Frontiers in pain research (Lausanne, Switzerland)最新文献

Background: Mind-body treatments can improve coping mechanisms to deal with pain, improve the quality of life of patients with fibromyalgia syndrome (FMS), and reduce perceived pain in some cases. However, responses to these treatments are highly variable, the mechanisms underpinning them remain unclear, and reliable predictors of treatment response are lacking. We employed resting-state blood oxygen level-dependent (rsBOLD) functional magnetic resonance imaging (fMRI) to examine changes in brain functional connectivity (FC) following mind-body treatment that may relate to and predict pain relief.

Methods: We recruited patients with FMS who underwent either mindfulness-based stress reduction (MBSR; n = 18) or a psychoeducational program (FibroQoL; n = 22) and a treatment-as-usual FMS group (TAU; n = 18). We collected rsBOLD data, alongside subjective pain, anxiety, depression, and catastrophizing measures prior to and following treatments. We examined behavioral changes and FC changes in the salience network (SN) and sensorimotor network (SMN) and performed regression analyses to identify predictors for treatment response.

Results: The MBSR and FibroQoL groups experienced significant reductions in pain catastrophizing. After treatment, the FC of the sensorimotor cortex with the rest of the SMN became significantly reduced in the MBSR group compared to the TAU group. The FC between the SN and the SMN at baseline was negatively correlated with pain reductions following MBSR but positively correlated with pain reductions in the FibroQoL group. These results yielded large to very large effect sizes. Following MBSR, only for those patients with lower baseline SMN-SN FC, minutes of mindfulness practice were positively associated with clinical improvement (small to medium effect size).

Conclusions: Different mind-body treatments are underpinned by discrete brain networks. Measures of the functional interplay between SN and SMN have the potential as predictors of mind-body treatment response in patients with FMS.

Background: Limited knowledge exists on recognition and treatment of equine abdominal pain in low- and middle-income countries. This study aimed at finding indicators for recognizing abdominal pain, evaluating responses to clinical and behavioral changes, and assessing the impact of timely referral on colic outcomes in a suburban region of Senegal. The final goal was to identify factors that may be leveraged to improve the outcome of horses presented for abdominal pain in Senegal.

Study design: Retrospective, observational cohort study.

Methods: Data from 26 foals and 40 adult horses referred for acute abdomen between 2013 and 2014 and the first semester of 2023 were reviewed. Signs of abdominal pain were grouped into behavioral, posture modification and animal interactions with the environment. Time to referral was defined as the time between the recognition of abdominal pain and referral. The association of time to referral and the outcome was calculated for each subpopulation and compared using logistic regression analysis as appropriate.

Results: A significant proportion of owners (47%) and veterinarians (77.8%) relied on behavioral changes to detect abdominal pain in foals. Most owners referred foals within 24 h, while veterinarians referred within 12 h. Mortality in foals exceeded 50% when referral was delayed by 12 h or more. In adult horses, groomers often were the first noticing behavioral changes (79%), and they referred the horse within three hours, whereas owners typically delayed referral for 24 h or longer, leading to increased hospitalization expenses.

Limitations: The study considered a limited cohort in an suburban area of Senegal. Sourcing complete data was challenging. Additionally, accurately assessing owner experience was difficult due to the participant group's heterogeneity. Absence of a reliable system to measure daily horse-owner interaction time and logistical challenges in the abdominal pain symptom alert chain were also limiting factors.

Conclusions: Early detection is critical for positive colic outcomes in both foals and adult horses. Therefore, raising awareness and providing training to horse owners for prompt recognition of symptoms and referral is essential. This proactive approach aims to improve overall outcomes and reduce the financial burden of equine hospitalization in Senegal.

Purpose: Cancer patients often experience pain, which can greatly reduce their quality of life. It affects their emotions, cognitive function, and daily interactions. Healthcare providers need to understand the obstacles to pain management to create helpful programs for patients and families. This study focuses on Iranian nurses' views on pain management barriers in cancer patients.

Methods: The study utilized a qualitative content analysis method with a purposive sampling approach, involving 27 nurses. Participants were selected to ensure a wide range of perspectives and experiences by considering factors such as gender, age, work experience, education levels, and positions until data saturation was achieved. Inclusion criteria specified a minimum of six months of oncology ward experience and a bachelor's degree or higher in nursing. Nurses with less than six months of oncology experience or lacking a nursing degree were excluded. Data collection was conducted through semi-structured interviews and analyzed using Lundman and Granheim's qualitative content analysis method.

Results: One main theme, four main categories, and nine subcategories in the study reflected the nurses' experiences and viewpoints about barriers to pain management. These categories included the marginalization of complementary medicine, medical malpractice, inadequate organizational infrastructure, and personal barriers.

Conclusion: The study demonstrated that the barriers to pain management in cancer patients were complex. To improve patients' comfort and quality of life, it is important to identify and address issues from different angles. It is crucial to train patients and healthcare providers in pain management and to address weaknesses in the healthcare system.

Globally, humans rely on cattle for food production; however, there is rising societal concern surrounding the welfare of farm animals. From a young age, cattle raised for dairy and beef production experience pain caused by routine management procedures and common disease conditions. The fundamental mechanisms, nociceptive pathways, and central nervous system structures required for pain perception are highly conserved among mammalian species. However, there are limitations to a comparative approach to pain assessment due to interspecies differences in the expression of pain. The stoicism of prey species may impede pain identification and lead to the assumption that cattle lack pain sensitivity. This highlights the importance of establishing validated bovine-specific indicators of pain-a prerequisite for evidence-based pain assessment and mitigation. Our first objective is to provide an overview of pain pathophysiology to illustrate the importance of targeted analgesia in livestock medicine and the negative welfare outcomes associated with unmitigated pain. This is followed by a review of available analgesics, the regulations governing their use, and barriers to implementation of on-farm pain management. We then investigate the current research undertaken to evaluate the pain response in cattle-a critical aspect of the drug approval process. With an emphasis on emerging research in animal cognition and pain pathology, we conclude by discussing the significant influence that pain has on cattle welfare and areas where further research and modified practices are indicated.

Approximately 356 million limb amputations are performed globally every year. In 2005, the prevalence of limb loss in the United States was 1.6 million people; and it is estimated to increase to 3.6 million by 2050. Many post-amputation patients experience chronically altered sensations and pain associated with the amputation, such as phantom limb pain. The risk factors for phantom limb pain are widely debated in the literature due to the heterogeneity of the population being studied. This review will highlight both the non-operative and operative risk factors for phantom limb pain.

Introduction: Nociplastic pain (NP), classified as a third type of pain alongside nociceptive and neuropathic pain, is chronic pain arising from the amplification of nociceptive stimuli through central sensitization, despite the absence of tissue damage, sensory nerve damage, or disease. An important clinical feature of NP is that it is not only associated with pain but also with sensory hypersensitivity to sound and light and cognitive dysfunction, including mood and attention disorders. Recent studies have suggested that depression and developmental disorders, such as attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), coexist with NP at high frequency. Additionally, cognitive impairment in individuals with NP may be associated with these psychiatric comorbidities. However, to our knowledge, there are no reports on (1) multidimensional evaluation and diagnostic details of abdominal NP in adults with ADHD/ASD; (2) how ADHD drugs and antidepressants are administered when ADHD and depression coexist with NP; and (3) how central sensitization, brain function, and family relationship problems underlying NP are altered by treatments of ADHD and depression.

Case presentation: Herein, we present the case of a 51-year-old woman with abdominal NP. She developed severe right lower abdominal pain and underwent a thorough medical examination; however, the physical, medical cause remained unknown, making treatment challenging. Additionally, she took time off work as she began to complain of insomnia and anxiety. She was referred to our pain center, where a diagnosis of depression, ADHD, and ASD was confirmed, and treatment with ADHD medication was initiated. While ADHD medications alone did not yield sufficient improvement, a combination of methylphenidate and the antidepressant venlafaxine eventually led to improvements in abdominal NP, depression, ADHD symptoms, central sensitization, and family relationship issues. During treatment, cerebral blood flow in the anterior cingulate, prefrontal, and parietal cortices also improved.

Conclusion: The treatment of comorbid depression is important while treating NP, and venlafaxine may be effective, especially in cases of comorbid ADHD/ASD. Screening for developmental disorders and depression is required in patients with abdominal NP.

Objective: Quantitative sensory testing is often used to investigate pain in the context of experimental and clinical research studies. However, many of the devices used for QST protocols are only available in resource rich environments, thereby inadvertently limiting the possible pool of participants. Development of remote protocols for appropriate QST measures has the potential to reduce barriers to participation in research.

Methods: Participants with insomnia and Crohn's disease were recruited as part of a clinical trial. We adapted a remote version of the cold pressor test for use during telehealth-based study assessments. Herein, we present data from the baseline assessments including an assessment of feasibility and acceptability of the task.

Results: 100% of participants (N = 28) were able to complete the remote cold pressor test using a combination of materials from their homes and mailed by the study team. Temperature changes during the test were minimal and fairly evenly balanced between increases and decreases. Correlations between submersion time and both general and disease specific pain trended toward significance.

Conclusions: We demonstrated that a remote version of the cold pressor test is feasible and acceptable in a clinical population and provided a step-by-step protocol for administration to facilitate use in other studies.

Background: While numeric scales to represent pain intensity have been well validated, individuals use various conceptualizations when assigning a number to pain intensity, referred to as pain rating schema. The 18-item Pain Schema Inventory (PSI-18) quantifies pain rating schema by asking for numeric values for multiple mild, moderate or severe pain conditions. This study aimed to assess the validity and reliability of a shortened form of the PSI, using only 6 items (PSI-6).

Methods: A secondary analysis was performed on two existing datasets. The first (n = 641) involved a community-based population that completed the PSI-18. The second (n = 182) included participants with chronic pain who completed the PSI-6 twice, one week apart. We assessed face validity, convergent validity, offset biases, test-retest reliability, and internal consistency of the PSI-6 compared to the PSI-18.

Results: Both the PSI-18 and PSI-6 demonstrated excellent face validity. The PSI-6 demonstrated excellent convergent validity relative to the PSI-18, with correlations from r = 0.88 to 0.92. Bland-Altman plots revealed offset biases near zero (< 0.22 on 0-10 scale) across all categories of mild, moderate, severe and average pain. Internal consistency was excellent, with Cronbach's Alpha = 0.91 and 0.80, for PSI-18 and PSI-6 respectively. Test-retest reliability of the PSI-6 was high with correlations from r = 0.70-0.76.

Conclusion: The PSI-6 is a valid and reliable tool to assess pain rating schema with reduced subject burden, to better interpret individuals' pain ratings and adjust for inter-individual variability.

[This corrects the article DOI: 10.3389/fpain.2024.1374929.].