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

{"title":"The interplay between pulse width and activation depth in TENS: a computational study.","authors":"Alexander Guillen, Dennis Q Truong, Yusuf O Cakmak, Sheng Li, Abhishek Datta","doi":"10.3389/fpain.2025.1526277","DOIUrl":"https://doi.org/10.3389/fpain.2025.1526277","url":null,"abstract":"<p><strong>Background: </strong>Transcutaneous electrical nerve stimulation (TENS) has been a commonly used modality to relieve aches and pain for over 40 years. Commercially available devices provide multiple therapy modes involving a different combination of frequency and pulse width with intensity. While frequency sets sensation, intensity helps determine tolerability, longer pulse width is reported to induce a feeling of deeper stimulation. In fact, longer pulse width has been empirically shown to deliver current into deeper tissues, but in context of other electrical stimulation modalities. The goal of this study was to unpack the relationship between pulse width and activation depth in TENS.</p><p><strong>Methods: </strong>A highly realistic, anatomically-based, 3D finite element model of the forearm was used to simulate the electric field (E-field) distribution, as the pulse width is varied. A typical titration-guided mechanism was used to obtain the strength-duration (S-D) curves of a sensory McIntyre-Richardson-Grill (MRG) axonal model simulating the pain-transmitting A-delta fibers. The pulse widths tested ranged from 30 μs to 495 μs.</p><p><strong>Results: </strong>As expected, shorter pulse widths required more current to achieve activation, resulting in a larger E-field. The S-D curve of the target median nerve indicates a rheobase of 1.75 mA and a chronaxie of 232 µs. When the applied currents are the same, shorter pulse widths result in a smaller volume of tissue activated (VTA) compared to the longer pulse widths. A 21 fold difference in VTA was found between the longest and shortest pulse widths considered. For the conditions tested in the study, an increase in pulse width resulted in an increase in activation depth, exhibiting a linear relationship.</p><p><strong>Conclusion: </strong>Our findings highlight the impact of pulse width on activation depth. While choice of a given therapy mode is usually based on an <i>ad-hoc</i> desirable sensation basis, medical professionals may consider advocating a certain therapy mode based on the depth of the intended target nerve.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1526277"},"PeriodicalIF":2.5,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029224","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":"Prenatal opioid exposure alters pain perception and increases long-term health risks in infants with neonatal opioid withdrawal syndrome.","authors":"Uppala Radhakrishna, Rupa Radhakrishnan, Lavanya V Uppala, Tithi S Trivedi, Jignesh Prajapati, Rakesh M Rawal, Srinivas B Muvvala, Ray O Bahado-Singh, Senthilkumar Sadhasivam","doi":"10.3389/fpain.2025.1497801","DOIUrl":"https://doi.org/10.3389/fpain.2025.1497801","url":null,"abstract":"<p><strong>Background: </strong>Opioids are often prescribed for pain relief, yet they pose risks such as addiction, dependence, and overdose. Pregnant women have unique vulnerabilities to opioids and infants born to opioid-exposed mothers could develop neonatal opioid withdrawal syndrome (NOWS). The study of opioid-induced epigenetic changes in chronic pain is in its early stages. This study aimed to identify epigenetic changes in genes associated with chronic pain resulting from maternal opioid exposure during pregnancy.</p><p><strong>Methods: </strong>We analyzed DNA methylation of chronic pain-related genes in 96 placental tissues using Illumina Infinium Methylation EPIC BeadChips. These samples comprised 32 from mothers with infants prenatally exposed to opioids who needed pharmacologic NOWS management (+Opioids/+NOWS), 32 from mothers with prenatally opioid-exposed infants not needing NOWS pharmacologic treatment (+Opioids/-NOWS), and 32 from unexposed control subjects (-Opioids/-NOWS).</p><p><strong>Results: </strong>The study identified significant methylation changes at 111 CpG sites in pain-related genes among opioid-exposed infants, with 54 CpGs hypomethylated and 57 hypermethylated. These genes play a crucial role in various biological processes, including telomere length regulation (<i>NOS3, ESR1, ESR2, MAPK3</i>); inflammation (<i>TNF, MAPK3, IL1B, IL23R</i>); glucose metabolism (<i>EIF2AK3, CACNA1H, NOTCH3, GJA1</i>); ion channel function (<i>CACNA1C, CACNA1H, CLIC4, KCNQ5</i>); autophagy (<i>CTSS, ULK1, ULK4, ATG5</i>); oxidative stress (<i>NGF, NRG1, OPRM1, ATP1A2</i>); aging (<i>GRIA1, NGFR, PRLR, EIF4E</i>); cytokine activity (<i>TRPV4, RUNX1, CXCL8, IL18R1</i>); and the risk of suicide (<i>ADORA2A, ANKK1, GABRG2, IGSF9B</i>). These epigenetic changes may influence 48 signaling pathways-including cAMP, MAPK, GnRH secretion, estrogen signaling, morphine addiction, circadian rhythms, and insulin secretion-profoundly affecting pain and inflammation-related processes.</p><p><strong>Conclusion: </strong>The identified methylation alterations may shed light on pain, neurodevelopmental changes, and other biological mechanisms in opioid-exposed infants and mothers with OUD, offering insights into NOWS and maternal-infant health. These findings may also pave the way for targeted interventions and improved pain management, highlighting the potential for integrated care strategies to address the interconnected health of mothers and infants.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1497801"},"PeriodicalIF":2.5,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044126","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":"Assessment of non-pharmacological nursing strategies for pain management in tumor patients: a systematic review and meta-analysis.","authors":"Shen Yan, Feng Yan, Pei Liangyu, Xu Fei","doi":"10.3389/fpain.2025.1447075","DOIUrl":"https://doi.org/10.3389/fpain.2025.1447075","url":null,"abstract":"<p><strong>Summary background: </strong>Cancer is a multifactorial disease associated with intense pain and fatigue. Pain is the main discomfort experienced during cancer treatment, particularly as a major side effect of chemotherapy.</p><p><strong>Objective: </strong>This study has aimed to investigate the effectiveness of non-pharmacological nursing strategies, including reflexology, aromatherapy, acupressure, massage therapy and acupuncture, in the management of cancer-associated pain. Moreover, it provides evidence-based recommendations for integrating these interventions into standard pain management protocols.</p><p><strong>Search methodology: </strong>We gathered data from three major online databases; PubMed, the Cochrane Library and Embase. For the analysis, we exclusively targeted randomized controlled trials (RCTs) assessing the effectiveness of non-pharmacological interventions in managing cancer-related pain. No language restrictions were applied, and pain was considered the primary outcome measure.</p><p><strong>Results: </strong>Seventeen RCTs (<i>n</i> = 1,070) were included in this meta-analysis from 166 eligible studies. The pooled effect size demonstrated that all evaluated non-pharmacological nursing strategies, including aromatherapy, massage, reflexology, acupressure and acupuncture significantly reduced cancer-related pain compared to usual care (<i>p</i> < 0.001). Moreover, the reflexology and massage showed negligible heterogeneity among other interventions.</p><p><strong>Conclusion: </strong>This meta-analysis found the significant effectiveness of non-pharmacological nursing strategies, particularly reflexology and massage in reducing cancer-related pain. The findings support their integration into clinical practice, providing evidence-based recommendations for enhancing standard pain management protocols.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1447075"},"PeriodicalIF":2.5,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045401","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 on perceived pain and somatosensory function after transcutaneous neuromodulation in patients with chronic low back pain: a quasi-experimental study with a crossover intervention.","authors":"Francisco Selva-Sarzo, Eleuterio A Sánchez Romero, Juan Nicolás Cuenca-Zaldívar, Beatriz García-Haba, Claudio Akiyama, Rob Sillevis, Samuel Fernández-Carnero","doi":"10.3389/fpain.2025.1525964","DOIUrl":"https://doi.org/10.3389/fpain.2025.1525964","url":null,"abstract":"<p><strong>Background: </strong>Transcutaneous magnetic neuromodulation is a noninvasive technique that may influence pain perception and mobility by modulating epidermal afferents and autonomic nervous system activity. However, its effects on chronic non-specific low back pain (CNSLBP) remain unclear.</p><p><strong>Objective: </strong>This study evaluated the effects of transcutaneous neuromodulation applied to the lumbar spine on the pressure pain threshold (PPT) and ankle dorsiflexion range of motion (DROM) in patients with chronic non-specific low back pain.</p><p><strong>Methods: </strong>A single-group prospective cohort study with crossover intervention was conducted from June to December 2021. A convenience sample of 39 patients with CNSLBP was included in this study. Each participant received two interventions in a randomized sequence: transcutaneous neuromodulation tape with magnetic particles (TMP) and placebo kinesiology tape (KT). A one-week washout period was implemented between the interventions. TMP was applied at the lumbar spinal levels for 48 h, following standard recommendations for neuromodulation frequency (constant exposure via magnetic particles), intensity (low-energy field), and time (continuous exposure over two days). The primary outcome measure was PPT assessed using algometry, and the secondary outcome was DROM assessed using the Lunge Test. This study adhered to the STROBE guidelines for observational studies.</p><p><strong>Results: </strong>The Lunge test revealed no significant group-time interaction [F(2, 152) = 0.132, <i>p</i> = 0.752], with a small effect size [F(1, 76) = 0.699, <i>p</i> = 0.406]. The main effect group showed a small non-significant effect [ <math><msubsup><mi>η</mi> <mi>p</mi> <mn>2</mn></msubsup> </math>  = 0.009 (0, 0.091)]. However, the main effect of time was significant [F(2, 152) = 147.669, <i>p</i> = 0.001] with a large effect size [ <math><msubsup><mi>η</mi> <mi>p</mi> <mn>2</mn></msubsup> </math>  = 0.66 (0.54, 0.735)]. Pairwise leg comparisons were not significant (<i>p</i> > 0.05). For the pressure pain threshold, significant differences (<i>p</i> < 0.05) with moderate to large effect sizes were observed. PPTs varied by vertebral level, with significant differences in site-specific comparisons between specific levels.</p><p><strong>Conclusions: </strong>Transcutaneous neuromodulation using TMP applied to the lumbar spine reduces perceived pain and increases ankle dorsiflexion range of motion in patients with CNSLBP. These findings suggest that epidermal afferent modulation may contribute to pain relief and motor function enhancement, providing a novel approach for noninvasive pain management.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1525964"},"PeriodicalIF":2.5,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001427","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":"Quantitative sensory testing in dogs with spontaneous osteoarthritis.","authors":"James Russell Hunt, David Knazovicky, Megan Goff, John Harris, Toby G Knowles, Masataka Enomoto, Michael Mendl, Becky Whay, B Duncan X Lascelles, Joanna C Murrell","doi":"10.3389/fpain.2025.1518725","DOIUrl":"https://doi.org/10.3389/fpain.2025.1518725","url":null,"abstract":"<p><strong>Objective: </strong>To investigate changes in somatosensory sensitivity in dogs with spontaneous osteoarthritis (OA) and pain of the stifle or hip, compared to a group of healthy control dogs.</p><p><strong>Study design: </strong>A non-randomised, non-blinded, prospective research study.</p><p><strong>Animals: </strong>30 control, 51 OA-pain, and 31 OA-pain dogs receiving NSAIDs.</p><p><strong>Methods: </strong>A range of noxious and non-noxious quantitative sensory testing (QST) modalities were applied. Dogs were tested twice, one month apart. Two sites were tested at each visit: a distal site located on the cranial aspect of the mid metatarsus and a primary site, lateral to the patella (in dogs with stifle OA) or craniodorsally to the greater trochanter (in dogs with coxofemoral OA). Control dogs were tested at appropriate primary sites to produce the same proportion of animals being tested at stifle or hip as those in the OA group. The order in which non-nociceptive and nociceptive tests were performed was randomized for each test site for each animal, although nociceptive tests were always performed after non-nociceptive tests. Feasibility for performing the tests was assessed for the final 45 dogs recruited to the study. The hierarchical structure of the QST testing data was accounted for within the statistical analysis by employing general linear modelling within a multilevel modelling framework using the MLwiN statistics package.</p><p><strong>Results: </strong>Osteoarthritis category was not a major determinant of QST outcome measures for the majority of modalities evaluated. In the few modalities in which OA category was determined to be a significant predictor variable, the results were not consistent with previously reported data. The novel, non-nociceptive tests employed overall suggested non-noxious hypoesthesia in association with OA pain. The feasibility of performing QST assessments was relatively low compared to previous studies.</p><p><strong>Conclusions: </strong>and clinical relevance: In a clinical environment, the variability in feasibility of performing QST between dogs may be sufficient to confound changes in QST outcome measures associated with spontaneous OA.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1518725"},"PeriodicalIF":2.5,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044034","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":"Outcome assessment in veterinary pain studies: a pain in animals workshop (PAW) perspective.","authors":"D C Brown, J Coetzee, M Gill, C Johnson, D P Mohapatra, M L Oshinsky, S A Robertson, E R Smith, B D X Lascelles","doi":"10.3389/fpain.2025.1579155","DOIUrl":"https://doi.org/10.3389/fpain.2025.1579155","url":null,"abstract":"<p><p>Biennially, the Pain in Animals Workshop (PAW) forum brings together scientists and clinicians to focus, across veterinary species and humans, on our shared passion of improving health through our ability to recognize and monitor pain. This collaboration has been instrumental in sharing current knowledge, identifying gaps, and aligning on the best paths forward in this challenging space. At the 2023 PAW held at the National Institutes of Health, Dr Dottie Brown delivered the inaugural Dr. Michele Sharkey PAW Lecture: \"<i>Outcome Assessment in Veterinary Pain Studies: The Yellow Brick Road Continues</i>\". This perspectives article captures the content of that inaugural lecture and provides a reflection on how the PAW forums have been integral to the most recent wave of knowledge gain and awareness.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1579155"},"PeriodicalIF":2.5,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058078","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":"Patient and health service factors associated with enrollment in a multidisciplinary pain rehabilitation program: a retrospective cohort study.","authors":"Michael A Bushey, Lindsay G Flegge, Melissa Melendez, Elizabeth K Harris, Flora M Hammond","doi":"10.3389/fpain.2025.1455792","DOIUrl":"https://doi.org/10.3389/fpain.2025.1455792","url":null,"abstract":"<p><strong>Introduction: </strong>Despite multidisciplinary pain rehabilitation programs (PRPs) being well-established as an effective treatment for chronic pain, the existence of such programs has been declining across the United States over recent decades.</p><p><strong>Objective: </strong>This study aims to identify factors associated with enrollment in a three-week, intensive outpatient PRP.</p><p><strong>Methods: </strong>This is a retrospective cohort study of all patient visits to a multidisciplinary pain evaluation clinic in 2023. The cohort was divided into those who did and did not subsequently enroll in a PRP program. Health service, demographic, and patient-reported outcome measures were compared between groups; continuous variables by independent samples Student's T-tests and categorical variables by chi-squared tests.</p><p><strong>Results: </strong>Of the 335 patients who had an evaluation in 2023, 48 went on to enroll in PRP (PRP-Yes group), and 287 did not (PRP-No group). Compared to PRP non-enrollers, the PRP-enrollers were more likely to have had a mental health (94% vs. 52%, <i>p</i> < .001) and physical therapy (94% vs. 48%, <i>p</i> < .001) assessment as part of their evaluation, had shorter lag times between their initial referral and medical evaluation [mean (SD) 43.5 (28.9) vs. 57.7 (41.7), <i>p</i> = .024], and had significantly greater anxiety, PTSD symptoms, somatic symptoms, and insomnia. Additionally, referral source, medical provider, and physical therapy provider seen differed significantly between PRP-enrollers and non-enrollers. PRP enrollment was not predicted by demographic variables including race, payer-type, or distance from the clinic.</p><p><strong>Discussion: </strong>Both personal and systemic factors were identified to be associated with enrollment in a three-week multidisciplinary PRP. These findings highlight variables worth considering for clinical and research programs looking to increase PRP enrollment.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1455792"},"PeriodicalIF":2.5,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051737","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":"An association between poor oral health, oral microbiota, and pain identified in New Zealand women with central sensitisation disorders: a prospective clinical study.","authors":"Sharon Erdrich, Ingrid C Gelissen, Momchilo Vuyisich, Ryan Toma, Joanna E Harnett","doi":"10.3389/fpain.2025.1577193","DOIUrl":"https://doi.org/10.3389/fpain.2025.1577193","url":null,"abstract":"<p><strong>Introduction: </strong>The portal to the gastrointestinal tract is the oral cavity, with transient and permanent microbial residents. Oral pathogens are implicated in the aetiology of several chronic conditions. To date, the role of oral health and the oral microbiota in the aetiology of pain in sensitisation disorders have not been explored. Here, we examined associations between self-reported oral health, the oral microbiome, and various pain presentations in women.</p><p><strong>Methods: </strong>Oral health in women was assessed using the WHO oral health questionnaire. Body pain, migraine, and abdominal pain were determined using validated instruments. Saliva samples were evaluated using metatranscriptomics for relative gene abundance. Demographic and clinical characteristics data were evaluated for relationships between oral health scores, pain measures, and the oral microbiota at three taxa levels.</p><p><strong>Results: </strong>Participants in the lowest quintiles for oral health were more likely to suffer migraine headaches (<i>χ</i> ² = 23.24, df 4, <i>p</i> < 0.001) and higher body pain scores. Four oral pathogenic species were significantly associated with SF36 bodily pain (<i>q</i> < 0.05) after controlling for confounders. Relative abundance of <i>Gardnerella</i> (genus) correlated moderately with oral health scores (<i>ρ</i> = -0.346, <i>q</i> = 0.001), while <i>Lancefieldella</i> (genus) and <i>Mycoplasma salivarius</i> were associated with migraine.</p><p><strong>Discussion: </strong>Low oral health scores correlated with higher pain scores. Both were associated with higher relative abundance of oral pathobionts. This suggests a potential role for the oral microbiota in the aetiology of pain experienced by women with migraine headache and abdominal and body pain. These findings prompt consideration of an oral microbiome-nervous system axis.</p><p><strong>Trial registration: </strong>The study was registered with the Australia and New Zealand Clinical Trials Registry (ANZCTR), registration number ACTRN12620001337965, on 11/12/2020 https://www.anzctr.org.au/, and with the World Health Organisation, UTN: U1111-1258-5108.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1577193"},"PeriodicalIF":2.5,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065047","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":"Spinal cord stimulation using time-dynamic pulses achieves longer reversal of allodynia compared to tonic pulses in a rat model of neuropathic pain.","authors":"Changfang Zhu, Ki-Soo Jeong, Muhammad Edhi, Victoria Rogness, Carl Y Saab, Rosana Esteller","doi":"10.3389/fpain.2025.1541078","DOIUrl":"https://doi.org/10.3389/fpain.2025.1541078","url":null,"abstract":"<p><strong>Background: </strong>Spinal cord stimulation (SCS) utilizing time-dynamic pulses (TDPs) is an emergent field of neuromodulation that continuously and automatically modulates pulse parameters. We previously demonstrated that TDPs delivered for 60 min at paresthesia-free or minimal paresthesia amplitudes significantly reversed allodynia in a rat model of neuropathic pain. Because the anti-allodynic effect was observed to persist post-stimulation, we hypothesized that the anti-nociceptive effects of TDPs may persist longer than those of tonic stimulation.</p><p><strong>Methods: </strong>We extended SCS stimulation period up to 90 min and investigated the temporal dynamics of SCS-induced analgesia through PWT analysis of the aggregated data from both cohorts.</p><p><strong>Results: </strong>Both TDPs and tonic stimulation reversed paw withdrawal thresholds (PWT) to near pre-neuropathic levels within 30 min. Most TDPs exhibited significantly slower ramp-up slope (analgesia 'wash-in' rates) as compared to tonic stimulation. All TDPs showed slower wind-down slopes (analgesia 'wash-out' rates) compared to tonic, with pulse width modulation reaching significance. Extending SCS from 60 to 90 min revealed that all TDPs maintained analgesic efficacy longer than tonic stimulation, which showed significant decrease at both 75 and 90 min.</p><p><strong>Discussion: </strong>Although TDPs and tonic stimulation comparably mitigated allodynia, TDPs exhibited slower rate of wash-out, suggesting longer-lasting analgesic effects and potentially different mechanisms of action.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1541078"},"PeriodicalIF":2.5,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001461","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":"Clinicians' opinion on massage in the intensive care unit patients.","authors":"Tomasz Zwoliński, Marta Jaskulak, Konrad Janicki, Bartłomiej Siek, Dominika Batycka-Stachnik, Bartosz Wilczyński, Dominika Szalewska, Kamila Gworys, Piotr Wąż","doi":"10.3389/fpain.2025.1452434","DOIUrl":"https://doi.org/10.3389/fpain.2025.1452434","url":null,"abstract":"<p><strong>Introduction: </strong>Physiotherapy in the Intensive Care Unit (ICU) is a common medical procedure involving mainly elements of mobilisation, electrotherapy and also, in various forms and to a lesser extent, elements of massage. Massage can positively influence the physical and psychological outcomes of the ICU) patients.</p><p><strong>Aim: </strong>The study aimed to assess the perception of physiotherapists (PTs), physicians (PHs), and registered nurses (RNs) working in ICU about the possibilities and safety of implementing massage in the process of rehabilitation of ICU patients.</p><p><strong>Methods: </strong>This multicentre survey was conducted in Poland in three ICUs (Gdansk, Koscierzyna, Krakow). A total of 135 people participated in the study. Of these, 25.9% (35/135) were PTs, 21.5% (29/135) were PHs, and 52.6% (71/135) were RNs. The questionnaires were distributed and collected online (directly by respondents to Google Form system) and in written form.</p><p><strong>Results: </strong>Most PTs-71% (25/35)-perceive massage as a beneficial and safe treatment while working with ICU patients. PHs 96% (28/29) and RNs 92% (65/71) also recommend using massage by physiotherapists to rehabilitate ICU patients. In the respondents' opinion, the possibilities for the use of massage by PHs and RNs are lower (between 20% and 55%).</p><p><strong>Conclusions: </strong>According to the surveyed clinicians working in the ICU, massage is a safe form of treatment, especially when performed by PTs and it could be a permanent element of rehabilitation among ICU patients, especially for reducing pain, anxiety and restlessness and also improving sleep quality and bowel movement.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"6 ","pages":"1452434"},"PeriodicalIF":2.5,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054673","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}