Subjects -> MEDICAL SCIENCES (Total: 8359 journals)
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ANAESTHESIOLOGY (119 journals)                     

Showing 1 - 119 of 119 Journals sorted alphabetically
Acta Anaesthesiologica Scandinavica     Hybrid Journal   (Followers: 60)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 6)
Acute Pain     Full-text available via subscription   (Followers: 15)
Advances in Anesthesia     Full-text available via subscription   (Followers: 30)
African Journal of Anaesthesia and Intensive Care     Full-text available via subscription   (Followers: 8)
Ain-Shams Journal of Anaesthesiology     Open Access   (Followers: 2)
Ain-Shams Journal of Anesthesiology     Open Access   (Followers: 1)
Ambulatory Anesthesia     Open Access   (Followers: 9)
Anaesthesia     Hybrid Journal   (Followers: 213)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 67)
Anaesthesia and Intensive Care     Full-text available via subscription   (Followers: 59)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 25)
Anaesthesia Reports     Hybrid Journal  
Anaesthesia, Pain & Intensive Care     Open Access  
Anaesthesiology Intensive Therapy     Open Access   (Followers: 9)
Analgesia & Resuscitation : Current Research     Hybrid Journal   (Followers: 6)
Anestesia Analgesia Reanimación     Open Access  
Anestesia en México     Open Access  
Anesthesia & Analgesia     Hybrid Journal   (Followers: 229)
Anesthesia : Essays and Researches     Open Access   (Followers: 10)
Anesthesia Progress     Hybrid Journal   (Followers: 5)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 2)
Anesthesiology     Hybrid Journal   (Followers: 212)
Anesthesiology and Pain Medicine     Open Access   (Followers: 23)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 25)
Anesthesiology Research and Practice     Open Access   (Followers: 15)
Angewandte Schmerztherapie und Palliativmedizin     Hybrid Journal  
Annales Françaises d'Anesthésie et de Réanimation     Full-text available via subscription   (Followers: 4)
Annals of Cardiac Anaesthesia     Open Access   (Followers: 14)
BDJ Team     Open Access   (Followers: 1)
Best Practice & Research Clinical Anaesthesiology     Hybrid Journal   (Followers: 16)
BJA : British Journal of Anaesthesia     Hybrid Journal   (Followers: 206)
BJA Education     Hybrid Journal   (Followers: 67)
BMC Anesthesiology     Open Access   (Followers: 17)
BMJ Supportive & Palliative Care     Hybrid Journal   (Followers: 42)
Brazilian Journal of Anesthesiology     Open Access   (Followers: 5)
Brazilian Journal of Anesthesiology (Edicion en espanol)     Open Access  
Brazilian Journal of Anesthesiology (English edition)     Open Access   (Followers: 1)
Brazilian Journal of Pain (BrJP)     Open Access  
British Journal of Pain     Hybrid Journal   (Followers: 26)
Canadian Journal of Anesthesia/Journal canadien d'anesthésie     Hybrid Journal   (Followers: 46)
Case Reports in Anesthesiology     Open Access   (Followers: 11)
Clinical Journal of Pain     Hybrid Journal   (Followers: 16)
Colombian Journal of Anesthesiology : Revista Colombiana de Anestesiología     Hybrid Journal  
Current Anaesthesia & Critical Care     Full-text available via subscription   (Followers: 36)
Current Anesthesiology Reports     Hybrid Journal   (Followers: 4)
Current Opinion in Anaesthesiology     Hybrid Journal   (Followers: 58)
Current Pain and Headache Reports     Hybrid Journal   (Followers: 2)
Der Anaesthesist     Hybrid Journal   (Followers: 8)
Der Schmerz     Hybrid Journal   (Followers: 4)
Der Schmerzpatient     Hybrid Journal  
Douleur et Analgésie     Hybrid Journal  
Egyptian Journal of Anaesthesia     Open Access   (Followers: 2)
Egyptian Journal of Cardiothoracic Anesthesia     Open Access  
EMC - Anestesia-Reanimación     Hybrid Journal  
EMC - Anestesia-Rianimazione     Hybrid Journal  
EMC - Urgenze     Full-text available via subscription  
European Journal of Anaesthesiology     Hybrid Journal   (Followers: 28)
European Journal of Pain     Full-text available via subscription   (Followers: 25)
European Journal of Pain Supplements     Full-text available via subscription   (Followers: 5)
Headache The Journal of Head and Face Pain     Hybrid Journal   (Followers: 5)
Indian Journal of Anaesthesia     Open Access   (Followers: 7)
Indian Journal of Pain     Open Access   (Followers: 2)
Indian Journal of Palliative Care     Open Access   (Followers: 6)
International Anesthesiology Clinics     Hybrid Journal   (Followers: 9)
International Journal of Clinical Anesthesia and Research     Open Access  
Itch & Pain     Open Access   (Followers: 2)
JA Clinical Reports     Open Access  
Journal Club Schmerzmedizin     Hybrid Journal  
Journal of Anesthesia & Clinical Research     Open Access   (Followers: 10)
Journal of Anaesthesiology Clinical Pharmacology     Open Access   (Followers: 8)
Journal of Anesthesia     Hybrid Journal   (Followers: 12)
Journal of Anesthesia History     Full-text available via subscription   (Followers: 1)
Journal of Anesthesiology and Clinical Science     Open Access   (Followers: 1)
Journal of Cellular and Molecular Anesthesia     Open Access  
Journal of Clinical Anesthesia     Hybrid Journal   (Followers: 13)
Journal of Critical Care     Hybrid Journal   (Followers: 40)
Journal of Headache and Pain     Open Access   (Followers: 3)
Journal of Neuroanaesthesiology and Critical Care     Open Access   (Followers: 3)
Journal of Neurosurgical Anesthesiology     Hybrid Journal   (Followers: 8)
Journal of Obstetric Anaesthesia and Critical Care     Open Access   (Followers: 22)
Journal of Pain     Hybrid Journal   (Followers: 18)
Journal of Pain and Symptom Management     Hybrid Journal   (Followers: 39)
Journal of Pain Research     Open Access   (Followers: 10)
Journal of Society of Anesthesiologists of Nepal     Open Access   (Followers: 2)
Journal of the Bangladesh Society of Anaesthesiologists     Open Access  
Jurnal Anestesi Perioperatif     Open Access  
Jurnal Anestesiologi Indonesia     Open Access  
Karnataka Anaesthesia Journal     Open Access   (Followers: 2)
Le Praticien en Anesthésie Réanimation     Full-text available via subscription   (Followers: 2)
Local and Regional Anesthesia     Open Access   (Followers: 8)
Medical Gas Research     Open Access   (Followers: 3)
Medycyna Paliatywna w Praktyce     Open Access   (Followers: 1)
OA Anaesthetics     Open Access   (Followers: 3)
Open Anesthesia Journal     Open Access  
Open Journal of Anesthesiology     Open Access   (Followers: 10)
Pain     Hybrid Journal   (Followers: 55)
Pain Clinic     Hybrid Journal   (Followers: 1)
Pain Management     Hybrid Journal   (Followers: 17)
Pain Medicine     Hybrid Journal   (Followers: 13)
Pain Research and Management     Open Access   (Followers: 8)
Pain Research and Treatment     Open Access   (Followers: 2)
Pain Studies and Treatment     Open Access   (Followers: 2)
Research and Opinion in Anesthesia and Intensive Care     Open Access   (Followers: 3)
Revista Chilena de Anestesia     Open Access   (Followers: 1)
Revista Colombiana de Anestesiología     Open Access   (Followers: 1)
Revista Cubana de Anestesiología y Reanimación     Open Access   (Followers: 1)
Revista da Sociedade Portuguesa de Anestesiologia     Open Access  
Revista Española de Anestesiología y Reanimación     Hybrid Journal  
Revista Española de Anestesiología y Reanimación (English Edition)     Full-text available via subscription   (Followers: 2)
Romanian Journal of Anaesthesia and Intensive Care     Open Access   (Followers: 1)
Saudi Journal of Anaesthesia     Open Access   (Followers: 7)
Scandinavian Journal of Pain     Hybrid Journal   (Followers: 1)
Southern African Journal of Anaesthesia and Analgesia     Open Access   (Followers: 8)
Sri Lankan Journal of Anaesthesiology     Open Access   (Followers: 2)
Survey of Anesthesiology     Full-text available via subscription   (Followers: 12)
Techniques in Regional Anesthesia and Pain Management     Hybrid Journal   (Followers: 11)
Topics in Pain Management     Full-text available via subscription   (Followers: 2)
Trends in Anaesthesia and Critical Care     Full-text available via subscription   (Followers: 23)

           

Similar Journals
Journal Cover
Pain
Number of Followers: 55  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0304-3959 - ISSN (Online) 1872-6623
Published by LWW Wolters Kluwer Homepage  [299 journals]
  • Is health-related quality of life a useful outcome in pain intervention
           research'
    • Authors: Costa; Daniel S.J.
      Abstract: No abstract available
      PubDate: Wed, 01 Jan 2020 00:00:00 GMT-
       
  • Rescue and concomitant analgesics in placebo-controlled trials of
           pharmacotherapy for neuropathic pain and low back pain
    • Authors: Grøvle; Lars; Hasvik, Eivind; Haugen, Anne Julsrud
      Abstract: imageRescue medication is commonly offered to participants in placebo-controlled trials of analgesic drugs. The use of pain medication in addition to the placebo or experimental drug may complicate the interpretation of effects and tolerability, but this issue has received little methodological attention. This study examined the handling and reporting of rescue and concomitant analgesic use in trials of pharmacotherapy for neuropathic pain and low back pain. We based our review on 265 trials included in 2 recent systematic reviews: 83 trials of low back pain and 182 of neuropathic pain. In total, 117 (44%) trials permitted rescue medication and 126 (48%) allowed participants to continue all or some of their usual analgesics. The utilization of rescue medication increased over time, occurring in 18% of trials before 2000 compared with 55% after 2000. Forty-one trials (16%) permitted both rescue analgesics and continued use of prestudy analgesics. More than one-third of the trials permitting rescue medication did not report the actual rescue drug consumption, and over half of the trials allowing concomitant analgesics did not report whether intake changed during the trial. Only 22 (19%) of the trials permitting rescue medication included complete information about whether rescue medication was used as an outcome, specified the drugs used, specified how consumption was assessed and measured, and reported and analyzed the use of rescue medication in each trial arm. Our findings suggest that poorly described procedures and incomplete reporting are likely to hinder the interpretation, critical appraisal, and replication of trial results.
      PubDate: Wed, 01 Jan 2020 00:00:00 GMT-
       
  • Neurotransmitter systems involved in placebo and nocebo effects in healthy
           participants and patients with chronic pain: a systematic review
    • Authors: Skyt; Ina; Lunde, Sigrid J.; Baastrup, Cathrine; Svensson, Peter; Jensen, Troels S.; Vase, Lene
      Abstract: imageThe investigation of neurotransmitter systems in placebo and nocebo effects has improved our understanding of these phenomena. Yet, most studies involve healthy participants. Because the pain modulatory system may differ in healthy participants and patients with chronic pain, it is important to investigate the evidence for neurotransmitter involvement in placebo and nocebo effects in each of these populations. PubMed, Embase, and Scopus databases, and the Cochrane Library were searched for articles investigating the endogenous opioid, endocannabinoid, dopaminergic, oxytocinergic, vasopressinergic, and cholecystokininergic (CCKergic) systems in placebo and nocebo effects in pain. Twenty-eight placebo and 2 nocebo studies were included. Vote counting was used to balance the number of positive vs negative findings. In healthy participants, the endogenous opioid, endocannabinoid, and vasopressinergic systems were involved in placebo effects, whereas findings on the dopaminergic and oxytocinergic systems were mixed. In patients with chronic pain, only 4 studies investigated neurotransmitters showing no involvement of the endogenous opioid system and mixed findings regarding the dopaminergic system. As to nocebo effects, 2 studies suggest that the CCKergic system is involved in nocebo effects in healthy participants. Overall, research has come a long way in specifying the neurotransmitter systems involved in placebo effects in healthy participants. Yet, evidence for the involvement of neurotransmitter systems in placebo effects in patients with chronic pain and in nocebo effects in healthy participants and patients is scarce. Based on the existing evidence, this systematic review suggests that knowledge obtained in healthy participants may not necessarily be transferred to chronic pain.
      PubDate: Wed, 01 Jan 2020 00:00:00 GMT-
       
  • Systematic review and meta-analysis of placebo/sham controlled randomised
           trials of spinal cord stimulation for neuropathic pain
    • Authors: Duarte; Rui V.; Nevitt, Sarah; McNicol, Ewan; Taylor, Rod S.; Buchser, Eric; North, Richard B.; Eldabe, Sam
      Abstract: imageThe aims of this review were to systematically identify the current evidence base of placebo (or “sham”) randomised controlled trials (RCTs) of spinal cord stimulation (SCS) for neuropathic pain and to undertake a meta-analysis to investigate the effectiveness of SCS when compared with a placebo comparator arm. Electronic databases were searched from inception until January 2019 for RCTs of SCS using a placebo/sham control. Searches identified 8 eligible placebo-controlled randomised trials of SCS for neuropathic pain. Meta-analysis shows a statistically significant reduction in pain intensity during the active stimulation treatment periods compared with the control treatment periods, pooled mean difference −1.15 (95% confidence interval −1.75 to −0.55, P = 0.001) on a 10-point scale. Exploratory study–level subgroup analysis suggests a larger treatment effect in RCTs using a placebo control (defined as studies where the device was inactive and at least one of the study procedures was different between the arms) than a sham control (defined as all study procedures being equal between arms including SCS device behaviour). Our findings demonstrate limited evidence that SCS is effective in reducing pain intensity when compared with a placebo intervention. Our analyses suggest that the magnitude of treatment effect varies across trials and, in part, depends on the quality of patient blinding and minimisation of carryover effects. Improved reporting and further methodological research is needed into placebo and blinding approaches in SCS trials. Furthermore, we introduce a differentiation between placebo and sham concepts that may be generalisable to trials evaluating surgical or medical procedures.
      PubDate: Wed, 01 Jan 2020 00:00:00 GMT-
       
  • Translating clinical trials into improved real-world management of pain:
           
    • Authors: Gilron; Ian; Blyth, Fiona; Smith, Blair H.
      Abstract: imageNo abstract available
      PubDate: Wed, 01 Jan 2020 00:00:00 GMT-
       
  • Targeting network hubs with noninvasive brain stimulation in patients with
           fibromyalgia
    • Authors: Kaplan; Chelsea M.; Harris, Richard E.; Lee, UnCheol; DaSilva, Alexandre F.; Mashour, George A.; Harte, Steven E.
      Abstract: imageNo abstract available
      PubDate: Wed, 01 Jan 2020 00:00:00 GMT-
       
  • MicroRNA-19b predicts widespread pain and posttraumatic stress symptom
           risk in a sex-dependent manner following trauma exposure
    • Authors: Linnstaedt; Sarah D.; Rueckeis, Cathleen A.; Riker, Kyle D.; Pan, Yue; Wu, Alan; Yu, Shan; Wanstrath, Britannia; Gonzalez, Michael; Harmon, Evan; Green, Paul; Chen, Chieh V.; King, Tony; Lewandowski, Christopher; Hendry, Phyllis L.; Pearson, Claire; Kurz, Michael C.; Datner, Elizabeth; Velilla, Marc-Anthony; Domeier, Robert; Liberzon, Israel; Mogil, Jeffrey S.; Levine, Jon; McLean, Samuel A.
      Abstract: imagePosttraumatic widespread pain (PTWP) and posttraumatic stress symptoms (PTSS) are frequent comorbid sequelae of trauma that occur at different rates in women and men. We sought to identify microRNA (miRNA) that may contribute to sex-dependent differences in vulnerability to these outcomes. Monte Carlo simulations (x10,000) identified miRNA in which predicted targeting of PTWP or PTSS genes was most enriched. Expression of the leading candidate miRNA to target PTWP/PTSS-related genes, miR-19b, has been shown to be influenced by estrogen and stress exposure. We evaluated whether peritraumatic miR-19b blood expression levels predicted PTWP and PTSS development in women and men experiencing trauma of motor vehicle collision (n = 179) and in women experiencing sexual assault trauma (n = 74). A sex-dependent relationship was observed between miR-19b expression levels and both PTWP (β = −2.41, P = 0.034) and PTSS (β = −3.01, P = 0.008) development 6 months after motor vehicle collision. The relationship between miR-19b and PTSS (but not PTWP) was validated in sexual assault survivors (β = −0.91, P = 0.013). Sex-dependent expression of miR-19b was also observed in blood and nervous tissue from 2 relevant animal models. Furthermore, in support of increasing evidence indicating a role for the circadian rhythm (CR) in PTWP and PTSS pathogenesis, miR-19b targets were enriched in CR gene transcripts. Human cohort and in vitro analyses assessing miR-19b regulation of key CR transcripts, CLOCK and RORA, supported the potential importance of miR-19b to regulating the CR pathway. Together, these results highlight the potential role that sex-dependent expression of miR-19b might play in PTWP and PTSS development after trauma/stress exposure.
      PubDate: Wed, 01 Jan 2020 00:00:00 GMT-
       
  • Peripheral brain-derived neurotrophic factor contributes to chronic
           osteoarthritis joint pain
    • Authors: Gowler; Peter R.W.; Li, Li; Woodhams, Stephen G.; Bennett, Andrew J.; Suzuki, Rie; Walsh, David A.; Chapman, Victoria
      Abstract: imageBrain-derived neurotrophic factor (BDNF) and the high-affinity receptor tropomyosin receptor kinase B (TrkB) have important roles in neuronal survival and in spinal sensitization mechanisms associated with chronic pain. Recent clinical evidence also supports a peripheral role of BDNF in osteoarthritis (OA), with synovial expression of TrkB associated with higher OA pain. The aim of this study was to use clinical samples and animal models to explore the potential contribution of knee joint BDNF/TrkB signalling to chronic OA pain. Brain-derived neurotrophic factor and TrkB mRNA and protein were present in knee synovia from OA patients (16 women, 14 men, median age 67 years [interquartile range: 61-73]). There was a significant positive correlation between mRNA expression of NTRK2 (TrkB) and the proinflammatory chemokine fractalkine in the OA synovia. Using the surgical medial meniscal transection (MNX) model and the chemical monosodium iodoacetate (MIA) model of OA pain in male rats, the effects of peripheral BDNF injection, vs sequestering endogenous BDNF with TrkB-Fc chimera, on established pain behaviour were determined. Intra-articular injection of BDNF augmented established OA pain behaviour in MIA rats, but had no effect in controls. Intra-articular injection of the TrkB-Fc chimera acutely reversed pain behaviour to a similar extent in both models of OA pain (weight-bearing asymmetry MIA: −11 ± 4%, MNX: −12 ± 4%), compared to vehicle treatment. Our data suggesting a contribution of peripheral knee joint BDNF/TrkB signalling in the maintenance of chronic OA joint pain support further investigation of the therapeutic potential of this target.
      PubDate: Wed, 01 Jan 2020 00:00:00 GMT-
       
  • Upregulation of cortical GABAA receptor concentration in fibromyalgia
    • Authors: Pomares; Florence B.; Roy, Steve; Funck, Thomas; Feier, Natasha A.; Thiel, Alexander; Fitzcharles, Mary-Ann; Schweinhardt, Petra
      Abstract: imageAn imbalance between excitatory and inhibitory neurotransmission has been linked to fibromyalgia (FM). Magnetic resonance spectroscopy has shown increased levels of glutamate in the insula and posterior cingulate cortex in FM as well as reduced insular levels of gamma-aminobutyric acid (GABA). Both of these changes have been associated with increased pain sensitivity. However, it is not clear whether excitatory and/or inhibitory neurotransmission is altered across the brain. Therefore, the aim of this study was to quantify GABAA receptor concentration on the whole brain level in FM to investigate a potential dysregulation of the GABAergic system. Fifty-one postmenopausal women (26 FM, 25 matched controls) underwent assessments of pain sensitivity, attention and memory, psychological status and function, as well as positron emission tomography imaging using a tracer for GABAA receptors, [18F]flumazenil. Patients showed increased pain sensitivity, impaired immediate memory, and increased cortical GABAA receptor concentration in the attention and default-mode networks. No decrease of GABAA receptor concentration was observed. Across the 2 groups, GABAA receptor concentration correlated positively with functional scores and current pain in areas overlapping with regions of increased GABAA receptor concentration. This study shows increased GABAA receptor concentration in FM, associated with pain symptoms and impaired function. The changes were widespread and not restricted to pain-processing regions. These findings suggest that the GABAergic system is altered, possibly indicating an imbalance between excitatory and inhibitory neurotransmission. Future studies should try to understand the nature of the dysregulation of the GABAergic system in FM and in other pain syndromes.
      PubDate: Wed, 01 Jan 2020 00:00:00 GMT-
       
  • Psychometric properties of Short Form-36 Health Survey, EuroQol
           5-dimensions, and Hospital Anxiety and Depression Scale in patients with
           chronic pain
    • Authors: LoMartire; Riccardo; Äng, Björn Olov; Gerdle, Björn; Vixner, Linda
      Abstract: imageRecent research has highlighted a need for the psychometric evaluation of instruments targeting core domains of the pain experience in chronic pain populations. In this study, the measurement properties of Short Form-36 Health Survey (SF-36),EuroQol 5-dimensions (EQ-5D) and Hospital Anxiety and Depression Scale (HADS) were analyzed within the item response-theory framework based on data from 35,908 patients. To assess the structural validity of these instruments, the empirical representations of several conceptually substantiated latent structures were compared in a cross-validation procedure. The most structurally sound representations were selected from each questionnaire and their internal consistency reliability computed as a summary of their precision. Finally, questionnaire scores were correlated with each other to evaluate their convergent and discriminant validity. Our results supported that SF-36 is an acceptable measure of 2 independent constructs of physical and mental health. By contrast, although the approach to summarize the health-related quality of life construct of EQ-5D as a unidimensional score was valid, its low reliability rendered practical model implementation of doubtful utility. Finally, rather than being separated into 2 subscales of anxiety and depression, HADS was a valid and reliable measure of overall emotional distress. In support of convergent and discriminant validity, correlations between questionnaires showed that theoretically similar traits were highly associated, whereas unrelated traits were not. Our models can be applied to score SF-36 and HADS in chronic pain patients, but we recommend against using the EQ-5D model due to its low reliability. These results are useful for researchers and clinicians involved in chronic pain populations because questionnaires' properties determine their discriminating ability in patient status assessment.
      PubDate: Wed, 01 Jan 2020 00:00:00 GMT-
       
  • Epigenetic reduction of miR-214-3p upregulates astrocytic
           colony-stimulating factor-1 and contributes to neuropathic pain induced by
           nerve injury
    • Authors: Liu; Lian; Xu, Dan; Wang, Tao; Zhang, Yi; Yang, Xijing; Wang, Xiangxiu; Tang, Yuying
      Abstract: imageEmerging evidence has indicated that colony-stimulating factor-1 (CSF1) modulates neuroinflammation in the central nervous system and the development of neuropathic pain, while the underlying mechanism remains unknown. Here, we identified the increased expression of CSF1 derived from activated astrocytes in the ipsilateral dorsal horn in rats with spinal nerve ligation (SNL). Suppression of CSF1 expression alleviated neuroinflammation, neuronal hyperexcitability, and glutamatergic receptor subunit upregulation in the dorsal horn and improved SNL-induced pain behavior. We also found reduced miR-214-3p expression in the ipsilateral dorsal horn following an SNL procedure; miR-214-3p directly bound to the 3′-UTR of CSF1 mRNA and negatively regulated CSF1 expression. Intrathecal delivery of miR-214-3p mimic reversed the enhanced expression of CSF1 and astrocyte overactivity and alleviated the IL-6 upregulation and pain behavior induced by SNL. Moreover, suppression of spinal miR-214-3p increased astrocyte reactivity, promoted CSF1 and IL-6 production, and induced pain hypersensitivity in naive animals. Furthermore, SNL induced the expression of DNA methyltransferase 3a (DNMT3a) that was associated with the hypermethylation of the miR-214-3p promoter, leading to reduced miR-214-3p expression in the model rodents. Treatment with the DNMT inhibitor zebularine significantly reduced cytosine methylation in the miR-214-3p promoter; this reduced methylation consequently increased the expression of miR-214-3p and decreased the content of CSF1 in the ipsilateral dorsal horn and, further, attenuated IL-6 production and pain behavior in rats with SNL. Together, our data indicate that the DNMT3a-mediated epigenetic suppression of miR-214-3p enhanced CSF1 production in astrocytes, which subsequently induced neuroinflammation and pain behavior in SNL model rats.
      PubDate: Wed, 01 Jan 2020 00:00:00 GMT-
       
  • Pain as a predictor of frailty over time among older Mexican Americans
    • Authors: Sodhi; Jaspreet K.; Karmarkar, Amol; Raji, Mukaila; Markides, Kyriakos S.; Ottenbacher, Kenneth J.; Al Snih, Soham
      Abstract: imageThe objective of this study was to examine pain as a predictor of frailty over 18 years of follow-up among older Mexican Americans who were nonfrail at baseline. Data were from a prospective cohort study of 1545 community-dwelling Mexican Americans aged ≥67 years from the Hispanic Established Populations for the Epidemiological Study of the Elderly (1995/1996-2012/2013). Frailty was defined as meeting 2 or more of the following: unintentional weight loss of>10 pounds, weakness, self-reported exhaustion, and slowness. The independent predictor was self-reported pain. Covariates included age, sex, marital status, education, comorbid conditions, body mass index, Mini-Mental State Examination, depressive symptoms, and limitation in activities of daily livings. General equation estimation was performed to estimate the odds ratio of frailty as a function of pain. A total of 538 participants (34.8%) reported pain at baseline. The prevalence of frailty among those with pain ranged from 24.4% in wave 3 to 41% in wave 8. The odds ratio of becoming frail over time as a function of pain was 1.71; 95% confidence interval: 1.41 to 2.09 after controlling for all covariates. Older age, hip fracture, high depressive symptoms, and activities of daily living disability were also associated with higher odds of becoming frail over time. Female participants and those with higher levels of education and high Mini-Mental State Examination scores were less at risk. In conclusion, pain was a significantly predictor of frailty. Early assessment and better management of pain may prevent early onset of frailty in older Mexican Americans.
      PubDate: Wed, 01 Jan 2020 00:00:00 GMT-
       
  • Machine-learning–based knowledge discovery in rheumatoid
           arthritis–related registry data to identify predictors of persistent
           pain
    • Authors: Lötsch; Jörn; Alfredsson, Lars; Lampa, Jon
      Abstract: imageEarly detection of patients with chronic diseases at risk of developing persistent pain is clinically desirable for timely initiation of multimodal therapies. Quality follow-up registries may provide the necessary clinical data; however, their design is not focused on a specific research aim, which poses challenges on the data analysis strategy. Here, machine-learning was used to identify early parameters that provide information about a future development of persistent pain in rheumatoid arthritis (RA). Data of 288 patients were queried from a registry based on the Swedish Epidemiological Investigation of RA. Unsupervised data analyses identified the following 3 distinct patient subgroups: low-, median-, and high-persistent pain intensity. Next, supervised machine-learning, implemented as random forests followed by computed ABC analysis–based item categorization, was used to select predictive parameters among 21 different demographic, patient-rated, and objective clinical factors. The selected parameters were used to train machine-learned algorithms to assign patients pain-related subgroups (1000 random resamplings, 2/3 training, and 1/3 test data). Algorithms trained with 3-month data of the patient global assessment and health assessment questionnaire provided pain group assignment at a balanced accuracy of 70%. When restricting the predictors to objective clinical parameters of disease severity, swollen joint count and tender joint count acquired at 3 months provided a balanced accuracy of RA of 59%. Results indicate that machine-learning is suited to extract knowledge from data queried from pain- and disease-related registries. Early functional parameters of RA are informative for the development and degree of persistent pain.
      PubDate: Wed, 01 Jan 2020 00:00:00 GMT-
       
  • Adoptive immunotherapy with autologous T-cell infusions reduces opioid
           requirements in advanced cancer patients
    • Authors: Zhou; Xinna; Qiao, Guoliang; Ren, Jun; Wang, Xiaoli; Wang, Shuo; Zhu, Siyu; Yuan, Yanhua; Morse, Michael A.; Hobeika, Amy; Lyerly, Herbert Kim
      Abstract: imageRelief of cancer-related pain remains challenging despite the availability of a range of opioid and nonopioid medications. Animal models demonstrate that T lymphocytes may mediate analgesia by producing endogenous opioids, but definitive clinical data are limited. Transfer of ex vivo adoptive cellular therapy (ACT) is being tested as an anticancer therapy. We retrospectively reviewed the medical charts of 357 patients with various malignancies who received 3 intravenous infusions of autologous cytokine-activated T-cell–enriched products. Among these were 55 patients who required opioids for moderate or severe cancer-related pain. Opioid dosage and cancer pain score were recorded daily for 2 consecutive weeks before and 2 weeks after the ACT infusions. The average oral morphine equivalent doses and cancer pain scores were significantly decreased after the ACT infusions. The proportion of patients with breakthrough pain also declined. Moreover, higher frequencies of expanded CD3+, CD3+/CD4+, and CD3+/CD8+ T cells within the ACT product were associated with favorable analgesic effects. Transient elevations in CD3+ and CD3+/CD8+T-cell subpopulations and decreases in CD4+CD25+ Treg were observed in patients' blood after the ACT. In conclusion, ACT was capable of reducing cancer pain severity and opioid consumption and favorably modulating peripheral blood T-cell populations.
      PubDate: Wed, 01 Jan 2020 00:00:00 GMT-
       
  • The metabotropic glutamate receptor 5 negative allosteric modulator
           fenobam: pharmacokinetics, side effects, and analgesic effects in healthy
           human subjects
    • Authors: Cavallone; Laura F.; Montana, Michael C.; Frey, Karen; Kallogjeri, Dorina; Wages, James M.; Rodebaugh, Thomas L.; Doshi, Tina; Kharasch, Evan D.; Gereau, Robert W. IV
      Abstract: imageMetabotropic glutamate receptor 5 (mGlu5) has been shown to modulate nociception in animals, but no mGlu5 antagonists have been developed commercially as analgesics. The mGlu5 antagonist fenobam [N-(3-chlorophenyl)-N′-(4,5-dihydro-1-methyl-4-oxo-1H-imidazole-2-yl)urea] was originally evaluated for development as a nonbenzodiazepine anxiolytic. Fenobam is analgesic in numerous mouse pain models, acting exclusively through mGlu5 blockade. Furthermore, fenobam showed no signs of analgesic tolerance with up to 2 weeks of daily dosing in mice. Analgesic effects of fenobam in humans have not been reported. The purpose of this investigation was to evaluate fenobam pharmacokinetics and analgesic effects in humans. We first evaluated single-dose oral fenobam disposition in a parallel-group dose-escalation study in healthy volunteers. A second investigation tested the analgesic effects of fenobam in an established experimental human pain model of cutaneous sensitization using capsaicin cream and heat, in a double-blind placebo-controlled study. The primary outcome measure was the area of hyperalgesia and allodynia around the area applied with heat/capsaicin. Secondary outcome measures included nociception, measured as pain rating on a visual analog scale, heat pain detection threshold, and effects on cognition and mood. Fenobam plasma exposures showed considerable interindividual variability and were not linear with dose. Fenobam reduced sensitization vs placebo at a single timepoint (peak plasma concentration); we found no other difference between fenobam and placebo. Our results suggest highly variable fenobam disposition and minimal analgesic effects at the dose tested. We suggest that future studies testing analgesic effects of mGlu5 blockade are warranted, but such studies should use molecules with improved pharmacokinetic profiles.
      PubDate: Wed, 01 Jan 2020 00:00:00 GMT-
       
  • Neuromas and postamputation pain
    • Authors: Buch; Nina Stockfleth; Qerama, Erisela; Brix Finnerup, Nanna; Nikolajsen, Lone
      Abstract: imagePostamputation stump and phantom pain are highly prevalent but remain a difficult condition to treat. The underlying mechanisms are not fully clarified, but growing evidence suggests that changes in afferent nerves, including the formation of neuromas, play an important role. The main objective of this cross-sectional study was to investigate whether ultrasound-verified neuroma swellings are more frequent in amputees with postamputation pain than in amputees without pain (primary outcome). Sixty-seven amputees were included. Baseline characteristics including the frequency and intensity of spontaneous stump and phantom pain were obtained, and sensory characteristics and evoked responses were assessed. A high-frequency ultrasound examination of the amputated extremity was performed to obtain information on the presence, size, and elasticity of swollen neuromas and pressure pain thresholds. Swollen neuromas were present in 53 (79.1%) of the 67 amputees included in the study, in 47 (82.5%) of 57 amputees with pain and in 6 (60.0%) of 10 amputees without pain (P = 0.2). No difference was found in stump pain intensity (P = 0.42) during the last week or in phantom pain intensity in the last month (P = 0.74) between amputees with and without swollen neuromas. Our findings suggest that it is not the presence of swollen neuromas itself that drives postamputation pain. However, changes in the transected nerve endings may still be crucial for driving postamputation pain because a positive Tinel sign was significantly more frequent in amputees with pain, irrespectively of the degree of neuroma swelling.
      PubDate: Wed, 01 Jan 2020 00:00:00 GMT-
       
  • Heightened risk of pain in young adult women with a history of childhood
           maltreatment: a prospective longitudinal study
    • Authors: Beal; Sarah J.; Kashikar-Zuck, Susmita; King, Christopher; Black, William; Barnes, Jaclyn; Noll, Jennie G.
      Abstract: imageA child maltreatment history is reported more frequently among adults with chronic pain compared with the general population; unfortunately, studies have primarily relied upon retrospective maltreatment reports by adults with chronic pain. This prospective study assessed pain symptoms in a cohort of young adult women with a documented history of child maltreatment, compared with a matched cohort of women who did not experience childhood maltreatment. Young women (N = 477) were recruited between ages 14 to 17 years and followed annually to age 19. Of these women, 57% experienced maltreatment (ie, physical, sexual, or emotional abuse, neglect; n = 273) substantiated by child welfare record. Maltreated women were demographically matched to nonmaltreated women, also confirmed by child welfare record. In adolescence, post-traumatic stress was assessed. Women were contacted as young adults (Mage = 24.76; n = 383) and surveyed about their pain experiences, including the presence of pain in the past week, pain severity (0-10), and number of body areas with pain. Mediation path analyses examining the impact of maltreatment and adolescent post-traumatic stress on young adult pain were estimated through structural equation modeling. As adults, women who had experienced child maltreatment reported higher pain intensity, a greater number of pain locations, and were more likely to experience pain in the previous week than nonmaltreated women. Adolescent post-traumatic stress partially explained the effects of maltreatment on pain. Young adult women who experienced child maltreatment are at higher risk of pain, particularly when they also experienced post-traumatic stress as adolescents.
      PubDate: Wed, 01 Jan 2020 00:00:00 GMT-
       
  • Spared nerve injury differentially alters parabrachial monosynaptic
           excitatory inputs to molecularly specific neurons in distinct subregions
           of the central amygdala
    • Authors: Li; Jun-Nan; Sheets, Patrick L.
      Abstract: imageDissecting the organization of circuit pathways involved in pain affect is pivotal for understanding behavior associated with noxious sensory inputs. The central nucleus of the amygdala (CeA) comprises distinct populations of inhibitory GABAergic neurons expressing a wide range of molecular markers. CeA circuits are associated with aversive learning and nociceptive responses. The CeA receives nociceptive signals directly from the parabrachial nucleus (PBn), contributing to the affective and emotional aspects of pain. Although the CeA has emerged as an important node in pain processing, key questions remain regarding the specific targeting of PBn inputs to different CeA subregions and cell types. We used a multifaceted approach involving transgenic reporter mice, viral vector-mediated optogenetics, and brain slice electrophysiology to delineate cell-type–specific functional organization of the PBn–CeA pathway. Whole-cell patch clamp recordings of molecularly defined CeA neurons while optogenetically driving long-range inputs originating from PBn revealed the direct monosynaptic excitatory inputs from PBn neurons to 3 major subdivisions of the CeA: laterocapsular (CeC), lateral (CeL), and medial (CeM). Direct monosynaptic excitatory inputs from PBn targeted both somatostatin-expressing (SOM+) and corticotropin-releasing hormone expressing (CRH+) neurons in the CeA. We find that monosynaptic PBn input is preferentially organized to molecularly specific neurons in distinct subdivisions of the CeA. The spared nerve injury model of neuropathic pain differentially altered PBn monosynaptic excitatory input to CeA neurons based on molecular identity and topographical location within the CeA. These results provide insight into the functional organization of affective pain pathways and how they are altered by chronic pain.
      PubDate: Wed, 01 Jan 2020 00:00:00 GMT-
       
  • Sexually dimorphic therapeutic response in bortezomib-induced neuropathic
           pain reveals altered pain physiology in female rodents
    • Authors: Stockstill; Katherine; Wahlman, Carrie; Braden, Kathryn; Chen, Zhoumou; Yosten, Gina L.; Tosh, Dilip K.; Jacobson, Kenneth A.; Doyle, Timothy M.; Samson, Willis K.; Salvemini, Daniela
      Abstract: imageChemotherapy-induced neuropathic pain (CINP) in both sexes compromises many current chemotherapeutics and lacks an FDA-approved therapy. We recently identified the sphingosine-1-phosphate receptor subtype 1 (S1PR1) and A3 adenosine receptor subtype (A3AR) as novel targets for therapeutic intervention. Our work in male rodents using paclitaxel, oxaliplatin, and bortezomib showed robust inhibition of CINP with either S1PR1 antagonists or A3AR agonists. The S1PR1 functional antagonist FTY720 (Gilenya) is FDA-approved for treating multiple sclerosis, and selective A3AR agonists are in advanced clinical trials for cancer and inflammatory disorders, underscoring the need for their expedited trials in patients with CINP as chemotherapy adjuncts. Our findings reveal that S1PR1 antagonists and A3AR agonists mitigate paclitaxel and oxaliplatin CINP in female and male rodents, but failed to block or reverse bortezomib-induced neuropathic pain (BINP) in females. Although numerous mechanisms likely underlie these differences, we focused on receptor levels. We found that BINP in male rats, but not in female rats, was associated with increased expression of A3AR in the spinal cord dorsal horn, whereas S1PR1 levels were similar in both sexes. Thus, alternative mechanisms beyond receptor expression may account for sex differences in response to S1PR1 antagonists. Morphine and duloxetine, both clinical analgesics, reversed BINP in female mice, demonstrating that the lack of response is specific to S1PR1 and A3AR agents. Our findings suggest that A3AR- and S1PR1-based therapies are not viable approaches in preventing and treating BINP in females and should inform future clinical trials of these drugs as adjuncts to chemotherapy.
      PubDate: Wed, 01 Jan 2020 00:00:00 GMT-
       
  • Selective-cold output through a distinct subset of lamina I
           spinoparabrachial neurons
    • Authors: Hachisuka; Junichi; Koerber, H. Richard; Ross, Sarah E.
      Abstract: imageSpinal projection neurons are a major pathway through which somatic stimuli are conveyed to the brain. However, the manner in which this information is coded is poorly understood. Here, we report the identification of a modality-selective spinoparabrachial (SPB) neuron subtype with unique properties. Specifically, we find that cold-selective SPB neurons are differentiated by selective afferent input, reduced sensitivity to substance P, distinct physiological properties, small soma size, and low basal drive. In addition, optogenetic experiments reveal that cold-selective SPB neurons do not receive input from Nos1 inhibitory interneurons and, compared with other SPB neurons, show significantly smaller inhibitory postsynaptic currents upon activation of Pdyn inhibitory interneurons. Together, these data suggest that cold output from the spinal cord to the parabrachial nucleus is mediated by a specific cell type with distinct properties.
      PubDate: Wed, 01 Jan 2020 00:00:00 GMT-
       
  • Are there really only 2 kinds of people in the world' Evaluating the
           distribution of change from baseline in pain clinical trials
    • Authors: Mbowe; Omar B.; Gewandter, Jennifer S.; Turk, Dennis C.; Dworkin, Robert H.; McDermott, Michael P.
      Abstract: imageIt is often assumed that there are 2 types of pain patients: those who respond well to efficacious pain therapies and those who do not respond at all, with few people in the middle. This assumption is based on research that claims that changes in pain intensity have a bimodal distribution. The claim of bimodality has led to calls for a change in how pain clinical trials are designed and analyzed, eg, performing “responder” analyses instead of comparing group mean values to evaluate the treatment effect. We analyzed data from 4 clinical trials, 2 each of duloxetine and pregabalin, for chronic musculoskeletal and neuropathic pain conditions to critically examine the claim of bimodality of the distribution of change in pain intensity. We found that the improper construction of histograms, using unequal bin widths, was the principal flaw leading to the bimodality claim, along with the use of the oft-criticized baseline observation carried forward method for imputing missing data also serving as a contributing factor. Properly constructed histograms of absolute change in pain intensity using equal bin widths, combined with more principled methods for handling missing data, resulted in distributions that had a more unimodal appearance. Although our findings neither support nor refute the hypothesis that distinct populations of “responders” and “nonresponders” to pain interventions exist, the analyses presented in earlier work do not provide support for this hypothesis, nor for the recommendation that pain clinical trials prioritize “responder” analyses, a less efficient analysis strategy.
      PubDate: Wed, 01 Jan 2020 00:00:00 GMT-
       
  • Innate immune response to bacterial urinary tract infection sensitises
           high-threshold bladder afferents and recruits silent nociceptors
    • Authors: Brierley; Stuart M.; Goh, Kelvin G.K.; Sullivan, Matthew J.; Moore, Kate H.; Ulett, Glen C.; Grundy, Luke
      Abstract: imageThe bladder is innervated by primary afferent nerve fibres that detect bladder distension and, through projections into the spinal cord, provide sensory input to the central nervous system circuits regulating bladder sensation and function. Uropathogenic E. coli (UPEC) bacteria are the primary cause of urinary tract infection (UTI) in adults, inducing clinical symptoms characterised by exaggerated bladder sensation, including urgency, frequency, and pelvic pain. However, the mechanisms underlying UTI-induced modulation of bladder afferent function are yet to be explored. Here, we isolated supernatants from the bladders of female mice acutely infected with UPEC (strain CFT073), or those sham-treated with phosphate buffered saline. Supernatants were then applied into the bladder lumen of healthy donor mice, and multiunit bladder afferent nerve responses to distension measured ex-vivo. Supernatant constituents from UPEC or sham-treated mice were analysed using a mouse cytokine multiplex assay. Supernatants from UPEC-infected mice significantly enhanced bladder afferent firing to distension in the absence of changes in muscle compliance. Further evaluation revealed that UPEC supernatants exclusively sensitised high-threshold bladder mechanoreceptors to graded bladder distension and also recruited a population of “silent nociceptors” to become mechanosensitive, thereby amplifying bladder afferent responses to physiological stimuli. UPEC supernatants contained significantly elevated concentrations of a range of cytokines released from innate immune cells, including but not limited to TNF-α, IL-1β, IL-6, IL-17, IFN-gamma, and MCP-1. These data provide novel mechanistic insight into how UPEC-mediated UTI induces bladder hypersensitivity and the symptoms of frequency, urgency, and pelvic pain.
      PubDate: Wed, 01 Jan 2020 00:00:00 GMT-
       
  • Foot shock stress generates persistent widespread hypersensitivity and
           anhedonic behavior in an anxiety-prone strain of mice
    • Authors: Wu; Pau Yen; Yang, Xiaofang; Wright, Douglas E.; Christianson, Julie A.
      Abstract: imageA significant subset of patients with urologic chronic pelvic pain syndrome suffer from widespread, as well as pelvic, pain and experience mood-related disorders, including anxiety, depression, and panic disorder. Stress is a commonly reported trigger for symptom onset and exacerbation within these patients. The link between stress and pain is believed to arise, in part, from the hypothalamic–pituitary–adrenal axis, which regulates the response to stress and can influence the perception of pain. Previous studies have shown that stress exposure in anxiety-prone rats can induce both pelvic and widespread hypersensitivity. Here, we exposed female A/J mice, an anxiety-prone inbred murine strain, to 10 days of foot shock stress to determine stress-induced effects on sensitivity, anhedonia, and hypothalamic–pituitary–adrenal axis regulation and output. At 1 and 28 days after foot shock, A/J mice displayed significantly increased bladder sensitivity and hind paw mechanical allodynia. They also displayed anhedonic behavior, measured as reduced nest building scores and a decrease in sucrose preference during the 10-day foot shock exposure. Serum corticosterone was significantly increased at 1 day after foot shock, and bladder mast cell degranulation rates were similarly high in both sham- and shock-exposed mice. Bladder cytokine and growth factor mRNA levels indicated a persistent shift toward a proinflammatory environment after foot shock exposure. Together, these data suggest that chronic stress exposure in an anxiety-prone mouse strain may provide a useful translational model for understanding mechanisms that contribute to widespreadness of pain and increased comorbidity in a subset of patients with urologic chronic pelvic pain syndrome.
      PubDate: Wed, 01 Jan 2020 00:00:00 GMT-
       
  • The association of early life stressors with pain sensitivity and pain
           experience at 22 years
    • Authors: Waller; Robert; Smith, Anne J.; O'Sullivan, Peter B.; Slater, Helen; Sterling, Michele; Straker, Leon M.
      Abstract: imageEarly life stress (ELS) can significantly influence biological pathways associated with nociception, increasing vulnerability to future heightened pain sensitivity and subsequent risk of pain events. However, very little human research has investigated the association of ELS, measured across multiple domains, with future pain sensitivity. Data from Gen1 and Gen2 of the Raine Study were used to assess the association between a wide range of early life stressors, including antenatally, and pressure and cold pain sensitivity at young adulthood. Participants were classified into 2 groups according to their cold pain sensitivity. In addition, the interaction between ELS, pain sensitivity, and pain experience (based on Örebro Musculoskeletal Pain Questionnaire) at age 22 years was examined. Analysis was performed using both a complete case and multiple imputation approach, adjusting for contemporaneous 22-year correlates, with comparable results in each model. More problematic behaviour at age 2 years was associated with less pressure pain sensitivity at 22 years (13.7 kPa, 95% CI: 1.0-27.0, P = 0.037), with no interaction between problematic behaviour and pain experience at 22 years. For those reporting a moderate/high pain experience at 22 years, poor family functioning increased the odds ratio for high cold pain sensitivity (3.0, 95% CI: 1.6-5.6), but for those reporting no/low pain experience, it did not (OR:1.2, 95% CI: 0.8-1.8). This study provides the most comprehensive investigation of the relationship between ELS and pressure and cold pain sensitivity in young adults supporting early life as a critical period of development influencing future nociceptive processing.
      PubDate: Wed, 01 Jan 2020 00:00:00 GMT-
       
  • Abnormal medial prefrontal cortex functional connectivity and its
           association with clinical symptoms in chronic low back pain: Erratum
    • Abstract: imageNo abstract available
      PubDate: Wed, 01 Jan 2020 00:00:00 GMT-
       
  • Thank you to PAIN reviewers
    • Abstract: No abstract available
      PubDate: Wed, 01 Jan 2020 00:00:00 GMT-
       
 
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