Prevalence and pattern of craniofacial pain and headache in Danish patients with neuromyelitis optica spectrum disorder

There is a dearth of knowledge about the pattern of pain and somatosensory alterations that co-exist with neuromyelitis optica spectrum disorder (NMOSD). Understanding the presence and underlying mechanisms will assist in better pain management in these patients. This study sought to identify prevalence and pattern of headache, craniofacial pain and abnormalities in somatosensory function within a group of NMOSD patients in Denmark. Six patients (two males, four females; mean age 41.2 ± 8.6 years) participated in a telephone interview. Eight questionnaires were used to assess pain, illness perception, fatigue, anxiety and depression. Pain occurred in several regions, including the head, face, neck, back and legs. Two patients experienced frequent headaches and one had headaches following neck pain. Pain occurred frequently over a 3-month period, ranging from mild to severe and described as ‘burning’ (66.7%), ‘exhausting’ (83.3%) and ‘sharp’ (50%). Correlations were found between pain severity and patients’ ‘ability to walk’ (r=0.889), ‘general activity’ (r=0.901), ‘mood’ (r=0.603), ‘normal work’ (r=0.664), ‘relations with other people’ (r=0.774) and ‘sleep’ (r=0.586). Somatosensory abnormality was only reported in legs. While fatigue had a great impact on patients’ daily life, patients did not report that for anxiety and depression. This study demonstrated that headaches and craniofacial pain occur frequently in NMOSD. Patients’ function, mobility, mood and sleep were all affected by pain. These findings highlight the value of further investigation on headaches, craniofacial and overall pain in NMOSD.</p

The effect of inhalation aromatherapy of geranium on pain and physiological indices after appendectomy: A double-blind randomized clinical trial

Introduction: The aim of the present study was to evaluate the effect of inhalation aromatherapy with sweet-scented geranium essential oil on pain and physiological indices after appendectomy. Methods: This double-blind clinical trial was performed on 120 patients undergoing appendectomy. Aromatherapy was performed with 1 sweet-scented geranium and sweet almond oil in the experimental placebo groups, respectively. Physiological symptoms were recorded before induction of anesthesia, before surgery, 30 min and 4 h after surgery. The control group received no intervention and only pain intensity and physiological indices were recorded in the mentioned stages. The placebo group underwent sweet almond essential oil aromatherapy. Data collection tools included demographic information form, physiological index checklist, and visual pain scale. Results: Results of 7 measurements showed significant differences between the experimental and placebo groups as well as the experimental and control groups in terms of mean heart rate, systolic and diastolic blood pressure, blood oxygen percentage, and pain (P < 0.001). Conclusion: Results of the present study showed that the effect of inhalation aromatherapy with sweet-scented geranium essential oil after appendectomy reduces pain and physiological indices. Therefore, the above aromatherapy can be used as a complementary treatment along with other treatments. © 2020 The Author

Investigation of itch in Parkinson disease

Introduction: Sensory abnormalities (eg, pain) are common in Parkinson disease (PD) with a negative impact on quality of life. As itch is less studied in PD, and pain and itch partially share sensory pathways, we designed this study to identify the occurrence and pattern of spontaneous itch, and responsiveness to a surrogate itch model in PD. Methods: The study protocol was approved (N-20180079) and PD patients and their best matched controls were recruited. A questionnaire was used to collect general information on itch. Sensory alterations were determined by subjective ratings and mechanical sensitivity threshold before and after a standard histamine-dependent itch model on forearms. Itch and pain intensities were rated on visual and numerical rating scales, respectively. Dispersion of itch was drawn on arm charts. Presence and area of alloknesis and hyperknesis were determined. Group comparisons were performed in SPSS with a significant level of 0.05. Descriptive statistic was used for questionnaire’s analysis. Results:Patients(n=20;68.10±7.91y,F/Mratio:8/12)andcontrols(n=20;67.35±7.65y,F/Mratio:8/12)wereexamined.PD patients rated less physical and emotional descriptors, except for the stinging (P = 0.028). No difference was found between the groups in histamine-provoked itch intensity (P = 0.799) or the itchy area. A significantly larger area of hyperknesis was found in PD (P = 0.011), but not for the area of alloknesis (P = 0.221). Sex-related responses yielded only a tendency toward higher responses in female patients. Discussion:PDdoesnotseemtoinfluenceperceptionofitch,neitherspontaneousnorevokeditch,exceptforhyperknesisarea,which was found significantly larger in PD patients following the application of histamine. This finding proposes a potential alteration in central processing of itch that needs further investigation and whether and how it is affected by, for example, PD pathogenesis

Cutaneous nociception and neurogenic inflammation evoked by PACAP38 and VIP

Pituitary adenylate cyclase-activating peptide-38 (PACAP38) and vasoactive intestinal peptide (VIP) belong to the same secretin–glucagon superfamily and are present in nerve fibers in dura and skin. Using a model of acute cutaneous pain we explored differences in pain perception and vasomotor responses between PACAP38 and VIP in 16 healthy volunteers in a double-blind, placebo-controlled, crossover study. All participants received intradermal injections of 200 pmol PACAP38, 200 pmol VIP and placebo into the volar forearm. Measurements included pain intensity on a visual analog scale (VAS), blood flow by laser Doppler flowmetry, visual flare and wheal. Pain intensities after PACAP38 and VIP were mild and limited to a short time of about 100 s after injection. The area under the VAS-time curve was larger following PACAP38 (P = 0.004) and VIP (P = 0.01) compared to placebo. We found no statistical difference in pain perception between PACAP38 and VIP. Skin blood flow increase, flare and wheal were larger after both PACAP38 (P = 0.011) and VIP (P = 0.001) compared to placebo. VIP induced a considerably larger increase in skin blood flow, flare and wheal than PACAP38 (P = 0.002). In conclusion, we found that peripheral nociceptive cutaneous responses elicited by PACAP38 and VIP are similar in healthy volunteers. This suggests that acute pain and vasomotor responses following intradermal injections of PACAP38 and VIP are primarily mediated by VPAC receptors

СТЕХИОМЕТРИЧЕСКИЙ СОСТАВ СЕСТОНА В ЛИТОРАЛИ И ПЕЛАГИАЛИ МЕЛКОВОДНОГО ОЗЕРА ОБСТЕРНО (БЕЛАРУСЬ)

We estimated the seston elemental composition (C, N, P) and its ratio in pelagic and littoral zones of mesotrophic shallow Lake Obsterno during two contrasting seasons, as well as the influence of macrophyte beds on the seston stoichiometry. In the both pelagial and littoral zones in summer the C: N ratio was small, 4.62 and 7.05 respectively. But it increased slightly during autumn to 5.66 in pelagic samples against 8.33 in littoral ones. The large N : P ratio and the small phosphorus content specially in the macrophyte covered littoral zone equal to 57.7 in July against 22.47 in September suggest a high level of phosphorus limitation in the littoral locations as a possible mediated reason suppressing zooplankton abundance in sumabundance in sum in summer. Our results in the both pelagial and littoral habitat showed a highly P limited situation in which the N : P ratio was larger in littoral with macrophyte than in pelagial zones. The obtained data of littoral seston stoichiometry were recorded for the first time and exceeded the classical Redfield ratio. The elemental imbalance between macrophyte covered littoral and pelagial suggest that nutrients, especially P, are more limiting in macrophyte beds in summer due to the resource competition between phytoplankton and macrophytes for nutrients, a poor food quality, low zooplankton abundance, as well as its poor taxon-specific elemental ratio in summer.Исследовали элементный состав (C, N, P) и соотношение данных элементов в литорали и пелагиали мелководного мезотрофного озера Обстерно летом и осенью, а также влияние зарослей макрофитов на стехиометрию сестона. В пелагиали и литорали летом соотношение C : N было низким, 4,62 и 7,05 соответственно, однако незначительно увеличивалось осенью – 5,66 в пелагиали против 8,33 в литорали. Высокие значения N : P и низкое содержание фосфора, особенно в литоральной зоне летом (57,7 в июле и 22,47 в сентябре) указывают на высокий уровень ограничения по фосфору в литоральной зоне. Данные о стехиометрии сестона литоральных местообитаний получены впервые и, как показано в данном исследовании, они значительно выше классического соотношения Рэдфилда. Таким образом, основные биогенные элементы – азот и фосфор в биотопах с зарослями макрофитов летом находятся в большем дефиците, чем в пелагиали, что, как мы считаем, может быть вызвано несколькими причинами: конкуренцией между макрофитами и фитопланктоном за биогенные вещества, низким качеством пищи, низкой численностью зоопланктона, а также его бедным таксон-специфичным элементным соотношением в летний сезон

Antidromic vasodilatation and the migraine mechanism

Despite the fact that an unprecedented series of new discoveries in neurochemistry, neuroimaging, genetics and clinical pharmacology accumulated over the last 20 years has significantly increased our current knowledge, the underlying mechanism of the migraine headache remains elusive. The present review article addresses, from early evidence that emerged at the end of the nineteenth century, the role of ‘antidromic vasodilatation’ as part of the more general phenomenon, currently defined as neurogenic inflammation, in the unique type of pain reported by patients suffering from migraine headaches. The present paper describes distinctive orthodromic and antidromic properties of a subset of somatosensory neurons, the vascular- and neurobiology of peptides contained in these neurons, and the clinical–pharmacological data obtained in recent investigations using provocation tests in experimental animals and human beings. Altogether, previous and recent data underscore that antidromic vasodilatation, originating from the activation of peptidergic somatosensory neurons, cannot yet be discarded as a major contributing mechanism of the throbbing head pain and hyperalgesia of migraine