The journal of pain : official journal of the American Pain Society
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Millions of Americans live with chronic inflammatory pain conditions, and the prevalence of these conditions increases with age and is higher in females. Still, it is poorly understood how sex, age and peripheral gene expression affect the trajectory of chronic inflammatory pain conditions. We used the inflammatory agent, Complete Freund's Adjuvant (CFA), to systematically test sex and age effects on mechanical and thermal sensitivity in adolescent and adult male and female Wistar rats over 3 weeks (Experiment 1 [onset]) or 11 weeks (Experiment 2 [recovery]). ⋯ Our results demonstrate apparent sex and age differences in the trajectory of chronic inflammatory pain-related behavior and gene expression in the affected paw of rats. PERSPECTIVE: This article highlights sex and age differences in the trajectory of chronic inflammatory pain and possible peripheral mechanisms driving recovery in Wistar rats. This data could be used to better understand recovery patterns in patients with this type of pain and provides a starting point for assessment of novel treatments.
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Resting-state electroencephalography (rsEEG) holds promise as a biomarker of chronic pain. However, the impact of centrally acting analgesics like opioids, antiepileptics, and antidepressants on rsEEG remains unclear. This confounds and limits the interpretability of previous studies and questions the specificity of rsEEG biomarker candidates of chronic pain, especially for potential diagnostic biomarkers. ⋯ The results predominantly provided evidence against effects on peak alpha frequency, oscillatory power, and connectivity-based network measures. This might help to develop clinically useful biomarkers of chronic pain. DATA AVAILABILITY: Datasets are available at https://osf.io/uzgxw/files/osfstorage.
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Treatment expectations (TE) are predictive of patient outcomes in clinical practice and suggested to moderate treatment responses in chronic pain clinical trials. However, evidence is mainly derived from studies conducted with adult populations with musculoskeletal pain, primarily focused on pharmacological treatments and a few alternative intervention modalities (e.g., acupuncture). We examined the role of pretreatment TE in youth participating in two randomized controlled trials of digital cognitive-behavioral therapy (CBT) for chronic pain-the WebMAP2 Trial of youth with chronic primary pain (n = 273) and the iCC-SCD Trial of youth with sickle cell pain (n = 111). ⋯ Overall, higher pretreatment TE were associated with better functioning over time, though the specific domains of improvement and the moderating effects on treatment efficacy somewhat differed between youth with primary and sickle cell-related chronic pain. PERSPECTIVE: Incorporating TE into clinical assessments and ensuring consistent collection, reporting, and analysis in clinical trials are crucial for identifying potential heterogeneous treatment responses. Standardizing TE measures for youth with chronic pain and considering population characteristics are important for understanding TE's role in treatment responses.
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Chronic ocular pain impacts quality of life and is often linked to ocular surgery. We assessed the prevalence of chronic postoperative pain (CPOP) after cataract surgery and associated risk factors using a secondary cohort post-hoc analysis of data from the Age-Related Eye Disease Study (AREDS), a multicenter, controlled, randomized clinical trial of antioxidant vitamins and minerals. Ocular pain was determined from item 4 of the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25), administered between 1997 and 2005. ⋯ PERSPECTIVE: We found a high prevalence of Chronic Postoperative Pain (CPOP) in the AREDS cohort, with 13 % of participants who underwent cataract surgery developing CPOP. Post-hoc analysis did not identify significant risk factors for CPOP. Our study contributes valuable insights into a growing area of interest in pain management within ophthalmology.
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Chronic pain is a debilitating condition associated with brain alterations. However, the variability in neuroimaging results across modalities necessitates a comprehensive multi-modal meta-analysis for a cohesive understanding. This study aims to elucidate brain alterations in chronic pain patients using a multi-modal meta-analysis approach encompassing structural, resting-state functional connectivity, and pain processing paradigms in functional magnetic resonance imaging. ⋯ This multi-modal meta-analysis reveals consistent brain alterations in chronic pain patients, shedding light on the complex interplay between structural and functional changes. PERSPECTIVE: This multi-modal meta-analysis integrates findings from structural, resting-state functional connectivity, and pain processing paradigms in fMRI, revealing consistent brain alterations in chronic pain patients. Notable brain changes highlight the intricate interplay between structural and functional brain changes, advancing our understanding of chronic pain's neural underpinnings.