Journal of Pain最新文献_第7页

Pain disparities attributed to linguistic minoritization in health care settings 医疗机构中因语言少数而造成的疼痛差异。

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Pain

Pub Date : 2025-12-01 DOI: 10.1016/j.jpain.2024.104688

Paulina S. Lim , Michelle A. Fortier , Zeev N. Kain

There is a paucity of understanding about how language influences pain communication and outcomes for families who speak languages other than English in the United States. This is of great importance because 21.6% (68 million) of the population speak a language other than English, with 8% (25 million) of the population speaking English “less than very well.” Thus, the aim of this paper is to present a narrative review that describes how spoken language influences pediatric pain assessment and outcomes for children who speak languages other than English and discuss hypothesized factors that contribute to pain disparities in hospital settings. Results from the narrative review reveal that children and families who speak languages other than English have disparate pain outcomes compared with children from English-speaking families. It is hypothesized that individual (eg, clinician bias), interpersonal (eg, miscommunication of pain concepts), cultural (eg, misunderstanding of cultural concepts of pain), and systemic (eg, lack of access to interpretation services) factors influence disparate pain outcomes for linguistically minoritized children. Empirical research, including randomized control trials, regarding hypothesized factors that contribute to pediatric pain disparities for language other than English-speaking children, is severely lacking. Thus, improved understanding of pain concepts and pain communication processes that center individual, interpersonal, cultural, and systemic factors will enable future research to design interventions that enhance culturally relevant pain assessment and management for families who speak languages other than English.

Perspective

This article summarizes factors that contribute to pain disparities for children who speak languages other than English. Hypothesized factors that contribute to pain disparities for language other than English-speaking children and families include clinician bias, misunderstanding of pain concepts, and lack of access to interpretation services.

在美国，人们对语言如何影响疼痛交流以及使用英语以外语言的家庭的治疗效果了解甚少。这一点非常重要，因为美国有 21.6% 的人口（6,800 万人）说英语以外的语言，其中 8% 的人口（2,500 万人）英语说得 "不是很好"。因此，本手稿旨在通过叙事性综述，描述口语如何影响儿科疼痛评估和非英语儿童的治疗效果，并讨论造成医院环境中疼痛差异的假设因素。叙述性综述的结果显示，与来自英语家庭的儿童相比，说英语以外语言的儿童和家庭在疼痛结果方面存在差异。假设个人因素（如临床医生的偏见）、人际因素（如疼痛概念的误解）、文化因素（如对疼痛文化概念的误解）和系统因素（如缺乏获得口译服务的途径）会影响语言上属于少数群体的儿童的疼痛结果。关于造成非英语儿童儿科疼痛差异的假设因素，包括随机对照试验在内的实证研究非常缺乏。因此，提高对疼痛概念和以个人、人际、文化和系统因素为中心的疼痛交流过程的理解，将有助于未来的研究设计干预措施，以加强对讲英语以外语言的家庭进行与文化相关的疼痛评估和管理。观点：本文总结了造成非英语儿童疼痛差异的因素。造成讲 LOE 语言的儿童和家庭疼痛差异的假定因素包括临床医生的偏见、对疼痛概念的误解以及缺乏获得口译服务的途径。

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引用次数: 0

Advancing equity in pain care through education, strategic partnerships, and advocacy 通过教育、战略伙伴关系和宣传促进疼痛护理的公平性。

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Pain

Pub Date : 2025-12-01 DOI: 10.1016/j.jpain.2025.105505

Amber K. Brooks , Janki Patel

This article highlights three key pathways to advancing equitable pain care: education, strategic partnerships, and advocacy. Education remains foundational, emphasizing both provider training in cultural competency and bidirectional patient education to improve pain management outcomes. Strategic partnerships between the private sector, academia, and the community are needed to advance pain care and research in an increasingly challenging sociopolitical climate. Moreover, community-based participatory research (CBPR) and patient advisory boards ensure that research remains patient-centered and impactful. Finally, advocacy is crucial in mitigating legislative and policy shifts that threaten equitable pain care. While institutional constraints may limit public advocacy efforts, individual researchers and clinicians can engage policymakers, promote equitable funding structures, and advocate for high-quality pain care. By integrating action research principles with community-driven solutions, the pain research community can move beyond identifying disparities to actively implementing strategies that improve outcomes for marginalized populations, ensuring that pain care remains inclusive, responsive, and effective amidst ongoing challenges.

本文强调了促进公平疼痛护理的三个关键途径：教育、战略伙伴关系和倡导。教育仍然是基础，强调提供者文化能力培训和双向患者教育，以改善疼痛管理结果。在日益具有挑战性的社会政治气候下，需要私营部门、学术界和社区之间的战略伙伴关系来推进疼痛护理和研究。此外，基于社区的参与性研究（CBPR）和患者咨询委员会确保研究始终以患者为中心并具有影响力。最后，倡导在减轻威胁公平疼痛护理的立法和政策转变方面至关重要。虽然制度限制可能会限制公共宣传工作，但个体研究人员和临床医生可以参与政策制定者，促进公平的资金结构，并倡导高质量的疼痛护理。通过将行动研究原则与社区驱动的解决方案相结合，疼痛研究社区可以超越识别差异，积极实施改善边缘化人群结果的策略，确保疼痛护理在持续挑战中保持包容性、响应性和有效性。

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引用次数: 0

Response to Nufi. letter to the editor, “From fragmented services to whole-person care: Rethinking young people’s pain-mental health management” 对Nufi的回应。致编辑的信，“从碎片化服务到全人护理：重新思考年轻人的疼痛-心理健康管理”。

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Pain

Pub Date : 2025-12-01 DOI: 10.1016/j.jpain.2025.105574

Nardia-Rose Klem, Andrew M. Briggs, Helen Slater

引用次数: 0

Heterogeneity matters: Interpretating amputation outcomes in CRPS. 异质性问题：解释CRPS的截肢结果。

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Pain

Pub Date : 2025-11-28 DOI: 10.1016/j.jpain.2025.105627

Daniël P C van der Spek, Jan van den Brink, Frank J P M Huygen, Maaike Dirckx

引用次数: 0

Post-traumatic osteoarthritis in aged rodents is associated with brain changes that correlate with joint remodeling 老年啮齿动物的创伤后骨关节炎与与关节重塑相关的大脑变化有关。

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Pain

Pub Date : 2025-11-22 DOI: 10.1016/j.jpain.2025.105594

Jacob L. Griffith , Pedro A. Valdes-Hernandez , Taylor D. Yeater , Shane H. Priester , Marcelo Febo , Yenisel Cruz-Almeida , Kyle D. Allen

Preclinical models of osteoarthritis (OA) can provide insights into joint-level remodeling and pain-related behaviors, but effects beyond the joint are poorly understood. The current study investigates joint remodeling and brain remodeling using aged rats in a surgical rodent model of post-traumatic OA. Male and female Fischer 344 rats (68 weeks old) received either a skin incision (n=6 male and n=10 female) or medial collateral ligament transection plus medial meniscus transection (MCLT+MMT) surgery (n=5 male and n=11 female). Tactile sensitivity was assessed pre-surgery and 4-, 8-, 12-, and 16-weeks post-surgery. Neuroimaging was performed pre-surgery and 6- and 14-weeks post-surgery, with analyses focused on gray matter volume, blood oxygen level dependent (BOLD) signal, and functional connectivity. Following euthanasia, histological analysis was performed to assess joint changes. Histology confirmed advanced cartilage loss and bone damage in animals with MCLT+MMT animals relative to skin-incision sham; however, tactile sensitivity decreased over time for both surgery groups. From the neuroimaging data, differences between the MCLT+MMT and skin-incision groups were present for both males and females at week 6 and week 14. Differences include gray matter volume, BOLD signal, and functional connectivity in regions responsible for pain transmission and modulation (thalamus, somatosensory cortex, and periaqueductal gray), along with the emotional and affective aspects of pain (striatum, hippocampus, prefrontal cortex, and amygdala). Despite a lack of differences in tactile sensitivity between groups, these findings in the central circuits involved in sensory and nociceptive processing indicate an association with knee OA development and brain remodeling.

Perspective

This work is the first to examine brain remodeling in the acute and chronic stages of osteoarthritis pain using the medial meniscus transection model in aged animals. Results demonstrate evidence of brain remodeling in a preclinical model of osteoarthritis and help elucidate osteoarthritis effects beyond the joint.

骨关节炎（OA）的临床前模型可以提供关节水平重塑和疼痛相关行为的见解，但对关节以外的影响知之甚少。本研究利用老年大鼠创伤后骨性关节炎手术模型研究关节重塑和脑重塑。雄性和雌性Fischer 344大鼠（68周龄）分别接受皮肤切开（雄性6只，雌性10只）或内侧副韧带横断+内侧半月板横断（MCLT+MMT）手术（雄性5只，雌性11只）。术前及术后4、8、12、16周评估触觉敏感性。术前、术后6周和14周进行神经影像学检查，重点分析灰质体积、血氧水平依赖性（BOLD）信号和功能连通性。安乐死后，进行组织学分析以评估关节变化。组织学证实，与皮肤切口假手术相比，MCLT+MMT动物存在严重的软骨丢失和骨损伤；然而，随着时间的推移，两个手术组的触觉灵敏度都有所下降。从神经影像学数据来看，在第6周和第14周，男性和女性在MCLT+MMT和皮肤切口组之间都存在差异。差异包括灰质体积、BOLD信号和负责疼痛传递和调节的区域（丘脑、体感皮层和导水管周围灰质）的功能连通性，以及疼痛的情绪和情感方面（纹状体、海马、前额叶皮层和杏仁核）。尽管两组之间的触觉敏感性缺乏差异，但这些涉及感觉和伤害性加工的中央回路的研究结果表明，与膝关节OA的发展和大脑重塑有关。观点：这项工作是第一次在老年动物中使用内侧半月板横断模型来研究骨关节炎疼痛急性和慢性阶段的脑重塑。结果证明了骨关节炎临床前模型中脑重塑的证据，并有助于阐明骨关节炎对关节以外的影响。

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引用次数: 0

Letter to the Editor Re: Effects of centrally acting analgesics on resting-state electroencephalography biomarker candidates of chronic pain. 致编辑的信回复：中枢镇痛药对慢性疼痛静息状态脑电图生物标志物候选物的影响。

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Pain

Pub Date : 2025-11-21 DOI: 10.1016/j.jpain.2025.105612

Lidong Wang

引用次数: 0

Depression and anxiety in adults with chronic headache conditions: A systematic review and meta-analysis 成人慢性头痛患者的抑郁和焦虑：一项系统回顾和荟萃分析。

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Pain

Pub Date : 2025-11-19 DOI: 10.1016/j.jpain.2025.105610

Scott G. Ravyts , Nicolette Carnahan , Nicole Harte , Kavya Bhattiprolu , Claire McCaulley , Joanne Dudeney , Rachel V. Aaron

Evidence from epidemiological studies suggest that the prevalence of depression and anxiety among adults with chronic headaches is high, however, uncertainties remain about the magnitude of this comorbidity. The current meta-analysis aimed to determine the prevalence of depression and anxiety among adults with chronic headache conditions and identify factors that moderate prevalence. Four databases were searched from 2013 to 2024: CENTRAL, MEDLINE, EMBASE, and PsycINFO. Studies reporting the prevalence or clinical symptoms scores of depression or anxiety among adults with chronic headaches (i.e., headaches > 15 days/month for > 3 months) were included. Prevalence rates among individuals without a headache condition, or with an episodic headache disorder, were extracted separately for comparison purposes. Of the 37,149 initial records identified, 48 studies (N = 9582) met inclusion criteria. Clinical symptoms of depression and anxiety were present in 43.1% (95% CI: 37.8, 48.6; I² = 94.52) and 45.9% (95% CI: 39.1, 52.9; I² = 96.06) of adults with chronic headaches, respectively. Headache condition (p= .006) and location (p= .001) moderated the prevalence of depression but not anxiety. Compared to adults without headaches, adults with chronic headaches were 4.86 times more likely to have clinical symptoms of depression, and 7.06 times more likely to have clinical symptoms of anxiety. Similarly, they were 2.45 and 2.20 times more likely to have clinical symptoms of depression and anxiety, respectively, compared to individuals with episodic headaches. Almost half of adults with chronic headaches experience comorbid depression or anxiety, highlighting the urgent need for better mental health screening and treatment.

来自流行病学研究的证据表明，患有慢性头痛的成年人中抑郁和焦虑的患病率很高，然而，这种合并症的严重程度仍然不确定。当前的荟萃分析旨在确定慢性头痛患者中抑郁和焦虑的患病率，并确定适度患病率的因素。检索了2013-2024年的四个数据库：CENTRAL、MEDLINE、EMBASE和PsycINFO。研究报告了慢性头痛成人（即每月头痛15天，持续3个月）中抑郁或焦虑的患病率或临床症状评分。没有头痛状况或有发作性头痛障碍的个体的患病率分别提取，以进行比较。在确定的37149份初始记录中，48项研究（N= 9582）符合纳入标准。慢性头痛成人患者中分别有43.1% （95% CI: 37.8, 48.6; I2 = 94.52）和45.9% （95% CI: 39.1, 52.9; I2 = 96.06）存在抑郁和焦虑的临床症状。头痛状况（p= 0.006）和地点（p= 0.001）可调节抑郁的发生率，但不能调节焦虑的发生率。与没有头痛的成年人相比，患有慢性头痛的成年人出现抑郁临床症状的可能性是没有头痛的成年人的4.86倍，出现焦虑临床症状的可能性是没有头痛的成年人的7.06倍。同样，与患有间歇性头痛的人相比，他们出现抑郁和焦虑临床症状的可能性分别高出2.45倍和2.20倍。近一半患有慢性头痛的成年人患有抑郁症或焦虑症，这突出表明迫切需要更好的精神健康筛查和治疗。

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引用次数: 0

Distinct multidimensional anger profiles predict current and long-term chronic pain outcomes 不同的多维愤怒档案预测当前和长期慢性疼痛的结果

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Pain

Pub Date : 2025-11-19 DOI: 10.1016/j.jpain.2025.105611

Marine Granjon , Noel Vest , Sean C. Mackey , Gadi Gilam

Anger is prevalent in chronic pain (CP), often co-occurring with heightened distress and disability. The complexity of the anger construct manifests in heterogeneity of how anger is experienced, expressed, and regulated. Nevertheless, most work does not consider the inter-relationships between multiple dimensions of anger, limiting understanding of how anger might differentially contribute to pain outcomes. Here, various anger metrics and latent profile analysis (LPA) were utilized to identify disparate anger profiles in people with CP. Whether these profiles associated cross-sectionally and longitudinally with pain outcomes was subsequently examined. Data was collected from 735 treatment-seeking adult patients with CP of varied etiologies, of which 242 also completed follow-up assessments about 5 months after baseline. Anger measures included state and trait anger, anger expression (anger-in, anger-out), anger control (control-in, control-out), and perceived injustice. Pain outcomes included pain- intensity, distribution, interference, and behavior, and physical function. LPA identified four distinct anger profiles characterized by the combination of varying levels (low, medium, high) of anger and of perceived injustice. These profiles significantly associated with pain outcomes at both baseline and follow-up, above and beyond anxiety and depression. Profiles with medium-to-high levels of both anger (state, trait, and expression) and perceived injustice predicted the worst pain outcomes, suggesting that injustice-based profiling should be prioritized for anger-related stratification of risk in CP. The mechanistic and prognostic value of these anger profiles suggests that early assessment could enhance long-term treatment planning and advance personalized pain care, further emphasizing the need for tailored, anger-focused, patient-specific interventions.

Perspectives

This study demonstrates that multidimensional anger profiles, particularly those marked by higher perceived injustice, are linked to more severe and persistent high impact chronic pain. Identifying these profiles may facilitate early clinical screening for at-risk patients, personalized emotion-focused interventions, and potentially prevent progression to high-impact chronic pain and long-term disability.

愤怒在慢性疼痛（CP）中很普遍，通常与高度痛苦和残疾同时发生。愤怒结构的复杂性表现在愤怒的体验、表达和调节方式的异质性上。然而，大多数研究没有考虑到愤怒的多个维度之间的相互关系，限制了对愤怒如何可能对疼痛结果产生不同影响的理解。本研究利用各种愤怒指标和潜在特征分析（LPA）来识别CP患者的不同愤怒特征。随后研究了这些特征是否与疼痛结果在横断面和纵向上相关。数据收集自735名不同病因的寻求治疗的成年CP患者，其中242人在基线后约5个月完成了随访评估。愤怒测量包括状态性和特质性愤怒、愤怒表达（愤怒输入、愤怒输出）、愤怒控制（控制输入、控制输出）和感知不公。疼痛结局包括疼痛强度、分布、干扰、行为和身体功能。LPA确定了四种不同的愤怒特征，其特征是不同水平（低、中、高）的愤怒和感知不公正的结合。这些特征与基线和随访时的疼痛结果显著相关，高于焦虑和抑郁。中高水平的愤怒（状态、特征和表达）和感知到的不公正预测了最糟糕的疼痛结果，这表明基于不公正的分析应该优先用于CP中与愤怒相关的风险分层。这些愤怒特征的机制和预后价值表明，早期评估可以加强长期治疗计划和推进个性化疼痛护理，进一步强调需要量身定制的，以愤怒为中心的，针对病人的干预措施。该研究表明，多维度的愤怒特征，特别是那些被认为不公正的特征，与更严重和持续的高影响慢性疼痛有关。识别这些特征可以促进对高危患者的早期临床筛查，个性化的以情绪为中心的干预，并有可能防止发展为高影响的慢性疼痛和长期残疾。

{"title":"Distinct multidimensional anger profiles predict current and long-term chronic pain outcomes","authors":"Marine Granjon , Noel Vest , Sean C. Mackey , Gadi Gilam","doi":"10.1016/j.jpain.2025.105611","DOIUrl":"10.1016/j.jpain.2025.105611","url":null,"abstract":"<div><div>Anger is prevalent in chronic pain (CP), often co-occurring with heightened distress and disability. The complexity of the anger construct manifests in heterogeneity of how anger is experienced, expressed, and regulated. Nevertheless, most work does not consider the inter-relationships between multiple dimensions of anger, limiting understanding of how anger might differentially contribute to pain outcomes. Here, various anger metrics and latent profile analysis (LPA) were utilized to identify disparate anger profiles in people with CP. Whether these profiles associated cross-sectionally and longitudinally with pain outcomes was subsequently examined. Data was collected from 735 treatment-seeking adult patients with CP of varied etiologies, of which 242 also completed follow-up assessments about 5 months after baseline. Anger measures included state and trait anger, anger expression (anger-in, anger-out), anger control (control-in, control-out), and perceived injustice. Pain outcomes included pain- intensity, distribution, interference, and behavior, and physical function. LPA identified four distinct anger profiles characterized by the combination of varying levels (low, medium, high) of anger and of perceived injustice. These profiles significantly associated with pain outcomes at both baseline and follow-up, above and beyond anxiety and depression. Profiles with medium-to-high levels of both anger (state, trait, and expression) and perceived injustice predicted the worst pain outcomes, suggesting that injustice-based profiling should be prioritized for anger-related stratification of risk in CP. The mechanistic and prognostic value of these anger profiles suggests that early assessment could enhance long-term treatment planning and advance personalized pain care, further emphasizing the need for tailored, anger-focused, patient-specific interventions.</div></div><div><h3>Perspectives</h3><div>This study demonstrates that multidimensional anger profiles, particularly those marked by higher perceived injustice, are linked to more severe and persistent high impact chronic pain. Identifying these profiles may facilitate early clinical screening for at-risk patients, personalized emotion-focused interventions, and potentially prevent progression to high-impact chronic pain and long-term disability.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"39 ","pages":"Article 105611"},"PeriodicalIF":4.0,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145555033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

GsMTx-4 reduces mechanical allodynia in a model of schwannomatosis-related pain GsMTx-4减轻神经鞘瘤相关疼痛模型中的机械异常性疼痛

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Pain

Pub Date : 2025-11-14 DOI: 10.1016/j.jpain.2025.105597

Carson Gutierrez , Randy Rubright , Kimberly Laskie Ostrow

Patients with schwannomatosis (SWN) develop multiple tumors, called schwannomas, along peripheral nerves, with most experiencing significant pain. Neuropathic, nociceptive, and inflammatory pain types have been reported, but many patients describe severe pain when a schwannoma is palpated or lightly touched. Currently, surgical removal is the only effective treatment for pain relief. We are investigating mechanisms of tumor-induced pain. In some cases, schwannoma growth increases pressure on nearby nerves, resulting in pain. Additionally, schwannoma cells in culture secrete proinflammatory cytokines into the surrounding medium (CM) that increases neuronal sensitivity both in vitro and in vivo. When injected into a mouse hind paw, painful CM reduced paw withdrawal thresholds fourfold within one hour (p = 0.006), with effects lasting 48 h (p = 0.002) as demonstrated by Von Frey assay. We developed a chronic SWN pain model showing neuronal priming by SWN CM. After priming, a secondary CM exposure prolongs mechanical hypersensitivity for up to two weeks (p < 0.0001). We hypothesize this is mediated by mechanosensitive ion channels (MSCs), which respond to pressure and stretch. GsMTx-4, a selective MSC blocker, penetrates strained membranes to prevent MSC opening without affecting other channels. When co-injected with CM into the mouse paw, 10 µM GsMTx-4 prevented hypersensitivity to light touch. Moreover, GsMTx-4 reversed hyperalgesia even in the primed state, restoring withdrawal thresholds to baseline (p < 0.0001). These findings suggest that local injection of GsMTx-4 near painful tumors offers a promising, minimally invasive therapeutic approach for SWN pain.

Perspective

Pain is a confounding comorbidity in the multiple tumor syndrome schwannomatosis. Patients harbor benign peripheral nerve sheath tumors that rarely become malignant or cause neurological deficits. Yet, patients undergo numerous surgeries for the removal of painful tumors. A non-invasive treatment for tumor-related pain is in dire need. We are examining the small peptide GsMTx-4, a blocker of mechanosensitive ion channels, as a potential therapy for painful tumors in the context of schwannomatosis.

神经鞘瘤病（SWN）患者沿周围神经发展为多发性肿瘤，称为神经鞘瘤，大多数患者经历明显的疼痛。神经性、伤害性和炎症性疼痛类型已被报道，但许多患者描述当触诊或轻触神经鞘瘤时剧烈疼痛。目前，手术切除是缓解疼痛的唯一有效方法。我们正在研究肿瘤引起疼痛的机制。在某些情况下，神经鞘瘤的生长增加了附近神经的压力，导致疼痛。此外，培养的神经鞘瘤细胞分泌促炎细胞因子到周围介质（CM）中，增加体外和体内神经元的敏感性。Von Frey实验表明，当注射到小鼠后爪时，疼痛CM在1小时内将爪脱脱阈值降低了4倍（p = 0.006），效果持续48小时（p = 0.002）。我们建立了一个慢性SWN疼痛模型，显示SWN CM引起的神经元启动。在启动后，二次CM暴露延长机械超敏长达两周（p < 0.0001）。我们假设这是由对压力和拉伸有反应的机械敏感离子通道（MSCs）介导的。GsMTx-4是一种选择性间充质干细胞阻断剂，可穿透张力膜，在不影响其他通道的情况下阻止间充质干细胞打开。将10µM GsMTx-4与CM共注射到小鼠爪中，可防止轻触超敏反应。此外，即使在启动状态下，GsMTx-4也能逆转痛觉过敏，将戒断阈值恢复到基线（p < 0.0001）。这些发现表明，在疼痛的肿瘤附近局部注射GsMTx-4是一种有希望的微创治疗SWN疼痛的方法。观点：疼痛是多发性肿瘤综合征神经鞘瘤病的一种混杂合并症。患者有良性周围神经鞘肿瘤，很少变成恶性或引起神经功能缺损。然而，为了切除痛苦的肿瘤，患者需要进行多次手术。目前迫切需要一种非侵入性治疗肿瘤相关疼痛的方法。我们正在研究小肽GsMTx-4，一种机械敏感离子通道阻滞剂，作为神经鞘瘤病中疼痛肿瘤的潜在治疗方法。

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引用次数: 0

Distress is positively associated with induced secondary hyperalgesia in people with suppressed HIV 在HIV感染者中，痛苦与继发性痛觉过敏呈正相关。

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Pain

Pub Date : 2025-11-14 DOI: 10.1016/j.jpain.2025.105600

Luyanduthando Mqadi , Gillian J. Bedwell , Ncumisa Msolo , Gwendoline Arendse , Maia Lesosky , Peter R. Kamerman , Mark R. Hutchinson , Andrew Schrepf , Robert R. Edwards , John A. Joska , Romy Parker , Victoria J. Madden

Pain and symptoms of depression and anxiety (here, ‘psychological distress’) are frequently reported by people with HIV. Although pain is widely acknowledged to contribute to distress, distress may also contribute to pain and its persistence. Facilitation of nociceptive signalling is one pathway by which distress could exacerbate pain. The current study investigated the relationships between symptoms of depression and anxiety, secondary hyperalgesia (SH), and persistent pain in people with HIV, reporting pain (n=19) or no pain (n=26). We hypothesised that self-reported distress would be positively associated with the surface area (primary measure) and magnitude (secondary measure) of induced SH, and that participants reporting persistent pain would display greater induced SH than those reporting no pain. We found that distress was positively associated with the surface area (p=0.02) and the magnitude (p=0.01) of induced SH. However, participants with persistent pain showed no difference in the surface area of SH compared to pain-free participants (p=0.87), and those with pain displayed a marginally lower magnitude of SH (p=0.05). These findings position SH as a potentially useful mechanistic outcome for interventions that aim to address pain by reducing symptoms of depression and anxiety.

Perspective

Symptoms of depression and anxiety were positively associated with induced secondary hyperalgesia in people with suppressed HIV.

艾滋病毒感染者经常报告疼痛和抑郁和焦虑症状（这里是“心理困扰”）。尽管人们普遍认为疼痛会导致痛苦，但痛苦也可能导致疼痛及其持续。伤害性信号的促进是痛苦加剧疼痛的一个途径。目前的研究调查了艾滋病毒感染者的抑郁和焦虑症状、继发性痛觉过敏（SH）和持续疼痛之间的关系，报告疼痛（n=19）或无疼痛（n=26）。我们假设自我报告的痛苦与诱导SH的表面积（主要测量）和大小（次要测量）呈正相关，并且报告持续疼痛的参与者比报告无疼痛的参与者表现出更大的诱导SH。我们发现，痛苦与诱导SH的表面积（p=0.02）和大小（p=0.01）呈正相关。然而，持续疼痛的参与者与无疼痛的参与者相比，SH的表面积没有差异（p=0.87），疼痛的参与者显示出略低的SH大小（p=0.05）。这些发现表明，对于旨在通过减轻抑郁和焦虑症状来解决疼痛的干预措施，SH可能是一个有用的机制结果。观点：在HIV感染者中，抑郁和焦虑症状与诱发继发性痛觉过敏呈正相关。

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引用次数: 0