European journal of pain : EJP
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Spinal cord stimulation (SCS) has been shown to be an effective treatment for painful diabetic polyneuropathy (PDP). An increase of efficacy is needed since only 67% of patients benefit from SCS. This study aimed to develop an animal model for SCS in PDP and study the effect of various stimulation frequencies on the functional outcome. As the pathophysiology of PDP is complex, including vasoconstriction and nerve injury, the frequency of SCS may result in different outcomes. ⋯ The pain-relieving effect of SCS in PDP was studied in an experimental model. Our study shows that SCS on mechanical hypersensitivity in PDP rats is equally effective when applied at low, mid and high frequency.
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Brain areas involved in nociception have been repeatedly investigated. Therefore, brain responses to physiological pain conditions are well identified. The same is not true for allodynic pain in patients with neuropathic pain since the cortical reorganizations that are involved in the conversion of non-noxious stimuli into painful sensations still remain unknown. ⋯ The insular subdivision was inappropriately activated considering the innocuous nature of the stimulus, but adequately activated with regard to pain-evoked sensation. Subcortically, the hypothesis of reorganization at any level of the somatosensory and pain pathways underlying such insular activity was supported by the observed shift of thalamic activation from a lateral-posterior to an anterior-medial position.
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Schizophrenia patients display impaired recognition of their own emotions and those of others and deficits in several domains of empathy. The first-person experience of pain and observing others in pain normally trigger strong emotional mechanisms. We therefore hypothesized that schizophrenia patients would display impaired recognition and categorization of both their own pain and the pain of others. ⋯ Schizophrenic patients have a deficit of the identification and categorization of pain both in themselves and in others.
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Several functional magnetic resonance imaging (fMRI) studies use thermal pain stimuli to determine brain activation patterns during pain. Studies use either a standard temperature condition for all participants or an individualized temperature condition based on the individually determined pain threshold of the participant. The aim of the present study was to compare both conditions in the same participants. ⋯ The similar activation patterns between the two conditions suggest that it is not necessary to use individualized stimuli per se. The temperature of 46 °C appeared to be an adequate temperature for standardized stimulation to observe significant brain activations related to thermal pain.
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Randomized Controlled Trial
Pre-medication with sublingual fentanyl did not relieve pain associated with bone marrow aspiration and biopsy: A randomized feasibility trial.
Bone marrow aspiration and/or biopsy (BMAB) is often an unpleasant and painful procedure in spite of local anaesthetic infiltration. This randomized placebo-controlled trial compared the pain relieving effect of sublingual fentanyl and placebo during BMAB. ⋯ The results suggest that sublingual fentanyl in a dose of 200 μg (100 μg in infirm patients) is not a feasible preventive analgesic during BMAB. Pain scores were similar and side effects more frequent in the fentanyl group than in the placebo group.