Memory of pain in adults : a protocol for systematic review and meta-analysis

Background: the way pain is remembered and reported can affect medical decisions taken by patients and health-care professionals. Memory of pain has been investigated extensively for the past few decades; however, the results of previous studies are highly variable, indicating that the recollection of pain can be accurate, overestimated or underestimated. It is therefore difficult to conclude how well pain is remembered. The aim of this systematic review and meta-analysis is to summarize research findings on memory of pain in healthy adults and patients suffering from acute and chronic pain. Methods: the systematic review will be performed by searching for articles indexed in the following databases: PubMed, MEDLINE, PsycINFO, Web of Science, ScienceDirect, PsycARTICLES, Scopus and Academic Search Complete. Studies will be included if (1) they investigated healthy adults or patients with any acute or chronic pain condition and if (2) they assessed experienced pain (pain intensity and/or pain unpleasantness) and its recollection. No restrictions related to the date of publication and recall delay will be applied. Studies will be screened for eligibility and risk of bias by two independent assessors. The risk of bias will be assessed by a modified Downs and Black checklist. A narrative synthesis will be performed in the first stage; in the second stage, the results of studies with comparable designs will be pooled in meta-analytical syntheses. Discussion: the question of whether pain is remembered accurately is crucial for valid pain diagnosis, effective treatment and prognosis. So far, a number of studies on memory of pain have been conducted; however, a definitive conclusion on whether memory of pain is accurate is still lacking. In this systematic review and meta-analysis, available data will be pooled together to further inform research and clinical practice

Mapping pathological phenotypes in a mouse model of CDKL5 disorder.

open14sihe research was supported by EMBL (E.A. and C.T.G.), the Italian Telethon Foundation (grant GGP09196, T.P. and M.G.; grant GGP10162, E.C., T.P., and M.G.), Epigenomics Flagship Project EPIGEN, MIUR-CNR to T.P., AIRETT onlus (T.P. and M.G.), the International Rett Syndrome Foundation (ISRF, M.G.), and a fellowship from the International Foundation for CDKL5 Research (IFCR) in collaboration with ISRF (E.A.). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Mutations in cyclin-dependent kinase-like 5 (CDKL5) cause early-onset epileptic encephalopathy, a neurodevelopmental disorder with similarities to Rett Syndrome. Here we describe the physiological, molecular, and behavioral phenotyping of a Cdkl5 conditional knockout mouse model of CDKL5 disorder. Behavioral analysis of constitutive Cdkl5 knockout mice revealed key features of the human disorder, including limb clasping, hypoactivity, and abnormal eye tracking. Anatomical, physiological, and molecular analysis of the knockout uncovered potential pathological substrates of the disorder, including reduced dendritic arborization of cortical neurons, abnormal electroencephalograph (EEG) responses to convulsant treatment, decreased visual evoked responses (VEPs), and alterations in the Akt/rpS6 signaling pathway. Selective knockout of Cdkl5 in excitatory and inhibitory forebrain neurons allowed us to map the behavioral features of the disorder to separable cell-types. These findings identify physiological and molecular deficits in specific forebrain neuron populations as possible pathological substrates in CDKL5 disorder.openAmendola E;Zhan Y;Mattucci C;Castroflorio E;Calcagno E;Fuchs C;Lonetti G;Silingardi D;Vyssotski AL;Farley D;Ciani E;Pizzorusso T;Giustetto M;Gross CTAmendola E;Zhan Y;Mattucci C;Castroflorio E;Calcagno E;Fuchs C;Lonetti G;Silingardi D;Vyssotski AL;Farley D;Ciani E;Pizzorusso T;Giustetto M;Gross C

Review of meta-analyses of studies on the effectiveness of cognitive-behavioral psychotherapy in the treatment of mental disorders

Celem raportu było przedstawienie przeglądu najnowszych wyników badań dotyczących skuteczności psychoterapii poznawczo-behawioralnej (cognitive-behavioural therapy, CBT) w leczeniu różnego rodzaju zaburzeń i problemów ze zdrowiem psychicznym. Opieranie się na aktualnych i wiarygodnych wynikach badań naukowych przy prowadzeniu psychoterapii jest elementem praktyki opartej na dowodach (evidence-based practice), typowo stosowanej w medycynie (evidence-based medicine). W celu podsumowania najlepszych dostępnych dowodów naukowych zebrano wyniki najnowszych metaanaliz, czyli badań analizujących i podsumowujących dotychczasowe badania kliniczne (od kilku do kilkudziesięciu badań na metaanalizę). W raporcie przedstawiono syntetycznie wyniki dotyczące skuteczności CBT pogrupowane według kategorii diagnostycznych

Age as a moderator in the interplay between locus of control, coping, and quality of life of chronic pain sufferers

Objective: Identifying the factors that determine the quality of life of patients with chronic pain is an integral part of developing interventions to reduce the negative impact of persistent pain. Locus of control (LoC) could play an important role in adaptation to prolonged pain, but the results of studies are inconsistent. We examined the link between pain LoC and quality of life. Moreover, we investigated whether the relationship between LoC and quality of life is mediated by passive and active coping, and whether age moderates the LoC–coping relationship. Methods: The study was cross-sectional, and variables (internal, chance and powerful-others LoC, pain coping strategies, average pain intensity, and quality of life) were assessed via questionnaires in a sample of 594 individuals (67% females) with chronic pain who were 18–72 (mean: 36) years of age. Results: Mediation and moderated mediation analyses were conducted. Internal and external LoC were associated, respectively, with better and with worse quality of life. Passive coping mediated the association between the powerful-others dimension of LoC and poor quality of life. Additionally, indirect effects of internal LoC on quality of life via passive and active coping were found. The relationship between the powerful-others dimension of LoC and coping was stronger for middle-aged and older individuals than for younger individuals. Conclusions: This study contributes to a better understanding of the mechanisms linking LoC with quality of life of patients with chronic pain. Depending on the age, control beliefs might translate differently into strategies used to cope with pain, and thus into quality of life

Order does matter : the combined effects of classical conditioning and verbal suggestions on placebo analgesia and nocebo hyperalgesia

In most experimental studies in which verbal suggestion and classical conditioning are implemented together to induce placebo effects, the former precedesthe latter. In naturally occurring situations, however,the information concerning pain does not always precede but often follows the pain experience. Moreover, this information is not always congruent with experience. This study investigates whether the chronology of verbal suggestion and conditioning, as well as their congruence, affects placebo hypoalgesia and nocebo hyperalgesia. The effects induced in 15 groups were compared. The participants in 8 experimental groups were presented with verbal suggestions that were either congruent or incongruent with classical conditioning. The verbal suggestions were provided either before or after conditioning. In 2 other experimental groups, placebo conditioning or nocebo conditioning was implemented without any verbal suggestion; in 2 groups, verbal suggestion of hypoalgesia or hyperalgesia without conditioning was applied. The control groups without any suggestions or conditioning were also included. Placebo hypoalgesia induced by congruent procedures was significantly stronger when the suggestion of hypoalgesia preceded rather than followed conditioning. The order of the congruent procedures did not affect the magnitude of nocebo hyperalgesia. In the groups in which incongruent procedures were implemented, placebo hypoalgesia or nocebo hyperalgesia was in line with the direction of the last-used procedure, regardless of whether it was conditioning or verbal suggestion. The results show that not the type of the procedure (verbal suggestion or conditioning), but the direction of the last-used procedure shapes pain-related expectancies and determines placebo effects

When one suffers less, all suffer less : Individual pain ratings are more effective than group ratings in producing placebo hypoalgesia

Background: Placebo hypoalgesia can be induced by observing a person (model) whose pain relief is the result of the use of an inert substance or procedure. This study examined whether verbal modelling, that is, showing pain ratings provided by other people, is sufficient to induce placebo hypoalgesia. Methods: Participants from the experimental groups were acquainted with pain ratings (presented on VASs) derived from a single person (groups 1 and 3) or a group of people (groups 2 and 4) that were allegedly subjected to the same painful procedure. The ratings of pain stimuli that were allegedly applied with placebo were lower than the ratings of stimuli applied without placebo. In two of the experimental groups (group 3 and 4), participants also watched a video recording showing individuals who allegedly provided pain ratings; however, they did not observe them undergoing pain stimulation. The control group did not undergo any manipulation. Then, the participants received a series of the same thermal pain stimuli that were applied either with or without placebo and rated their intensity. Results: Placebo hypoalgesia was induced only in participants presented with pain ratings provided by a single person, regardless of whether this person was previously seen. However, the pain ratings presented to the participants generally decreased individual pain sensations, regardless of whether they came from a group of people or a single person. Conclusions: Verbal modelling can produce placebo hypoalgesia and reduce pain sensations. It may be effectively used in clinical practice to modify patients' responses to pain treatment. Significance: This study shows that knowledge about pain ratings provided by another person is sufficient to induce placebo hypoalgesia; thus, neither direct nor indirect observation of a person experiencing pain is necessary to induce this effect. Pain ratings derived from a group of people can decrease pain sensations but they do not produce placebo hypoalgesia