Pain
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Clinical Trial Controlled Clinical Trial
Reactivity to superficial and deep stimuli in patients with chronic musculoskeletal pain.
In this study, we evaluated pain sensitivity in patients with fibromyalgia or other types of chronic, diffuse musculoskeletal pain to establish whether fibromyalgia represents the end of a continuum of dysfunction in the nociceptive system. One hundred and forty five patients and 22 healthy subjects (HS) completed an epidemiological questionnaire to provide information about fatigue, stiffness, sleep, the intensity of pain (VAS 0-100) and its extent both at onset and at present. Algometry was performed at all American College of Rheumatology (ACR) tender points and at ten control points. ⋯ In each psychophysical test, patients with widespread pain and patients with multiregional pain showed similar thresholds; however, the thresholds in the MP or MPTE groups differed from those in the FS and SCFS groups. In the FS group, pain thresholds and pain tolerance did not differ according to the presence of ongoing pain at the stimulated site and were not correlated to ongoing pain. The results indicate that dysfunction in the nociceptive system is already present in patients with multiregional pain with a low tender point count; it becomes more and more severe as the positive tender point count and pain extent increase and it is maximal in fibromyalgia patients.
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Clinical Trial
Temporo-spatial analysis of cortical activation by phasic innocuous and noxious cold stimuli--a magnetoencephalographic study.
Clinical findings and recent non-invasive functional imaging studies pinpoint the insular cortex as the crucial brain area involved in cold sensation. By contrast, the role of primary (SI) and secondary (SII) somatosensory cortices in central processing of cold is controversial. So far, temporal activation patterns of cortical areas involved in cold processing have not been examined. ⋯ In conclusion, this study strongly corroborates the posterior insular cortex as the primary somatosensory area for cortical processing of cold sensation. Furthermore, it supports the role of SII and the cingulate cortex in mediating freeze-pain. Therefore, these results suggest different processing of cold, freeze-pain and touch in the human brain.
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This case presents a patient with neuropathic pain in a lower extremity, which appeared subsequent to the removal of a C1 meningioma and which was successfully treated by lower thoracic spinal cord stimulation.
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Previous research exploring the relationship between litigation status and the symptoms of the plaintiff has been inconsistent and limited by methodological difficulties. This longitudinal study addressed many of the methodological shortcomings of previous research and examined the relationship between litigation status, employment, depression, pain and disability over the duration of the compensation process. Two hundred chronic back pain participants were selected from patients who attended an initial assessment interview at a pain centre. ⋯ On the other hand participants who were litigating scored higher on all the measures than did participants who were not litigating. There was a significant time effect on all measures but this was qualified on some measures by the interactions of time with litigation status and work status. The present research further demonstrated that both litigation and employment were significant factors influencing recovery from injury.
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Editorial Comment Comparative Study
New directions in research on pain and ethnicity: a comment on Riley, Wade, Myers, Sheffield, Pappas, and Price (2002).