Pain
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Cancer cells secrete pronociceptive mediators that sensitize adjacent sensory neurons and cause pain. Identification and characterization of these mediators could pinpoint novel targets for cancer pain treatment. In this study, we identified candidate genes in cancer cell lines that encode for secreted or cell surface proteins that may drive nociception. ⋯ Monoclonal antibody against EGFR, cetuximab, inhibited cell line supernatant-induced nociceptive behavior in an acute oral cancer pain mouse model. We infer from these data that ADAM17-EGFR signaling is involved in cancer mediator-induced nociception. The differentially expressed genes and their secreted protein products may serve as candidate therapeutic targets for oral cancer pain and warrant further evaluation.
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Meta Analysis
Persistent pain and cognitive decline in older adults: a systematic review and meta-analysis from longitudinal studies.
Both persistent pain and cognitive decline prevalence increase with advancing age and are associated with functional decline. However, the association of pain and cognitive decline has not been evaluated yet by a systematic assessment of longitudinal studies. We aimed to assess the association of persistent pain as a risk factor for cognitive decline in community older adults, using data from longitudinal studies in a systematic review and meta-analysis. ⋯ Persistent pain at baseline was not associated with the development of cognitive decline during the follow-up (pooled RR = 1.05, 95% confidence interval = 0.92-1.21). In sensitivity analyses, only length of follow-up time ≤4.5 years was associated with a higher risk of cognitive impairment (pooled RR = 1.19, 95% confidence interval = 1.10-1.28). Persistent pain was not associated with the incidence of cognitive decline.
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Randomized Controlled Trial
Effects of hypnosis, cognitive therapy, hypnotic cognitive therapy, and pain education in adults with chronic pain: a randomized clinical trial.
Chronic pain is a significant health problem worldwide with limited pharmacological treatment options. This study evaluated the relative efficacy of 4 treatment sessions each of 4 nonpharmacological treatments: (1) hypnotic cognitive therapy (using hypnosis to alter the meaning of pain); (2) standard cognitive therapy; (3) hypnosis focused on pain reduction, and (4) pain education. One hundred seventy-three individuals with chronic pain were randomly assigned to receive 4 sessions of 1 of the 4 treatments. ⋯ Pretreatment to posttreatment improvements were observed across the 4 treatment conditions on the secondary outcomes of pain interference and depressive symptoms, with some return towards pretreatment levels at 12-month follow-up. No significant between-group differences emerged in omnibus analyses, and few statistically significant between-group differences emerged in the planned pairwise analyses, although the 2 significant effects that did emerge favored hypnotic cognitive therapy. Future research is needed to determine whether the significant differences that emerged are reliable.
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This article is the first to present the Graphical Index of Pain (GRIP), a new user-friendly web-based method for high-throughput screening of pain. The long-term goal of the method is to improve global standardization of pain measurements. GRIP consists of a hierarchical body map with 10 first-tier body regions, and a second tier with multiple pain loci (167 among men, 168 among women), which provides detailed information about pain location and distribution. ⋯ Pain intensity at first-tier regions and pain location and distribution at second-tier regions are in this article presented by sex-stratified customized heat maps showing large sex difference. Mean time to mark the first- and second-tier regions was 74 seconds. In conclusion, GRIP allows for high-resolution assessment and presentation of pain location and distribution with minimal use of time.