Journal of Pain最新文献

{"title":"GsMTx-4 reduces mechanical allodynia in a model of schwannomatosis-related pain","authors":"Carson Gutierrez ,&nbsp;Randy Rubright ,&nbsp;Kimberly Laskie Ostrow","doi":"10.1016/j.jpain.2025.105597","DOIUrl":"10.1016/j.jpain.2025.105597","url":null,"abstract":"<div><div>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 &lt; 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 &lt; 0.0001). These findings suggest that local injection of GsMTx-4 near painful tumors offers a promising, minimally invasive therapeutic approach for SWN pain.</div></div><div><h3>Perspective</h3><div>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.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"38 ","pages":"Article 105597"},"PeriodicalIF":4.0,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534781","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}

{"title":"Distress is positively associated with induced secondary hyperalgesia in people with suppressed HIV","authors":"Luyanduthando Mqadi ,&nbsp;Gillian J. Bedwell ,&nbsp;Ncumisa Msolo ,&nbsp;Gwendoline Arendse ,&nbsp;Maia Lesosky ,&nbsp;Peter R. Kamerman ,&nbsp;Mark R. Hutchinson ,&nbsp;Andrew Schrepf ,&nbsp;Robert R. Edwards ,&nbsp;John A. Joska ,&nbsp;Romy Parker ,&nbsp;Victoria J. Madden","doi":"10.1016/j.jpain.2025.105600","DOIUrl":"10.1016/j.jpain.2025.105600","url":null,"abstract":"<div><div>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.</div></div><div><h3>Perspective</h3><div>Symptoms of depression and anxiety were positively associated with induced secondary hyperalgesia in people with suppressed HIV.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"39 ","pages":"Article 105600"},"PeriodicalIF":4.0,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534638","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}

{"title":"Pain rating variability and response to treatment in osteoarthritis clinical trials","authors":"Camila Bonin Pinto ,&nbsp;Joana Barroso ,&nbsp;Thomas J. Schnitzer","doi":"10.1016/j.jpain.2025.105601","DOIUrl":"10.1016/j.jpain.2025.105601","url":null,"abstract":"<div><div>Despite recognition that osteoarthritis (OA) pain is dynamic, most clinical trials rely on static, single-point assessments. This study examined whether daily pre-treatment pain variability predicts treatment response in OA. We retrospectively analyzed data from 345 knee OA patients enrolled in two randomized, double-blind trials comparing naproxen (500 mg BID; n=190) to placebo (n=155). Participants reported daily pain (0–10 NRS) over 117 days (5-day baseline + 112-day treatment). Pain variability before treatment was quantified using: (1) standard deviation (pre-treatment pain variability, PTPV); (2) autocorrelation (AR); and (3) probability of acute change (PAC; ≥2-point shift). Logistic regression assessed responder status (≥30% pain reduction), and linear mixed-effects models evaluated longitudinal pain changes. Participants were stratified by treatment arm and high/low PTPV (median split). Correlations between variability metrics were also analyzed. Higher PTPV significantly predicted treatment response at Weeks 4, 8, 12, and 16 (p&lt;0.05). Though both groups improved, participants receiving naproxen with high PTPV showed significantly greater pain reduction over time (p&lt;0.001) compared to those with low variability and placebo subgroups. PTPV was not correlated with baseline pain, indicating independence from pain severity. Variability metrics captured distinct aspects of the pain experience: PTPV and PAC were strongly correlated (r=0.67), AR was negatively correlated with PAC (r=-0.25), and weakly with PTPV (r=0.12). Importantly none was associated with mean pain levels. Our study shows pre-treatment pain variability is a robust, independent predictor of response to both active drug and placebo. We suggest incorporating dynamic pain metrics may improve outcome prediction and trial design in OA.</div></div><div><h3>Perspective</h3><div>This study demonstrates that pre-treatment pain variability reflects unique aspects of the pain experience, independent of average pain intensity. Its consistent association with treatment response—regardless of intervention—supports its value as a predictive marker. Incorporating variability into clinical trial design may enhance outcome sensitivity and improve patient stratification.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"39 ","pages":"Article 105601"},"PeriodicalIF":4.0,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534779","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}

{"title":"Adding insult to injury: Examining the influence of peer pain-related stigma on daily functioning in youth with chronic musculoskeletal pain","authors":"Felicitas A. Huber ,&nbsp;Kathryn A. Thompson-Phillips ,&nbsp;Emily O. Wakefield ,&nbsp;Parker A. Kell ,&nbsp;Tolulope Adetayo ,&nbsp;Pavithra A. Thomas ,&nbsp;Burel R. Goodin","doi":"10.1016/j.jpain.2025.105602","DOIUrl":"10.1016/j.jpain.2025.105602","url":null,"abstract":"<div><div>Our research, in line with previous literature, has indicated that pain-related stigma plays a role in pain outcomes for children and adolescents with chronic musculoskeletal pain conditions. However, the influence of pain-related stigma on functioning and internalizing symptoms is less clear, as is whether stigma may differently influence youth dependent on gender and chronic pain type. The current study was a secondary analysis of cross-sectional data from 32 youth with Juvenile Idiopathic Arthritis (JIA), 31 youth with Juvenile Primary Fibromyalgia Syndrome (JFM), and 25 youth with non-specific chronic pain (NSCP) from a study examining group differences and biopsychosocial correlates of chronic musculoskeletal pain conditions. Participants self-reported their pain-related stigma, pain, physical, school, emotional and social functioning, and symptoms of anxiety and depression. Multiple regression analyses assessed associations between pain-related stigma and functioning, and pain-related stigma and internalizing symptoms, as well as interactions between stigma and gender as well as stigma and chronic pain type. Results showed that pain-related stigma significantly influenced physical and social functioning across groups. Stigma was associated with worse emotional functioning for girls, who also reported worse overall emotional functioning and greater anxiety and depression symptoms. Youth with JFM and NSCP demonstrated lower functioning compared to children and adolescents with JIA. These findings indicate that stigma substantially influences functioning and wellbeing of children and adolescents with chronic pain, especially for girls. Regardless of stigma experienced, those with chronic pain diagnoses lacking a known pathophysiology reported lower functioning in several domains.</div></div><div><h3>Perspective</h3><div>Youth with chronic musculoskeletal pain experience stigma about their pain which contributes not only to pain outcomes, but also physical and social functioning. Girls and youth with chronic pain conditions with unclear pathophysiology are especially at risk for adverse outcomes.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"39 ","pages":"Article 105602"},"PeriodicalIF":4.0,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534173","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}

{"title":"‘Maybe you should have a bowl of ice cream’: Inequities in patient-clinician interactions among individuals with chronic low back pain","authors":"Mark Vorensky ,&nbsp;Allison Squires ,&nbsp;Zina Trost ,&nbsp;John A. Sturgeon ,&nbsp;Adam T. Hirsh ,&nbsp;Nisha Sajnani ,&nbsp;Simon Jones ,&nbsp;Smita Rao","doi":"10.1016/j.jpain.2025.105599","DOIUrl":"10.1016/j.jpain.2025.105599","url":null,"abstract":"<div><div>Prior literature has shown inequities in patient-clinician interactions experienced by individuals with chronic low back pain (CLBP) with underlying pain-related stigmatization and invalidation. Yet, there is a notable gap in understanding how these inequities intersect with multiple systems of oppression, including racism and sexism. This qualitative study examined intersectional perspectives and experiences of patient-clinician interactions among individuals with CLBP. Semi-structured interviews were conducted after the participants engaged in simulated enhanced or limited patient-clinician interactions as part of an experimental study. Participants were asked to compare the simulated patient-clinician interaction to their real-life patient-clinician interactions for their CLBP. The study included 50 participants with CLBP for at least three months and half the days in the past six months. Participants were Black and multi-racial women (n=14), Black and multi-racial men (n=12), non-Hispanic White women (n=12), and non-Hispanic White men (n=12). A basic qualitative approach with principles from constructivist grounded theory and intercategorical intersectional research were used to propose three core categories when describing inequities in patient-clinician interactions: higher-level systems (subcategories: institutional, community, macro-level), the patient-clinician interaction (subcategories: being taken seriously, person-centered care), and effects of the patient-clinician interaction (subcategories: indirect, direct effects). Inequities were identified across all categories, disproportionately affecting Black and multi-racial women. Black and multi-racial women also distinctly shared a wider range of both positive and negative patient-clinician interactions and effects from these interactions, and potential pathways to more equitable care. These findings highlight the need for multi-level interventions to promote more equitable care for individuals with CLBP.</div></div><div><h3>Perspective</h3><div>This qualitative study examined intersectional perspectives and experiences of patient-clinician interactions among individuals with CLBP. Multiple intersecting systems shaped inequities in patient-clinician interactions. Black and multi-racial women shared the broadest range of patient-clinician interactions, distinctly discussed intersecting systems of oppression, and highlighted pathways to more equitable care.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"38 ","pages":"Article 105599"},"PeriodicalIF":4.0,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145530783","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}

{"title":"Savoring pleasure to relieve pain: An ecological momentary assessment study in patients with chronic low back pain","authors":"Patrick H. Finan ,&nbsp;Siny Tsang ,&nbsp;Nicholas P. Cherup ,&nbsp;Liza Abraham ,&nbsp;Matthew J. Reid ,&nbsp;David B. Yaden ,&nbsp;Michael T. Smith","doi":"10.1016/j.jpain.2025.105598","DOIUrl":"10.1016/j.jpain.2025.105598","url":null,"abstract":"<div><div>As pain persists, individuals with chronic pain must draw upon resilience resources to improve physical function and emotional well-being. Leading theoretical models highlight positive emotions as central to the process of pain-related resilience. This ecological momentary assessment (EMA) study investigated the role of savoring—a positive emotion upregulation strategy—in the daily experience of pain among individuals with chronic low back pain (CLBP) who had not received prior training in savoring or other emotion regulation strategies. Of the 135 participants included in the study, 81 were maintained on long-term opioid therapy (LTOT), permitting further investigation of the associations between savoring and opioid analgesia. Across 14 days of EMA (3367 total observations), greater momentary savoring was concurrently and prospectively associated with lower pain severity. Momentary savoring was also associated with greater opioid analgesia, particularly when participants reported taking lower opioid doses than usual. The effects of savoring on both pain and opioid analgesia were mediated by increased positive affect. Collectively, the findings provide a mechanistic framework for how patients with chronic pain naturally utilize savoring as a positive emotion upregulation strategy to promote daily resilience to chronic pain. Future work is needed to determine which individuals are most likely to experience pain relief as a result of savoring, the circumstances in which savoring is most likely to be adopted as a pain self-management tool, and how to most efficiently and effectively intervene to promote savoring in the course of daily life with chronic pain.</div></div><div><h3>Perspective</h3><div>This microlongitudinal study demonstrates the naturalistic use of savoring, an emotional upregulation strategy, improves momentary and future pain severity ratings in those with chronic low back pain. Savoring was related to improved responses to opioid medication use, with increasing positive affect mediating the effects of savoring on opioid associated analgesia.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"39 ","pages":"Article 105598"},"PeriodicalIF":4.0,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145530841","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}

{"title":"Embedding expectation effects on the management of cancer pain and related symptoms: A focus review","authors":"Ankita Moss ,&nbsp;Julia H. Terhune ,&nbsp;Katherine H.R. Tkaczuk ,&nbsp;Luana Colloca","doi":"10.1016/j.jpain.2025.105586","DOIUrl":"10.1016/j.jpain.2025.105586","url":null,"abstract":"<div><div>As of 2022, an estimated 18 million individuals in the United States were living as cancer survivors, a number projected to rise to approximately 26 million by 2040. Advances in treatment and early detection have improved the 5-year cancer survival rate from 35% in 1960 to 65% today. However, cancer treatment often takes its own toll, and multi-modal treatments can have life-long consequences themselves, particularly in the form of chronic pain, which is known to compound the physical and emotional burden of cancer. In this review, we examine the complex burden of cancer-related pain, using breast cancer as a representative case. We first outline current pain management strategies, then highlight emerging non-pharmacological approaches that show promise in enhancing treatment outcomes. Among these, placebo effects and specifically, the role of the patient’s expectations, represent compelling and safe avenues for non-pharmacological modes of symptom relief. Critically, we position expectation modulation not as a substitute but as an adjuvant to pharmacological interventions, targeting the psychosocial dimensions of pain without adding to the side-effect burden. Finally, we explore virtual reality and other extended reality technologies as innovative tools for delivering expectation-based interventions, offering scalable, immersive, and engaging platforms for integrated management of pain and other symptoms.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"38 ","pages":"Article 105586"},"PeriodicalIF":4.0,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507860","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}

{"title":"A randomized controlled trial investigating feasibility, acceptability and effects of dry needling for provoked vestibulodynia","authors":"Mélanie Roch ,&nbsp;Nathaly Gaudreault ,&nbsp;Josianne Paré ,&nbsp;Marie-Elisabeth Bouchard ,&nbsp;Małgorzata Starzec-Proserpio ,&nbsp;Jan Dommerholt ,&nbsp;Nathalie J Bureau ,&nbsp;Marie-Hélène Mayrand ,&nbsp;Sophie Bergeron ,&nbsp;Marie-France Dubois ,&nbsp;Mélanie Morin","doi":"10.1016/j.jpain.2025.105596","DOIUrl":"10.1016/j.jpain.2025.105596","url":null,"abstract":"<div><div>This study aimed to investigate the feasibility, acceptability, and effects of dry needling in women with provoked vestibulodynia. Forty-six women diagnosed with provoked vestibulodynia were randomized to receive six weekly sessions of either real or sham dry needling (DN). Participants, investigators and data analysts were blinded. Feasibility outcomes (adherence to treatment, questionnaire completion and dropout rate) and side effects were measured throughout the study. Pain intensity during intercourse (0−10 numeric rating scale) was measured at baseline and posttreatment, and acceptability (questionnaire) was assessed at posttreatment. Women in the realDN group attended 99% of the planned treatment sessions, compared to 91% in the shamDN group. Additionally, 100% of the questionnaires were completed in the realDN group, compared to 93% in the shamDN group. All participants in the realDN group completed the study. In contrast, two participants in the shamDN group withdrew. For the main side effects, 96% of the participants in the realDN group and 52% in the shamDN group experienced muscle aches (<em>p</em>&lt;.001). Moreover, 35% experienced autonomic reactions in the realDN group, while these were not observed in the shamDN group (<em>p</em>&lt;.001). All participants reported high levels of acceptability across all dimensions, with no significant difference between groups. The realDN group showed a significant decrease in pain intensity compared to the shamDN group (mean difference between groups 2.4; 95%CI 1.4–3.3; <em>p</em>&lt;.001). Our findings support the feasibility and acceptability of dry needling to treat women with provoked vestibulodynia and showed a significant effect in reducing pain.</div></div><div><h3>Perspective</h3><div>This article presents the results of a novel study examining the feasibility and acceptability of using dry needling to treat women suffering from provoked vestibulodynia and lays the groundwork to inform a future randomized controlled trial.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"38 ","pages":"Article 105596"},"PeriodicalIF":4.0,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145483206","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}

{"title":"Single-nuclei RNA sequencing reveals distinct transcriptomic signatures of rat dorsal root ganglia in a chronic discogenic low back pain model","authors":"Sydney M. Caparaso ,&nbsp;Ishwarya Sankaranarayanan ,&nbsp;David J. Lillyman ,&nbsp;Theodore J. Price ,&nbsp;Rebecca A. Wachs","doi":"10.1016/j.jpain.2025.105590","DOIUrl":"10.1016/j.jpain.2025.105590","url":null,"abstract":"<div><div>Chronic low back pain (LBP), often correlated with intervertebral disc degeneration, is a leading source of disability worldwide, yet remains poorly understood. Current treatments often fail to provide sustained relief, highlighting the need to better understand the mechanisms driving discogenic LBP. During disc degeneration, the extracellular matrix degrades, allowing nociceptive nerve fibers to innervate previously aneural disc regions. Persistent mechanical and inflammatory stimulation of nociceptors can induce plastic changes within dorsal root ganglia (DRG) neurons, characterized by altered gene expression, enhanced excitability, and lowered activation thresholds. Although these transcriptional changes have been described in other pain states, including osteoarthritis, they remain underexplored in discogenic LBP. To address this gap, this study represents the first application of comprehensive single-nuclei RNA sequencing of T13-L1 bilateral DRG neurons in a female Sprague Dawley rat model of chronic discogenic LBP, 15 weeks post-injury. Eighteen distinct DRG subpopulations were identified and mapped to existing mouse and cross-species atlases revealing strong similarities in neuronal populations with the mouse. Differential expression analysis revealed increased expression of pain-associated genes, including <em>Scn9a</em> and <em>Piezo2</em>, and neuroinflammatory mediators such as <em>Fstl1</em> and <em>Ngfr</em>, in LBP animals. Axial hypersensitivity, measured using grip strength, significantly correlated with increased expression of <em>Scn9a, Fstl1, and Ngfr,</em> which suggests their role in maintaining axial hypersensitivity in this model. These findings establish a relationship between DRG transcriptomic changes and axial hypersensitivity in a discogenic LBP model, identifying potential molecular targets for non-opioid treatments and advancing understanding of discogenic LBP mechanisms.</div></div><div><h3>Perspective</h3><div>This study identifies transcriptomic changes in sensory neurons linked to axial hypersensitivity in a rat model of chronic discogenic low back pain. These findings highlight potential molecular targets for non-opioid therapies and may help to better understand the neuronal mechanisms underlying persistent discogenic pain.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"39 ","pages":"Article 105590"},"PeriodicalIF":4.0,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145483610","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}

{"title":"Factor structure and measurement invariance of the PTSD Checklist for DSM-5 in a national sample of veterans prescribed long-term opioid therapy for chronic pain","authors":"Kate Clauss ,&nbsp;Andrew J. Muth ,&nbsp;Travis I. Lovejoy ,&nbsp;Steven K. Dobscha ,&nbsp;Natassja Pal ,&nbsp;Benjamin J. Morasco","doi":"10.1016/j.jpain.2025.105587","DOIUrl":"10.1016/j.jpain.2025.105587","url":null,"abstract":"<div><div>Posttraumatic stress disorder (PTSD) and chronic pain are highly comorbid, share overlapping symptoms, and exacerbate and maintain one another, which makes the accurate assessment of symptoms critical to effective clinical care. The present study evaluated the factor structure of the PTSD Checklist for <em>DSM-5</em> (PCL-5) in a veteran sample with chronic pain and determined the extent to which pain intensity is associated with PCL-5 responses. Participants were a national sample of 384 veterans prescribed long-term opioid therapy who reported moderate or severe pain, experienced a traumatic event, and completed the PCL-5. The majority of the sample identified as White (79.9%) and Male (84.1%). Confirmatory factor analysis was used to evaluate the factor structure of the PCL-5, and measurement invariance testing was used to determine the extent to which pain intensity was associated with how patients responded to the PCL-5. The six-factor anhedonia (χ² <strong>=</strong> 313.45, <em>df</em> = 155, CFI =.969, RMSEA =.052, 90% CI:.043,.060, DRMR =.036, TLI =.95) and seven-factor hybrid (χ² <strong>=</strong> 304.20, <em>df</em> = 149, CFI =.960, RMSEA =.052, 90% CI:.044,.060, SRMR =.036, TLI =.95) models emerged as the best fitting and both exhibited configural, metric and scalar invariance. This suggests that PCL-5 scores can be interpreted similarly among patients with moderate and severe chronic pain and that complex models can be employed to help determine the focus of treatment and track granular changes in PTSD symptoms over time.</div></div><div><h3>Perspective</h3><div>In a sample of veterans with chronic pain, this article evaluates the factor structure of the PCL-5 and whether it is invariant across different levels of pain intensity. The PCL-5 shows similar psychometric properties regardless of pain intensity, which is important for its continued use in research and clinical settings.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"38 ","pages":"Article 105587"},"PeriodicalIF":4.0,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145483626","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}