Articles: neuralgia.
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Observational Study
Microstructural Abnormalities in Gray Matter of Patients with Postherpetic Neuralgia: A Diffusional Kurtosis Imaging Study.
Changes in functional activity and connectivity have been shown in patients experiencing postherpetic neuralgia (PHN) pain. However, PHN-induced structural changes, particularly in the gray matter of which volume and density was widely reported to be altered by other chronic pain, have not been well characterized. ⋯ Postherpetic neuralgia, diffusional kurtosis imaging, insula cortex, gray matter, voxel-based analysis.
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Human cytochrome P4502D6 (CYP2D6) gene is highly polymorphic, leading to wide interindividual ethnic differences in CYP2D6-mediated drug metabolism. Its activity ranges from complete deficiency to excessive activity, potentially causing toxicity of the medication or therapeutic failure with recommended drug dosages. The aim of the study was to find the association of CYP2D6*2 polymorphisms with demographic characters (age, sex, and weight), pain intensity scales [numerical rating scale (NRS) sleep, global perceived effect (GPE)], and adverse drug effects in postherpetic neuralgia (PHN) patients receiving tramadol. ⋯ In addition, CYP2D6*2 genotype was not related to the adverse effects of analgesic therapy. The overall results suggested that CYP2D6*2 polymorphism plays no role in the PHN patients receiving tramadol treatment. The CYP2D6*2 polymorphism may not be a predictor of treatment outcome of patients with respect to PHN-receiving tramadol.
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There were several reports suggesting α-adrenoceptor antagonists are effective to treat neuropathic pain. The aims of this study were as follows: (1) to introduce drug delivery system for dorsal root ganglion (DRG) neurons; (2) to elucidate the effects of α-adrenoceptor antagonists in acute, subacute or chronic phase and (3) to determine which subtype of adrenoceptor was mainly involved. ⋯ This study showed α-adrenoceptor antagonists could suppress pain behaviour via α2-adrenoceptor in acute phase and temporary attenuate pain behaviour in chronic phase. These findings presented potentials sympathetic nerve blockade contributed to treat neuropathic pain.
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Journal of neurosurgery · May 2016
Correlation of preoperative MRI with the long-term outcomes of dorsal root entry zone lesioning for brachial plexus avulsion pain.
OBJECT Lesioning of the dorsal root entry zone (DREZotomy) is an effective treatment for brachial plexus avulsion (BPA) pain. The role of preoperative assessment with MRI has been shown to be unreliable for determining affected levels; however, it may have a role in predicting pain outcomes. Here, DREZotomy outcomes are reviewed and preoperative MRI is examined as a possible prognostic factor. ⋯ A longer duration of pain prior to operation was also a significant predictor of treatment success (p = 0.004). CONCLUSIONS Overall, the DREZotomy procedure has a 66% chance of achieving meaningful pain relief on long-term follow-up. Successful pain relief is associated with the lack of damage to the DREZ and dorsal horn on preoperative MRI.
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Psychometric Validity and Reliability of the Thai Version of the Neuropathic Pain Symptom Inventory.
The aim of this study was to evaluate validity and reliability of the Thai version of the Neuropathic Pain Symptom Inventory (NPSI-T) in Thai patients with neuropathic pain. Although the Thai version of Neuropathic Pain Symptom Inventory (NPSI-T) has been linguistically validated, the tool has to be psychometrically validated before applying to neuropathic pain patients in daily practice. ⋯ The study demonstrated validity and reliability of the NPSI-T for assessing the neuropathic pain in Thai patients.