Symposia Abstracts

Nader Ghasemlou, Bradley Kerr, Vivianne Tawfik
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We will present evidence from our respective laboratories showing how sexually dimorphic responses in neuroimmunity help control pain using models of multiple sclerosis (Dr. Bradley Kerr), complex regional pain syndrome (Dr. Vivianne Tawfik), and in the baseline control of nociception (Dr. Nader Ghasemlou). Abstract Activated myeloid-lineage cells, macrophages peripherally and microglia centrally, contribute to the acute-to-chronic pain transition, however, the details on the timing and possible sex-specificity of such involvement remains a matter of debate. For example, there is evidence that CNS microglia may contribute to chronic pain only in males. In this talk I will discuss data from my laboratory using complementary pharma-cologic and transgenic approaches in mice to more specifically manipulate myeloid-lineage cells using a model of the pain condition, complex regional pain syndrome. I will discuss a novel spatiotemporal transgenic mouse line, Cx3CR1-Cre ERT2 -eYFP;TLR4 fl/fl (TLR4 cKO) that we used to specifically knock out toll-like receptor 4 (TLR4), only in microglia and no other myeloid-lineage cells. Using this transgenic mouse, we find that early TLR4 cKO results in profound improvement in chronic, but not acute, allodynia in males, with a significant but less robust effect in females. In contrast, late TLR4 cKO results in partial improvement in allodynia in both sexes, suggesting that downstream cellular or molecular TLR4-independent events may have already been triggered. I will further discuss new data using a transgenic mouse that allows for microglia-specific depletion, Cx3CR1-Cre ERT2 -eYFP;iDTR lox-STOP-lox (microglia cKO). We performed microglial depletion at multiple time points after peripheral injury and see the most striking decrease in mechanical allodynia in males and females when depletion is performed several weeks after injury. Overall, Symposium Abstract: Observing the pain of brings about a cascade of biological and psychological in the self For caregivers and loved ones of individuals in pain, the ability to adaptively manage these reactions is closely related to the ability to provide appropriate pain assessment and pain management behaviours. This three-part symposium examines the psychological, physiological, and neural responses of individuals observing their loved ones as they undergo a range of painful experiences, across the lifespan. The workshop will be introduced with a personal reflection by session Riddell, a pain scientist with lived experience in supporting a spouse with chronic pain. on the toddler period, mechanisms physiological psychological sub-optimal behaviours. In the second talk, focused Symposium Abstract: With the increasing demands on clinical pain specialists and ever-growing waitlists in pain clinics across Canada, there is a need to find innovative ways for patients to access support in managing their pain and mental health. The internet has provided many people with access to information and treatment applications in several different areas of health, and with the COVID-19 global pandemic, there has never been a greater need to deliver care virtually. There is growing interest in online, self-directed pain management programs by both govern-ing structures and patient populations, with the goal to deliver timely interventions to people that is both evidence-based, accessible, and easy to understand. Various options for internet-based multidisciplinary pain management are currently being created and tested in Canada for both adult and pediatric populations. The Power Over Pain portal aims to provide Canadians with rapid access to bilingual empirically-based, stepped care resources for the management of pain, mental health, and substance use across the lifespan. One of the proposed programs in this portal is the Internet-based Multidisciplinary Acceptance and Commitment Therapy (IMPACT) program for Abstract Title : Feasibility study: Improving access to pain interventions for adult patients with chronic pain through the IMPACT (Internet-based Multidisciplinary Acceptance and Commitment Therapy) Program Speaker 2 Abstract : Background/Aim Accessing pain clinic services can be challenging, with long waitlists delaying patients from receiving any form of pain management treatment. We sought to create and evaluate the Internet-based Multidisciplinary Pain Acceptance and Commitment Therapy (IMPACT) Program to address this gap in pain services. Methods With patient partners’ input, we developed a multi-disciplinary, online, self-directed pain management program based on Acceptance and Commitment Therapy. The IMPACT program content contains multi-media and interactive components, including videos, audio recordings, and reflective questions. Some program videos consist of patient partners reflecting on their experiences with program themes (e.g., acceptance, values, committed action). The program also includes additional units related to exercise, medications, sleep, and communication and relationships. We conducted a feasibility study with people waiting for treatment at a tertiary pain management centre in Winnipeg, Canada. Participants completed baseline measures before accessing the program, and follow-ups immediately after completing the program and at 6-months post-completion. They provided feedback on the content throughout the program. Results Seventy-one people consented to participate, and 63 completed program enrollments. Average age of enrolled participants was 55 years (range 23-83); 76% identified as female. Seventeen participants have completed the full program and 27 participants have completed follow-up measures. Between 75% and 100% of participants recommended the various units they completed. Further outcome data and program feedback will be presented. Conclusion Based on study results, the IMPACT program shows promise in supporting individuals with chronic pain, including those who may not have timely access to pain specialist services. of Symposium Abstract: Chronic pain is a public health concern affecting 21% of the Canadian population. Symposium Abstract: In September 2018, the Minister of Health directed Health Canada to establish a Canadian Pain Task Force to help the Government of Canada better understand and address the needs of Canadians who live with chronic pain. Between March 2019 and May 2021, the Task Force reviewed the literature and conducted national consultations, which led to the publications of three reports that provided an overview of the gaps, challenges and opportunities towards an improved approach to the prevention and management of chronic pain in Canada. The Task Force’s final report entitled Action Plan for Pain in Canada and released in May 2021, provides a series of recommendations towards specific and targeted actions to prevent pain, improve health outcomes for people living with chronic pain, and to address its impacts on families, communities and society. This session will involve members of the Canadian Pain Task Force Symposium Abstract: The biopsychosocial model of chronic pain suggests that psychological and social factors must be considered in addition to biological factors to understand an individuals’ pain experience. It follows that these factors should also be considered to develop the most effective treatment plans. In this symposia, Dr. Stone will begin with a brief summary of the current biological understanding of musculoskeletal pain with a focus on fresh insights from human and animal studies on the role of epigenetic drivers in chronic low back pain. Since epigenetic modifications are potentially reversible, the therapeutic implications will be emphasized. Dr. Massieh Moayedi will present an overview of the psychological factors that contribute to chronic pain and will present new data on the interaction between pain and cognition, and how these could potentially be leveraged as novel Speaker Abstract Title : Social drivers and consequences of musculoskeletal pain with from a patient’s perspective Speaker 3 Abstract : Dr. Hovey has defined expertise in bridging gaps between theory and practice in areas such as patient centered care and communication in healthcare. His research approach utilizes philosophical hermeneutics in strengthening our understanding of the experiences of vulnerable and underserved populations, like those living with chronic pain and illness, cancer, disability, or the effects of medically induced trauma. He also brings the perspective as a person who has lived in chronic pain for 10 years. Learning Objective 1 : Integrate new knowledge on the molecular drivers of low back pain. Learning Objective 2 : Explain how pain competes for resources, and novel potential therapeutic targets for pain management. Learning Objective 3 : Describe the lived experience of pain from the perspective of a patient consultant. Symposium Abstract: Single-entry models consisting of a centralized referral and triage system have shown to improve wait times, reduce duplicate referrals and prevent cancelled appointments, in tertiary clinical settings. 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引用次数: 0

Abstract

Symposium Abstract: Females are disproportionately affected by chronic pain compared to males, with a higher prevalence of pain conditions including arthritis, migraine and fibromyalgia, among others. Seminal work from various laboratories has shown that differing inflammatory responses underlie some of the sexual dimorphism observed in the regulation of pain. While it is now clear that interactions between the nervous and immune systems are critical mediators of both acute and chronic pain responses, the underlying molecular and cellular mechanisms controlling these differences remain poorly understood. We will present evidence from our respective laboratories showing how sexually dimorphic responses in neuroimmunity help control pain using models of multiple sclerosis (Dr. Bradley Kerr), complex regional pain syndrome (Dr. Vivianne Tawfik), and in the baseline control of nociception (Dr. Nader Ghasemlou). Abstract Activated myeloid-lineage cells, macrophages peripherally and microglia centrally, contribute to the acute-to-chronic pain transition, however, the details on the timing and possible sex-specificity of such involvement remains a matter of debate. For example, there is evidence that CNS microglia may contribute to chronic pain only in males. In this talk I will discuss data from my laboratory using complementary pharma-cologic and transgenic approaches in mice to more specifically manipulate myeloid-lineage cells using a model of the pain condition, complex regional pain syndrome. I will discuss a novel spatiotemporal transgenic mouse line, Cx3CR1-Cre ERT2 -eYFP;TLR4 fl/fl (TLR4 cKO) that we used to specifically knock out toll-like receptor 4 (TLR4), only in microglia and no other myeloid-lineage cells. Using this transgenic mouse, we find that early TLR4 cKO results in profound improvement in chronic, but not acute, allodynia in males, with a significant but less robust effect in females. In contrast, late TLR4 cKO results in partial improvement in allodynia in both sexes, suggesting that downstream cellular or molecular TLR4-independent events may have already been triggered. I will further discuss new data using a transgenic mouse that allows for microglia-specific depletion, Cx3CR1-Cre ERT2 -eYFP;iDTR lox-STOP-lox (microglia cKO). We performed microglial depletion at multiple time points after peripheral injury and see the most striking decrease in mechanical allodynia in males and females when depletion is performed several weeks after injury. Overall, Symposium Abstract: Observing the pain of brings about a cascade of biological and psychological in the self For caregivers and loved ones of individuals in pain, the ability to adaptively manage these reactions is closely related to the ability to provide appropriate pain assessment and pain management behaviours. This three-part symposium examines the psychological, physiological, and neural responses of individuals observing their loved ones as they undergo a range of painful experiences, across the lifespan. The workshop will be introduced with a personal reflection by session Riddell, a pain scientist with lived experience in supporting a spouse with chronic pain. on the toddler period, mechanisms physiological psychological sub-optimal behaviours. In the second talk, focused Symposium Abstract: With the increasing demands on clinical pain specialists and ever-growing waitlists in pain clinics across Canada, there is a need to find innovative ways for patients to access support in managing their pain and mental health. The internet has provided many people with access to information and treatment applications in several different areas of health, and with the COVID-19 global pandemic, there has never been a greater need to deliver care virtually. There is growing interest in online, self-directed pain management programs by both govern-ing structures and patient populations, with the goal to deliver timely interventions to people that is both evidence-based, accessible, and easy to understand. Various options for internet-based multidisciplinary pain management are currently being created and tested in Canada for both adult and pediatric populations. The Power Over Pain portal aims to provide Canadians with rapid access to bilingual empirically-based, stepped care resources for the management of pain, mental health, and substance use across the lifespan. One of the proposed programs in this portal is the Internet-based Multidisciplinary Acceptance and Commitment Therapy (IMPACT) program for Abstract Title : Feasibility study: Improving access to pain interventions for adult patients with chronic pain through the IMPACT (Internet-based Multidisciplinary Acceptance and Commitment Therapy) Program Speaker 2 Abstract : Background/Aim Accessing pain clinic services can be challenging, with long waitlists delaying patients from receiving any form of pain management treatment. We sought to create and evaluate the Internet-based Multidisciplinary Pain Acceptance and Commitment Therapy (IMPACT) Program to address this gap in pain services. Methods With patient partners’ input, we developed a multi-disciplinary, online, self-directed pain management program based on Acceptance and Commitment Therapy. The IMPACT program content contains multi-media and interactive components, including videos, audio recordings, and reflective questions. Some program videos consist of patient partners reflecting on their experiences with program themes (e.g., acceptance, values, committed action). The program also includes additional units related to exercise, medications, sleep, and communication and relationships. We conducted a feasibility study with people waiting for treatment at a tertiary pain management centre in Winnipeg, Canada. Participants completed baseline measures before accessing the program, and follow-ups immediately after completing the program and at 6-months post-completion. They provided feedback on the content throughout the program. Results Seventy-one people consented to participate, and 63 completed program enrollments. Average age of enrolled participants was 55 years (range 23-83); 76% identified as female. Seventeen participants have completed the full program and 27 participants have completed follow-up measures. Between 75% and 100% of participants recommended the various units they completed. Further outcome data and program feedback will be presented. Conclusion Based on study results, the IMPACT program shows promise in supporting individuals with chronic pain, including those who may not have timely access to pain specialist services. of Symposium Abstract: Chronic pain is a public health concern affecting 21% of the Canadian population. Symposium Abstract: In September 2018, the Minister of Health directed Health Canada to establish a Canadian Pain Task Force to help the Government of Canada better understand and address the needs of Canadians who live with chronic pain. Between March 2019 and May 2021, the Task Force reviewed the literature and conducted national consultations, which led to the publications of three reports that provided an overview of the gaps, challenges and opportunities towards an improved approach to the prevention and management of chronic pain in Canada. The Task Force’s final report entitled Action Plan for Pain in Canada and released in May 2021, provides a series of recommendations towards specific and targeted actions to prevent pain, improve health outcomes for people living with chronic pain, and to address its impacts on families, communities and society. This session will involve members of the Canadian Pain Task Force Symposium Abstract: The biopsychosocial model of chronic pain suggests that psychological and social factors must be considered in addition to biological factors to understand an individuals’ pain experience. It follows that these factors should also be considered to develop the most effective treatment plans. In this symposia, Dr. Stone will begin with a brief summary of the current biological understanding of musculoskeletal pain with a focus on fresh insights from human and animal studies on the role of epigenetic drivers in chronic low back pain. Since epigenetic modifications are potentially reversible, the therapeutic implications will be emphasized. Dr. Massieh Moayedi will present an overview of the psychological factors that contribute to chronic pain and will present new data on the interaction between pain and cognition, and how these could potentially be leveraged as novel Speaker Abstract Title : Social drivers and consequences of musculoskeletal pain with from a patient’s perspective Speaker 3 Abstract : Dr. Hovey has defined expertise in bridging gaps between theory and practice in areas such as patient centered care and communication in healthcare. His research approach utilizes philosophical hermeneutics in strengthening our understanding of the experiences of vulnerable and underserved populations, like those living with chronic pain and illness, cancer, disability, or the effects of medically induced trauma. He also brings the perspective as a person who has lived in chronic pain for 10 years. Learning Objective 1 : Integrate new knowledge on the molecular drivers of low back pain. Learning Objective 2 : Explain how pain competes for resources, and novel potential therapeutic targets for pain management. Learning Objective 3 : Describe the lived experience of pain from the perspective of a patient consultant. Symposium Abstract: Single-entry models consisting of a centralized referral and triage system have shown to improve wait times, reduce duplicate referrals and prevent cancelled appointments, in tertiary clinical settings. The Toronto Academic Pain Medicine Institute (TAPMI) is a comprehensive, interdisciplinary, tertiary pain program in Toronto. It is the only provincially funded program in Ontario to successfully implement a single-entry system for chronic pain
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会议摘要
摘要:与男性相比,女性更容易受到慢性疼痛的影响,包括关节炎、偏头痛和纤维肌痛等疼痛状况的患病率更高。来自不同实验室的开创性工作表明,不同的炎症反应是疼痛调节中观察到的一些性别二态性的基础。虽然现在很清楚,神经和免疫系统之间的相互作用是急性和慢性疼痛反应的关键介质,但控制这些差异的潜在分子和细胞机制仍然知之甚少。我们将展示来自我们各自实验室的证据,展示神经免疫中的两性二态反应如何帮助多发性硬化症(Bradley Kerr博士)、复杂局部疼痛综合征(Vivianne Tawfik博士)和痛感基线控制(Nader Ghasemlou博士)的模型控制疼痛。活化的髓系细胞,外周巨噬细胞和中枢小胶质细胞,有助于急性到慢性疼痛的转变,然而,关于这种参与的时间和可能的性别特异性的细节仍然是一个争论的问题。例如,有证据表明中枢神经系统小胶质细胞可能仅在男性中导致慢性疼痛。在这次演讲中,我将讨论从我的实验室获得的数据,使用互补的药理学和转基因方法在小鼠中更具体地操纵髓系细胞,使用疼痛状况模型,复杂的局部疼痛综合征。我将讨论一种新的时空转基因小鼠系,Cx3CR1-Cre ERT2 -eYFP;TLR4 fl/fl (TLR4 cKO),我们用来特异性敲除toll样受体4 (TLR4),仅在小胶质细胞中,而不是其他髓系细胞中。使用这种转基因小鼠,我们发现早期TLR4 cKO对男性慢性而非急性异常性疼痛有显著改善,对女性有显著但不那么强大的作用。相比之下,TLR4晚期cKO导致两性异常性痛的部分改善,这表明下游细胞或分子TLR4独立事件可能已经被触发。我将进一步讨论使用允许小胶质细胞特异性消耗的转基因小鼠的新数据,Cx3CR1-Cre ERT2 -eYFP;iDTR lox-STOP-lox(小胶质细胞cKO)。我们在外周损伤后的多个时间点进行了小胶质细胞清除,发现在损伤后几周进行清除时,男性和女性的机械异常性痛的减少最为显著。摘要:观察疼痛会给患者自身带来一系列的生理和心理反应,对于疼痛患者的照顾者和亲人来说,适应性管理这些反应的能力与提供适当的疼痛评估和疼痛管理行为的能力密切相关。这个由三部分组成的研讨会探讨了个人观察他们所爱的人在一生中经历一系列痛苦经历时的心理、生理和神经反应。研讨会将由疼痛科学家里德尔介绍他的个人反思,里德尔在帮助患有慢性疼痛的配偶方面有着丰富的经验。关于幼儿期生理心理次优行为的机制。摘要:随着对临床疼痛专家的需求不断增加,加拿大疼痛诊所的等待名单不断增加,有必要为患者找到创新的方法来获得管理疼痛和心理健康的支持。互联网为许多人提供了多个不同卫生领域的信息和治疗应用,随着2019冠状病毒病全球大流行,提供虚拟护理的需求从未像现在这样强烈。管理机构和患者群体对在线、自我指导的疼痛管理项目越来越感兴趣,其目标是向人们提供及时的干预,这些干预既基于证据,又易于理解。目前,加拿大正在为成人和儿童创建和测试基于互联网的多学科疼痛管理的各种选择。“战胜疼痛的力量”门户网站旨在为加拿大人提供快速访问基于经验的双语、阶梯式护理资源,以管理整个生命周期的疼痛、心理健康和物质使用。该门户网站提出的一个项目是基于互联网的多学科接受和承诺治疗(IMPACT)项目。摘要标题:可行性研究:通过IMPACT(基于互联网的多学科接受和承诺治疗)改善成年慢性疼痛患者获得疼痛干预的机会背景/目的获得疼痛诊所服务可能具有挑战性,长时间的等待名单延迟了患者接受任何形式的疼痛管理治疗。 我们试图创建和评估基于互联网的多学科疼痛接受和承诺治疗(IMPACT)计划,以解决疼痛服务中的这一差距。方法在患者伴侣的参与下,我们开发了一个基于接受和承诺疗法的多学科、在线、自我指导的疼痛管理项目。IMPACT课程内容包含多媒体和互动组件,包括视频、录音和反思性问题。一些项目视频由耐心的合作伙伴反映他们对项目主题的经历(例如,接受、价值观、承诺的行动)组成。该项目还包括与运动、药物、睡眠、沟通和人际关系相关的额外单元。我们对在加拿大温尼伯三级疼痛管理中心等待治疗的患者进行了可行性研究。参与者在进入项目前完成了基线测量,并在完成项目后立即和完成后6个月进行了随访。他们对整个课程的内容提供了反馈。结果71人同意参与,63人完成项目登记。参与者的平均年龄为55岁(23-83岁);76%被认定为女性。17名参与者完成了整个项目,27名参与者完成了随访。75%到100%的参与者推荐了他们完成的各个单元。将提供进一步的结果数据和项目反馈。根据研究结果,IMPACT项目在支持慢性疼痛患者方面显示出希望,包括那些可能无法及时获得疼痛专家服务的人。摘要:慢性疼痛是影响21%加拿大人口的公共卫生问题。摘要:2018年9月,卫生部长指示加拿大卫生部成立加拿大疼痛工作组,以帮助加拿大政府更好地了解和解决患有慢性疼痛的加拿大人的需求。在2019年3月至2021年5月期间,工作组审查了文献并进行了全国磋商,最终发表了三份报告,概述了加拿大在预防和管理慢性疼痛方面存在的差距、挑战和机遇。工作组于2021年5月发布的题为《加拿大疼痛行动计划》的最终报告为采取具体和有针对性的行动提供了一系列建议,以预防疼痛,改善慢性疼痛患者的健康结果,并解决其对家庭、社区和社会的影响。摘要:慢性疼痛的生物心理社会模型表明,除了生物因素外,还必须考虑心理和社会因素来理解个体的疼痛体验。因此,在制定最有效的治疗计划时,也应考虑这些因素。在本次研讨会上,Stone博士将首先简要总结当前对肌肉骨骼疼痛的生物学理解,重点介绍人类和动物研究中表观遗传驱动因素在慢性腰痛中的作用的新见解。由于表观遗传修饰是潜在可逆的,因此将强调其治疗意义。Massieh Moayedi博士将概述导致慢性疼痛的心理因素,并将介绍疼痛和认知之间相互作用的新数据,以及如何利用这些数据作为新的演讲者摘要题目:从患者的角度来看肌肉骨骼疼痛的社会驱动因素和后果Hovey博士在以患者为中心的护理和医疗保健沟通等领域弥合理论与实践之间的差距方面拥有专业知识。他的研究方法利用哲学解释学来加强我们对弱势群体和服务不足人群的理解,比如那些患有慢性疼痛和疾病、癌症、残疾或医学创伤的人。他还带来了作为一个在慢性疼痛中生活了10年的人的观点。学习目标1:整合关于腰痛分子驱动的新知识。学习目标2:解释疼痛如何竞争资源,以及疼痛管理的新潜在治疗靶点。学习目标3:从患者咨询师的角度描述疼痛的生活经验。摘要:在三级临床设置中,由集中转诊和分诊系统组成的单入口模式已显示出改善等待时间,减少重复转诊和防止取消预约的效果。多伦多学术疼痛医学研究所(TAPMI)是一个综合性的,跨学科的,三级疼痛计划在多伦多。 这是安大略省唯一一个成功实施慢性疼痛单入口系统的省级资助项目
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CiteScore
3.70
自引率
12.50%
发文量
36
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