The Clinical journal of pain
-
To investigate if hypersensitivity is present in elders with pain. Chronic headache was used as a model of chronic pain and mechanical and thermal pain thresholds were measured. ⋯ Central hyperexcitability does not seem to be a feature of elders with headache. This may be as a consequence of age-related changes in the sensory system but could also be related to the nature of the stimulus provided. Further research in this area is required to better understand pain processing in elders.
-
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.