European journal of pain : EJP
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The effect of catechol-O-methyltransferase polymorphisms on pain is modified by depressive symptoms.
Variations within the catechol-O-methyltransferase (COMT) gene have been associated with pain severity in temporomandibular disorders (TMDs). Psychological factors such as personal conflicts, life stress and depression, are well known to be associated with onset, severity and chronicity of pain disorders. ⋯ Our results indicate that variants within the COMT gene are associated with pain perception. However, this association is highly moderated by the absence or presence of lifetime depressive symptoms.
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Randomized Controlled Trial Multicenter Study Comparative Study
Randomized controlled trial of the combined monoaminergic and opioid investigational compound GRT9906 in painful polyneuropathy.
GRT9906 is an investigational novel compound with μ-opioid receptor agonism and inhibition of noradrenalin/serotonin re-uptake. In this randomized, double-blind, placebo-controlled, three-way cross-over trial in painful polyneuropathy, the efficacy and safety of GRT9906 was assessed and compared with tramadol. During 4-week treatment periods, daily oral doses of either GRT9906 120-240 mg, or placebo, or tramadol 200-400 mg were given. ⋯ The most frequently reported adverse events were nausea, fatigue, constipation and sleep disorder for GRT9906 and tramadol. Four patients dropped out due to adverse events during both GRT9906 and tramadol treatment and two dropped out during placebo treatment. In conclusion, in painful polyneuropathy, GRT9906 demonstrated analgesic efficacy with a magnitude of effect comparable with tramadol and was well tolerated.
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The aim of this review was to determine the impact of spinal cord stimulation (SCS) on physical function and sleep quality in individuals with failed back surgery syndrome (FBSS). This review comprised three phases: an electronic database search (PubMed, Cinahl Plus, EMBASE, PsychInfo, Pedro, Cochrane Library) identified potential papers; these were screened for inclusion criteria, with extraction of data from accepted papers and rating of internal validity by two independent reviewers using the Effective Public Health Practice Project quality assessment tool, a tool designed to assess non-RCTs (randomized controlled trials) as well as RCTs. Strength of the evidence was rated using the Agency for Health Care Policy and Research guidelines. ⋯ Improvements in sleep quantity, a reduction in awakenings and a decrease in sleep medication use were also noted (level D). The impact of SCS on cognitive function, i.e., memory and concentration, was also assessed using the same search strategy, no papers fulfilled the inclusion criteria for this study. Spinal cord stimulation effectively addressed many physical function and sleep problems associated with FBSS; however, there is a need for further high-quality objective investigations to support this.