The Clinical journal of pain
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To compare the predictive ability of the Orebro Musculoskeletal Pain Questionnaire-a screening tool for psychosocial factors in patients with low back pain across 2 cultural settings (Norway and Australasia) and to establish whether the Orebro provides additional information about outcome than that provided by the baseline value of the prognostic outcome. ⋯ The Orebro questionnaire had similar predictive ability in Norway and Australasia when pain was used as an outcome, whereas the Orebro tended to be a stronger predictor in Norway when disability was used as outcome.
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The pathophysiology of neuropathic pain is still poorly understood. Studies in experimental animals showed that neurotrophic factors such as glial cell line-derived neurotrophic factor (GDNF), brain-derived neurotrophic factor (BDNF), ciliary neurotrophic factor (CNTF), and nerve growth factor (NGF) might be involved in the pathophysiology of neuropathic pain. On the basis of these findings it is conceivable that neurotrophic factors also play a role in pain processing in man. Thus far, it remains unknown whether neurotrophic factors are altered in the cerebrospinal fluid (CSF) of patients with different pain syndromes. Here, we analyzed the concentrations of neurotrophic factors in the CSF of patients with chronic neuropathic pain in comparison to controls with nociceptive pain or hydrocephalus. ⋯ We did not detect any difference between patients with neuropathic versus nociceptive pain and nonpainful controls for spinal CNTF, BDNF, and NGF levels. Lower GDNF concentrations found in neuropathic pain patients might be associated with increased receptor expression. Possible alterations of neurotrophic factors at spinal relays, however, might not be reflected adequately in changes of CSF concentrations.