European journal of pain : EJP
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Pain among children is common, yet far less studied compared to that among adults. Little has been reported regarding various types of pain in a national community sample of German children. ⋯ The rather high pain prevalence suggests pain among children may be a potential public health issue. Further studies are required to investigate the characteristics and correlational attributes of children suffering most frequently from pain and children from families with low socioeconomic status.
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Patients with Alzheimer's disease (AD) are administered fewer analgesics and report less clinical pain compared with their cognitively-intact peers, prompting much speculation about the likely impact of neurodegeneration on pain perception and processing. This study used functional connectivity analysis to examine the impact of AD on the integrated functioning of brain regions mediating the sensory, emotional, and cognitive aspects of pain. Fourteen patients with AD and 15 controls attended two experimental sessions. ⋯ Between-group comparisons revealed enhanced functional connectivity between the DLPFC and the anterior mid cingulate cortex, periaqueductal grey, thalamus, hypothalamus, and several motor areas in patients with AD compared with control group. Likewise, inter-regional functional connectivity across most regions of the predefined pain network was shown to be greater in the patient group, with the enhanced functional connectivity centred on three nodes: the DLPFC-R, hypothalamus, and PAG. The results of this study support previous research suggesting an interplay between pain and cognitive processes in patients with AD.
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Somatostatin (SST) in spinal cord has been linked with the inhibition of nociceptive neurotransmission in several experimental paradigms. The SST2 receptor (SSTR2) is the main SST receptor subtype in the superficial dorsal horn (DH) and is activated, besides to the naïve peptide, by the SST synthetic analogue octreotide (OCT). In the present work, we have studied the central effects of SSTR2 activation on capsaicin (CAP)-induced glutamate release in mouse DH. ⋯ A subset of them was also found to express the CAP receptor TRPV1. These data show that the SST analogue OCT inhibits CAP-mediated activation of non-peptidergic nociceptive PAFs in lamina II. Our data indicate that SSTR2a plays an important role in the pre-synaptic modulation of central excitatory nociceptive transmission in mouse.
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Randomized Controlled Trial
The anticonvulsant levetiracetam for the treatment of pain in polyneuropathy: a randomized, placebo-controlled, cross-over trial.
Levetiracetam is an anticonvulsant which is assumed to act by modulating neurotransmitter release via binding to the vesicle protein SV2A. This could have an impact on signaling in the nociceptive system, and a pilot study indicated relief of neuropathic pain with levetiracetam. ⋯ This study indicates that the anticonvulsant levetiracetam has no clinically relevant effect on painful polyneuropathy.
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Emotions and attention have been shown to influence the perception of pain and several psychophysiological studies have suggested an implication of descending modulatory mechanisms to explain these effects. However, the specificity of the neurophysiological mechanisms underlying the emotional and attentional modulation of pain still remains unclear. In order to differentiate the supra-spinal and spinal mechanisms involved in emotional and attentional modulation of pain, we measured pain perception (self-ratings) and the RIII reflex in healthy volunteers during the presentation of pleasant, unpleasant and neutral pictures, as well as during a baseline condition with no visual distractor (Experiment 1). ⋯ Increased arousal further potentiated the effects of negative valence on both pain and the RIII reflex and the effects of positive emotions on pain, as previously reported. However, arousal did not potentiate the inhibitory effect of positive pictures on the RIII and seems insufficient to account for the effect of distraction on the RIII. Overall, these data provide further evidence that attention and emotion modulate pain through partially dissociable neurophysiological mechanisms.