53 research outputs found
Hyperexcitability of the central nervous system in children with chronic pain : a systematic review
OBJECTIVE: Hyperexcitability of the central nervous system plays an important role in the development and maintenance of chronic pain in adults. This knowledge has led to improved treatment strategies within this population. In children, however, research on the presence of central hyperexcitability is scarce. To further investigate this topic in children with chronic pain, there is a need for a clear literature overview.
DESIGN: Systematic review.
METHODS: The literature search was performed using the electronic databases PubMed and Web of Science. An article was considered eligible if it included children (age two to 12 years) diagnosed with chronic pain. Articles had to report original research outcomes related to central hyperexcitability, and a comparison with a healthy control group was necessary. Characteristics of the study sample, the assessment, and conclusions regarding central hyperexcitability were extracted from each included article.
RESULTS: Twelve case-control studies were included with moderate to good methodological quality (510 children with chronic pain and 670 healthy controls). After summarizing the articles' results on indices of central hyperexcitability, we concluded that secondary hyperalgesia might be present in children with recurrent abdominal pain, juvenile fibromyalgia, and juvenile idiopathic arthritis. Preliminary evidence exists for altered cortical nociceptive processing in children with migraine and recurrent abdominal pain.
CONCLUSIONS: Based on the results of this review, central hyperexcitability might be present in in several pediatric chronic pain conditions. Further research on other manifestations of central hyperexcitability (e.g., bottom-up and top-down mechanisms and nociceptive brain changes) is necessary to provide firm evidence about its presence in children with chronic pain
Georgii Simonis Winteri Tractatio nova de re equaria, complectens partes tres... = Georg Simon Winters Neuer Tractat von der Stuteren oder Fohlenzucht..
Port. paralela en italiano y francésER
Identifying pain generators and potentiators of residual complaints following lumbar discectomy: protocol of prospective cohort study
Introduction: Up to 37% of lumbar radiculopathy patients experience residual pain and disability following lumbar discectomy. Although it is assumed that dysfunctional pain processing may play a mechanistic role in symptom persistence, research in this area is lacking. Therefore, this study will evaluate pain processing in lumbar radiculopathy patients prior to and 3 months following
lumbar discectomy.
Methods: Lumbar radiculopathy patients (n = 122) scheduled for discectomy will be recruited through
Flemish hospitals. At follow-up, patients with ≥1.5/10 average pain intensity on a visual analogue scale and <20% improvement on the Oswestry Disability Index will be categorized as having residual complaints. These will be compared to matched patients without residual complaints and pain-free
controls. Pain sensitivity will be evaluated using Quantitative Sensory Testing including thermal, mechanical, and electrical perception and pain thresholds. Spinal modulation will be assessed
using nociceptive flexion reflex thresholds; pain facilitation by the presence of psychocognitive factors through questionnaires and temporal summation of mechanical stimuli and the NFR; and pain inhibition using a conditioned pain modulation paradigm.
Results: Not applicable.
Discussion: We hypothesize that pre-operative pain characteristics are predictive of residual complaints and that patients with residual complaints exhibit dysfunctional pain processing compared to individuals without residual complaints as expressed by impaired pain inhibition and enhanced spinal modulation, pain sensitivity and facilitation. The findings will provide the potential to identify patients at risk of poor surgical outcome and explore treatment strategies according to dysfunctions in pain processing.
Process evaluation: Currently recruiting and completing ethical committee applications for multicentric recruitment.
Keywords: Radiculopathy; discectomy; central sensitization; quantitative sensory testing; neuropathic pai
Identifying pain generators and potentiators of residual complaints following lumbar discectomy : protocol of prospective cohort study
IDENTIFYING PAIN GENERATORS AND POTENTIATORS OF RESIDUAL COMPLAINTS FOLLOWING LUMBAR DISCECTOMY: PROTOCOL OF PROSPECTIVE COHORT STUDY
Van Oosterwijck Sophie1,2,3, Danneels Lieven1, Van Oosterwijck Jessica1,2,3
1SPINE Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; 2Pain in Motion international research group, www.paininmotion.be; 3Research Foundation – Flanders (FWO), Brussels, Belgium
Introduction
Up to 37% of lumbar radiculopathy patients experience residual pain and disability following lumbar discectomy. Although it is assumed that dysfunctional pain processing may play a mechanistic role in symptom persistence, research in this area is lacking. Therefore, this study will evaluate pain processing in lumbar radiculopathy patients prior to and 3 months following lumbar discectomy.
Method
Lumbar radiculopathy patients (n=122) scheduled for discectomy will be recruited through Flemish hospitals. At follow-up, patients with ≥1.5/10 average pain intensity on a visual analogue scale and <20% improvement on the Oswestry Disability Index will be categorized as having residual complaints. These will be compared to matched patients without residual complaints and pain-free controls. Pain sensitivity will be evaluated using Quantitative Sensory Testing including thermal, mechanical, and electrical perception and pain thresholds. Spinal modulation will be assessed using nociceptive flexion reflex thresholds; pain facilitation by the presence of psychocognitive factors through questionnaires and temporal summation of mechanical stimuli and the NFR; and pain inhibition using a conditioned pain modulation paradigm.
Results
Not applicable.
Discussion
We hypothesize that pre-operative pain characteristics are predictive of residual complaints and that patients with residual complaints exhibit dysfunctional pain processing compared to individuals without residual complaints as expressed by impaired pain inhibition and enhanced spinal modulation, pain sensitivity and facilitation. The findings will provide the potential to identify patients at risk of poor surgical outcome and explore treatment strategies according to dysfunctions in pain processing.
Process Evaluation
Currently recruiting and completing ethical committee applications for multicentric recruitment.
References
Not applicable.
Keywords
Radiculopathy; discectomy; central sensitization; quantitative sensory testing; neuropathic pain
Word count
25
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