Pub Date : 2023-10-24eCollection Date: 2023-01-01DOI: 10.3389/fpain.2023.1281277
Adarsh Aratikatla, Samir Ghandour, Nicola Maffulli, Manu Gupta, Ashim Gupta
The temporomandibular joint (TMJ) is crucial for functions of daily living such as mastication and articulation. Common TMJ issues include osteoarthritis, internal derangement, and myofascial pain dysfunction. Conservative methods such as physical therapy and medications are used, with surgical options such as arthroscopy and replacement for severe cases. Emerging regenerative medicine explores non-surgical treatments using human stem cells from umbilical cord derivatives, showing potential for tissue regeneration in TMJ disorders. A systematic search was conducted across PubMed, Embase, Scopus, and Web of Science databases, adhering to PRISMA guidelines, aiming to identify relevant articles published in English until August 2023. The search used specific terms to target in vitro, preclinical, and clinical studies on umbilical cord (UC)-derived tissue and mesenchymal stem cells (MSCs) for treating TMJ disorders. The search was extended to three clinical trial registries for on-going investigations related to UC tissue and MSCs for TMJ disorder management. The studies included in this article report the safety and efficacy profiles of allogenically acquired, umbilical cord-derived tissues and associated mesenchymal stem cells for temporomandibular joint ailments, future adequately powered, randomized controlled trials are warranted to conclusively justify the clinical use of this biologic therapy.
颞下颌关节(TMJ)对日常生活功能(如咀嚼和关节)至关重要。常见的TMJ问题包括骨关节炎、内部紊乱和肌筋膜疼痛功能障碍。使用物理治疗和药物治疗等保守方法,并可选择关节镜检查和严重病例的替代手术。新兴的再生医学探索了使用脐带衍生物的人类干细胞进行非手术治疗,显示出TMJ疾病组织再生的潜力。根据PRISMA指南,在PubMed、Embase、Scopus和Web of Science数据库中进行了系统搜索,旨在识别2023年8月之前以英语发表的相关文章。这项研究使用了特定的术语来靶向脐带(UC)衍生组织和间充质干细胞(MSC)治疗TMJ疾病的体外、临床前和临床研究。搜索范围扩大到三个临床试验注册中心,以进行与UC组织和MSCs有关的TMJ疾病管理的持续研究。本文中的研究报告了同种异体获得的脐带来源组织和相关间充质干细胞治疗颞下颌关节疾病的安全性和有效性,未来有必要进行充分的随机对照试验,以最终证明这种生物疗法的临床应用是合理的。
{"title":"Allogenic umbilical cord tissue for temporomandibular joint injuries.","authors":"Adarsh Aratikatla, Samir Ghandour, Nicola Maffulli, Manu Gupta, Ashim Gupta","doi":"10.3389/fpain.2023.1281277","DOIUrl":"10.3389/fpain.2023.1281277","url":null,"abstract":"<p><p>The temporomandibular joint (TMJ) is crucial for functions of daily living such as mastication and articulation. Common TMJ issues include osteoarthritis, internal derangement, and myofascial pain dysfunction. Conservative methods such as physical therapy and medications are used, with surgical options such as arthroscopy and replacement for severe cases. Emerging regenerative medicine explores non-surgical treatments using human stem cells from umbilical cord derivatives, showing potential for tissue regeneration in TMJ disorders. A systematic search was conducted across PubMed, Embase, Scopus, and Web of Science databases, adhering to PRISMA guidelines, aiming to identify relevant articles published in English until August 2023. The search used specific terms to target <i>in vitro</i>, preclinical, and clinical studies on umbilical cord (UC)-derived tissue and mesenchymal stem cells (MSCs) for treating TMJ disorders. The search was extended to three clinical trial registries for on-going investigations related to UC tissue and MSCs for TMJ disorder management. The studies included in this article report the safety and efficacy profiles of allogenically acquired, umbilical cord-derived tissues and associated mesenchymal stem cells for temporomandibular joint ailments, future adequately powered, randomized controlled trials are warranted to conclusively justify the clinical use of this biologic therapy.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"4 ","pages":"1281277"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10627879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71523575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-24eCollection Date: 2023-01-01DOI: 10.3389/fpain.2023.1125992
Yuelin Cindy Li, Eleni G Hapidou
Psychologically-based chronic pain variables measure multiple domains of the pain experience such as anxiety, depression, catastrophizing, acceptance and stages of change. These variables measure specific areas such as emotional and cognitive states towards chronic pain and its management, acceptance towards the chronic pain condition, and an individual's readiness to move towards self-management methods. Conceptually, these variables appear to be interrelated to each other, and also form groupings of similar underlying themes. Groupings that have been previously discussed for these variables include positive and negative affect, and improved and poor adjustment. Psychological experience of chronic pain as a whole is mostly understood through conceptually consolidating individual scores across different measures covering multiple domains. A map of these variables in relation to each other can offer an overview for further understanding and exploration. We hereby visualize highlights of relationships among 11 psychosocial chronic pain variables including measures examining physical and somatic aspects, using three-dimensional biplots. Variables roughly form two groupings, with one grouping consisting of items of negative affect, cognition, and physical state ratings, and the other grouping consisting of items of acceptance and the later three stages of change (contemplation, action, maintenance). Also, we follow up with canonical correlation as a complement to further identify key relationships between bimodal groupings. Key variables linking bimodal relationships consist of catastrophizing, depression and anxiety in one grouping and activity engagement in the other. Results are discussed in the context of existing literature.
{"title":"Multidimensional visualization and analysis of chronic pain variables of patients who attended a chronic pain program.","authors":"Yuelin Cindy Li, Eleni G Hapidou","doi":"10.3389/fpain.2023.1125992","DOIUrl":"10.3389/fpain.2023.1125992","url":null,"abstract":"<p><p>Psychologically-based chronic pain variables measure multiple domains of the pain experience such as anxiety, depression, catastrophizing, acceptance and stages of change. These variables measure specific areas such as emotional and cognitive states towards chronic pain and its management, acceptance towards the chronic pain condition, and an individual's readiness to move towards self-management methods. Conceptually, these variables appear to be interrelated to each other, and also form groupings of similar underlying themes. Groupings that have been previously discussed for these variables include positive and negative affect, and improved and poor adjustment. Psychological experience of chronic pain as a whole is mostly understood through conceptually consolidating individual scores across different measures covering multiple domains. A map of these variables in relation to each other can offer an overview for further understanding and exploration. We hereby visualize highlights of relationships among 11 psychosocial chronic pain variables including measures examining physical and somatic aspects, using three-dimensional biplots. Variables roughly form two groupings, with one grouping consisting of items of negative affect, cognition, and physical state ratings, and the other grouping consisting of items of acceptance and the later three stages of change (contemplation, action, maintenance). Also, we follow up with canonical correlation as a complement to further identify key relationships between bimodal groupings. Key variables linking bimodal relationships consist of catastrophizing, depression and anxiety in one grouping and activity engagement in the other. Results are discussed in the context of existing literature.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"4 ","pages":"1125992"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10628043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71523576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-23eCollection Date: 2023-01-01DOI: 10.3389/fpain.2023.1293919
Michael D Staudt, Nasser K Yaghi, David J Mazur-Hart, Prasad Shirvalkar
{"title":"Editorial: Advancements in deep brain stimulation for chronic pain control.","authors":"Michael D Staudt, Nasser K Yaghi, David J Mazur-Hart, Prasad Shirvalkar","doi":"10.3389/fpain.2023.1293919","DOIUrl":"10.3389/fpain.2023.1293919","url":null,"abstract":"","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"4 ","pages":"1293919"},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10627217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71489611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-19eCollection Date: 2023-01-01DOI: 10.3389/fpain.2023.1269018
Santiago Galán, Rocío de la Vega, Rosa Esteve, Alicia E López-Martínez, Mariano Fernández Baena, Carmen Ramírez-Maestre
Background: Opioids are being prescribed widely, and increasingly, for the treatment of chronic non-cancer pain (CNCP). However, several side effects are associated with mid- and long-term opioid use and, for certain patients, with the risk of problematic opioid use. The aim of this study is to know the perception of the physicians about which variables could be associated with increased risk of patients with CNCP developing a problem of abuse or misuse of the prescribed opioid medication.
Methods: Twenty-nine physicians with experience in CNCP pain management and opioids prescription participated in a two-round Delphi study focused on the risk factors for opioid misuse and abuse.
Results: The variables that reached consensus regarding their relationship with the increased risk of suffering a problem of opioid abuse or misuse were: (1) Experiencing pain on a daily basis, (2) previous use of high-dose opioids, (3) generalized anxiety, (4) hopelessness, (5) benzodiazepine intake, (6) use of opioids for reasons other than pain, (7) family problems, family instability or family breakdown, and (8) having access to several opioid prescribers. The only variable that reached consensus regarding it not being associated to a possible risk of abuse or misuse was having mild pain intensity (0-4 on a NRS-11).
Conclusions: This study provides useful information that could help make decisions about the use of opioids for CNCP treatment and prevent future difficulties. Prospective studies testing the relationship of the variables that reached consensus with the risk of opioid misuse and abuse are warranted.
Significance: This study shows the variables of CNCP that the professional must take into account in order to avoid possible problems when prescribing opioids.
{"title":"Physicians' perception about predictors of opioid abuse in patients with chronic non-cancer pain: a Delphi study.","authors":"Santiago Galán, Rocío de la Vega, Rosa Esteve, Alicia E López-Martínez, Mariano Fernández Baena, Carmen Ramírez-Maestre","doi":"10.3389/fpain.2023.1269018","DOIUrl":"https://doi.org/10.3389/fpain.2023.1269018","url":null,"abstract":"<p><strong>Background: </strong>Opioids are being prescribed widely, and increasingly, for the treatment of chronic non-cancer pain (CNCP). However, several side effects are associated with mid- and long-term opioid use and, for certain patients, with the risk of problematic opioid use. The aim of this study is to know the perception of the physicians about which variables could be associated with increased risk of patients with CNCP developing a problem of abuse or misuse of the prescribed opioid medication.</p><p><strong>Methods: </strong>Twenty-nine physicians with experience in CNCP pain management and opioids prescription participated in a two-round Delphi study focused on the risk factors for opioid misuse and abuse.</p><p><strong>Results: </strong>The variables that reached consensus regarding their relationship with the increased risk of suffering a problem of opioid abuse or misuse were: (1) Experiencing pain on a daily basis, (2) previous use of high-dose opioids, (3) generalized anxiety, (4) hopelessness, (5) benzodiazepine intake, (6) use of opioids for reasons other than pain, (7) family problems, family instability or family breakdown, and (8) having access to several opioid prescribers. The only variable that reached consensus regarding it not being associated to a possible risk of abuse or misuse was having mild pain intensity (0-4 on a NRS-11).</p><p><strong>Conclusions: </strong>This study provides useful information that could help make decisions about the use of opioids for CNCP treatment and prevent future difficulties. Prospective studies testing the relationship of the variables that reached consensus with the risk of opioid misuse and abuse are warranted.</p><p><strong>Significance: </strong>This study shows the variables of CNCP that the professional must take into account in order to avoid possible problems when prescribing opioids.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"4 ","pages":"1269018"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10621745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71489614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-19eCollection Date: 2023-01-01DOI: 10.3389/fpain.2023.1298882
Jakub Mlost, Mateusz Kucharczyk
{"title":"Editorial: Computational methods for pain pharmacology.","authors":"Jakub Mlost, Mateusz Kucharczyk","doi":"10.3389/fpain.2023.1298882","DOIUrl":"https://doi.org/10.3389/fpain.2023.1298882","url":null,"abstract":"","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"4 ","pages":"1298882"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10622655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71489612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-19eCollection Date: 2023-01-01DOI: 10.3389/fpain.2023.1288707
Luca Giani, Pınar Yalinay Dikmen
{"title":"Editorial: Emerging trends in headache.","authors":"Luca Giani, Pınar Yalinay Dikmen","doi":"10.3389/fpain.2023.1288707","DOIUrl":"https://doi.org/10.3389/fpain.2023.1288707","url":null,"abstract":"","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"4 ","pages":"1288707"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10621905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71489613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-13eCollection Date: 2023-01-01DOI: 10.3389/fpain.2023.1237802
Siddhartha Sikdar, John Srbely, Jay Shah, Yonathan Assefa, Antonio Stecco, Secili DeStefano, Marta Imamura, Lynn H Gerber
Low back pain (LBP) is the leading cause of disability worldwide. Most LBP is non-specific or idiopathic, which is defined as symptoms of unknown origin without a clear specific cause or pathology. Current guidelines for clinical evaluation are based on ruling out underlying serious medical conditions, but not on addressing underlying potential contributors to pain. Although efforts have been made to identify subgroups within this population based on response to treatment, a comprehensive framework to guide assessment is still lacking. In this paper, we propose a model for a personalized mechanism-based assessment based on the available evidence that seeks to identify the underlying pathologies that may initiate and perpetuate central sensitization associated with chronic non-specific low back pain (nsLBP). We propose that central sensitization can have downstream effects on the "myofascial unit", defined as an integrated anatomical and functional structure that includes muscle fibers, fascia (including endomysium, perimysium and epimysium) and its associated innervations (free nerve endings, muscle spindles), lymphatics, and blood vessels. The tissue-level abnormalities can be perpetuated through a vicious cycle of neurogenic inflammation, impaired fascial gliding, and interstitial inflammatory stasis that manifest as the clinical findings for nsLBP. We postulate that our proposed model offers biological plausibility for the complex spectrum of clinical findings, including tissue-level abnormalities, biomechanical dysfunction and postural asymmetry, ecological and psychosocial factors, associated with nsLBP. The model suggests a multi-domain evaluation that is personalized, feasible and helps rule out specific causes for back pain guiding clinically relevant management. It may also provide a roadmap for future research to elucidate mechanisms underlying this ubiquitous and complex problem.
{"title":"A model for personalized diagnostics for non-specific low back pain: the role of the myofascial unit.","authors":"Siddhartha Sikdar, John Srbely, Jay Shah, Yonathan Assefa, Antonio Stecco, Secili DeStefano, Marta Imamura, Lynn H Gerber","doi":"10.3389/fpain.2023.1237802","DOIUrl":"10.3389/fpain.2023.1237802","url":null,"abstract":"<p><p>Low back pain (LBP) is the leading cause of disability worldwide. Most LBP is non-specific or idiopathic, which is defined as symptoms of unknown origin without a clear specific cause or pathology. Current guidelines for clinical evaluation are based on ruling out underlying serious medical conditions, but not on addressing underlying potential contributors to pain. Although efforts have been made to identify subgroups within this population based on response to treatment, a comprehensive framework to guide assessment is still lacking. In this paper, we propose a model for a personalized mechanism-based assessment based on the available evidence that seeks to identify the underlying pathologies that may initiate and perpetuate central sensitization associated with chronic non-specific low back pain (nsLBP). We propose that central sensitization can have downstream effects on the \"myofascial unit\", defined as an integrated anatomical and functional structure that includes muscle fibers, fascia (including endomysium, perimysium and epimysium) and its associated innervations (free nerve endings, muscle spindles), lymphatics, and blood vessels. The tissue-level abnormalities can be perpetuated through a vicious cycle of neurogenic inflammation, impaired fascial gliding, and interstitial inflammatory stasis that manifest as the clinical findings for nsLBP. We postulate that our proposed model offers biological plausibility for the complex spectrum of clinical findings, including tissue-level abnormalities, biomechanical dysfunction and postural asymmetry, ecological and psychosocial factors, associated with nsLBP. The model suggests a multi-domain evaluation that is personalized, feasible and helps rule out specific causes for back pain guiding clinically relevant management. It may also provide a roadmap for future research to elucidate mechanisms underlying this ubiquitous and complex problem.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"4 ","pages":"1237802"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10606250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71415769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-12eCollection Date: 2023-01-01DOI: 10.3389/fpain.2023.1303660
Carolin Assel
[This corrects the article DOI: 10.3389/fpain.2023.1151886.].
[这更正了文章DOI:10.3389/fpain.2023.1151886.]。
{"title":"Corrigendum: Effect of manual therapy on music students with playing-related musculoskeletal disorders: a prospective study.","authors":"Carolin Assel","doi":"10.3389/fpain.2023.1303660","DOIUrl":"https://doi.org/10.3389/fpain.2023.1303660","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fpain.2023.1151886.].</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"4 ","pages":"1303660"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10602799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71415770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-11eCollection Date: 2023-01-01DOI: 10.3389/fpain.2023.1281698
S Stevens Negus, Hamid I Akbarali, Minho Kang, Young K Lee, Samuel A Marsh, Edna J Santos, Yan Zhang
Introduction: Intermediate efficacy mu opioid receptor (MOR) agonists have potential to retain analgesic effectiveness while improving safety, but the optimal MOR efficacy for effective and safe opioid analgesia is unknown. Preclinical assays of pain-depressed behavior can assess effects of opioids and other candidate analgesics on pain-related behavioral depression, which is a common manifestation of clinically relevant pain and target of pain treatment. Accordingly, the present study goal was to validate a novel assay of pain-depressed locomotor behavior in mice and evaluate the role of MOR efficacy as a determinant of opioid analgesic effects and related safety measures.
Methods: Male and female ICR mice were tested in a locomotor chamber consisting of 2 compartments connected by a doorway that contained a 1-inch-tall barrier. Dependent measures during 15-min behavioral sessions included crosses between compartments (which required vertical activity to surmount the barrier) and total movement counts (which required horizontal activity to break photobeams in each compartment).
Results and discussion: Intraperitoneal injection of lactic acid (IP acid) produced a concentration- and time-dependent depression of both endpoints. Optimal blockade of IP acid-induced behavioral depression with minimal motor impairment was achieved with intermediate-efficacy MOR treatments that also produced less gastrointestinal-transit inhibition and respiratory depression than the high-efficacy MOR agonist fentanyl. Sex differences in treatment effects were rare. Overall, these findings validate a novel procedure for evaluating opioids and other candidate analgesic effects on pain-related behavioral depression in mice and support continued research with intermediate-efficacy MOR agonists as a strategy to retain opioid analgesic effectiveness with improved safety.
{"title":"Role of mu opioid receptor (MOR) agonist efficacy as a determinant of opioid antinociception in a novel assay of pain-depressed behavior in female and male mice.","authors":"S Stevens Negus, Hamid I Akbarali, Minho Kang, Young K Lee, Samuel A Marsh, Edna J Santos, Yan Zhang","doi":"10.3389/fpain.2023.1281698","DOIUrl":"10.3389/fpain.2023.1281698","url":null,"abstract":"<p><strong>Introduction: </strong>Intermediate efficacy mu opioid receptor (MOR) agonists have potential to retain analgesic effectiveness while improving safety, but the optimal MOR efficacy for effective and safe opioid analgesia is unknown. Preclinical assays of pain-depressed behavior can assess effects of opioids and other candidate analgesics on pain-related behavioral depression, which is a common manifestation of clinically relevant pain and target of pain treatment. Accordingly, the present study goal was to validate a novel assay of pain-depressed locomotor behavior in mice and evaluate the role of MOR efficacy as a determinant of opioid analgesic effects and related safety measures.</p><p><strong>Methods: </strong>Male and female ICR mice were tested in a locomotor chamber consisting of 2 compartments connected by a doorway that contained a 1-inch-tall barrier. Dependent measures during 15-min behavioral sessions included crosses between compartments (which required vertical activity to surmount the barrier) and total movement counts (which required horizontal activity to break photobeams in each compartment).</p><p><strong>Results and discussion: </strong>Intraperitoneal injection of lactic acid (IP acid) produced a concentration- and time-dependent depression of both endpoints. Optimal blockade of IP acid-induced behavioral depression with minimal motor impairment was achieved with intermediate-efficacy MOR treatments that also produced less gastrointestinal-transit inhibition and respiratory depression than the high-efficacy MOR agonist fentanyl. Sex differences in treatment effects were rare. Overall, these findings validate a novel procedure for evaluating opioids and other candidate analgesic effects on pain-related behavioral depression in mice and support continued research with intermediate-efficacy MOR agonists as a strategy to retain opioid analgesic effectiveness with improved safety.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"4 ","pages":"1281698"},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10598607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54232729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-10eCollection Date: 2023-01-01DOI: 10.3389/fpain.2023.1103497
Abouch Krymchantowski, Carla Jevoux, Ana Gabriela Krymchantowski, Luiza Barbosa Ramos, Jackeline S S Barbosa, Raimundo Pereira Silva-Neto
Medication-overuse headache (MOH) can develop from primary headaches. MOH is usually the result of overuse of symptomatic medications. It is a noteworthy personal and societal burden. The identification and treatment of patients at risk for MOH is an essential component of MOH management. Medication overuse can be modifiable and can advance from episodic to chronic migraine. Treatment for MOH is complex, and experts in the field have varied views on the most appropriate strategy for MOH treatment. The objective of this review is to give a comprehensive synopsis of the literature for the management of MOH. Treatment strategies, such as detoxification and prevention, are the debatable issues. Medication withdrawal is the foundation for management. The available literature suggested abrupt withdrawal with preventive approaches for early management. Bridging therapy could be useful to get relief from withdrawal symptoms. Multidisciplinary choices proved beneficial in supporting withdrawal and preventing relapse. Worldwide, the termination of overused medications has been observed as a standard treatment strategy; however, patient-specific approaches should be taken.
{"title":"Medication-overuse headache-a review of different treatment strategies.","authors":"Abouch Krymchantowski, Carla Jevoux, Ana Gabriela Krymchantowski, Luiza Barbosa Ramos, Jackeline S S Barbosa, Raimundo Pereira Silva-Neto","doi":"10.3389/fpain.2023.1103497","DOIUrl":"10.3389/fpain.2023.1103497","url":null,"abstract":"<p><p>Medication-overuse headache (MOH) can develop from primary headaches. MOH is usually the result of overuse of symptomatic medications. It is a noteworthy personal and societal burden. The identification and treatment of patients at risk for MOH is an essential component of MOH management. Medication overuse can be modifiable and can advance from episodic to chronic migraine. Treatment for MOH is complex, and experts in the field have varied views on the most appropriate strategy for MOH treatment. The objective of this review is to give a comprehensive synopsis of the literature for the management of MOH. Treatment strategies, such as detoxification and prevention, are the debatable issues. Medication withdrawal is the foundation for management. The available literature suggested abrupt withdrawal with preventive approaches for early management. Bridging therapy could be useful to get relief from withdrawal symptoms. Multidisciplinary choices proved beneficial in supporting withdrawal and preventing relapse. Worldwide, the termination of overused medications has been observed as a standard treatment strategy; however, patient-specific approaches should be taken.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"4 ","pages":"1103497"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10597723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50163998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}