European journal of pain : EJP
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Injury to the trigeminal nerve often results in the development of chronic pain states including tactile allodynia, or hypersensitivity to light touch, in orofacial area, but its underlying mechanisms are poorly understood. Peripheral nerve injury has been shown to cause up-regulation of thrombospondin-4 (TSP4) in dorsal spinal cord that correlates with neuropathic pain development. In this study, we examined whether injury-induced TSP4 is critical in mediating orofacial pain development in a rat model of chronic constriction injury to the infraorbital nerve. ⋯ Our data support that infraorbital nerve injury leads to TSP4 up-regulation in trigeminal spinal complex that contributes to orofacial neuropathic pain states. Blocking this pathway may provide an alternative approach in management of orofacial neuropathic pain states.
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The Child Health Questionnaire (CHQ) is a widely used instrument for measuring health-related quality of life covering both the physical and psychosocial domain. This study examined the responsiveness of the Dutch CHQ 50-item Parent Form (PF50) in a sample of adolescents with chronic non-specific pain and/or fatigue. ⋯ Using the methods SRM, ES and AUC, the responsiveness of the CHQ-PF50 in adolescents with non-specific chronic pain or fatigue treated in a rehabilitation clinic is adequate for the physical scale and moderate for the psychosocial scale.
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Experimental data regarding age effects on sensitivity and pain thresholds are not always consistent, with the type of stimulus being a major source of variability. This could suggest that some types of peripheral sensory fibres undergo more important modifications with age than others. We investigated whether ageing affects differently myelinated and unmyelinated fibres. ⋯ These findings suggest that myelinated Aδ-fibres are compromised by the normal ageing process, whereas unmyelinated C-fibres seem to remain unaltered or, at least, less affected.
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High intensity of acute post-surgical pain is one of the strongest predictors for chronic post-surgical pain (CPSP). We investigated the predictive power of acute post-surgical pain trajectories and the interplay of pain trajectories and diverse psychosocial risk factors in the development of CPSP. ⋯ In this study, we demonstrated that going beyond conventional one-time measurements of acute pain by modelling pain trajectories may substantially enhance research on pain chronification in two ways: First, pain trajectories bear great potential to improve the prediction of CPSP. Second, they represent a meaningful link between psychosocial vulnerability and CPSP because they can be used to uncover mechanisms by which psychosocial vulnerability unfolds. The reported findings suggest that the incidence of CPSP may be reduced by optimizing post-operative pain monitoring.
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Fear of childbirth is associated with preference for an elective caesarean section (ECS); however, the role of fear of pain and pain catastrophizing (the tendency to predict the worst case scenario) have not been investigated. The aim of current study was to investigate whether fear of pain and catastrophizing were independent predictors of preference for ECS. We hypothesized that pain catastrophizing and negative affectivity would mediate the relationship between fear of pain and preference for ECS. ⋯ Fear of both childbirth and pain were both independent predictors of preference for ECS. Catastrophizing mediated the relationship between fear of pain and preference for ECS. Interventions that target these factors may reduce the trend towards increasing numbers of ECS internationally.