Pain

This prospective study examined 1) whether antenatal pain is associated with postnatal maternal bonding disorder (MBD) through postnatal depression and 2) whether intimate partner violence (IPV) has a moderating effect on the association between antenatal pain and postnatal MBD. We analyzed 77,326 pregnancies of women who completed self-report questionnaires including the SF-8 bodily pain item, the Edinburgh Postnatal Depression Scale, the Mother-to-Infant Bonding Scale, and an assessment of IPV. We conducted a mediation analysis to assess whether postnatal depression mediated the association between antenatal pain and MBD 1 year after delivery...

Previous meta-analyses investigating attentional biases towards pain have utilized reaction time measures. Eye-tracking methods have been adopted to more directly and reliably assess biases, but this literature has not been synthesized in relation to pain. This meta-analysis aimed to investigate the nature and time-course of attentional biases to pain-related stimuli in participants of all ages with and without chronic pain using eye-tracking studies; and determine the role of task parameters and theoretically relevant moderators...

Pain and loneliness are consistently associated, but the direction of the relationship is uncertain. We assessed bidirectional associations over a 4 year period in a sample of 4,906 men and women (mean 65.1 ± 8.72 years) who were participants in the English Longitudinal Study of Ageing. The role of inflammation in these links was also investigated. Pain was defined by reports of being often troubled by pain at a moderate or severe intensity, while loneliness was measured using the shortened UCLA scale. Age, sex, ethnicity, educational attainment, wealth as a marker of socioeconomic resources, marital status, physical activity, and depressive symptoms were included as covariates...

The fear-avoidance model of chronic pain predicts that catastrophic (mis)interpretation of pain elicits pain-related fear that in turn may spur avoidance behaviour leading to chronic pain disability. Here we investigated whether performing a movement to avoid a painful stimulus in the context of a novel movement increases threat and pain-related fear towards this novel movement, and whether avoidance behaviour persisted when given the choice between performing the acquired movement to avoid a painful stimulus or an alternative, novel movement...

Despite a century of research on the physiology/pathophysiology of the spinal cord in chronic pain condition, the properties of the spinal cord were rarely studied at the large-scale level from a neurovascular point of view. This is mostly due to the limited spatial and/or temporal resolution of the available techniques. Functional ultrasound imaging (fUS) imaging is an emerging neuroimaging approach that allows, through the measurement of cerebral blood volume, the study of brain functional connectivity or functional activations with excellent spatial (100 μm) and temporal (1 msec) resolutions and a high sensitivity...

Surgical procedures are necessary in up to 50% of trigeminal neuralgia (TN) patients. While radiofrequency (RF) is more widely used, it is associated with high intra-procedural costs and long technical learning time. Other simpler procedures such as balloon compression (BC) require a lower training period and have significant lower costs. We evaluated the effects of BC and RF in pain control in primary TN in a randomized, double-blinded, head-to-head trial. Individuals were randomly allocated in one of two groups: BC and RF...

Sociodemographic inequalities in the occurrence of low back pain (LBP) are well-studied. This study aimed to examine complex sociodemographic inequalities in the risk LBP consultation in the population from a socioeconomical intersectional perspective. Using register data, we identified 458,852 individuals aged 35-75 years residing in Skåne in 2013, with no previous LBP consultation since 2006. We created 108 strata using categories of age, sex, education, income, and nativity. With individuals nested within strata, we modelled the absolute risk (AR) of LBP consultation during 2014 in a series of multilevel logistic regression models...

Low back pain is a leading cause of disability globally. It is a common reason for presentation to the emergency department where opioids are commonly prescribed. This is a retrospective cohort study of opioid naïve adults with low back pain presenting to one of four emergency departments in Nova Scotia. We use routinely collected administrative clinical and drug-use data (July 2010-November 2017) to investigate the prevalence of prolonged opioid use and associated individual and prescription characteristics...

Neuropathic cancer pain (NcP) is associated with worse treatment responses and specific therapy indications, but a standardized clinical diagnosis of NcP is still lacking.This is a prospective observational study on cancer outpatients, comparing different clinical approaches to NcP evaluation. A three-step assessment of NcP was performed using DN4 (cut-off of 4), palliative care physician Clinical Impression, including etiology and pain syndrome identification, and Retrospective Clinical Classification by a board of specialists with the IASP Neuropathic Pain Special Interest Group criteria...

Cervical spondylosis (CS)-related neck pain is difficult to treat due to its degenerative nature. The aim of this nine-center, single-blinded, randomized controlled trial was to evaluate the efficacy of optimized acupuncture for CS-related neck pain. Participants who met the inclusion criteria were randomized to optimized, shallow, and sham acupuncture groups (1:1:1). The primary outcome was the change from baseline in the Northwick Park Neck Pain Questionnaire (NPQ) score at week 4. Participants were followed up until week 16...

Approximately one-half of patients with substance use disorders (SUD) experience chronic pain. Yet how patients perceive the relationship between their substance use and chronic pain remains poorly understood. We sought to identify how patients with comorbid SUD and chronic pain describe the relationship between, and mechanisms linking, these conditions. We conducted qualitative interviews with 34 patients engaged in SUD treatment who were also diagnosed with chronic pain. Interviews were transcribed verbatim and coded by both primary and secondary coders...

While clinical studies support the suggestion that stress is a risk factor for painful chemotherapy-induced peripheral neuropathy (CIPN), there is little scientific validation to support this link. Here, we evaluated the impact of stress on CIPN induced by oxaliplatin, and its underlying mechanisms, in male and female rats. A single dose of oxaliplatin produced mechanical hyperalgesia of similar magnitude in both sexes, still present at similar magnitude in both sexes, on day 28. Adrenalectomy mitigated oxaliplatin-induced hyperalgesia, in both sexes...

The primary somatosensory cortex (SI) is a critical part of the neural substrate underlying interindividual differences in pain sensitivity. Here, we investigated whether resting-state functional connectivity, grey matter density (GMD) and GABA and Glx (glutamate and glutamine) levels of the sensorimotor cortices were related to pain thresholds and whether such imaging measures could predict high and low pain sensitivity. Functional, structural and spectroscopic magnetic resonance data was obtained from 48 healthy participants together with pain thresholds of the right index finger...

Placebo analgesia is hypothesized to involve top-down engagement of prefrontal regions that access endogenous pain inhibiting opioid pathways. Fibromyalgia (FM) patients have neuroanatomical and neurochemical alterations in pathways relevant to placebo analgesia. Thus, it remains unclear whether placebo analgesic mechanisms would differ in FM patients compared to healthy controls (HCs). Here, using placebo-analgesia-inducing paradigms that included verbal suggestions and conditioning manipulations, we examined whether behavioral and neural placebo analgesic responses differed between 32 FM patients and 46 age- and sex-matched HCs...

One in three patients with lumbar spinal stenosis (LSS) undergoing decompressive laminectomy (DL) to alleviate neurogenic claudication do not experience substantial improvement. This prospective cohort study conducted in 193 Veterans aimed to identify key spinal and extra-spinal factors that may contribute to a favorable DL outcome. Biopsychosocial factors evaluated pre-DL and one year post-DL were hip osteoarthritis, imaging-rated severity of spinal stenosis, scoliosis/kyphosis, leg length discrepancy, comorbidity, fibromyalgia, depression, anxiety, pain coping, social support, pain self-efficacy, sleep, opioid and non-opioid pain medications, smoking and other substance use...

Parents with chronic pain have a higher likelihood of having depression and anxiety and more often have children with these conditions. Depressive and anxious symptoms in children worsen pain-related disability and may be derived from exposure to their parents' symptoms. We assessed a model of intergenerational chronic pain-related disability that relies upon depressive and anxious symptoms of a mother and their child. Adolescents in grades 5-10 from 5 schools, and their mothers, completed standardized electronic questionnaires about pain...

Spatial acuity measured by 2-point discrimination threshold (2PD) and spatial summation of pain (SSp) are useful paradigms to probe the pain system in humans. Whether the results of these paradigms are influenced by different stimulus modalities and intensities is unclear. The aim of this study was to test 2PD controlling the stimulus modality and the intensity and to investigate the effect of modality on SSp. Thirty-seven healthy volunteers were tested for 2PDs with two stimulus modalities (electrocutaneous, mechanical) and intensity (noxious, innocuous)...

The use of high-dose spinal cord stimulation (HD-SCS) has increased drastically during the past few years, with positive results. However, there remains a deficit of real-world data of the effectiveness of HD-SCS. Therefore, the primary aim was to evaluate the effectiveness of HD-SCS in patients with failed back surgery syndrome (FBSS). The second aim was to develop a prediction model for a holistic responder. One hundred ninety-four patients were recruited to a multicenter real-world registry. Self-reporting outcome variables were evaluated at baseline (before SCS) and at 1, 3, and 12 months of HD-SCS implant...

Complex Regional Pain Syndrome (CRPS) is thought to be characterized by cognitive deficits affecting patients' ability to represent, perceive and use their affected limb as well as its surrounding space. This has been tested, among others, by straight-ahead tasks testing oneself's egocentric representation, but such experiments lead to inconsistent results. Because spatial cognitive abilities encompass various processes, we completed such evaluations by varying the sensory inputs used to perform the task. CRPS and matched control participants were asked to assess their own body midline either visually (i...

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