Frontiers in pain research (Lausanne, Switzerland)最新文献

{"title":"Underutilized treatments for patients with refractory cancer pain: a qualitative study assessing the use of intrathecal drug delivery devices in the United Kingdom compared to alternative treatments in cancer pain management.","authors":"Victoria Barnosky, Matthew Brown, Somnath Bagchi, Remy Blain, Demir Husejnovic, Sandra Johnson, Meredith Mackworth-Praed","doi":"10.3389/fpain.2025.1481245","DOIUrl":"10.3389/fpain.2025.1481245","url":null,"abstract":"<p><strong>Objectives: </strong>This research aims to better delineate how intrathecal drug delivery systems (IDDS) are incorporated into the oncology care continuum and highlight the need for further awareness of interventional options for pain management of cancer patients in the United Kingdom. The study focuses on exploring the knowledge, perspectives, and experiences of healthcare professionals regarding IDDS as a treatment option for managing chronic refractory pain in cancer patients.</p><p><strong>Methodology: </strong>A thematic coding using inductive analysis was employed to achieve the research objectives. Semi-structured interviews were conducted with 18 healthcare professionals in various specialties, including oncology, neurosurgery, pain management, and palliative care. The interviews were transcribed, and a two-phased qualitative inductive coding approach was used to analyze the data.</p><p><strong>Results: </strong>The findings of the study revealed four major themes: Education, Barriers & Benefits, Technical & Administrative, and Patient-Centered Care. The theme of Education highlighted the need for increased knowledge and awareness of IDDS among healthcare professionals. Barriers & Benefits encompassed concerns about infection risk, suitability for patients with a short life expectancy, and the challenges and advantages of IDDS use. The Technical & Administrative theme addressed cost considerations, device management, and the need for improved guidelines. Patient-Centered Care emphasized the importance of involving patients in decision-making and considering their physical and emotional well-being throughout the treatment pathway.</p><p><strong>Conclusions: </strong>This research identifies several areas of unmet need in the management of refractory pain in cancer patients, including the development of more inclusive guidelines, greater awareness among clinicians and patients, and the role of medical technology companies in supporting effective pain management. The findings underscore the impact of IDDS on improving pain control and highlight the potential importance of early intervention and comprehensive pain management in influencing the trajectory of oncological diseases.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1481245"},"PeriodicalIF":2.5,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574866","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":"Pain without presence: a narrative review of the pathophysiological landscape of phantom limb pain.","authors":"Hong Wu, Chandan Saini, Roi Medina, Sharon L Hsieh, Aria Meshkati, Kerry Sung","doi":"10.3389/fpain.2025.1419762","DOIUrl":"10.3389/fpain.2025.1419762","url":null,"abstract":"<p><p>Phantom limb pain (PLP) is defined as the perception of pain in a limb that has been amputated. In the United States, approximately 30,000-40,000 amputations are performed annually with an estimated 2.3 million people living with amputations. The prevalence of PLP among amputees is approximately 64%. Over the years, various theories regarding the etiology of PLP have been proposed, with some gaining more prominence than others. Yet, there is a lack of consensus on PLP mechanisms as the current literature exploring the pathophysiology of PLP is multifactorial, involving complex interactions between the central and peripheral nervous systems, psychosocial factors, and genetic influences. This review seeks to enhance the understanding of PLP by exploring its multifaceted pathophysiology, including genetic predispositions. We highlight historical aspects of pain theories and PLP, examining how these theories have expanded to include psychosocial dimensions associated with chronic pain in amputees. Additionally, we present significant findings from both human and animal studies focused on neuroaxial systems and recent advances in molecular research to further elucidate the complex and multifactorial nature of PLP. Ultimately, we hope that the integration of current theoretical frameworks and findings will lay a more robust foundation for future research on PLP.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1419762"},"PeriodicalIF":2.5,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11876430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560145","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":"Pain and the autonomic nervous system. The role of non-invasive neuromodulation with NESA microcurrents.","authors":"Nelson Azevedo, Raquel Medina-Ramírez","doi":"10.3389/fpain.2025.1410808","DOIUrl":"10.3389/fpain.2025.1410808","url":null,"abstract":"","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1410808"},"PeriodicalIF":2.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11873094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544802","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":"Evaluation of long-term outcomes with intrathecal opioid treatment: a comparison utilizing data derived from pain clinic populations in Australia and New Zealand.","authors":"Elouise Rose Comber, Jenny Strong, Orla Moore, Asaduzzaman Khan, James O'Callaghan, Benjamin Manion, Brendan Joseph Moore, Maree Therese Smith","doi":"10.3389/fpain.2025.1527371","DOIUrl":"https://doi.org/10.3389/fpain.2025.1527371","url":null,"abstract":"<p><strong>Introduction: </strong>An obstacle to analysis of the long-term effectiveness of intrathecal (IT) opioids is absence of historical patient baseline data. The electronic Persistent Pain Outcomes Collaboration (ePPOC) is an initiative of the Faculty of Pain Medicine of the Australian and New Zealand College of Anaesthetists. Recently published ePPOC data has provided justifiable surrogate baseline data allowing opportunities for pain outcomes research into select patient treatment groups. Our aim was to compare long-term outcomes of IT opioid therapy with a surrogate baseline utilizing a large ePPOC data set for patients at the time of initial presentation to 36 pain clinics in Australia and New Zealand.</p><p><strong>Methods: </strong>Study participants were 49 consenting patients receiving IT opioids as part of a long-term pain management regime for treating chronic non-cancer pain. Their data were compared with the large ePPOC data set (<i>n</i> = 13,343). The questionnaires comprised a demographic questionnaire, the Brief Pain Inventory, the Depression, Anxiety and Stress Scale, the Pain Catastrophizing Questionnaire, and the Pain Self-Efficacy Questionnaire.</p><p><strong>Results: </strong>Compared with the ePOCC group, participants who received IT opioids long-term for the relief of chronic non-cancer pain reported significantly lower (<i>p</i> ≤ 0.001) pain severity (4.3 vs. 6.4), and pain interference scores (5.5 vs. 7), significantly lower depression (20.2 vs. 13.7), anxiety (9.6 vs. 14.1), stress (15.5 vs. 21), rumination (6.9 vs. 10), magnification (3.8 vs. 5.9), helplessness (9.7 vs. 14.1), general catastrophizing (20.4 vs. 29.8), and higher self-efficacy (29.5 vs. 20.7).</p><p><strong>Discussion: </strong>The observed improvements in all measured pain variables have occurred in the context of comprehensive pain management, and therefore, may be attributable to pain reduction and not directly to IT opioid use or the device itself. Favourable pain management outcomes, in a select patient treatment group utilizing long-term IT opioid therapy, were demonstrated using the large-data ePPOC initiative, highlighting the research opportunities it provides.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1527371"},"PeriodicalIF":2.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544799","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":"Anatomical and physiological contributions of nasal turbinate vessels and lymphatics to the pathogenesis of nasal congestion in recurrent headaches: a pilot study.","authors":"Jacob M Chmielecki, Aishwarya Vemula, Joyce G Schwartz, Jonathan A Gelfond, William T Phillips","doi":"10.3389/fpain.2025.1521500","DOIUrl":"10.3389/fpain.2025.1521500","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to determine if specific anatomical changes were present in patients with recurrent headaches including patients with chronic migraines, chronic tension-type headaches, and daily persistent headaches. A retrospective study of 200 patients was performed to evaluate the potential of measuring the amount of nasal blood pool activity (nasal congestion) as a predictive marker for recurrent headaches.</p><p><strong>Methods: </strong>A cohort analysis was performed involving patients who had been referred to the Nuclear Medicine Clinic over a 3-year period for whole-body blood pool scans. The scans were evaluated by region of interest (ROI) analysis of nasal and heart max pixel count ratios (NHMRs) to determine an association between nasal blood pooling activity and recurrent headaches at the time of the initial scan and in follow-up evaluations over a period of 3-6 years.</p><p><strong>Results: </strong>Significantly greater NHMRs were observed in 122 patients with chronic headaches at the time of referral for their initial whole-body blood pool scan when compared with those patients without recurrent headaches (<i>p</i> = 0.004; OR 10.5; 95% CI 2.22-56.7). An additional 15 patients, for a total of 137, developed recurrent headaches following their initial scan and before their follow-up evaluation. NHMRs were also significantly increased in the additional patients when compared to those without recurrent headaches (<i>p</i> = 0.004; OR 12.3; 95% CI 2.34-75.5).</p><p><strong>Conclusion: </strong>Patients with recurrent headaches have significantly increased nasal activity as observed on ^99mTc-MDP whole-body blood pool scans, supporting the hypothesis that nasal lymphatic dysfunction plays a role in the etiology of recurrent headaches. This research highlights a novel diagnostic use of the whole-body blood pool scan for the assessment of nasal turbinate vasodilation as well as a possible new target for the treatment of recurrent headaches.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1521500"},"PeriodicalIF":2.5,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460710","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":"Towards painless and productive research relationships: reflections on study design by a researcher with chronic pain for participants with chronic pain.","authors":"Catherine Wilkinson","doi":"10.3389/fpain.2024.1450667","DOIUrl":"10.3389/fpain.2024.1450667","url":null,"abstract":"<p><p>Building flexibility into the research design of a study allows for responsiveness to the embodied and fluctuating nature of participants' chronic illnesses, which may be shaped, for instance, by flare-ups and periods of remission of acute pain. Whilst the methodology literature has, to some extent, considered how to accommodate the pain of research participants when designing a study, consideration of how methodological choices are responsive to the researcher's pain needs has not to date been foregrounded. From the perspective of a researcher with Ankylosing Spondylitis (AS), a form of inflammatory arthritis characterized by chronic pain, and Crohn's disease, a type of inflammatory bowel disease, characterized by stomach and joint pain, this paper provides insight into pain and researcher-participant relationships, from the perspective of a researcher in pain, designing a study to accommodate her own pain needs, as well as anticipating the needs of prospective participants in pain. This paper proposes the use of flexible, remote, and asynchronous research methods as ways to make studies inclusive for researchers living with pain, whilst fostering the most fruitful research relationships with participants who also live with pain, thereby moving towards a position of shared vulnerability. It also highlights the relative absence of the researcher's needs and possible vulnerability in ethics forms and considered by research ethics committees, in comparison to the needs and vulnerability of participants.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"5 ","pages":"1450667"},"PeriodicalIF":2.5,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460708","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":"Editorial: Advancements in equine pain management.","authors":"Ludovica Chiavaccini, Rachel Anne Reed, Claudia Spadavecchia","doi":"10.3389/fpain.2025.1547764","DOIUrl":"10.3389/fpain.2025.1547764","url":null,"abstract":"","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1547764"},"PeriodicalIF":2.5,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460891","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":"Healing synchrony? potential benefits of interpersonal synchrony for chronic pain management.","authors":"Justyna Świdrak","doi":"10.3389/fpain.2025.1463321","DOIUrl":"10.3389/fpain.2025.1463321","url":null,"abstract":"<p><p>Fibromyalgia is called a pathology of misconnection at the neurophysiological, psychological, and social levels, and is characterised by widespread musculoskeletal pain, which is accompanied by a series of symptoms, such as chronic fatigue, depression, anxiety, body perception disturbances, and cognitive deficits. In this article, I argue that interventions that in various ways enhance interpersonal neural synchronisation (INS) may bring long-term benefits to people with fibromyalgia (PwF). In the first part, I briefly introduce studies on INS in the general population. In the second part, I hypothesise that interpersonal synchrony may contribute to symptom reduction for individuals with fibromyalgia, in the sense that repeated experience of being in sync with others may play a role in restoring both the brain-body and self-others connection in this population and consequently result in simultaneous lasting improvement of wellbeing. In the final part, I discuss potential future research directions.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1463321"},"PeriodicalIF":2.5,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460960","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":"Proteomic profiling of serum in cats with naturally occurring degenerative joint disease and co-morbid conditions.","authors":"B Duncan X Lascelles, Rakesh Ponnala, Steven G Kamerling, Tracey Williams","doi":"10.3389/fpain.2025.1501932","DOIUrl":"10.3389/fpain.2025.1501932","url":null,"abstract":"<p><strong>Introduction: </strong>Degenerative joint disease (DJD) occurs very commonly in cats and can be associated with pain. Almost 70% of cats with DJD-associated pain suffer the co-morbidity of chronic kidney disease (CKD). There are currently very limited treatment or management options. A greater understanding of the systems biology of DJD, DJD-associated pain, and CKD may contribute to identifying disease specific biomarkers and relevant targets for the development of therapeutics for the control of these conditions in cats, and help inform human pain therapeutic development.</p><p><strong>Methods: </strong>Using mass spectrometry-based proteomic profiling of the serum of 200 highly phenotyped cats with varying burdens of DJD, pain, and CKD, we identified significant individual proteins and pathways.</p><p><strong>Results: </strong>Functional pathway analysis, based on differentially abundant proteins across individual disease states (DJD, pain, CKD), identified pathways playing a role in DJD and DJD-associated pain including acute phase response signaling, LXR/RXR and FXR/RXR activation and the complement system. With the added co-morbidity of CKD, similar pathways were identified, with the addition of IL-12 signaling and production in macrophages.</p><p><strong>Discussion: </strong>We identified differentially abundant proteins associated with DJD, pain and CKD and future work should evaluate these proteins as potential biomarkers of disease (individually or as clusters). Further, these data could be leveraged to identify novel therapeutic targets to address the gap in our ability to manage DJD, pain, and CKD in cats. Given that our work was in cats with naturally occurring DJD, these results may have translational applicability to human health.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1501932"},"PeriodicalIF":2.5,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451162","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":"Pain science education concepts for pelvic pain: an e-Delphi of expert clinicians.","authors":"Amelia K Mardon, Hayley B Leake, Monique V Wilson, Emma L Karran, Romy Parker, Rinkle Malani, G Lorimer Moseley, K Jane Chalmers","doi":"10.3389/fpain.2025.1498996","DOIUrl":"10.3389/fpain.2025.1498996","url":null,"abstract":"<p><strong>Introduction: </strong>Persistent pelvic pain is a prevalent condition that negatively impacts one's physical, psychological, social, and sexual wellbeing. Pain science education (PSE) involves learning about the biology of pain and is commonly integrated into the management of persistent pain. However, PSE is yet to be thoroughly investigated for persistent pelvic pain potentially due to the lack of targeted curricula, including learning concepts. The aim of this study was to gain consensus on PSE learning concepts important for persistent pelvic pain according to expert clinicians.</p><p><strong>Methods: </strong>A three-round e-Delphi survey was conducted to generate and gain consensus on important PSE learning concepts for female persistent pelvic pain among 20 international, multidisciplinary expert clinicians (e.g., physiotherapists, gynaecologists, psychologists). Learning concepts generated by clinicians were rated by importance using a six-point Likert scale. Consensus on importance rating was considered reached for items with an IQR <1.0.</p><p><strong>Results: </strong>The expert clinicians generated 125 PSE learning concepts that were considered important for persistent pelvic pain; 92 (73.6%) learning concepts reached consensus on their importance rating. Of the 125 learning concepts, 102 were generated for persistent pelvic pain in general, and were categorised into 13 overarching PSE concepts (e.g., persistent pelvic pain involves changes to the brain and nervous system). Sixteen PSE concepts were generated for specific pelvic pain conditions (e.g., endometriosis) and seven concepts for specific life stages (e.g., adolescence).</p><p><strong>Discussion: </strong>This study provides the first list of key PSE concepts tailored for persistent pelvic pain developed by expert clinicians. These concepts provide a framework for developing and implementing PSE curricula for persistent pelvic pain in research and clinical settings.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1498996"},"PeriodicalIF":2.5,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451161","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}