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| 2. |
- Coppieters, I., et al.
(författare)
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The Role of Serotonergic and Noradrenergic Descending Pathways on Performance-Based Cognitive Functioning at Rest and in Response to Exercise in People with Chronic Whiplash-Associated Disorders: A Randomized Controlled Crossover Study
- 2023
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Ingår i: Clinics and Practice. - 2039-7275. ; 13:3, s. 684-700
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Tidskriftsartikel (refereegranskat)abstract
- (1) Background: Dysregulation in serotonergic and noradrenergic systems may be implicated in the neurobiophysiological mechanisms underlying pain-related cognitive impairment in chronic whiplash-associated disorders (CWAD). This study aimed to unravel the role of serotonergic and noradrenergic descending pathways in cognitive functioning at rest and in response to exercise in people with CWAD. (2) Methods: 25 people with CWAD were included in this double-blind, randomized, controlled crossover study. Endogenous descending serotonergic and noradrenergic inhibitory mechanisms were modulated by using a single dose of a selective serotonin reuptake inhibitor (Citalopram) or a selective norepinephrine reuptake inhibitor (Atomoxetine). Cognitive performance was studied at rest and in response to exercise (1) without medication intake; (2) after intake of Citalopram; and (3) after intake of Atomoxetine. (3) Results: After Atomoxetine intake, selective attention improved compared with the no medication day (p < 0.05). In contrast, a single dose of Citalopram had no significant effect on cognitive functioning at rest. When performing pairwise comparisons, improvements in selective attention were found after exercise for the no medication condition (p < 0.05). In contrast, after intake of Citalopram or Atomoxetine, selective and sustained attention worsened after exercise. (4) Conclusions: A single dose of Atomoxetine improved selective attention only in one Stroop condition, and a single dose of Citalopram had no effect on cognitive functioning at rest in people with CWAD. Only without medication intake did selective attention improve in response to exercise, whereas both centrally acting medications worsened cognitive performance in response to a submaximal aerobic exercise bout in people with CWAD.
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| 3. |
- Nijs, Jo, et al.
(författare)
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Nociplastic Pain Criteria or Recognition of Central Sensitization? Pain Phenotyping in the Past, Present and Future
- 2021
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Ingår i: Journal of Clinical Medicine. - : MDPI AG. - 2077-0383. ; 10:15
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Tidskriftsartikel (refereegranskat)abstract
- Recently, the International Association for the Study of Pain (IASP) released clinical criteria and a grading system for nociplastic pain affecting the musculoskeletal system. These criteria replaced the 2014 clinical criteria for predominant central sensitization (CS) pain and accounted for clinicians' need to identify (early) and correctly classify patients having chronic pain according to the pain phenotype. Still, clinicians and researchers can become confused by the multitude of terms and the variety of clinical criteria available. Therefore, this paper aims at (1) providing an overview of what preceded the IASP criteria for nociplastic pain ('the past'); (2) explaining the new IASP criteria for nociplastic pain in comparison with the 2014 clinical criteria for predominant CS pain ('the present'); and (3) highlighting key areas for future implementation and research work in this area ('the future'). It is explained that the 2021 IASP clinical criteria for nociplastic pain are in line with the 2014 clinical criteria for predominant CS pain but are more robust, comprehensive, better developed and hold more potential. Therefore, the 2021 IASP clinical criteria for nociplastic pain are important steps towards precision pain medicine, yet studies examining the clinimetric and psychometric properties of the criteria are urgently needed.
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| 4. |
- Nijs, Jo, et al.
(författare)
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Towards precision pain medicine for pain after cancer: the Cancer Pain Phenotyping Network multidisciplinary international guidelines for pain phenotyping using nociplastic pain criteria
- 2023
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Ingår i: British Journal of Anaesthesia. - : Elsevier BV. - 0007-0912. ; 130:5, s. 611-621
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Tidskriftsartikel (refereegranskat)abstract
- Pain after cancer remains underestimated and undertreated. Precision medicine is a recent concept that refers to the ability to classify patients into subgroups that differ in their susceptibility to, biology, or prognosis of a particular disease, or in their response to a specific treatment, and thus to tailor treatment to the individual patient characteristics. Applying this to pain after cancer, the ability to classify post-cancer pain into the three major pain phenotypes (i.e. nociceptive, neuropathic, and nociplastic pain) and tailor pain treatment accordingly, is an emerging issue. This is especially relevant because available evidence suggests that nociplastic pain is present in an important subgroup of those patients experiencing post-cancer pain. The 2021 International Association for the Study of Pain (IASP) clinical criteria and grading system for nociplastic pain account for the need to identify and correctly classify patients according to the pain phenotype early in their treatment. These criteria are an important step towards precision pain medicine with great potential for the field of clinical oncology. Within this framework, the Cancer Pain Phenotyping (CANPPHE) Network, an international and interdisciplinary group of oncology clinicians and researchers from seven countries, applied the 2021 IASP clinical criteria for nociplastic pain to the growing population of those experiencing post-cancer pain. A manual is provided to allow clinicians to differentiate between predominant nociceptive, neuropathic, or nociplastic pain after cancer. A seven-step diagnostic approach is presented and illustrated using cases to enhance understanding and encourage effective implementation of this approach in clinical practice.
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| 5. |
- Beyens, L., et al.
(författare)
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Are soil biota buffered against climatic extremes? An experimental test on testate amoebae in arctic tundra (Qeqertarsuaq, West Greenland)
- 2009
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Ingår i: Polar Biology. - : Springer Science and Business Media LLC. - 0722-4060 .- 1432-2056. ; 32, s. 453-462
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Tidskriftsartikel (refereegranskat)abstract
- Climate warming is likely to have pronounced impacts on soil biota in arctic ecosystems. In a warmer climate, heatwaves are more frequent and intense, but it is unclear to what extent soil communities are buffered against this. We studied the effects of an artificially induced heatwave on the structure of testate amoebae communities in dry heath tundra in Qeqertarsuaq (Disko Island, West Greenland) during the summer of 2003. While the heatwave was severe enough to induce significant leaf mortality in the aboveground vegetation, overall testate amoebae abundance did not react to the difference in temperature. However, in the heated plots transient shifts in species populations occurred during the exposure, followed by increases in species richness weeks after the heatwave had ended. The most important taxa appearing after the heating period belonged to bacterivorous genera, in agreement with a transient peak in bacterial colony forming units, caused by the heatwave. Lobose testate amoebae resisted the heating and its associated desiccation better than their filose counterparts.
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| 6. |
- De Baets, L., et al.
(författare)
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The interplay between symptoms of insomnia and pain in people with osteoarthritis: A narrative review of the current evidence
- 2023
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Ingår i: Sleep Medicine Reviews. - 1087-0792. ; 70
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Forskningsöversikt (refereegranskat)abstract
- Osteoarthritis (OA) is a leading cause of disability worldwide and clinical pain is the major symptom of OA. This clinical OA-related pain is firmly associated with symptoms of insomnia, which are reported in up to 81% of people with OA. Since understanding the association between both symptoms is critical for their appropriate management, this narrative review synthesizes the existing evidence in people with OA on i) the mechanisms underlying the association between insomnia symptoms and clinical OA-related pain, and ii) the effectiveness of conservative non-pharmacological treatments on insomnia symptoms and clinical OA-related pain. The evidence available identifies depressive symptoms, pain catastrophizing and pain self-efficacy as mechanisms partially explaining the cross-sectional association between insomnia symptoms and pain in people with OA. Furthermore, in comparison to treatments without a specific insomnia intervention, the ones including an insomnia intervention appear more effective for improving insomnia symptoms, but not for reducing clinical OA-related pain. However, at a withinperson level, treatment-related positive effects on insomnia symptoms are associated with a longterm pain reduction. Future longitudinal prospective studies offering fundamental insights into neurobiological and psychosocial mechanisms explaining the association between insomnia symptoms and clinical OA-related pain will enable the development of effective treatments targeting both symptoms.
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| 7. |
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| 8. |
- Elma, Ö, et al.
(författare)
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Diet can exert both analgesic and pronociceptive effects in acute and chronic pain models: a systematic review of preclinical studies
- 2022
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Ingår i: Nutritional neuroscience. - 1028-415X. ; 25:10, s. 2195-2217
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Tidskriftsartikel (refereegranskat)abstract
- Background: Although diet is an essential aspect of human health, the link between diet and pain is still not well understood. Preclinical animal research provides information to understand underlying mechanisms that allow identifying the needs for human research. Objectives: This study aims to give a systematic overview of the current evidence from preclinical studies regarding the analgesic and pronociceptive effects of various diets in non-neuropathic, non-cancer, or non-visceral acute and chronic pain models. Study Design: A systematic Review Setting: This study examined studies that investigate the analgesic and pronociceptive effects of various diets in non-neuropathic, non-cancer, or non-visceral acute and chronic pain models. Methods: This review was conducted following the PRISMA guidelines and was registered in PROSPERO with the registration number CRD42019133473. The certainty of evidence was examined by a modified GRADE approach. Results: After the screening process twenty-four eligible papers were included in this review. Nineteen studies examined acute pain, nine studies chronic inflammatory pain, and four studies assessed both acute and chronic pain models. Limitations: Due to the heterogeneity of the included studies, a meta-analysis was not included in this study. Conclusions: In animal models, excessive saturated, monounsaturated or omega-6 polyunsaturated fat ingestion and diets rich in fats and carbohydrates can decrease pain sensitivity in acute nociceptive pain, whereas it can induce mechanical allodynia and heat hyperalgesia in chronic inflammatory pain. Additionally, diets rich in anti-inflammatory ingredients, as well as a calorie-restricted diet can promote recovery from primary mechanical allodynia and heat hyperalgesia in chronic inflammatory pain. © 2021 Informa UK Limited, trading as Taylor & Francis Group.
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| 9. |
- Escriche-Escuder, A., et al.
(författare)
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Pain neuroscience education in persistent painful tendinopathies: A scoping review from the Tendon PNE Network
- 2023
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Ingår i: Physical Therapy in Sport. - 1466-853X. ; 63, s. 38-49
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Tidskriftsartikel (refereegranskat)abstract
- Objective: to conduct and report a scoping review of the available evidence of the effects and content of pain neuroscience education for patients with persistent painful tendinopathies.Methods: PubMed, Embase, Web of Science, CINAHL, SPORTDiscus, and grey literature databases were searched from database inception to May 2022. Randomised and non-randomised controlled trials, non-controlled clinical trials, cohort studies, case series, case studies including people with persistent painful tendinopathy aged & GE;18 years, a pain education intervention, and in English were included. Studies were excluded if they were crosssectional studies, reviews, editorials, abstracts, or full-text not available or if included heterogeneous study cohorts, patients with tendon rupture, or patients with systemic diseases.Results: five studies (n = 164) were included. Pain neuroscience education entailed face-to-face discussion sessions or educational materials including videos, brochures, paper drawings, and review questions. All studies used pain neuroscience education in conjunction with other interventions, obtaining significant benefits in outcomes related to pain, physical performance, or self-reported function, among others.Conclusions: The application of pain neuroscience education in conjunction with other interventions seemed to improve several outcomes. However, considering the current knowledge about tendon pain and the scarcity of well-designed trials studying pain neuroscience education in tendinopathy, additional research is needed.
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| 10. |
- Fernandez-de-las-Penas, C., et al.
(författare)
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Carpal Tunnel Syndrome: Neuropathic Pain Associated or Not with a Nociplastic Condition
- 2023
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Ingår i: Biomedicines. - 2227-9059. ; 11:6
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Tidskriftsartikel (refereegranskat)abstract
- Carpal tunnel syndrome (CTS) has been traditionally classified as primarily a neuropathic condition with or without pain. Precision medicine refers to an evidence-based method of grouping patients based on their susceptibility to biology, prognosis of a particular disease, or in their response to a specific treatment, and tailoring specific treatments accordingly. In 2021, the International Association for the Study of Pain (IASP) proposed a grading system for classifying patients into nociceptive, neuropathic, or nociplastic phenotypes. This position paper presents data supporting the possibility of subgrouping individuals with specific CTS related-pain into nociceptive, neuropathic, nociplastic or mixed-type phenotypes. Carpal tunnel syndrome is a neuropathic condition but can also be comorbid with a nociplastic pain condition. The presence of extra-median symptoms and the development of facilitated pain processing seem to be signs suggesting that specific CTS cases can be classified as the nociplastic pain phenotype. The clinical responses of therapeutic approaches for the management of CTS are inconclusive. Accordingly, the ability to identify the predominant pain phenotype in patients with CTS could likely be problematic for producing efficient treatment outcomes. In fact, the presence of a nociplastic or mixed-type pain phenotype would explain the lack of clinical effect of treatment interventions targeting the carpal tunnel area selectively. We propose a clinical decision tree by using the 2021 IASP classification criteria for identifying the predominant pain phenotype in people with CTS-related pain, albeit CTS being a priori a neuropathic pain condition. The identification of a nociplastic-associated condition requires a more nuanced multimodal treatment approach to achieve better treatment outcomes.
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