scholarly journals Intrinsic brain connectivity in fibromyalgia is associated with chronic pain intensity

2010 ◽  
Vol 62 (8) ◽  
pp. 2545-2555 ◽  
Author(s):  
Vitaly Napadow ◽  
Lauren LaCount ◽  
Kyungmo Park ◽  
Sawsan As-Sanie ◽  
Daniel J. Clauw ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Brain Connectivity

Altered Dynamic Brain Connectivity in Individuals With Sickle Cell Disease and Chronic Pain Secondary to Hip Osteonecrosis

2021 ◽  
pp. 155005942110542
Author(s):  
Jamille Evelyn R. S. Santana ◽  
Abrahão F. Baptista ◽  
Rita Lucena ◽  
Tiago da S. Lopes ◽  
Raphael S. do Rosário ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Sickle Cell Disease ◽  
Pain Intensity ◽  
Motor Imagery ◽  
High Intensity ◽  
Brain Connectivity ◽  
Brain Network ◽  
Average Weight ◽  
Cell Disease ◽  
Hip Osteonecrosis

Individuals with sickle cell disease (SCD) exhibit changes in static brain connectivity in rest. However, little known as chronic pain associated with hip osteonecrosis affects dynamic brain connectivity during rest and the motor imagery task. The aim of this study was to investigate the characteristics of the dynamic functional brain connectivity of individuals with SCD and chronic pain secondary to hip osteonecrosis. This is a cross-sectional study comparing the dynamic brain connectivity of healthy individuals (n = 18) with the dynamic brain connectivity of individuals with SCD and chronic pain (n = 22). Individuals with SCD and chronic pain were stratified into high- or low-intensity pain groups based on pain intensity at the time of assessment. Dynamic brain connectivity was assessed through electroencephalography in 3 stages, resting state with eyes closed, and during hip (painful for the SCD individuals) and hand (control, nonpainful) motor imagery. Average weight of the edges and full synchronization time (FST)—time required for 95% of the possible edges to appear over time during a given task—were evaluated. Regarding the average weight of the edges, individuals with SCD and high-intensity pain presented higher edge weight during hip motor imagery. The average weight of the edges correlated positively with pain intensity and depression symptoms. Individuals with SCD and chronic pain complete the cerebral network at rest more quickly (lower FST). Individuals with SCD and chronic pain/hip osteonecrosis have impaired dynamic brain network with shorter FST in rest network and more pronounced diffuse connectivity in individuals with high-intensity pain. The dynamic brain network evaluated by time-varying graphs and motif synchronization was able to identify differences between groups.

Collecting patient reported outcomes to facilitate prescription opioid management: Development and testing of the Opioid Management App (OM-App) (Preprint)

2020 ◽  
Author(s):  
Jessica Robinson-Papp ◽  
Gabriela Cedillo ◽  
Richa Deshpande ◽  
Mary Catherine George ◽  
Qiuchen Yang ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Risk Behaviors ◽  
Digital Health ◽  
Monitoring Program ◽  
Prescription Opioid ◽  
Research Database ◽  
Cross Sectional ◽  
Study Duration ◽  
Patient Reported

BACKGROUND Collecting patient-reported data needed by clinicians to adhere to opioid prescribing guidelines represents a significant time burden. OBJECTIVE We developed and tested an opioid management app (OM-App) to collect these data directly from patients. METHODS OM-App used a pre-existing digital health platform to deliver daily questions to patients via text-message and organize responses into a dashboard. We pilot tested OM-App over 9 months in 40 diverse participants with HIV who were prescribed opioids for chronic pain. Feasibility outcomes included: ability to export/integrate OM-App data with other research data; patient-reported barriers and adherence to OM-App use; capture of opioid-related harms, risk behaviors and pain intensity/interference; comparison of OM-App data to urine drug testing, prescription drug monitoring program data, and validated questionnaires. RESULTS OM-App data was exported/integrated into the research database after minor modifications. Thirty-nine of 40 participants were able to use OM-App, and over the study duration 70% of all OM-App questions were answered. Although the cross-sectional prevalence of opioid-related harms and risk behaviors reported via OM-App was low, some of these were not obtained via the other measures, and over the study duration all queried harms/risks were reported at least once via OM-App. Clinically meaningful changes in pain intensity/interference were captured. CONCLUSIONS OM-App was used by our diverse patient population to produce clinically relevant opioid- and pain-related data, which was successfully exported and integrated into a research database. These findings suggest that OM-App may be a useful tool for remote monitoring of patients prescribed opioids for chronic pain. CLINICALTRIAL NCT03669939 INTERNATIONAL REGISTERED REPORT RR2-doi:10.1016/j.conctc.2019.100468

scholarly journals The Pain Situation of Older Home-Care Recipients and Influencing Factors

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 204-205
Author(s):  
Dagmar Dräger ◽  
Reinhold Kreutz ◽  
Adelheid Kuhlmey ◽  
Andrea Budnick ◽  
Dagmar Draeger
Keyword(s):  
Chronic Pain ◽  
Home Care ◽  
Older People ◽  
Pain Intensity ◽  
Prevalence Rate ◽  
Severe Pain ◽  
Self Report ◽  
Primary Data ◽  
Common Symptom ◽  
Care Recipients

Abstract Chronic pain is a common symptom among older people. The international prevalence rate reaches 50% for older home-care recipients (aged ≥60). The most common causes of pain among older people are degenerative arthropathy and musculoskeletal diseases. Care recipients (81% aged ≥65) constitute a specific sub-group among pain patients, due to the restrictions they experience. In Germany, the prevalence rate in this group is 70%. Currently, no comprehensive information on the pain situation of older home-care recipients exists in Germany. The findings presented are based on a cross-sectional study of older (aged ≥65) home-care recipients (SGB XI) in Berlin, with chronic pain (n=225), capable of self-report (MMST≥18). Structured interviews comprised the primary data source. The pain situation was determined using the German Brief Pain Inventory (BPI-NH). Multiple regression analysis was applied to test how the most severe pain (dependent variable) was influenced by socio-demographic and medical parameters, mental and physical restrictions and pain medication. Analyses of the pain situation show a value of M=4.81 (SD±1.88) on the BPI intensity index, and a BPI pain interference index of M=5.47 (SD±2.15). The most intense pain averaged 6.96 (SD±2.15). On average, respondents reported 16.20 (SD±13.25) pain locations (range: 0-65). The number of pain locations, alongside other factors, had a significant influence, R²=0.038 (corrected R²=0.034), F (1.219) = 8.760, p<0.01), on pain intensity. The findings show severe pain intensity among older home-care recipients not reported in previous findings (e.g. in long-term in-patient care). Action in medical care, nursing care and educational aspects is urgently needed.

Sleep disturbance in patients attending specialized chronic pain clinics in Denmark: a longitudinal study examining the relationship between sleep and pain outcomes

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Henrik Bjarke Vaegter ◽  
Mette Terp Høybye ◽  
Frederik Hjorth Bergen ◽  
Christine E. Parsons
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Sleep Quality ◽  
Pain Intensity ◽  
Sleep Disturbances ◽  
Pain Disability ◽  
Pain Clinics ◽  
Pain Outcomes

Abstract Objectives Sleep disturbances are highly prevalent in patients with chronic pain. However, the majority of studies to date examining sleep disturbances in patients with chronic pain have been population-based cross-sectional studies. The aims of this study were to 1) examine the frequency of sleep disturbances in patients referred to two interdisciplinary chronic pain clinics in Denmark, 2) explore associations between sleep disturbances and pain intensity, disability and quality of life at baseline and follow-up, and 3) explore whether changes in sleep quality mediated the relationships between pain outcomes at baseline and pain outcomes at follow-up. Methods We carried out a longitudinal observational study, examining patients enrolled in two chronic pain clinics assessed at baseline (n=2,531) and post-treatment follow-up (n=657). Patients reported on their sleep disturbances using the sleep quality subscale of the Karolinska Sleep Questionnaire (KSQ), their pain intensity using 0–10 numerical rating scales, their pain-related disability using the Pain Disability Index (PDI), and quality of life using the EuroQol-VAS scale. The average time between baseline and follow-up was 207 days (SD=154). Results At baseline, the majority of patients reported frequent sleep disturbances. We found a significant association at baseline between self-reported sleep disturbances and pain intensity, pain-related disability, and quality of life, where greater sleep disturbance was associated with poorer outcomes. At follow-up, patients reported significant improvements across all pain and sleep outcomes. In two mediation models, we showed that changes in sleep disturbances from baseline to follow-up were significantly associated with (i) pain intensity at follow-up, and (ii) pain disability at follow-up. However, baseline pain intensity and disability scores were not associated with changes in sleep disturbances and, we did not find evidence for significant mediation of either pain outcome by changes in sleep disturbances. Conclusions Self-reported sleep disturbances were associated with pain outcomes at baseline and follow-up, with greater sleep disturbances associated with poorer pain outcomes. Changes in sleep quality did not mediate the relationships between baseline and follow-up scores for pain intensity and disability. These findings contribute to a growing body of evidence confirming an association between sleep and chronic pain experience, particularly suggestive of a sleep to pain link. Our data following patients after interdisciplinary treatment suggests that improved sleep is a marker for a better outcome after treatment.

scholarly journals Telemedicine for chronic pain treatment during the COVID‐19 pandemic: Do pain intensity and anxiousness correlate with patient acceptance?

Pain Practice ◽  
2021 ◽  
Author(s):  
Michael Alexander Harnik ◽  
Larissa Blättler ◽  
Andreas Limacher ◽  
Florian Reisig ◽  
Martin Grosse Holtforth ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Pain Treatment ◽  
Patient Acceptance ◽  
Chronic Pain Treatment

Transdiagnostic Cognitive Processes in Chronic Pain and Comorbid PTSD and Depression in Veterans

2021 ◽  
Author(s):  
Melissa A Day ◽  
Rhonda M Williams ◽  
Aaron P Turner ◽  
Dawn M Ehde ◽  
Mark P Jensen
Keyword(s):  
Chronic Pain ◽  
Depressive Symptoms ◽  
Pain Intensity ◽  
Cognitive Processes ◽  
Cognitive Process ◽  
Stress Disorder ◽  
Secondary Analysis ◽  
Lower Pain ◽  
Depression Scales ◽  
Ptsd Group

Abstract Background Chronic pain in Veterans is a major problem compounded by comorbid posttraumatic stress disorder (PTSD) and depression. Adopting a transdiagnostic framework to understanding “shared territory” among these diagnoses has the potential to inform our understanding of the underlying cognitive processes and mechanisms that transverse diagnostic boundaries. Purpose To examine the associations between pain-related cognitive processes (diversion, distancing, absorption, and openness), pain intensity, PTSD and depressive symptoms, and the extent to which Veterans with chronic pain with and without comorbid PTSD and depression engage in different/similar pain-related cognitive processes. Methods Secondary analysis of pretreatment data with a subsample (n = 147) of Veterans with chronic pain from a larger clinical trial. Pretreatment PCL-5 and PROMIS Depression scales were used to categorize participants into three groups: (a) Pain-only; (b) Pain-PTSD; and (c) Pain-PTSD-DEP. Results Compared to the Pain-only group, the Pain-PTSD and Pain-PTSD-DEP groups reported significantly greater pain intensity, PTSD and depressive symptoms, and ruminative pain absorption. The Pain-PTSD-DEP group had significantly lower pain diversion and pain openness scores. When diversion and openness were used within the Pain-PTSD-DEP group, however, they were both associated with lower pain intensity and openness was additionally associated with lower PTSD scores. However, in the Pain-PTSD group, pain openness was associated with higher depression scores. Conclusions Across increasing complexity of comorbidity profiles (i.e., one vs. two comorbid conditions), ruminative absorption with pain emerged as a cognitive process that transverses diagnoses and contributes to worse outcomes. Nonjudgmental acceptance may not be universally beneficial, potentially depending upon the nature of comorbidity profiles.

The Effect of Chronic Pain Intensity on Sit-to-Stand Strategy in Patients With Herniated Lumbar Disks

2016 ◽  
Vol 39 (3) ◽  
pp. 169-175 ◽  
Author(s):  
Tomasz Sipko ◽  
Edmund Glibowski ◽  
Katarzyna Barczyk-Pawelec ◽  
Michał Kuczyński
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Sit To Stand

scholarly journals Can local-community-paradigm and epitopological learning enhance our understanding of how local brain connectivity is able to process, learn and memorize chronic pain?

2017 ◽  
Vol 2 (1) ◽  
Author(s):  
Vaibhav Narula ◽  
Antonio Giuliano Zippo ◽  
Alessandro Muscoloni ◽  
Gabriele Eliseo M. Biella ◽  
Carlo Vittorio Cannistraci
Keyword(s):  
Chronic Pain ◽  
Local Community ◽  
Brain Connectivity ◽  
Local Brain

scholarly journals A physical activity program versus usual care in the management of quality of life for pre-frail older adults with chronic pain in primary care: randomized controlled trial.

2020 ◽  
Author(s):  
Pedro Otones ◽  
Eva García ◽  
Teresa Sanz ◽  
Azucena Pedraz
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Older Adults ◽  
Chronic Pain ◽  
Usual Care ◽  
Pain Intensity ◽  
Physical Performance ◽  
Frail Older Adults

Abstract Background Exercise have shown being effective for managing chronic pain and preventing frailty status in older adults but the effect of an exercise program in the quality of life of pre-frail older adults with chronic pain remains unclear. Our objective was to evaluate the effectiveness of multicomponent structured physical exercise program for pre-frail adults aged 65 years or more with chronic pain to improve their perceived health related quality of life, compared with usual care. Methods Open label randomized controlled trial. Participants were community-dwelling pre-frail older adults aged 65 years or older with chronic pain and non-dependent for basic activities of daily living attending a Primary Healthcare Centre. Forty-four participants were randomly allocated to a control group (n = 20) that received usual care or an intervention group (n = 24) that received an 8-week physical activity and education program. Frailty status (SHARE Frailty Index), quality of life (EuroQol-5D-5L), pain intensity (Visual Analogue Scale), physical performance (Short Physical Performance Battery) and depression (Yessavage) were assessed at baseline, after the intervention and after 3 months follow-up. The effect of the intervention was analysed by mean differences between the intervention and control groups. Results The follow-up period (3 months) was completed by 32 patients (73%), 17 in the control group and 15 in the intervention group. Most participants were women (78.1%) with a mean age (standard deviation) of 77.2 (5.9) years and a mean pain intensity of 48.1 (24.4) mm. No relevant differences were found between groups at baseline. After the intervention, mean differences in the EuroQol Index Value between control and intervention groups were significant (-0.19 95%CI(-0.33- -0.04)) and remained after three months follow-up (-0.21 95%CI(-0.37- -0.05)). Participants in the exercise group showed better results in pain intensity and frailty after the intervention, and an improvement in physical performance after the intervention and after three months. Conclusions An eight-week physical activity and education program for pre-frail older adults with chronic pain, compared with usual care, could be effective to improve quality of life after the intervention and after three-months follow-up. Study registration details: This study was retrospectively registered in ClinicalTrials.gov with the identifier NCT04045535.

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