Pain
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Considerable research indicates increased experience of clinical pain among females relative to males, and females also demonstrate enhanced responses to experimentally-induced pain. However, previous research has not investigated the relationship between clinical and experimental pain responses in healthy females and males. This experiment examined recent clinical pain as well as thermal pain thresholds and tolerances in 209 (117 female, 92 male) healthy young adults. ⋯ The differences remained significant after correcting for psychological variables including hypervigilance and sex role expectancies. These results indicate that experimental pain responses may be more clinically relevant for females than males. Potential explanations and implications for this pattern of results are discussed.
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In this study, pain perception, somatosensory event-related potential (SERP) and skin conductance response (SCR) changes during hypnotic suggestions of Deep Relaxation, Dissociated Imagery, Focused Analgesia, and Placebo, compared with a Waking baseline condition, were investigated. SERPs were recorded from frontal, temporal, central, and parietal scalp sites. Ten high, 9 mid, and 10 low hypnotizable right-handed women participated in the experiment. ⋯ These subjects also showed faster habituation of SCRs when compared with mid and low hypnotizables. During Dissociated Imagery and Focused Analgesia, highly hypnotizable subjects also disclosed a smaller total number of evoked SCRs than did mid and low hypnotizable subjects. The results are discussed considering possible common and different mechanisms to account for the effects of different hypnotic suggestions.
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Expression of bradykinin receptors was analyzed in freshly isolated dorsal root ganglion neurons of the ipsi- and contralateral segments L4/L5, L2/L3, and T12/T13 two to twenty days after unilateral injury of the adult rat sciatic nerve using gold labeled bradykinin. The number of infiltrating leucocytes was investigated by flow cytometry. Sciatic nerve injury transiently increased the proportion of neurons expressing bradykinin receptors not only in the ipsilateral ganglia L4/L5, but also in the homonymous contralateral ganglia and also bilaterally in the adjacent ganglia L2/L3. ⋯ No increase was observed prior to day ten and only in ipsilateral ganglia L4/L5, not contralaterally and not in adjacent ganglia L2/L3 and T12/T13. The experiments show that the induction of bradykinin receptors following a unilateral nerve lesion is not restricted to neurons projecting into the damaged nerve but is (i) bilateral, (ii) different in time course between injured and uninjured neurons, and (iii) locally confined to neurons of the adjacent ganglia. Macrophages and lymphocytes are increased after ten day ligation only in the affected ganglia and are probably not involved in the induction of bradykinin receptors.
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Pain intensity ratings of 'usual' pain, or pain 'on average', are gaining in popularity since they are arguably a more realistic measure of a patient's pain status than the single snapshot of 'current' pain. An alternative to the 'actual average' of ratings obtained from multiple measures is the single rating of patients' recall of their 'usual' pain over a period of time, usually 1 week. The use of such a scale relies on the assumption that patients can accurately recall their 'usual' pain. ⋯ Using the Intra-class Correlation Coefficient (ICC) to compute accuracy, the single rating asking patients to estimate their pain 'on average' over the week was found to be an accurate measure of 'actual average' pain intensity (ICC=0.82) and more accurate than 'current' pain (ICC=0.66). Although some composite measures of single ratings gave more accurate estimates of 'actual average' pain, this was not considered sufficient advantage to advocate their use. The results of this study propose the single rating of pain 'on average' as a valid and practical measure of a patient's pain intensity over a period of 1 week.
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The development of tolerance following repeated doses of morphine hinders the treatment of clinical pain. We have previously shown that morphine tolerance develops in neuropathic rats without cross-tolerance to a systemic kappa-opioid agonist; in the current work, using paw-pressure vocalization thresholds, we studied the antinociceptive effect of the peripherally-selective kappa (kappa)-opioid agonist, asimadoline, in both morphine-tolerant and opioid-naïve rats 2 weeks after sciatic nerve injury. In naïve rats, intraplantar (i.pl.) injection of asimadoline into the nerve-injured paw, at doses of 10, 15 and 20 (but not 30) microg, dose-dependently relieved the mechanical allodynia-like behaviour. ⋯ These results confirm that at low doses, asimadoline exerts its action only in the periphery. In morphine-tolerant rats (after 10 mg/kg s.c. , twice daily for 4 days) and naïve, saline-pretreated rats, asimadoline (15 microg, i.pl.) relieved the mechanical allodynia-like behaviour to the same extent, indicating no cross-tolerance between morphine and the peripherally-selective drug. Our findings show promise for the treatment of neuropathic pain with low doses of peripherally-selective kappa-opioids.