Pub Date : 2024-06-19DOI: 10.1101/2024.06.18.24309141
Eva Herrmann, Magnus Schindehuette, Gudrun Kindl, Ann-Kristin Reinhold, Felix Aulbach, Norman Rose, Johannes Dreiling, Daniel Schwarzkopf, Michael Meir, Yujing Jin, Karolin Teichmueller, Anna Widder, Robert Blum, Abdelrahman Sawalma, Nadine Cebulla, Michael Sendtner, Winfried Meissner, Alexander Brack, Mirko Pham, Claudia Sommer, Nicolas Schlegel, Heike L Rittner
Background: Chronic postsurgical inguinal pain (CPIP) is the most common complication of groin hernia surgery. The characteristics of patients, their medical care, and choice of the best diagnostic tools remain to be defined to optimize preventive and therapeutic interventions. Methods: Claims data from 2018 and a 1-year follow-up were analysed and deep phenotyping including sensory testing, blood and skin biopsies, MRI imaging of the dorsal root ganglion (DRG), and patient-reported outcomes were used to define normative values, as well as incidence, medical care, and pathophysiological factors. Results: 11,221 patients with hernia surgery in 2018 were identified; 8.5% had pain before which was relieved by surgery, but a similar percentage had novel groin pain. Deep phenotyping of 141 healthy controls provided a map of the inguinal sensory system. CPIP patients suffered from moderate pain with neuropathic features, individual sensory abnormalities, and unilateral L1 DRG atrophy. In the blood, C-C-motif chemokine ligand (CCL2) and brain-derived neurotrophic factor (BDNF) were upregulated while apolipoprotein A1 (ApoA1) was reduced. A cluster of DRG atrophy, BDNF, ApoA1 and anxiety correlated best with the diagnosis. CPIP patients with novel pain had significantly more DRG atrophy (-22% ipsi vs. contra). Conclusion: CPIP is relevant and often newly acquired after surgery. A combination of DRG imaging, serum markers, and anxiety screening can support the diagnosis. Using this core set of markers could guide surgeons towards more personalized therapies and possible preventive intraoperative techniques. Trial registration: German Trial Registry DRKS00024588 and DRKS00016790
{"title":"Dorsal root ganglia atrophy and serum biomarkers supporting the diagnosis of chronic postsurgical inguinal pain","authors":"Eva Herrmann, Magnus Schindehuette, Gudrun Kindl, Ann-Kristin Reinhold, Felix Aulbach, Norman Rose, Johannes Dreiling, Daniel Schwarzkopf, Michael Meir, Yujing Jin, Karolin Teichmueller, Anna Widder, Robert Blum, Abdelrahman Sawalma, Nadine Cebulla, Michael Sendtner, Winfried Meissner, Alexander Brack, Mirko Pham, Claudia Sommer, Nicolas Schlegel, Heike L Rittner","doi":"10.1101/2024.06.18.24309141","DOIUrl":"https://doi.org/10.1101/2024.06.18.24309141","url":null,"abstract":"Background: Chronic postsurgical inguinal pain (CPIP) is the most common complication of groin hernia surgery. The characteristics of patients, their medical care, and choice of the best diagnostic tools remain to be defined to optimize preventive and therapeutic interventions. Methods: Claims data from 2018 and a 1-year follow-up were analysed and deep phenotyping including sensory testing, blood and skin biopsies, MRI imaging of the dorsal root ganglion (DRG), and patient-reported outcomes were used to define normative values, as well as incidence, medical care, and pathophysiological factors. Results: 11,221 patients with hernia surgery in 2018 were identified; 8.5% had pain before which was relieved by surgery, but a similar percentage had novel groin pain. Deep phenotyping of 141 healthy controls provided a map of the inguinal sensory system. CPIP patients suffered from moderate pain with neuropathic features, individual sensory abnormalities, and unilateral L1 DRG atrophy. In the blood, C-C-motif chemokine ligand (CCL2) and brain-derived neurotrophic factor (BDNF) were upregulated while apolipoprotein A1 (ApoA1) was reduced. A cluster of DRG atrophy, BDNF, ApoA1 and anxiety correlated best with the diagnosis. CPIP patients with novel pain had significantly more DRG atrophy (-22% ipsi vs. contra). Conclusion: CPIP is relevant and often newly acquired after surgery. A combination of DRG imaging, serum markers, and anxiety screening can support the diagnosis. Using this core set of markers could guide surgeons towards more personalized therapies and possible preventive intraoperative techniques.\u0000Trial registration: German Trial Registry DRKS00024588 and DRKS00016790","PeriodicalId":501393,"journal":{"name":"medRxiv - Pain Medicine","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141502890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-09DOI: 10.1101/2024.05.09.24307012
Yann Quidé, Negin Hesam-Shariati, Nell Norman-Nott, James H. McAuley, Sylvia M. Gustin
Background Posttraumatic stress symptoms (PTSS) are commonly experienced by people with chronic pain. Although PTSS and chronic pain are associated with similar effects on brain morphology, the present study aimed to clarify the relationship between chronic pain and PTSS on the brain.
{"title":"Posttraumatic stress symptoms in chronic pain: impacts on brain morphology","authors":"Yann Quidé, Negin Hesam-Shariati, Nell Norman-Nott, James H. McAuley, Sylvia M. Gustin","doi":"10.1101/2024.05.09.24307012","DOIUrl":"https://doi.org/10.1101/2024.05.09.24307012","url":null,"abstract":"<strong>Background</strong> Posttraumatic stress symptoms (PTSS) are commonly experienced by people with chronic pain. Although PTSS and chronic pain are associated with similar effects on brain morphology, the present study aimed to clarify the relationship between chronic pain and PTSS on the brain.","PeriodicalId":501393,"journal":{"name":"medRxiv - Pain Medicine","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140930366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-03DOI: 10.1101/2024.05.01.24306684
Ryosuke Ono, Ken Horibata
Objectives To investigate whether CT signs of the xiphoid process, such as xiphisternal angle and evidence of soft tissue compression, are useful for diagnosing xiphodynia.
目的 探讨剑突的 CT 征象，如剑突角和软组织压迫的证据，是否有助于诊断剑突症。
{"title":"A case-control study evaluating CT signs of xiphoid process associated with xiphodynia","authors":"Ryosuke Ono, Ken Horibata","doi":"10.1101/2024.05.01.24306684","DOIUrl":"https://doi.org/10.1101/2024.05.01.24306684","url":null,"abstract":"<strong>Objectives</strong> To investigate whether CT signs of the xiphoid process, such as xiphisternal angle and evidence of soft tissue compression, are useful for diagnosing xiphodynia.","PeriodicalId":501393,"journal":{"name":"medRxiv - Pain Medicine","volume":"96 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140930110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-02DOI: 10.1101/2024.05.02.24306119
Shreya Mandloi, Christian V Tran, Sara Thalheimer, Samantha Jaffe, Leonard Braitman, Kevin Hines, Ashwini Sharan, Chengyuan Wu
Objective To create a questionnaire that can identify patients who will respond well to high-frequency spinal cord stimulation.
目标 制作一份调查问卷，以确定对高频脊髓刺激反应良好的患者。
{"title":"Longitudinal Study to Better Understand Neuropathic Back Pain as a Means of Improving Patient Selection for 10 kHz Spinal Cord Stimulation","authors":"Shreya Mandloi, Christian V Tran, Sara Thalheimer, Samantha Jaffe, Leonard Braitman, Kevin Hines, Ashwini Sharan, Chengyuan Wu","doi":"10.1101/2024.05.02.24306119","DOIUrl":"https://doi.org/10.1101/2024.05.02.24306119","url":null,"abstract":"<strong>Objective</strong> To create a questionnaire that can identify patients who will respond well to high-frequency spinal cord stimulation.","PeriodicalId":501393,"journal":{"name":"medRxiv - Pain Medicine","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140887733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-29DOI: 10.1101/2024.04.26.24306460
Laura S. Gold, Patrick J. Heagerty, Ryan N. Hansen, Janna L. Friedly, Sandra K. Johnston, Richard A. Deyo, Michele Curatolo, Judith A. Turner, Sean D. Rundell, Katherine Wysham, Jeffrey G. Jarvik, Pradeep Suri
Importance Given the negative impact of opioid use on population health, prescriptions for alternative pain-relieving medications, including gabapentin, have increased. Concurrent gabapentin and opioid prescriptions are commonly reported in retrospective studies of opioid-related overdose deaths.
{"title":"Mortality with concurrent treatment with gabapentin and opioids among people with spine diagnoses in the U.S. Medicare population: a propensity-matched cohort study","authors":"Laura S. Gold, Patrick J. Heagerty, Ryan N. Hansen, Janna L. Friedly, Sandra K. Johnston, Richard A. Deyo, Michele Curatolo, Judith A. Turner, Sean D. Rundell, Katherine Wysham, Jeffrey G. Jarvik, Pradeep Suri","doi":"10.1101/2024.04.26.24306460","DOIUrl":"https://doi.org/10.1101/2024.04.26.24306460","url":null,"abstract":"<strong>Importance</strong> Given the negative impact of opioid use on population health, prescriptions for alternative pain-relieving medications, including gabapentin, have increased. Concurrent gabapentin and opioid prescriptions are commonly reported in retrospective studies of opioid-related overdose deaths.","PeriodicalId":501393,"journal":{"name":"medRxiv - Pain Medicine","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140840153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-24DOI: 10.1101/2024.04.24.24306176
Enrico De Martino, Adenauer Girardi Casali, Bruno Andry Nascimento Couto, Thomas Graven-Nielsen, Daniel Ciampi de Andrade
Background High-frequency (10 Hz) repetitive transcranial magnetic stimulation (rTMS) to the primary motor cortex (M1) is used to treat several neuropsychiatric disorders, but its main mechanism of action remains unclear.
{"title":"Repetitive transcranial magnetic stimulation to the motor cortex leads to a sequential increase in phase synchronization and power of TMS-evoked electroencephalographic recordings","authors":"Enrico De Martino, Adenauer Girardi Casali, Bruno Andry Nascimento Couto, Thomas Graven-Nielsen, Daniel Ciampi de Andrade","doi":"10.1101/2024.04.24.24306176","DOIUrl":"https://doi.org/10.1101/2024.04.24.24306176","url":null,"abstract":"<strong>Background</strong> High-frequency (10 Hz) repetitive transcranial magnetic stimulation (rTMS) to the primary motor cortex (M1) is used to treat several neuropsychiatric disorders, but its main mechanism of action remains unclear.","PeriodicalId":501393,"journal":{"name":"medRxiv - Pain Medicine","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140802192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives The overall experience of cancer pain reflects patients’ needs and concerns. Therefore, a thorough understanding of the patient’s needs and concerns is crucial to implementing satisfactory pain outcomes. This study aims to explore the needs and concerns of patients with cancer pain in Sri Lanka.
{"title":"“Mitigating Cancer Pain: What else Matters?”—A Qualitative Study into the Needs and Concerns of Cancer Patients in Sri Lanka","authors":"NP Edirisinghe, PTR Makuloluwa, AATD Amarasekara, CSE Goonewardena","doi":"10.1101/2024.04.10.24305649","DOIUrl":"https://doi.org/10.1101/2024.04.10.24305649","url":null,"abstract":"<strong>Objectives</strong> The overall experience of cancer pain reflects patients’ needs and concerns. Therefore, a thorough understanding of the patient’s needs and concerns is crucial to implementing satisfactory pain outcomes. This study aims to explore the needs and concerns of patients with cancer pain in Sri Lanka.","PeriodicalId":501393,"journal":{"name":"medRxiv - Pain Medicine","volume":"221 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140617729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Automatic analysis of endoscopic images will played an important role in the future spine robotic surgery. The study is designed as a translational study to develop AI models of semantic segmentation for spinal endoscopic instruments and anatomic structures. The aim is to provide the visual understanding basis of endoscopic images for future intelligent robotic surgery.
{"title":"Protocol for semantic segmentation of spinal endoscopic instruments and anatomic structures : how far is robotic endoscopy surgery?","authors":"Guoxin Fan, Guanghui Yue, Zhouyang Hu, Zhipeng Xu, Jianjin Zhang, Hong Wang, Xiang Liao","doi":"10.1101/2024.04.14.24305785","DOIUrl":"https://doi.org/10.1101/2024.04.14.24305785","url":null,"abstract":"<strong>Background</strong> Automatic analysis of endoscopic images will played an important role in the future spine robotic surgery. The study is designed as a translational study to develop AI models of semantic segmentation for spinal endoscopic instruments and anatomic structures. The aim is to provide the visual understanding basis of endoscopic images for future intelligent robotic surgery.","PeriodicalId":501393,"journal":{"name":"medRxiv - Pain Medicine","volume":"96 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140612810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-12DOI: 10.1101/2024.04.09.24305574
Trisha F. Hue, Jeffrey C. Lotz, Patricia Zheng, Dennis M. Black, Jeannie Bailey, Susan K. Ewing, Aaron J. Fields, Wolf Mehling, Aaron Scheffler, Irina Strigo, Thomas Petterson, Lucy A. Wu, Conor O’Neill, The UCSF REACH Center, the CoRe CEnter for PAtient-Centric Mechanistic PHenotyping in Chronic Low Back Pain
Objective The University of California, San Francisco (UCSF) Core Center for Patient-centric, Mechanistic Phenotyping in Chronic Low Back Pain (REACH) is one of the three NIH Back Pain Consortium (BACPAC) Research Programs Mechanistic Research Centers (MRCs). The goal of UCSF REACH is to define cLBP phenotypes and pain mechanisms that can lead to effective, personalized treatments for patients across the population. The primary objective of this research project is to address the critical need for new diagnostic and prognostic markers, and associated patient classification protocols for chronic low back pain (cLBP) treatment.
{"title":"Design of the COMEBACK and BACKHOME Studies, Longitudinal Cohorts for Comprehensive Deep Phenotyping of Adults with Chronic Low-Back Pain (cLBP): a part of the BACPAC Research Program","authors":"Trisha F. Hue, Jeffrey C. Lotz, Patricia Zheng, Dennis M. Black, Jeannie Bailey, Susan K. Ewing, Aaron J. Fields, Wolf Mehling, Aaron Scheffler, Irina Strigo, Thomas Petterson, Lucy A. Wu, Conor O’Neill, The UCSF REACH Center, the CoRe CEnter for PAtient-Centric Mechanistic PHenotyping in Chronic Low Back Pain","doi":"10.1101/2024.04.09.24305574","DOIUrl":"https://doi.org/10.1101/2024.04.09.24305574","url":null,"abstract":"<strong>Objective</strong> The University of California, San Francisco (UCSF) Core Center for Patient-centric, Mechanistic Phenotyping in Chronic Low Back Pain (REACH) is one of the three NIH Back Pain Consortium (BACPAC) Research Programs Mechanistic Research Centers (MRCs). The goal of UCSF REACH is to define cLBP phenotypes and pain mechanisms that can lead to effective, personalized treatments for patients across the population. The primary objective of this research project is to address the critical need for new diagnostic and prognostic markers, and associated patient classification protocols for chronic low back pain (cLBP) treatment.","PeriodicalId":501393,"journal":{"name":"medRxiv - Pain Medicine","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140590460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-28DOI: 10.1101/2024.03.27.24304974
Vidya Chidambaran, Qing Duan, Valentina Pilipenko, Susan Glynn, Alyssa Sproles, Lisa J Martin, Michael Lacagnina, Christopher D King, Lili Ding
Study Objective: To determine if baseline cytokines and their changes over postoperative days 0-2 (POD0-2) predict acute and chronic postsurgical pain (CPSP) after major surgery. Design: Prospective, observational, longitudinal nested study. Setting: University-affiliated quaternary childrens hospital. Patients: Subjects (≥8 years old) with idiopathic scoliosis undergoing spine fusion or pectus excavatum undergoing Nuss procedure. Measurements: Demographics, surgical, psychosocial measures, pain scores, and opioid use over POD0-2 were collected. Cytokine concentrations were analyzed in serial blood samples collected before and after (up to two weeks) surgery, using Luminex bead arrays. After data preparation, relationships between pre- and post-surgical cytokine concentrations with acute (% time in moderate-severe pain over POD0-2) and chronic (pain score>3/10 beyond 3 months post-surgery) pain were analyzed. After adjusting for covariates, univariate/multivariate regression analyses were conducted to associate baseline cytokine concentrations with postoperative pain, and mixed effects models were used to associate longitudinal cytokine concentrations with pain outcomes. Main Results: Analyses included 3,164 measures of 16 cytokines from 112 subjects (median age 15.3, IQR 13.5-17.0, 54.5% female, 59.8% pectus). Acute postsurgical pain was associated with higher baseline concentrations of GM-CSF (β=0.95, SE 0.31; p=.003), IL-1β (β=0.84, SE 0.36; p=.02), IL-2 (β=0.78, SE 0.34; p=.03), and IL-12 p70 (β=0.88, SE 0.40; p=.03) and longitudinal postoperative elevations in GM-CSF (β=1.38, SE 0.57; p=.03), IFNγ (β=1.36, SE 0.6; p=.03), IL-1β(β=1.25, SE 0.59; p=.03), IL-7 (β=1.65, SE 0.7, p=.02), and IL-12 p70 (β=1.17, SE 0.58; p=.04). In contrast, CPSP was associated with lower baseline concentration of IL-8 (β= -0.39, SE 0.17; p=.02), and the risk of developing CPSP was elevated in patients with lower longitudinal postoperative concentrations of IL-6 (β= -0.57, SE 0.26; p=.03), IL-8 (β= -0.68, SE 0.24; p=.006), and IL-13 (β= -0.48, SE 0.22; p=.03). Furthermore, higher odds for CPSP were found for females (vs. males) for IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, and TNFα ; and for pectus (vs. spine) surgery for IL-8 and IL-10. Conclusion: We identified pro-inflammatory cytokines associated with increased acute postoperative pain and anti-inflammatory cytokines associated with lower CPSP risk, with the potential to serve as predictive and prognostic biomarkers.
{"title":"The Role of Cytokines in Acute and Chronic Postsurgical Pain in Pediatric Patients after Major Musculoskeletal Surgeries","authors":"Vidya Chidambaran, Qing Duan, Valentina Pilipenko, Susan Glynn, Alyssa Sproles, Lisa J Martin, Michael Lacagnina, Christopher D King, Lili Ding","doi":"10.1101/2024.03.27.24304974","DOIUrl":"https://doi.org/10.1101/2024.03.27.24304974","url":null,"abstract":"Study Objective: To determine if baseline cytokines and their changes over postoperative days 0-2 (POD0-2) predict acute and chronic postsurgical pain (CPSP) after major surgery.\u0000Design: Prospective, observational, longitudinal nested study.\u0000Setting: University-affiliated quaternary childrens hospital.\u0000Patients: Subjects (≥8 years old) with idiopathic scoliosis undergoing spine fusion or pectus excavatum undergoing Nuss procedure.\u0000Measurements: Demographics, surgical, psychosocial measures, pain scores, and opioid use over POD0-2 were collected. Cytokine concentrations were analyzed in serial blood samples collected before and after (up to two weeks) surgery, using Luminex bead arrays. After data preparation, relationships between pre- and post-surgical cytokine concentrations with acute (% time in moderate-severe pain over POD0-2) and chronic (pain score>3/10 beyond 3 months post-surgery) pain were analyzed. After adjusting for covariates, univariate/multivariate regression analyses were conducted to associate baseline cytokine concentrations with postoperative pain, and mixed effects models were used to associate longitudinal cytokine concentrations with pain outcomes.\u0000Main Results: Analyses included 3,164 measures of 16 cytokines from 112 subjects (median age 15.3, IQR 13.5-17.0, 54.5% female, 59.8% pectus). Acute postsurgical pain was associated with higher baseline concentrations of GM-CSF (β=0.95, SE 0.31; p=.003), IL-1β (β=0.84, SE 0.36; p=.02), IL-2 (β=0.78, SE 0.34; p=.03), and IL-12 p70 (β=0.88, SE 0.40; p=.03) and longitudinal postoperative elevations in GM-CSF (β=1.38, SE 0.57; p=.03), IFNγ (β=1.36, SE 0.6; p=.03), IL-1β(β=1.25, SE 0.59; p=.03), IL-7 (β=1.65, SE 0.7, p=.02), and IL-12 p70 (β=1.17, SE 0.58; p=.04). In contrast, CPSP was associated with lower baseline concentration of IL-8 (β= -0.39, SE 0.17; p=.02), and the risk of developing CPSP was elevated in patients with lower longitudinal postoperative concentrations of IL-6 (β= -0.57, SE 0.26; p=.03), IL-8 (β= -0.68, SE 0.24; p=.006), and IL-13 (β= -0.48, SE 0.22; p=.03). Furthermore, higher odds for CPSP were found for females (vs. males) for IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, and TNFα ; and for pectus (vs. spine) surgery for IL-8 and IL-10.\u0000Conclusion: We identified pro-inflammatory cytokines associated with increased acute postoperative pain and anti-inflammatory cytokines associated with lower CPSP risk, with the potential to serve as predictive and prognostic biomarkers.","PeriodicalId":501393,"journal":{"name":"medRxiv - Pain Medicine","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140325885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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