Articles: neuralgia.
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Neuropathic pain (NP) is a debilitating condition following spinal cord injury (SCI). The role of periaqueductal gray (PAG) in NP development following SCI remains underexplored. Using resting-state functional MRI (rsfMRI), our study aimed to demonstrate the alterations in functional connectivity (FC) of PAG in NP following SCI. ⋯ Altered FC between PAG and right anterior insula, VPL, DRN, RN, SN, cerebellar vermis lobules IV and V, frontal cortex, and PCC was associated with NP sequelae of SCI. Additionally, SCI was independently associated with decreased FC between PAG and right posterior insula, cerebellar lobules IV and V, and cerebellar vermis lobules III, IV, and V.
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Randomized Controlled Trial
Mean of Daily Versus Single Week Recall-Based Pain Quality Assessments in Neuropathic Pain Trials: Implications for Assay Sensitivity.
Patients with neuropathic pain often present with variable pain and nonpainful sensory qualities that could serve as outcomes in randomized clinical trials (RCTs). This study aimed to investigate the within-participant variability in the severity of these sensory qualities and whether the means of 7 daily pain quality assessments provide better assay sensitivity (ie, more sensitivity to treatment effects) than single-week recall-based assessments. This secondary analysis used data from an RCT of transcutaneous electrical nerve stimulation for chemotherapy-induced peripheral neuropathy (N = 142). ⋯ Compared with single-week recall-based assessments of pain qualities, the mean of daily assessments may improve RCT assay sensitivity when used to define entry criteria and assess outcomes. PERSPECTIVE: This study suggests that means of daily pain quality assessments may improve assay sensitivity when used to define entry criteria and assess outcomes in clinical trials. This work may inform design of future clinical trials evaluating the intensity of different pain qualities.
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Observational Study
A Nomogram Model for Predicting Postherpetic Neuralgia in Patients with Herpes Zoster: A Prospective Study.
Herpes zoster (HZ) and postherpetic neuralgia (PHN) have a negative effect on patients. A simple and practical PHN prediction model is lacking. ⋯ The incidence of PHN is influenced by factors such as being a woman, being more than 50 years old, having prodromal phase pain, having a large rash area, and having great pain severity during the acute stage. The prediction model developed in this study effectively forecasts the occurrence of PHN using these 5 risk factors, making it a valuable tool for clinical practice.
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Cisplatin-based chemotherapy is a common treatment for paediatric cancer. Unfortunately, cisplatin treatment causes neuropathic pain, a highly prevalent adverse health related complication in adult childhood cancer survivors. Due to minimal understanding of this condition, there are currently no condition tailored analgesics available. ⋯ Nerve growth factor (NGF) induced TrkA activation led to sensory neuritogenesis and nociceptor sensitisation, which could be prevented through pharmacological TrkA inhibition (GW441756 either s.c. 100 nM or i.p. 2 mg/kg). Administration of TrkA antagonist suppressed cisplatin induced TRPV1 mediated nociceptor sensitisation and prevented cisplatin induced neuropathic pain. These studies provide greater understanding of the underlying mechanisms that cause cisplatin induced childhood cancer survivorship pain and allowing identification of potential therapeutic targets.
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Low back pain is a highly prevalent condition with substantial costs. Superior cluneal neuralgia is present in up to 14% of low back pain cases. This etiology of back pain is often overlooked because the symptoms of superior cluneal neuralgia manifest similarly to those of other conditions, such as radiculopathy and sacroiliac joint pain. Peripheral nerve stimulation (PNS) is an emerging pain management modality used to treat various chronic pain conditions. This retrospective study will examine the outcomes of patients who have back pain caused by neuralgia and are treated with the permanent Freedom® PNS System (Curonix LLC) at the superior cluneal nerve. ⋯ When used to target the superior cluneal nerve, the Curonix Freedom® PNS System is an effective and safe treatment for neuralgia-caused chronic lower back pain resistant to conservative therapy.