Pain medicine : the official journal of the American Academy of Pain Medicine
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Electroconvulsive shock therapy (ECT) has been widely used as an effective and established treatment for refractory depression and schizophrenia. Some reports have shown that ECT is also effective for treating refractory neuropathic pain. ⋯ Symptoms of neuropathic pain improved and expression of NPY in the brain was increased in CCI model rats after ECS, suggesting that changes in the expression of NPY in the brain may be related to the mechanism of action of ECT in treating neuropathic pain.
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To provide an overview of the role of voltage-gated sodium channels in pathophysiology of acquired and inherited pain states, and of recent developments that validate these channels as therapeutic targets for treating chronic pain. ⋯ These studies suggest that isoform-specific blockers of these channels or targeting of their modulators may provide novel approaches to treatment of pain.
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An increasing number of Operation Iraqi Freedom/Operation Enduring Freedom veterans experience chronic pain. Despite treatment guidelines, there is wide variation in physicians' approaches to pain treatment, and many physicians are unsure of the best treatment approach. Research has examined factors associated with opioid prescribing, but there is little information on physician characteristics that predict patterns of clinical responses to pain. ⋯ There may be distinct patterns in primary care physicians' responses to patients with chronic pain. Relatively few physicians use the multimodal approach endorsed by proponents of the biopsychosocial model of pain treatment. Several physician and practice characteristics predict patterns of clinical action.
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The objective of the study was to determine if there is dysregulated autonomic nervous system activity as manifested by depressed heart rate variability (HRV) among veterans of Operations Enduring and Iraqi Freedom (OEF/OIF). ⋯ These preliminary findings support the high prevalence of depressed HRV and P3 among veterans seen in a level II Polytrauma Center. The findings also suggest a possible synergistic effect of pain, PTSD, and mTBI on depressed HRV. The nature and implications of these relationships require additional research to elucidate.