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Virtual Reality Is Safe and Can Reduce In-Hospital Anxiety and Pain: A Systematic Review With Meta-Analyses and Trial Sequence Analyses 虚拟现实是安全的，可以减少住院焦虑和疼痛：荟萃分析和试验序列分析的系统评价。
IF 3.4 2区 医学 Q1 ANESTHESIOLOGY
European Journal of Pain
Pub Date : 2025-11-05 DOI: 10.1002/ejp.70165
Karsten L. Lassen, Kristian Hermander, Pether Jildenstål, Nanna Wagner, Annelie Augustinsson, Carina Sjöberg, Anja Geisler

Background and Objective

Virtual reality (VR) is a rapidly evolving technology that is currently utilized in hospital settings for various types of surgical procedures. The extent to which VR is evident in improving patient outcomes is unknown. This systematic review assesses the impact of VR on adult patients undergoing elective surgical procedures.

Databases and Data Treatment

The following databases were sought: CENTRAL, MEDLINE, EMBASE, and CINAHL. All studies published after 2017 were included. The risk of bias was assessed using the ROB2 and ROBINS-I. Meta-analyses and Trial Sequential Analyses were performed, and the quality of evidence was evaluated using the GRADE approach for the randomised controlled trials.

Results

A total of 37 full-text studies (n = 3152) were included. VR significantly reduced anxiety measured by the Numeric Rating Scale (p < 0.0001) and the State–Trait Anxiety Inventory (p = 0.008). Furthermore, Numeric Rating Scale pain was significantly reduced (p < 0.00005), with a significantly shorter recovery time and a non-significant improvement in patient satisfaction. Adverse events were infrequent and mild, with no serious adverse events reported. The risk of bias was primarily “some concerns”, and the certainty of evidence ranged from moderate to low.

Conclusions

VR appears effective in reducing pain and anxiety in adult patients in an in-hospital setting. It offers a relatively safe adjunct to standard care with minimal side effects. However, heterogeneity in outcomes and the risk of bias suggest a need for more standardised, high-quality trials.

Significance Statement

This systematic review with meta-analysis and trial sequential analysis provides updated evidence that virtual reality can significantly reduce anxiety and pain in patients undergoing surgical procedures. Through combining recent RCTs and cohort studies with robust methodological approaches, this review strengthens the evidence for VR as an effective non-pharmacological intervention. With minimal adverse events and significant improvements in recovery time, VR represents a scalable tool that can strengthen multimodal strategies and promote safer and more comfortable patient experiences.

背景和目的：虚拟现实（VR）是一项快速发展的技术，目前在医院环境中用于各种类型的外科手术。VR在改善患者预后方面的明显程度尚不清楚。本系统综述评估了VR对接受选择性外科手术的成年患者的影响。数据库和数据处理：寻求以下数据库：CENTRAL， MEDLINE， EMBASE和CINAHL。2017年之后发表的所有研究都被纳入其中。使用ROB2和ROBINS-I评估偏倚风险。对随机对照试验进行meta分析和试验序贯分析，并使用GRADE方法评估证据质量。结果：共纳入37项全文研究（n = 3152）。结论：虚拟现实似乎有效地减轻了住院成人患者的疼痛和焦虑。它提供了一种相对安全的辅助标准护理，副作用最小。然而，结果的异质性和偏倚风险表明需要更多标准化、高质量的试验。意义声明：本系统综述采用荟萃分析和试验序列分析，提供了最新证据，证明虚拟现实可以显著减轻外科手术患者的焦虑和疼痛。通过结合最近的随机对照试验和队列研究以及稳健的方法学方法，本综述加强了VR作为有效的非药物干预措施的证据。VR具有最小的不良事件和显著的恢复时间改善，是一种可扩展的工具，可以加强多模式策略，促进更安全和更舒适的患者体验。
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引用次数: 0
Baseline Chronic Pain Intensity and Long-Term Depressive Symptoms in French Older Community-Dwelling Adults: A 12-Year Prospective Cohort Study 基线慢性疼痛强度和长期抑郁症状在法国老年社区居住的成年人：一个12年的前瞻性队列研究
IF 3.4 2区 医学 Q1 ANESTHESIOLOGY
European Journal of Pain
Pub Date : 2025-11-04 DOI: 10.1002/ejp.70159
Isabelle Rouch, Michèle Koleck, Arlette Edjolo, Karine Peres, Bernard Laurent, Jean-Michel Dorey, Jean-François Dartigues, Hélène Amieva
<div> <section> <h3> Background</h3> <p>Chronic pain (CP) in older adults was associated with depression in numerous cross-sectional studies. However, the longitudinal link between CP characteristics and depressive symptoms in this population remains unsettled. We aimed to assess the prospective link between CP intensity and long-term depressive symptoms in a population-based cohort of older participants, considering numerous potential confounders.</p> </section> <section> <h3> Methods</h3> <p>The study sample was gathered from the PAQUID study, a prospective cohort study of community-dwellers above 65. Information regarding CP characteristics was collected at the 3-year follow-up visit. The sample included the 742 participants who fulfilled this CP questionnaire. Three CP groups were distinguished: no (<i>n</i> = 504), mild (<i>n</i> = 101), and intense (<i>n</i> = 137) CP. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression scale (CES-D) every 2–3 years during 12 years (6 waves). The association between CP and the 12-year CES-D course (12 years after the 3-year visit) was investigated using a multivariate latent process mixed model for curvilinear data.</p> </section> <section> <h3> Results</h3> <p>Compared with the participants without CP, those with moderate and intense CP had significantly higher CES-D levels at baseline with a dose–response relationship as a function of pain intensity (<i>β</i> = 0.366, <i>p</i> = 0.0308; 0.607, <i>p</i> < 0.0001, respectively). However, the time course was comparable in the three groups (<i>β</i> = −0.003, <i>p</i> = 0.8351; −0.003, <i>p</i> = 0.8516, for mild and intense CP, respectively).</p> </section> <section> <h3> Conclusion</h3> <p>CP intensity is associated with higher levels of depressive symptoms persisting throughout the long period of follow-up. This finding reinforces the importance of early treatment of CP in older adults to prevent its sustainable psychological consequences.</p> </section> <section> <h3> Significance Statement</h3> <p>Depression and chronic pain (CP) have been frequently associated in older adults. The longitudinal relationship between CP characteristics and the long-term course of depressive symptoms in this population has yet to be specified. The present results showed that CP intensity is associated with higher levels of depressive symptoms persisting throughout a 15-year follow-up period, with a dose–response relationship. This finding reinforces the importance of early treatment of CP in the older population, in order to prevent its last
背景：在许多横断面研究中，老年人慢性疼痛（CP）与抑郁症有关。然而，在这一人群中，CP特征与抑郁症状之间的纵向联系仍不确定。我们的目的是在一个以人群为基础的老年参与者队列中，考虑到许多潜在的混杂因素，评估CP强度与长期抑郁症状之间的前瞻性联系。方法：研究样本来自PAQUID研究，这是一项针对65岁以上社区居民的前瞻性队列研究。在3年的随访中收集有关CP特征的信息。样本包括742名完成CP问卷的参与者。将CP分为三组：无CP （n = 504）、轻度CP （n = 101）和重度CP （n = 137）。在12年（6波）中，每2-3年用流行病学研究中心抑郁量表（CES-D）评估抑郁症状。使用曲线数据的多变量潜过程混合模型研究CP与12年CES-D病程（3年就诊后的12年）之间的关系。结果：与无CP的受试者相比，中度和重度CP的受试者在基线时的CES-D水平显著较高，且与疼痛强度呈剂量-反应关系（β = 0.366, p = 0.0308; 0.607, p）。结论：CP强度与长期随访中持续较高水平的抑郁症状相关。这一发现加强了早期治疗老年CP的重要性，以防止其持续的心理后果。意义声明：抑郁症和慢性疼痛（CP）经常与老年人相关。在这一人群中，CP特征与抑郁症状的长期病程之间的纵向关系尚未明确。目前的结果表明，CP强度与持续15年随访期间的高水平抑郁症状相关，并呈剂量-反应关系。这一发现强化了老年人群早期治疗CP的重要性，以防止其持久的心理后果。
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引用次数: 0
Societal Cost Analysis of Spinal Cord Stimulation in Chronic Pain Patients: A Danish Register-Based Study With 3 Years Follow-Up 慢性疼痛患者脊髓刺激的社会成本分析：一项丹麦基于登记的3年随访研究。
IF 3.4 2区 医学 Q1 ANESTHESIOLOGY
European Journal of Pain
Pub Date : 2025-11-02 DOI: 10.1002/ejp.70160
Kaare Meier, Bettina Wulff Risør, Dennis Møgeltoft Poulsen, Jens Christian Hedemann Sørensen, Nasrin Tayyari

Background

Spinal cord stimulation (SCS) constitutes a treatment option for patients with severe chronic pain responding insufficiently to pharmacological treatment. High device costs and expenses associated with surgical procedures and follow-up constitute a barrier to adoption. However, CNP patients also constitute a significant burden on public finances, with high public costs relating to health care utilisation, medicine, and lost work capacity.

Methods

We investigated the costs of SCS therapy from a healthcare perspective (primary and secondary healthcare and medicine costs) 3 years before and 3 years after initiation of the SCS therapy in a large, mixed, well-characterised patient cohort derived from a dedicated neuromodulation registry, including patients with different diagnoses and characteristics from three of the four Danish SCS centers. We additionally compared costs of productivity loss for patients under the age of retirement. Data on societal costs were retrieved from public Danish registries.

Results

Three hundred and eight-four patients were included. Total healthcare costs 3 years after SCS were significantly higher than 3 years before SCS, with an increase of €29,835. The expenses associated with establishing SCS therapy are reflected in a sharp increase in in-patient secondary health care cost in year one after SCS. Primary health care, secondary out-patient health care and medicine costs all decrease after SCS but not enough to compensate for the cost of establishing treatment. Costs due to productivity loss remain stable throughout the period.

Conclusions

Our findings highlight evaluating high-cost interventions within a broader cost framework to inform more efficient resource allocation in chronic pain management.

Significance

This study analyzes the real-world socioeconomic impact of spinal cord stimulation (SCS) in Denmark. By using data from public Danish registries, we find a sharp increase in in-hospital expenses at the year of implantation, only partially offset by a subsequent reduction in other health care expenses and medicine costs. These findings give unique insights into the financial aspects of SCS, offering a perspective for healthcare providers, policymakers, and patients when evaluating the long-term budgetary implications of this treatment.

背景：脊髓刺激（SCS）是严重慢性疼痛患者对药物治疗反应不足的一种治疗选择。高昂的设备成本和与外科手术和随访相关的费用构成了采用的障碍。然而，非裔美国人患者也构成了公共财政的重大负担，与保健利用、药品和丧失工作能力有关的公共费用很高。方法：我们从医疗保健角度（初级和二级医疗保健和医药费用）调查了SCS治疗开始前3年和开始后3年的费用（初级和二级医疗保健和医药费用），研究对象是来自专门的神经调节登记处的大型、混合、特征明确的患者队列，包括来自丹麦四个SCS中心中的三个中心的不同诊断和特征的患者。我们还比较了退休年龄以下患者生产力损失的成本。社会成本数据从丹麦公共登记处检索。结果：共纳入384例患者。SCS后3年的总医疗费用显著高于SCS前3年，增加了29,835欧元。与建立SCS治疗相关的费用反映在SCS治疗后第一年住院患者二级卫生保健费用的急剧增加。初级卫生保健、二级门诊卫生保健和药品费用在SCS后都有所下降，但不足以弥补建立治疗的费用。由于生产力损失造成的成本在整个期间保持稳定。结论：我们的研究结果强调了在更广泛的成本框架内评估高成本干预措施，以告知慢性疼痛管理中更有效的资源分配。意义：本研究分析了丹麦脊髓刺激（SCS）对现实世界的社会经济影响。通过使用丹麦公共登记处的数据，我们发现在植入那年住院费用急剧增加，仅部分被随后其他医疗保健费用和药品费用的减少所抵消。这些发现为SCS的财务方面提供了独特的见解，为医疗保健提供者、政策制定者和患者评估这种治疗的长期预算影响提供了一个视角。
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引用次数: 0
Posters in Viewing Sessions 海报展映环节
IF 3.4 2区 医学 Q1 ANESTHESIOLOGY
European Journal of Pain
Pub Date : 2025-11-02 DOI: 10.1002/ejp.70133
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引用次数: 0
Guided Poster Walks 导赏海报漫步
IF 3.4 2区 医学 Q1 ANESTHESIOLOGY
European Journal of Pain
Pub Date : 2025-11-02 DOI: 10.1002/ejp.70131
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引用次数: 0
Oral Abstract Presentations 口头摘要报告
IF 3.4 2区 医学 Q1 ANESTHESIOLOGY
European Journal of Pain
Pub Date : 2025-11-02 DOI: 10.1002/ejp.70130
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引用次数: 0
An Exploratory Study for Proteomic-Based Markers of Joint Pain and Chronic Back Pain 基于蛋白质组学的关节疼痛和慢性背痛标志物的探索性研究
IF 3.4 2区 医学 Q1 ANESTHESIOLOGY
European Journal of Pain
Pub Date : 2025-10-31 DOI: 10.1002/ejp.70158
Tessa Schillemans, Ann-Sofie Rönnegård, Themistocles L. Assimes, Magnus Peterson, Per Wändell, Lars Lind, Johan Ärnlöv

Background

Joint pain and chronic back pain are highly prevalent in the aging population and have a large impact on life quality. As the underlying mechanisms are not fully understood, this exploratory cross-sectional study aimed to discover proteins and pathways associated with these two pain conditions in Swedish 70-year-old men.

Methods

Plasma proteins (n = 720) were measured in participants from the Uppsala Longitudinal Study of Adult Men (ULSAM; n = 931) using Olink target panels. Participants self-reported current joint pain or continuous back pain during the past year. We used logistic regression with multiple testing adjustments and RIDGE regression (selecting ~10% highest-ranking proteins) to identify proteins associated with either joint or chronic back pain, which were then investigated for clusters and pathway enrichments.

Results

Out of 931 subjects with protein data, 131 reported joint pain and 31 reported chronic back pain. We identified 19 (significant after multiple testing adjustment) and 25 (nominally significant) highest-ranking proteins associated with joint and chronic back pain, respectively. Enriched pathways included immune responses, inflammation, lipid, coagulation and rheumatoid arthritis pathways. Similar pathways were found for both joint and chronic back pain, even though only two proteins were associated with both these pain conditions.

Conclusions

This exploratory proteomics study provides support for systemic inflammation as a common underlying mechanism for joint and chronic back pain. Although similar pathways were found for both pain conditions, the selected proteins differed. Nevertheless, caution is advised due to low sample size and validation in larger studies including both women and men is needed.

Significance Statement

Logistic and RIDGE regression analyses indicated that joint pain and chronic back pain were associated with different proteins, which were enriched for similar inflammatory pathways.

背景关节痛和慢性背痛在老年人群中非常普遍，对生活质量有很大影响。由于潜在的机制尚不完全清楚，这项探索性横断面研究旨在发现与瑞典70岁男性这两种疼痛状况相关的蛋白质和途径。方法使用Olink靶板对乌普萨拉成年男性纵向研究（ULSAM; n = 931）参与者的血浆蛋白（n = 720）进行测量。参与者在过去一年中自我报告当前的关节疼痛或持续的背部疼痛。我们使用多重测试调整的逻辑回归和RIDGE回归（选择~10%的最高排名的蛋白质）来确定与关节或慢性背痛相关的蛋白质，然后研究这些蛋白质的簇和通路富集。结果在931名有蛋白质数据的受试者中，131名报告关节疼痛，31名报告慢性背痛。我们分别确定了19个（在多次测试调整后显著）和25个（名义上显著）与关节和慢性背痛相关的最高级蛋白。富集的途径包括免疫反应、炎症、脂质、凝血和类风湿性关节炎途径。在关节痛和慢性背痛中发现了类似的途径，尽管只有两种蛋白质与这两种疼痛有关。这项探索性蛋白质组学研究为全身性炎症作为关节和慢性背痛的共同潜在机制提供了支持。虽然在两种疼痛条件下发现了相似的途径，但选择的蛋白质不同。然而，由于样本量小，需要在包括女性和男性的大型研究中进行验证，因此建议谨慎。Logistic和RIDGE回归分析表明，关节痛和慢性背痛与不同的蛋白质相关，这些蛋白质富集于相似的炎症途径。
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引用次数: 0
Targeting Upregulation of Neuronal IGF1/IGF1R Signalling in the Spinal Cord Prevents Cisplatin-Induced Peripheral Neuropathy in Mice 脊髓IGF1/IGF1R信号的靶向上调可预防小鼠顺铂诱导的周围神经病变
IF 3.4 2区 医学 Q1 ANESTHESIOLOGY
European Journal of Pain
Pub Date : 2025-10-31 DOI: 10.1002/ejp.70161
Chieh-Ru Fu, Jia-Hao Chen, Ya-Chen Yang, Hui Chen, Ruo-Fan Zhang, Yu-Xia Chu, Yan-Qing Wang, Qi-Liang Mao-Ying

Background

Chemotherapy-induced peripheral neuropathy (CIPN), characterised by a stocking-glove distribution of numbness and pain, is a severe clinical challenge. Our previous study showed that overexpression of neuronal G protein-coupled receptor kinase (GRK2) in the spinal dorsal horn (SDH) prevented cisplatin-induced CIPN in mice. The underlying mechanism, however, remains unclear. This study aimed to explore the role of insulin-like growth factor 1 (IGF1) in preventing CIPN through neuronal GRK2 in the SDH of mice.

Methods

CIPN model was established by intraperitoneally injecting cisplatin (23 mg/kg) in mice. Neuronal IGF1R or GRK2 in SDH was downregulated by intraspinally injecting an AAV vector delivering IGF1R or GRK2 shRNA with hSyn promoter. Mechanical allodynia and sensory deficits were assessed by von Frey test and adhesive removal test. The expression of IGF1, IGF1R and Iba1 was assessed by immunostaining. Neuroinflammation was assessed by real-time PCR. The IGF1R and GRK2 levels were assessed by Western blot.

Results

Cisplatin chemotherapy induced a decrease of IGF1 and p-IGF1R in SDH; intrathecal (i.t) injection of recombinant IGF1 (rIGF1) significantly prevented cisplatin-induced mechanical allodynia, sensory deficit, and microglia activation and neuroinflammation in SDH. IGF1R was primarily localised within neurons (~81%). Downregulation of neuronal IGF1R (AAV-shIGF1R) inhibited the preventive effect of i.t. rIGF1 on CIPN, and on the upregulation of GRK2 in SDH. Furthermore, downregulation of neuronal GRK2 in SDH inhibited the preventive effect of i.t. rIGF1 on CIPN.

Conclusions

I.t. injection of rIGF1 regulates neuronal GRK2 through neuronal IGF1R in SDH, alleviates microglial activation and neuroinflammation, thereby preventing cisplatin-induced CIPN.

Significance Statement

This work elucidates the role of neuronal IGF1/IGF1R in the process of CIPN prevention and provides new animal-based evidence for CIPN prevention by targeting neuronal IGF1/IGF1R in SDH.

化疗引起的周围神经病变（CIPN）的特征是麻木和疼痛的长袜手套分布，是一个严重的临床挑战。我们之前的研究表明，脊髓背角（SDH）中神经元G蛋白偶联受体激酶（GRK2）的过表达可阻止顺铂诱导的小鼠CIPN。然而，其潜在机制尚不清楚。本研究旨在探讨胰岛素样生长因子1 （IGF1）在小鼠SDH中通过神经元GRK2预防CIPN的作用。方法采用顺铂23 mg/kg腹腔注射法建立小鼠CIPN模型。通过棘内注射携带hSyn启动子的IGF1R或GRK2 shRNA的AAV载体，可下调SDH神经元IGF1R或GRK2。采用von Frey试验和黏合剂去除试验评估机械异常性痛和感觉缺陷。免疫染色法检测IGF1、IGF1R和Iba1的表达。实时荧光定量PCR检测神经炎症。Western blot检测IGF1R和GRK2水平。结果顺铂化疗导致SDH中IGF1和p-IGF1R水平降低；鞘内注射重组IGF1 （rIGF1）可显著预防顺铂诱导的SDH机械性异常痛、感觉缺陷、小胶质细胞激活和神经炎症。IGF1R主要定位于神经元内（约81%）。神经元IGF1R （AAV-shIGF1R）的下调抑制了i.t rIGF1对CIPN的预防作用，抑制了SDH中GRK2的上调。此外，SDH中神经元GRK2的下调抑制了i.t rIGF1对CIPN的预防作用。结论静脉注射rIGF1通过SDH中神经元IGF1R调节神经元GRK2，减轻小胶质细胞活化和神经炎症，从而预防顺铂诱导的CIPN。本工作阐明了神经元IGF1/IGF1R在CIPN预防过程中的作用，并为SDH中靶向神经元IGF1/IGF1R预防CIPN提供了新的动物证据。
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引用次数: 0
Recommendations for the Neurophysiological Assessment of Conditioned Pain Modulation: A Systematic Review of Nociceptive Blink Reflex and Nociceptive Withdrawal Reflex Protocols 条件疼痛调节的神经生理评估建议：对伤害性眨眼反射和伤害性戒断反射方案的系统回顾。
IF 3.4 2区 医学 Q1 ANESTHESIOLOGY
European Journal of Pain
Pub Date : 2025-10-27 DOI: 10.1002/ejp.70149
Josh Murphy, Sophie Clarke, Paul Strutton, Celia Morgan, Kirsty Bannister, Sam W. Hughes

Background and Objective

The nociceptive blink reflex (NBR) and nociceptive withdrawal reflex (NWR) are increasingly used as neurophysiological test stimuli to assess conditioned pain modulation (CPM). However, methodological inconsistencies limit reproducibility and cross-study comparison. This systematic review aimed to evaluate experimental protocols and outcome measures used in CPM studies employing NBR or NWR, and to propose recommendations for standardisation.

Databases and Data Treatment

Following PRISMA guidelines, a systematic search of PubMed, Cochrane and Ovid databases was conducted. Studies were included if they assessed CPM in healthy adults using NBR or NWR. Data were extracted on stimulation parameters, electrode configuration, participant positioning, data acquisition, signal processing and CPM protocols. Sixteen studies met inclusion criteria (6 NBR, 10 NWR).

Results

Across studies, stimulation protocols varied in frequency, pulse duration and threshold calibration. Electrode placements and participant positioning were often inconsistently reported. Data acquisition methods differed in sampling rates and filtering, and analysis windows were not always defined. CPM protocols included cold pressor, heat and electrocutaneous stimulation. Outcome measures included both amplitude- and threshold-based metrics.

Conclusions

This review highlights significant methodological heterogeneity in reflex-based CPM research in healthy participants. Standardisation of stimulation parameters, recording techniques, and CPM protocols is needed to enhance comparability and reproducibility across studies. To address this, we provide structured recommendations, based on GRADE classifications, for standardising protocols related to experimental setup, data acquisition and CPM outcome measures for both the NBR and NWR.

Significance Statement

Reflex-based conditioned pain modulation demonstrates methodological inconsistencies, highlighting the need for standardised protocols. With standardised protocols recommended in this review, future efforts should focus on enhancing its reliability, reproducibility and clinical applicability.

背景与目的：伤害性眨眼反射（NBR）和伤害性戒断反射（NWR）越来越多地被用作评估条件疼痛调节（CPM）的神经生理测试刺激。然而，方法上的不一致性限制了可重复性和交叉研究比较。本系统综述旨在评估采用NBR或NWR的CPM研究中使用的实验方案和结果测量，并提出标准化建议。数据库和数据处理：遵循PRISMA指南，系统检索PubMed、Cochrane和Ovid数据库。纳入使用NBR或NWR评估健康成人CPM的研究。提取刺激参数、电极配置、参与者定位、数据采集、信号处理和CPM协议的数据。16项研究符合纳入标准（6项NBR， 10项NWR）。结果：在研究中，刺激方案在频率、脉冲持续时间和阈值校准方面有所不同。电极放置和参与者的位置经常不一致的报道。数据采集方法在采样率和滤波方面存在差异，分析窗口并不总是定义。CPM方案包括冷压、热和皮肤电刺激。结果测量包括基于幅度和阈值的指标。结论：本综述强调了在健康受试者中基于反射的CPM研究的显著方法学异质性。需要标准化增产参数、记录技术和CPM方案，以增强研究之间的可比性和可重复性。为了解决这个问题，我们根据GRADE分类提供了结构化的建议，以标准化与NBR和NWR的实验设置、数据采集和CPM结果测量相关的协议。意义声明：基于反射的条件疼痛调节证明了方法上的不一致性，强调了标准化方案的必要性。随着本综述推荐的标准化方案，未来的工作应侧重于提高其可靠性、可重复性和临床适用性。
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引用次数: 0
Modulation of Spinal Nociceptive Excitability by Nociceptive-Visual Interaction 损伤-视觉交互作用对脊髓损伤性兴奋性的调节。
IF 3.4 2区 医学 Q1 ANESTHESIOLOGY
European Journal of Pain
Pub Date : 2025-10-22 DOI: 10.1002/ejp.70153
Lieve Filbrich, Ole Kæseler Andersen, Ken Steffen Frahm
<div> <section> <h3> Background</h3> <p>The existence of multisensory interactions between nociception and vision has recently been highlighted by showing that near visual stimuli can influence nociceptive perception. However, although such interactions have been hypothesized to serve a motor function, their effects on nociception-related motor responses have not been empirically demonstrated. The present study tested whether spinal nociceptive excitability, measured with the nociceptive withdrawal reflex (NWR), can be modulated by the presence of dynamic visual stimuli, and whether this would be specifically the case for visual stimuli presented near the stimulated lower limb.</p> </section> <section> <h3> Methods</h3> <p>NWRs were elicited by applying transcutaneous electrical stimuli at the sole of the foot of healthy participants (<i>N</i> = 21). The electrical stimulus was either preceded by a visual stimulus rapidly approaching a location near the stimulated foot, a visual stimulus approaching a location further away from the foot, or applied without any visual stimulus (baseline). Measures of interest were NWR amplitude, latency, and perceived intensity of the electrical stimuli.</p> </section> <section> <h3> Results</h3> <p>Results show that NWR amplitude was significantly increased (change from baseline ~30%) by the presence of a visual stimulus (<i>p</i> = 0.013, <span></span><math> <semantics> <mrow> <msubsup> <mi>η</mi> <mi>p</mi> <mn>2</mn> </msubsup> <mo>=</mo> <mn>0.196</mn> </mrow> <annotation>$$ {eta}_{mathrm{p}}^2=0.196 $$</annotation> </semantics></math>), but no significant difference between near and far visual stimuli. There were furthermore no significant effects on latency and perceived intensity.</p> </section> <section> <h3> Conclusions</h3> <p>This suggests that spinal nociceptive excitability can be modulated by the presence of external visual stimuli that have no explicit emotional or task-related valence. Whether the proximity of the visual stimuli might play a role in such interactions needs to be further investigated.</p> </section> <section> <h3> Significance Statement</h3> <p>Multisensory interactions between vision and nociception have been shown to affect nociceptive perception, but whether such interactions can also shape nociception-related mo
背景：最近有研究表明，近视觉刺激可以影响伤害知觉，从而强调了伤害感觉和视觉之间存在多感觉相互作用。然而，尽管这种相互作用被假设为一种运动功能，但它们对伤害感觉相关运动反应的影响尚未得到实证证明。本研究测试了脊髓伤害性兴奋性（用伤害性戒断反射（NWR）测量）是否可以被动态视觉刺激调节，以及这种情况是否特别适用于在受刺激的下肢附近呈现的视觉刺激。方法：采用经皮电刺激健康人（N = 21）的脚底诱发nwr。在电刺激之前，视觉刺激迅速接近受刺激足附近的一个位置，视觉刺激接近远离足的一个位置，或者没有任何视觉刺激（基线）。感兴趣的测量是NWR振幅、潜伏期和电刺激的感知强度。结果：与基线相比，NWR幅值明显增加(变化幅度为30%) by the presence of a visual stimulus (p = 0.013, η p 2 = 0.196 $$ {eta}_{mathrm{p}}^2=0.196 $$ ), but no significant difference between near and far visual stimuli. There were furthermore no significant effects on latency and perceived intensity.Conclusions: This suggests that spinal nociceptive excitability can be modulated by the presence of external visual stimuli that have no explicit emotional or task-related valence. Whether the proximity of the visual stimuli might play a role in such interactions needs to be further investigated.Significance statement: Multisensory interactions between vision and nociception have been shown to affect nociceptive perception, but whether such interactions can also shape nociception-related motor processes is currently unknown. We investigated the potential influence of dynamic visual stimulation on the NWR in healthy participants. Results show that the presence of dynamic visual stimuli without any explicit task-related attentional or emotional valence can modulate the amplitude of the NWR without affecting the perceived intensity of the electrical stimulus eliciting the reflex.
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