European journal of pain : EJP
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Randomized Controlled Trial
Masseter corticomotor excitability is decreased after intramuscular administration of nerve growth factor.
Quantification of motor-evoked potentials (MEPs) can contribute to better elucidate the central modulation of motor pathways in response to nociceptive inputs. The primary aim of this study was to assess the modulatory effects of nerve growth factor (NGF) injection on masseter corticomotor excitability. ⋯ Intramuscular administration of nerve growth factor into masseter muscle causes inhibitory corticomotor plasticity, which likely occurs to prevent further damage and seems associated with lower pain intensity on function.
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Sensorimotor conflicts are well known to induce sensory disturbances. However, explanations as to why patients with chronic pain are more sensitive to sensorimotor conflicts remain elusive. The main objectives of this study were (a) to assess and compare the sensory disturbances induced by sensorimotor conflict in complex regional pain syndrome (n = 38), fibromyalgia (n = 36), arthritis (n = 34) as well as in healthy volunteers (HV) (n = 32); (b) to assess whether these disturbances were related to the intensity and duration of pain, or to other clinical variables assessed using questionnaires (abnormalities in sensory perception, depression and anxiety); and (c) to categorize different subgroups of conflict-induced sensory disturbances. ⋯ Individuals with complex regional pain syndrome and fibromyalgia were more sensitive to sensorimotor conflicts than arthritis patients and controls. Moreover, conflict-induced sensory disturbances were specific to higher pain intensity and higher sensory abnormalities in all groups, suggesting that pain lowers the threshold for the detection of sensorimotor conflicts.
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The assessment of pressure pain has become an integral part in pain research. The distribution of pressure under a plunger can be uneven. However, measurements based on conventional devices show the applied force or mean pressure, failing to take local pressure peaks into account. Our main question was whether peak pressures under the probe are responsible for pain onset. ⋯ This study adds some important considerations for the use of pressure algometers. It was found that during pressure pain thresholds readings distinct peak pressure profiles could arise, which may influence the perception of pain. Peak pressure could be another contributing factor, which may explain some of the high variability in pressure pain readings.
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Randomized Controlled Trial Clinical Trial
Complete withdrawal is the most feasible treatment for medication-overuse headache: A randomized controlled open-label trial.
Complete stop of acute medication and/or migraine medication for treatment of medication-overuse headache (MOH) has previously been reported more effective in reducing headache days and migraine days per month compared with restricted intake of acute medication. However, it is unknown whether complete stop or restricted intake is the most feasible treatment for patients. ⋯ A complete stop of all analgesics is the most effective treatment for MOH regarding reduction in headache days but has often been regarded as too challenging for patients. However, in this study, complete stop appears to be more feasible compared with restricted intake of analgesics seen from the patients' perspective.
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Individuals born preterm are at risk of later developmental problems and long-term morbidities. There is conflicting evidence regarding musculoskeletal pain in young adulthood. We investigated the prevalence of self-reported musculoskeletal pain in young adults born across the range of preterm birth compared with a term-born reference group. ⋯ Young adults born preterm do not have increased rates of musculoskeletal pain. Our findings rather suggest that these rates may be slightly lower than among those born at term.