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Pain
Number of Followers: 68  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0304-3959 - ISSN (Online) 1872-6623
Published by LWW Wolters Kluwer Homepage  [301 journals]
  • In memoriam: Joel D. Greenspan 1952 to 2021

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      Authors: Meeker; Timothy J.; Quiton, Raimi L.; Moulton, Eric A.
      Abstract: imageNo abstract available
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Medical interventions have not solved the epidemic of chronic low back
           pain: will neurostimulation of the multifidus muscle be different'

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      Authors: Atlas; Steven J.
      Abstract: No abstract available
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Chronic pain in patients with inflammatory bowel disease

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      Authors: Bakshi; Nikul; Hart, Ailsa L.; Lee, Michael C.; Williams, Amanda C de C.; Lackner, Jeffrey M.; Norton, Christine; Croft, Peter
      Abstract: No abstract available
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Sufficient conditions for effective psychological treatment of chronic
           pain: a qualitative comparative analysis

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      Authors: Batho; Anna; Kneale, Dylan; Sutcliffe, Katy; Williams, Amanda C de C.
      Abstract: imageChronic pain (CP) is the leading cause of years lived with disability globally. Treatment within Western medicine is often multicomponent; the psychological element of treatment varies, yet the optimal conditions for effective reduction of pain-related outcomes remain unclear. This study used qualitative comparative analysis, a relatively new form of evidence synthesis in the field based on set theory to ascertain configurations of intervention components and processes of psychological treatment of chronic pain in adults that lead to more effective interventions. Data were extracted from 38 studies identified in a concurrent Cochrane review and were then subjected to qualitative comparative analysis. Two analyses were conducted: one to examine what is most effective for reducing disability and one to examine what is most effective for reducing distress. Analysis and comparison of the 10 treatments with best outcomes with the 10 treatments with poorest outcomes showed that interventions using graded exposure, graded exercise or behavioural rehearsal (exposure/activity), and interventions aiming to modify reinforcement contingencies (social/operant) reduced disability levels when either approach was applied but not both. Exposure/activity can improve distress levels when combined with cognitive restructuring, as long as social/operant methods are not included in treatment. Clinical implications of this study suggest that treatment components should not be assumed to be synergistic and provided in a single package.
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • An implantable restorative-neurostimulator for refractory mechanical
           chronic low back pain: a randomized sham-controlled clinical trial

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      Authors: Gilligan; Christopher; Volschenk, Willem; Russo, Marc; Green, Matthew; Gilmore, Christopher; Mehta, Vivek; Deckers, Kristiaan; De Smedt, Kris; Latif, Usman; Georgius, Peter; Gentile, Jonathan; Mitchell, Bruce; Langhorst, Meredith; Huygen, Frank; Baranidharan, Ganesan; Patel, Vikas; Mironer, Eugene; Ross, Edgar; Carayannopoulos, Alexios; Hayek, Salim; Gulve, Ashish; Van Buyten, Jean-Pierre; Tohmeh, Antoine; Fischgrund, Jeffrey; Lad, Shivanand; Ahadian, Farshad; Deer, Timothy; Klemme, William; Rauck, Richard; Rathmell, James; Levy, Robert; Heemels, Jan Pieter; Eldabe, Sam; for the ReActiv8-B investigators
      Abstract: imageChronic low back pain can be caused by impaired control and degeneration of the multifidus muscles and consequent functional instability of the lumbar spine. Available treatment options have limited effectiveness and prognosis is unfavorable. We conducted an international randomized, double-blind, sham-controlled trial at 26 multidisciplinary centers to determine safety and efficacy of an implantable, restorative neurostimulator designed to restore multifidus neuromuscular control and facilitate relief of symptoms (clinicaltrials.gov identifier: NCT02577354). Two hundred four eligible participants with refractory mechanical (musculoskeletal) chronic LBP and a positive prone instability test indicating impaired multifidus control were implanted and randomized to therapeutic (N = 102) or low-level sham (N = 102) stimulation of the medial branch of the dorsal ramus nerve (multifidus nerve supply) for 30 minutes twice daily. The primary endpoint was the comparison of responder proportions (≥30% relief on the LBP visual analogue scale without analgesics increase) at 120 days. After the primary endpoint assessment, participants in the sham-control group switched to therapeutic stimulation and the combined cohort was assessed through 1 year for long-term outcomes and adverse events. The primary endpoint was inconclusive in terms of treatment superiority (57.1% vs 46.6%; difference: 10.4%; 95% confidence interval, −3.3% to 24.1%, P = 0.138). Prespecified secondary outcomes and analyses were consistent with a modest but clinically meaningful treatment benefit at 120 days. Improvements from baseline, which continued to accrue in all outcome measures after conclusion of the double-blind phase, were clinically important at 1 year. The incidence of serious procedure- or device-related adverse events (3.9%) compared favorably with other neuromodulation therapies for chronic pain.
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Protein kinase Cδ as a neuronal mechanism for headache in a chronic
           intermittent nitroglycerin model of migraine in mice

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      Authors: He; Ying; Shi, Zuoxiao; Kashyap, Yavnika; Messing, Robert O.; Wang, Zaijie Jim
      Abstract: imageMigraine is one of the most common neurological disorders characterized by recurrent attacks of typically throbbing and unilateral headaches, affecting up to 20% of the population worldwide. Despite the high prevalence and severity of this primary headache disorder, it remains to be a challenge to fully understand and treat migraine headaches. By characterizing and validating a mouse migraine model, this study aimed to investigate the functional contribution of protein kinase C (PKC) isoforms in migraine. In this study, we identified the presence of migraine-like ongoing pain in mice after chronic intermittent treatment with nitroglycerin (NTG). The peptide antagonist of calcitonin gene-related peptide α-CGRP (8-37), but not topiramate nor sumatriptan, effectively blocked ongoing pain and elicited pain relief-induced conditioned place preference in NTG-treated mice. Prominent activation of PKCδ was observed in chronic NTG-treated mice. Functional inhibition of PKCδ significantly attenuated ongoing spontaneous pain in chronic NTG-treated mice. Furthermore, we recapitulated the NTG-triggered migraine behavior in wild-type mice, but not in PKCδ-null mice. In response to repeated administration of NTG, ongoing spontaneous pain was not developed in mice lacking the specific PKC isoform. This study identified the presence of ongoing pain in mice treated with NTG, a known human migraine trigger that closely resembles the common manifestation of spontaneous migraine attacks in humans. These findings demonstrated a critical regulatory role of PKCδ in migraine pathophysiology, which may offer new pharmacological targets for antimigraine treatment.
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Opening of BKCa channels causes migraine attacks: a new downstream target
           for the treatment of migraine

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      Authors: Al-Karagholi; Mohammad Al-Mahdi; Ghanizada, Hashmat; Waldorff Nielsen, Cherie Amalie; Skandarioon, Camilla; Snellman, Josefin; Lopez-Lopez, Cristina; Hansen, Jakob Møller; Ashina, Messoud
      Abstract: imageMigraine is a common and frequently disabling neurological disorder, but the initiating migraine mechanisms are still poorly understood. Potassium channel opening may cause migraine, and we therefore examined the migraine-inducing effect of MaxiPost, a large (big)-conductance calcium-activated potassium (BKCa) channel opener, on migraine induction and cephalic vasodilation in individuals with migraine. Twenty-six patients with migraine without aura were randomly allocated to receive an infusion of MaxiPost or placebo on 2 study days separated by at least 1 week. The primary endpoint was the difference in incidence of migraine attacks after MaxiPost compared with placebo. The secondary endpoints were the difference in incidence of headaches and the difference in area under the curve for headache intensity scores (0-12 hours), for middle cerebral artery blood flow velocity (VMCA) (0-2 hours), and for superficial temporal artery and radial artery diameter. Twenty-two patients completed the study. Twenty-one of 22 (95%) developed migraine attacks after MaxiPost compared with none after placebo (P < 0.0001); the difference of incidence is 95% (95% confidence interval 86%-100%). The incidence of headache over the 12-hour observation period was higher after MaxiPost day (n = 22) than after placebo (n = 7) (P < 0.0001). We found a significant increase of VMCA and superficial temporal and radial arteries' diameter. Because BKCa channel opening initiates migraine attacks, we suggest that BKCa channel blockers could be potential candidates for novel antimigraine drugs.
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Effect of back problems on healthcare utilization and costs in Ontario,
           Canada: a population-based matched cohort study

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      Authors: Wong; Jessica J.; Côté, Pierre; Tricco, Andrea C.; Watson, Tristan; Rosella, Laura C.
      Abstract: imageWe assessed the effect of back problems on healthcare utilization and costs in a population-based sample of adults from a single-payer health system in Ontario. We conducted a population-based cohort study of Ontario respondents aged ≥18 years of the Canadian Community Health Survey (CCHS) from 2003 to 2012. The CCHS data were individually linked to health administrative data to measure healthcare utilization and costs up to 2018. We propensity score-matched (hard matched on sex) adults with self-reported back problems to those without back problems, accounting for sociodemographic, health-related, and behavioural factors. We evaluated cause-specific and all-cause healthcare utilization and costs adjusted to 2018 Canadian dollars using negative binomial and linear (log transformed) regression models. After propensity score matching, we identified 36,806 pairs (women: 21,054 pairs; men: 15,752 pairs) of CCHS respondents with and without back problems (mean age 51 years, standard deviation = 18). Compared with propensity score matched adults without back problems, adults with back problems had 2 times the rate of cause-specific visits (rate ratio [RR]women 2.06, 95% confidence interval [CI] 1.88-2.25; RRmen 2.32, 95% CI 2.04-2.64), slightly more all-cause physician visits (RRwomen 1.12, 95% CI 1.09-1.16; RRmen 1.10, 95% CI 1.05-1.14), and 1.2 times the costs (women: 1.21, 95% CI 1.16-1.27; men: 1.16, 95% CI 1.09-1.23). Incremental annual per-person costs were higher in adults with back problems than those without back problems (women: $395, 95% CI $281-$509; men: $196, 95% CI $94-$300). This corresponded to $532 million for women and $227 million for men (adjusted to 2018 Canadian dollars) annually in Ontario given the high prevalence of back problems. Given the high health system burden, new strategies to effectively prevent and treat back problems and thus potentially reduce the long-term costs are warranted.
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Pain phenotypes among adults living with cerebral palsy and spina bifida

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      Authors: Peterson; Mark D.; Haapala, Heidi; Kamdar, Neil; Lin, Paul; Hurvitz, Edward A.
      Abstract: imageChronic pain is the most commonly reported physical symptomology of cerebral palsy (CP) and spina bifida (SB) throughout the lifespan, and yet, pain is perhaps the least understood comorbidity in these populations. The objective of this study was to compare the prevalence and types of pain diagnosed among adults living with and without CP or SB. In this retrospective cohort study, we analyzed data from a nationwide commercial insurance claims database. Beneficiaries were included if they had an International Classification of Diseases, Ninth revision, Clinical Modification diagnosis code for CP or SB (n = 22,648). Adults without CP or SB were also included as controls (n = 931,623). Pain phenotypes (nociceptive, nociplastic, and neuropathic pain) and pain multimorbidity (≥2 conditions) were compared. We found that adults living with CP or SB had a higher prevalence of any pain disorders (55.9% vs 35.2%), nociceptive pain (44.0% vs 26.7%), nociplastic pain (26.1% vs 11.9%), neuropathic pain (9.6% vs 5.6%), and pain multimorbidity (21.1% vs 8.4%), as compared to adults without CP or SB, and differences were to a clinically meaningful extent. Adjusted odds ratios of nociceptive pain (odds ratio [OR]: 2.20; 95% confidence interval [CI]: 2.15-2.24), nociplastic pain (OR: 2.47; 95% CI: 2.41-2.53), neuropathic pain (OR: 2.71; 95% CI: 2.54-2.89), and other pain (OR: 3.92; 95% CI: 3.67-4.19) were significantly higher for adults living with CP or SB. In conclusion, adults with CP or SB have a significantly higher prevalence and odds of common peripheral, central, and neuropathic pain disorders and pain multimorbidity, as compared to adults without CP or SB.
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Core outcome set for pediatric chronic pain clinical trials: results from
           a Delphi poll and consensus meeting

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      Authors: Palermo; Tonya M.; Walco, Gary A.; Paladhi, Unmesha Roy; Birnie, Kathryn A.; Crombez, Geert; de la Vega, Rocio; Eccleston, Christopher; Kashikar-Zuck, Susmita; Stone, Amanda L.
      Abstract: imageAppropriate outcome measures and high-quality intervention trials are critical to advancing care for children with chronic pain. Our aim was to update a core outcome set for pediatric chronic pain interventions. The first phase involved collecting providers', patients', and parents' perspectives about treatment of pediatric chronic pain to understand clinically meaningful outcomes to be routinely measured. The second phase was to reach consensus of mandatory and optional outcome domains following the OMERACT framework. A modified Delphi study with 2 rounds was conducted including 3 stakeholder groups: children with chronic pain (n = 93), their parents (n = 90), and health care providers who treat youth with chronic pain (n = 52). Quantitative and qualitative data from round 1 of the Delphi study were summarized to identify important outcomes, which were condensed to a list of 10 outcome domains. Round 2 surveys were analyzed to determine the importance of the 10 domains and their relative ranking in each stakeholder group. A virtual consensus conference was held with the steering committee to reach consensus on a set of recommended outcome domains for pediatric chronic pain clinical trials. It was determined, by unanimous vote, that pain severity, pain interference with daily living, overall well-being, and adverse events, including death, would be considered mandatory domains to be assessed in all trials of any type of intervention. Emotional functioning, physical functioning, and sleep were important but optional domains. Last, the research agenda identifies several important emerging areas, including biomarkers. Future work includes selecting appropriate validated measures to assess each outcome domain.
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Consensus agreement to rename burning mouth syndrome and improve
           International Classification of Diseases-11 disease criteria: an
           international Delphi study

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      Authors: Chmieliauskaite; Milda; Stelson, Elisabeth A.; Epstein, Joel B.; Klasser, Gary D.; Farag, Arwa; Carey, Barbara; Albuquerque, Rui; Mejia, Lina; Ariyawardana, Anura; Nasri-Heir, Cibele; Sardella, Andrea; Carlson, Charles; Miller, Craig S.
      Abstract: image : The International Classification of Diseases (ICD-11) proposes revisions in the nomenclature, disease definition, and diagnostic criteria for “burning mouth syndrome” (BMS). This process could benefit from additional systematically collected expert input. Thus, the purpose of this study was to use the Delphi method to (1) determine whether revision in nomenclature and alternative names for “BMS” are warranted and (2) identify areas of consensus among experts for changes to the disease description and proposed diagnostic criteria of “BMS,” as described in the ICD-11 (World Health Organization). From 31 international invited experts, 23 who expressed interest were sent the survey. The study used 4 iterative surveys, each with a response rate of ≥82%. Consensus was predefined as 70% of participants in agreement. Data were summarized using both descriptive statistics and qualitative thematic analysis. Consensus indicated that BMS should not be classified as a syndrome and recommended instead renaming to “burning mouth disorder.” Consensus included deletion of 2 diagnostic criteria: (1) emotional distress or functional disability and (2) the number of hours symptoms occur per day. Additional items that reached consensus clarified the disease definition and proposed more separate diagnostic criteria, including a list of local and systemic factors to evaluate as potential secondary causes of oral burning. Experts in this study recommended and came to consensus on select revisions to the proposed ICD-11 BMS nomenclature, diagnostic criteria, and disease definition. The revisions recommended have the potential to improve clarity, consistency, and accuracy of diagnosis for this disorder.
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • What do patients value learning about pain' A mixed-methods survey on
           the relevance of target concepts after pain science education

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      Authors: Leake; Hayley B.; Moseley, G. Lorimer; Stanton, Tasha R.; O'Hagan, Edel T.; Heathcote, Lauren C.
      Abstract: imagePain education is a popular treatment approach for persistent pain that involves learning a variety of concepts about pain (ie, target concepts), which is thought to be an important part of recovery. Yet, little is known about what patients value learning about pain. A mixed-methods survey was conducted to identify pain concepts that were valued by people with persistent pain who improved after a pain science education intervention. An online survey was distributed to 123 people who were treated for persistent pain with a pain science education approach; responses of participants who self-identified as “improved” were analysed. Open-ended survey questions were analysed using reflexive thematic analysis and close-ended questions were analysed for frequency of responses. Each question-type was analysed separately, before integration for complementarity. We analysed the data of 97 participants. We constructed 3 themes from the open-ended questions. Pain does not mean my body is damaged (theme 1) captured the importance of abandoning preexisting ideas that pain indicated damage. Thoughts, emotions and experiences affect pain (theme 2) captured the value of recognising multifactorial influences on pain. I can retrain my overprotective pain system (theme 3) captured the importance of conceptualising pain as a heightened protective response that could be lessened. Responses from close-ended questions confirmed that the target concepts represented by these themes are among those most valued, although divergence with the qualitative data suggests differences between patient and clinician language. These data offer patient-centred conceptualizations and language that could assist in further refining pain education interventions.
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Fibromyalgia vs small fiber neuropathy: diverse keratinocyte transcriptome
           signature

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      Authors: Karl; Franziska; Bischler, Thorsten; Egenolf, Nadine; Evdokimov, Dimitar; Heckel, Tobias; Üçeyler, Nurcan
      Abstract: imageDamage to thinly myelinated and unmyelinated nerve fibers causes small fiber pathology, which is increasingly found in pain syndromes such as small fiber neuropathy (SFN) and fibromyalgia syndrome (FMS). The peripheral nerve endings of the small nerve fibers terminate within the epidermis, where they are surrounded by keratinocytes that may act as primary nociceptive transducers. We performed RNA sequencing of keratinocytes obtained from patients with SFN, FMS, and healthy controls. We found 141 deregulated protein coding genes between SFN patients and healthy controls and no differentially expressed genes between patients with FMS and healthy controls. When comparing patients with SFN with patients with FMS, we detected 167 differentially expressed protein coding genes (129 upregulated and 38 downregulated). Further analysis revealed enriched inflammatory pathways. Validation of selected candidates in an independent cohort confirmed higher expression of the proinflammatory mediators interleukin-8, C-X-C motif chemokine 3, endothelin receptor type A, and the voltage-gated sodium channel 1.7 in SFN compared with patients with FMS. We provide a diverse keratinocyte transcriptome signature between patients with SFN and patients with FMS, which may hint toward distinct pathomechanisms of small fiber sensitization in both entities and lay the basis for advanced diagnostics.
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Efficacy and safety of EMA401 in peripheral neuropathic pain: results of 2
           randomised, double-blind, phase 2 studies in patients with postherpetic
           neuralgia and painful diabetic neuropathy

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      Authors: Rice; Andrew S.C.; Dworkin, Robert H.; Finnerup, Nanna B.; Attal, Nadine; Anand, Praveen; Freeman, Roy; Piaia, Alessandro; Callegari, Francesca; Doerr, Christie; Mondal, Subhayan; Narayanan, Nisha; Ecochard, Laurent; Flossbach, Yanina; Pandhi, Shaloo
      Abstract: imageThe analgesic efficacy and safety of 2 phase 2b studies of EMA401 (a highly selective angiotensin II type 2 receptor antagonist) in patients with postherpetic neuralgia (EMPHENE) and painful diabetic neuropathy (EMPADINE) were reported. These were multicentre, randomised, double-blind treatment studies conducted in participants with postherpetic neuralgia or type I/II diabetes mellitus with painful distal symmetrical sensorimotor neuropathy. Participants were randomised 1:1:1 to either placebo, EMA401 25 mg, or 100 mg twice daily (b.i.d) in the EMPHENE and 1:1 to placebo or EMA401 100 mg b.i.d. in the EMPADINE. The primary outcome for both the studies was change in weekly mean of the 24-hour average pain score, using a numeric rating scale from baseline to week 12. Both the studies were prematurely terminated due to preclinical hepatotoxicity on long-term dosing, although not observed in these studies. Out of the planned participants, a total of 129/360 (EMPHENE) and 137/400 (EMPADINE) participants were enrolled. The least square mean reduction in numeric rating scale pain score was numerically in favour of EMA401 100 mg arm in both EMPHENE (treatment difference: −0.5 [95% confidence interval: −1.6 to 0.6; P value: 0.35]) and EMPADINE (treatment difference: −0.6 [95% confidence interval: −1.4 to 0.1; P value: 0.10]) at the end of week 12. However, as the studies were terminated prematurely, no firm conclusion could be drawn but the consistent clinical improvement in pain intensity reduction across these 2 studies in 2 different populations is worth noting.
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Migraine chronification is associated with beta-band connectivity within
           the pain-related cortical regions: a magnetoencephalographic study

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      Authors: Hsiao; Fu-Jung; Chen, Wei-Ta; Liu, Hung-Yu; Wang, Yen-Feng; Chen, Shih-Pin; Lai, Kuan-Lin; Hope Pan, Li-Ling; Coppola, Gianluca; Wang, Shuu-Jiun
      Abstract: imagePain disorders are associated with aberrant oscillations in the pain-related cortical regions; however, few studies have investigated the relationship between the functional cortical network and migraine chronification through direct neural signals. Magnetoencephalography was used to record the resting-state brain activity of healthy controls as well as patients with episodic migraine (EM) and chronic migraine (CM). The source-based oscillatory dynamics of the pain-related cortical regions, which comprises 10 node regions (the bilateral primary [SI] and secondary somatosensory cortices, insula, medial frontal cortex, and anterior cingulate cortex [ACC]), were calculated to determine the intrinsic connectivity and node strength at 1 to 40 Hz. The total node strength within the pain-related cortical regions was smaller in the beta band in patients with migraine (70 EM and 80 CM) than in controls (n = 65). In the beta band, the node strength and functional connectivity values of patients with CM and patients with EM differed from those of controls in specific cortical areas, notably the left SI (EM < control) and bilateral ACC (CM < control); moreover, the node strength was lower in patients with CM than in those with EM. In all patients with migraine, negative correlations were observed between headache frequency and node strength in the bilateral ACC. In conclusion, migraine is characterized by reduced beta oscillatory connectivity within the pain-related cortical regions. Reduced beta connectivity in the ACC is linked to migraine chronification. Longitudinal studies should verify whether this oscillation change is a brain signature and a potential neuromodulation target for migraine.
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Inhibition of dual leucine zipper kinase prevents chemotherapy-induced
           peripheral neuropathy and cognitive impairments

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      Authors: Ma; Jiacheng; Goodwani, Sunil; Acton, Paul J.; Buggia-Prevot, Virginie; Kesler, Shelli R.; Jamal, Imran; Mahant, Iteeben D.; Liu, Zhen; Mseeh, Faika; Roth, Bruce L.; Chakraborty, Chaitali; Peng, Bo; Wu, Qi; Jiang, Yongying; Le, Kang; Soth, Michael J.; Jones, Philip; Kavelaars, Annemieke; Ray, William J.; Heijnen, Cobi J.
      Abstract: imageChemotherapy-induced peripheral neuropathy (CIPN) and chemotherapy-induced cognitive impairments (CICI) are common, often severe neurotoxic side effects of cancer treatment that greatly reduce quality of life of cancer patients and survivors. Currently, there are no Food and Drug Administration-approved agents for the prevention or curative treatment of CIPN or CICI. The dual leucine zipper kinase (DLK) is a key mediator of axonal degeneration that is localized to axons and coordinates the neuronal response to injury. We developed a novel brain-penetrant DLK inhibitor, IACS′8287, which demonstrates potent and highly selective inhibition of DLK in vitro and in vivo. Coadministration of IACS′8287 with the platinum derivative cisplatin prevents mechanical allodynia, loss of intraepidermal nerve fibers in the hind paws, cognitive deficits, and impairments in brain connectivity in mice, all without interfering with the antitumor activity of cisplatin. The protective effects of IACS′8287 are associated with preservation of mitochondrial function in dorsal root ganglion neurons and in brain synaptosomes. In addition, RNA sequencing analysis of dorsal root ganglia reveals modulation of genes involved in neuronal activity and markers for immune cell infiltration by DLK inhibition. These data indicate that CIPN and CICI require DLK signaling in mice, and DLK inhibitors could become an attractive treatment in the clinic when coadministered with cisplatin, and potentially other chemotherapeutic agents, to prevent neurotoxicities as a result of cancer treatment.
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Comparative differences in musculoskeletal pain consultation and analgesic
           prescription for people with dementia: a UK-wide matched cohort study

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      Authors: Bullock; Laurna; Bedson, John; Chen, Ying; Chew-Graham, Carolyn A.; Campbell, Paul
      Abstract: imagePainful musculoskeletal conditions are common in older adults; however, pain identification, assessment, and management are reported to be suboptimal for people with dementia. Adequate pain management is an integral aspect of care for people with dementia to prevent or delay negative outcomes, such as behavioural and psychological changes, emergency department attendance, and premature nursing home admission. This study aims to examine musculoskeletal consultations and analgesic prescriptions for people with dementia compared with those for people without dementia. A dementia cohort (n = 36,582) and matched cohort were identified in the Clinical Practice Research Datalink (a UK-wide primary care database). Period prevalence for musculoskeletal consultations and analgesic prescriptions was described, and logistic regression applied to estimate associations between dementia and musculoskeletal consultation or analgesic prescription from the time of dementia diagnosis to 5 years after diagnosis. People with dementia had a consistently (over time) lower prevalence and odds of musculoskeletal consultation and analgesic prescription compared with people without dementia. The evidence suggests that pain management may be suboptimal for people with dementia. These results highlight the need to increase awareness of pain and use better methods of pain assessment, evaluation of treatment response, and acceptable and effective management for people with dementia, in primary care.
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
 
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