Pain
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It has been proposed that goal pursuit plays a role in the development of chronic pain disorders. On the basis of (affective) motivational theories, it was hypothesized that both long-term achievement goals and short-term hedonic goals would be related to increased levels of pain and disability, particularly in patients with high negative affect. Participants with musculoskeletal pain complaints (N=299) completed a battery of questionnaires including a novel goal pursuit questionnaire (GPQ) measuring the extent to which participants preferred hedonic goals (mood-management or pain-avoidance goals) over achievement goals in various situations. ⋯ These findings provide support for the validity of an affective-motivational approach to chronic pain, suggesting that the experience of pain and the interference of pain on daily life activities depends on goal pursuit and negative affect. Interventions aimed at improving disability in chronic pain should address both patient's goal pursuit and negative affect. An affective-motivational approach to chronic pain indicates that achievement and pain-avoidance goals are associated with pain severity and disability, particularly in patients with high negative affect.
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The ability to determine precisely the location of sensory stimuli is fundamental to how we interact with the world; indeed, to our survival. Crossing the hands over the body midline impairs this ability to localize tactile stimuli. We hypothesized that crossing the arms would modulate the intensity of pain evoked by noxious stimulation of the hand. ⋯ Besides studies showing relief of phantom limb pain using mirrors, this is the first evidence that impeding the processes by which the brain localises a noxious stimulus can reduce pain, and that this effect reflects modulation of multimodal neural activities. By showing that the neural mechanisms by which pain emerges from nociception represent a possible target for analgesia, we raise the possibility of novel approaches to the treatment of painful clinical conditions. Crossing the arms over the midline impairs multimodal processing of somatosensory stimuli and induces significant analgesia to noxious hand stimulation.
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Opioid receptors are major actors in pain control and are broadly distributed throughout the nervous system. A major challenge in pain research is the identification of key opioid receptor populations within nociceptive pathways, which control physiological and pathological pain. In particular, the respective contribution of peripheral vs. central receptors remains unclear, and it has not been addressed by genetic approaches. ⋯ Delta receptors in these neurons tonically inhibit mechanical hypersensitivity in both inflammatory and neuropathic pain, and they are essential to mediate delta opioid analgesia under conditions of persistent pain. This delta receptor population represents a feasible therapeutic target to alleviate chronic pain while avoiding adverse central effects. The conditional knockout of delta-opioid receptor in primary afferent Na(V)1.8 neurons augmented mechanical allodynia in persistent pain models and abolished delta opioid analgesia in these models.