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- Nijs, Jo, et al.
(författare)
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Nutritional intervention in chronic pain: an innovative way of targeting central nervous system sensitization?
- 2020
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Ingår i: Expert Opinion on Therapeutic Targets. - : Informa UK Limited. - 1472-8222 .- 1744-7631. ; 24:8, s. 793-803
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Few treatment programs for chronic pain nowadays take a dietary pattern or adipose status into account. Areas covered An important role of neuroinflammation in chronic pain is now well established, at least in part due to increased central nervous system glial activation. Based on preclinical studies, it is postulated that the interaction between nutrition and central sensitization is mediated via bidirectional gut-brain interactions. This model of diet-induced neuroinflammation and consequent central sensitization generates a rationale for developing innovative treatments for patients with chronic pain. Methods: An umbrella approach to cover the authors' expert opinion within an evidence-based viewpoint. Expert opinion A low-saturated fat and low-added sugar dietary pattern potentially decreases oxidative stress, preventing Toll-like receptor activation and subsequent glial activation. A low-saturated fat and low-added sugar diet might also prevent afferent vagal nerve fibers sensing the pro-inflammatory mediators that come along with a high-(saturated) fat or energy-dense dietary pattern, thereby preventing them to signal peripheral inflammatory status to the brain. In addition, the gut microbiota produces polyamines, which hold the capacity to excite N-methyl-D-aspartate receptors, an essential component of the central nervous system sensitization. Hence, a diet reducing polyamine production by the gut microbiota requires exploration as a therapeutic target for cancer-related and non-cancer chronic pain.
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- Leemans, L., et al.
(författare)
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Do psychological factors relate to movement-evoked pain in people with musculoskeletal pain? A systematic review and meta-analysis
- 2022
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Ingår i: Brazilian Journal of Physical Therapy. - : Elsevier BV. - 1413-3555. ; 26:6
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Tidskriftsartikel (refereegranskat)abstract
- Background: A growing body of evidence has demonstrated the importance of implementing movement-evoked pain in conventional pain assessments, with a significant role for psychologi-cal factors being suggested. Whether or not to include these factors in the assessment of move-ment-evoked pain has not yet been determined.Objectives: The aim of this systematic review is to explore the association between psychologi-cal factors and movement-evoked pain scores in people with musculoskeletal pain.Methods: For this systematic review with meta-analysis, four electronic databases (PubMed, Medline, WOS, and Scopus) were searched. Cross-sectional studies, longitudinal cohort studies, and randomized controlled trials investigating the association between movement-evoked pain and psychological factors in adults with musculoskeletal pain were considered. Meta-analysis was conducted for outcomes with homogeneous data from at least 2 studies. Fischer-Z transfor-mations were used as the measure of effect. Quality of evidence was assessed using the National Institutes of Health's Quality assessment tool for observational cohort and cross-sectional studies and Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Results: Meta-analyses and grading the quality of evidence revealed moderate evidence for a relation between movement-evoked pain and depressive symptoms (Fisher-z=0.27; 95%CI: 0.17, 0.36; 5 studies (n=440)), pain-related fear (Fisher-z=0.35; 95%CI: 0.26, 0.44; 6 studies (n=492)), and pain catastrophizing (Fisher-z=0.47; 95%CI: 0.36, 0.58; 4 studies (n=312)) in people with musculoskeletal pain.Conclusions: Movement-evoked pain is weakly to moderately associated to depressive symp-toms, pain-related fear, and pain catastrophizing in people with musculoskeletal pain.(c) 2022 Associa4ao Brasileira de Pesquisa e Pos-Gradua4ao em Fisioterapia. Published by Elsevier Espana, S.L.U. All rights reserved.
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