Pain medicine : the official journal of the American Academy of Pain Medicine
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The primary symptom of fibromyalgia is chronic, widespread pain; however, patients report additional symptoms including decreased concentration and memory. Performance-based deficits are seen mainly in tests of working memory and executive functioning. It has been hypothesized that pain interferes with cognitive performance; however, the neural correlates of this interference are still a matter of debate. In a previous, cross-sectional study, we reported that fibromyalgia patients (as compared with healthy controls) showed a decreased blood oxygen level dependent (BOLD) response related to response inhibition (in a simple Go/No-Go task) in the anterior/mid cingulate cortex, supplementary motor area, and right premotor cortex. ⋯ Our results suggest that the clinical distribution of pain is associated with the BOLD response elicited by a cognitive task. The cingulate cortex and the supplementary motor area are critically involved in both the pain system as well as the response inhibition network. We hypothesize that increases in the spatial distribution of pain might engage greater neural resources, thereby reducing their availability for other networks. Our data also point to the potential for, at least partial, reversibility of these changes.
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The present study aimed to develop the Japanese version of the Pain Self-Efficacy Questionnaire (PSEQ-J) and to evaluate its psychometric properties. ⋯ The results demonstrated that the PSEQ-J has adequate psychometric properties, supporting its use in clinical and research settings and suggest that the PSEQ-J may be particularly strongly associated with more social and less physical activity.
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Clinical Trial
Smoking behavior and motivation to quit among chronic pain patients initiating multidisciplinary pain treatment: a prospective study.
The primary aim of this study was to assess smoking characteristics and cessation motivation prior to and after initiation of multidisciplinary chronic pain treatment. A secondary aim was to identify predictors of cessation motivation among smokers initiating treatment for chronic pain. ⋯ Patients in this sample were more motivated to quit smoking a few weeks after, as compared with before initiating specialty pain treatment. Future research into pain-specific predictors of cessation motivation is warranted to inform the development of interventions that address pain patients' unique needs.
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Clinical Trial
Characterizing heat-sensitization responses in suspended moxibustion with high-density EEG.
We have reported "heat-sensitization" responses during suspended moxibustion, whose occurrence is associated with significantly better therapeutic effects. The present study aimed to characterize the electrophysiological features of this interesting phenomenon with high-density electroencephalography (EEG). ⋯ These data were the first objective evidence of heat-sensitization responses during suspended moxibustion, which were characterized by widespread oscillatory changes in scalp EEG.
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This study seeks to measure the radiation dose incurred in the evaluation of vascular filling during transforaminal epidural steroid injections (TFESI) using conventional fluoroscopy (CF), digital subtraction angiography (DSA), and multislice, pulsed computed tomography fluoroscopy (CT/F). ⋯ The use of DSA imaging to exclude vascular uptake during TFESI increases radiation dose over CF. CT/F incurs additional dose beyond most DSA. Minimizing radiation dose by limiting DSA and CT/F use to spine segments or clinical situations involving higher risk may be desirable. However, the incremental radiation doses incurred by DSA or CT/F are of such low magnitude that health risks cannot currently be estimated.