgia through skin biopsy, corneal confocal microscopy, and microneurography. However, blood-based biomarkers of ongoing neuronal damage, particularly neurofilament light chain (NfL), an axonal structural protein, are not well established.</p><p><strong>Objectives: </strong>The aim of this study was to evaluate serum NfL concentrations in fibromyalgia compared with other chronic pain conditions and assess their relationship with neuropathic-like pain.</p><p><strong>Methods: </strong>We measured serum NfL using Simoa SR-X NF Light v2 digital-immunoassay in 60 participants with fibromyalgia, 61 with endometriosis (another traditionally considered non-neuropathic pain condition), 24 with small fibre neuropathy (a recognised neuropathic pain condition), and 30 healthy controls. Serum NfL concentrations were compared between the groups controlling for age and body mass index. Neuropathic-like pain was assessed using the painDETECT questionnaire for fibromyalgia and endometriosis and NeuPSIG grading criteria for small fibre neuropathy.</p><p><strong>Results: </strong>Compared with healthy controls (mean concentration = 6.77 pg/mL, Z-score = -1.15), serum NfL concentrations were significantly elevated in fibromyalgia (mean concentration = 8.52 pg/mL <i>P</i> = 0.048; Z-score = -0.30, and <i>P</i> = 0.006) and small fibre neuropathy (mean concentration = 8.98 pg/mL, <i>P</i> = 0.004; Z-score = 0.23, <i>P</i> = 0.0001), with endometriosis representing an intermediate phenotype (mean concentration = 5.57 pg/mL, <i>P</i> = 0.44; Z-score = -0.41, <i>P</i> = 0.024). Using PainDETECT, 44% of fibromyalgia and 26% of endometriosis participants met likely neuropathic pain criteria; using NeupSIG grading, 96% of small fibre neuropathy participants met probable/definite criteria.</p><p><strong>Conclusion: </strong>Our study provides serological evidence of nerve pathology in fibromyalgia at comparable levels with small fibre neuropathy, although this did not correlate with neuropathic-like pain presence or severity. These findings highlight the need for subgroup-specific treatment strategies.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"11 2","pages":"e1423"},"PeriodicalIF":4.3,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13016184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147522793","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":"Acceptance of pain neuroscience education in chronic musculoskeletal pain conditions: qualitative systematic review.","authors":"Lukas Kühn, Eileen Wengemuth, Lara Kleist, Kyung Eun Anna Choi","doi":"10.1097/PR9.0000000000001420","DOIUrl":"10.1097/PR9.0000000000001420","url":null,"abstract":"<p><p>Pain neuroscience education (PNE) is a recognized strategy to manage biopsychosocial aspects of chronic pain. To this date, a systematic synthesis of determinants affecting the use and acceptance of PNE in clinical practice is pending. Primary qualitative articles were included if they investigated patient and/or provider perspectives on the use and acceptance of PNE in chronic musculoskeletal pain management. We searched MEDLINE (PubMed), Web of Science, and PsycInfo to identify eligible articles. Two researchers independently conducted the consensus-guided study selection process. Methodological quality was assessed using the Joanna Briggs Institute's (JBI) critical appraisal tool for qualitative research. Data from retrieved articles were synthesized using the JBI meta-aggregation approach. Confidence in findings was assessed by the ConQual approach to synthesized findings. Sixteen studies were included for qualitative meta-aggregation, comprehending perspectives of 329 participants. The analysis revealed 6 synthesized findings: (1) Basic didactic principles such as metaphors, multichannels, repetition, and plain messages support the delivery of PNE; (2) persisting beliefs in biomedical explanations of pain can lead to skepticism and misunderstandings of PNE; (3) emphasize the benefits of PNE and create personal relevance; (4) a group vs an individual setting should be chosen according to patient needs; (5) a good clinician-patient relationship is crucial for the acceptance of PNE; and (6) lacking confidence, unclear responsibilities, and a professional culture focused on biomedical aspects of care can keep practitioners from delivering PNE. Addressing these findings will contribute to a wider use and acceptance of PNE clinical practice.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"11 2","pages":"e1420"},"PeriodicalIF":4.3,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13004225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500678","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":"Cuff algometry induces large yet variable conditioned pain modulation effects.","authors":"Joseph L Taylor, Timothy Lawn, Olivia S Kowalczyk, Thomas Graven-Nielsen, Matthew A Howard, Kirsty Bannister","doi":"10.1097/PR9.0000000000001425","DOIUrl":"10.1097/PR9.0000000000001425","url":null,"abstract":"<p><strong>Introduction: </strong>Conditioned pain modulation (CPM) paradigms provide a proxy measure of activity in the descending pain modulatory system. Cuff-pressure algometry offers a standardised CPM assessment tool although comprehensive validation in large samples is lacking.</p><p><strong>Objective: </strong>To characterise cuff-pressure-algometry assessed CPM and its test-retest reliability in a large healthy control sample.</p><p><strong>Methods: </strong>Cuff-algometry CPM data from 324 healthy participants across 8 studies were pooled. Conditioned pain modulation magnitude was calculated as pain detection threshold (PDT) and pain tolerance threshold (PTT) changes, assessed on the dominant leg in the presence and absence of a painful \"conditioning\" cuff stimulus on the contralateral leg.</p><p><strong>Results: </strong>Conditioned pain modulation effects were robust for both changes in PDT and PTT (<i>P</i> < 0.001). Using a classification approach where a ≥20% change in threshold designated a CPM responder, 69% of participants were CPM responders for PDT and 59% for PTT. Test-retest reliability data were assessed in a subset of participants (n = 72; interval 16.49 ± 18.39 days) using intraclass correlation coefficients (ICCs). Test-retest reliability was <i>poor</i> for CPM effects (ICC = 0.25-0.37) despite <i>moderate</i>-to-<i>good</i> reliability for PDT and PTT (ICC = 0.69-0.87). Responder classification showed <i>none</i>-to-<i>minimal</i> agreement across sessions (Cohen κ = 0.17-0.21), with 38% of participants switching classification for both PDT and PTT. Bootstrap analysis revealed that smaller samples provide highly variable ICC estimates, potentially explaining discrepancies with previous reliability reports.</p><p><strong>Conclusion: </strong>Despite producing large group-level CPM effects, <i>poor</i> test-retest reliability of cuff algometry suggests that it captures dynamic, state-dependent processes, which obscure any underlying stable trait-like individual characteristic. This highlights the need to consider the temporal instability of CPM when interpreting data and considering its deployment within precision pain medicine.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"11 2","pages":"e1425"},"PeriodicalIF":4.3,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13004212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500738","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}