Pain
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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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Spinal antinociception produced by delta 9-tetrahydro-cannabinol (Delta(9)-THC) and other cannabinoid agonists has been suggested to be mediated by the release of dynorphin acting at the kappa opioid receptor. Alternatively, as cannabinoid receptors are distributed appropriately in the pain transmission pathway, cannabinoid agonists might act directly at the spinal level to inhibit nociception, without requiring dynorphin release. Here, these possibilities were explored using mice with a deletion of the gene encoding prodynorphin. ⋯ However, the same dose of nor-BNI used blocked U50,488H-induced antinociception in both wild-type and prodynorphin knock-out mice, confirming kappa opioid receptor activity. Pretreatment with SR141716A, a cannabinoid receptor antagonist blocked the antinociceptive actions of both WIN 55,212-2 and Delta(9)-THC. These data support the conclusion that antinociception produced by spinal cannabinoids are likely to be mediated directly through activation of cannabinoid receptors without the requirement for dynorphin release or activation of kappa opioid receptors.
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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).