A Possible Source of Heterogeneity in Nociceptive Flexion Reflex (NFR) Threshold Among Patients with Fibromyalgia: Systematic Review and Meta-Analysis

2019 ◽  
Author(s):  
Mohammadreza Amiri ◽  
Jamie Rhudy ◽  
Kei Masani ◽  
Dinesh Kumbhare
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Flexion Reflex ◽  
Nociceptive Flexion Reflex

scholarly journals The nociceptive flexion reflex: a scoping review and proposed standardized methodology for acquisition in those affected by chronic pain

2020 ◽  
pp. 204946372091328
Author(s):  
Lukas D Linde ◽  
Felipe CK Duarte ◽  
Hamid Esmaeili ◽  
Abdul Hamad ◽  
Kei Masani ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Degrees Of Freedom ◽  
Meta Analysis ◽  
Objective Measure ◽  
Cochrane Library ◽  
Narrative Synthesis ◽  
Flexion Reflex ◽  
Nociceptive Flexion Reflex ◽  
Chronic Pain Conditions ◽  
Substantial Heterogeneity

The nociceptive flexion reflex (NFR) is used in neurophysiological research as an objective measure of nociception. NFR thresholds are reduced in numerous chronic pain pathologies, which are indicative of common central hyperexcitability within conditions. However, variation exists in both the NFR assessment and determinants of NFR threshold among research groups. Our purpose was to provide a review of the recent literature to (a) confirm the NFR threshold’s efficacy in identifying those with chronic pain compared to controls and (b) provide a narrative synthesis on the current methodology used to assess the NFR in clinical populations. We conducted a review of multiple databases (MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Google Scholar and Cochrane Library), including articles that reported controlled clinical studies of humans, in English, comparing NFR thresholds within chronic pain conditions to matched control subjects, published since the last NFR review in 2010. Our search resulted in nine studies included in our narrative synthesis and eight studies included in a meta-analysis. There was a significant pooled standardized mean difference in NFR threshold between chronic pain conditions and controls (−0.94, 95% confidence interval (CI) −1.33 to −0.55, p < 0.0001), with substantial heterogeneity of pooled estimates ( I2 = 87%, τ2 = 0.41, Q = 76.13, the degrees of freedom (df) = 11, p < 0.0001). Significant variations in participant positioning, stimulation parameters and determinants of the NFR threshold were evident among included studies. We provided a narrative synthesis on the methodologies of included studies, as a recommendation for future studies in the assessment of the NFR in chronic pain.

scholarly journals Defensive reflexes in people with pain – a biomarker of the need to protect? A meta-analytical systematic review

2017 ◽  
Vol 28 (4) ◽  
pp. 381-396 ◽  
Author(s):  
Sarah B. Wallwork ◽  
Luzia Grabherr ◽  
Neil E. O’Connell ◽  
Mark J. Catley ◽  
G. Lorimer Moseley
Keyword(s):  
Systematic Review ◽  
Cognitive Control ◽  
English Language ◽  
Meta Analysis ◽  
A Priori ◽  
Body Part ◽  
Nociceptive Flexion Reflex ◽  
Clinical Pain ◽  
Defensive Reflex ◽  
Reflex Threshold

AbstractUpregulation of defensive reflexes such as the nociceptive flexion reflex (NFR) has been attributed to sensitisation of peripheral and spinal nociceptors and is often considered biomarkers of pain. Experimental modulation of defensive reflexes raises the possibility that they might be better conceptualised as markers of descending cognitive control. Despite strongly held views on both sides and several narrative reviews, there has been no attempt to evaluate the evidence in a systematic manner. We undertook a meta-analytical systematic review of the extant English-language literature from inception. Thirty-six studies satisfied our a priori criteria. Seventeen were included in the meta-analysis. Reflexive threshold was lower in people with clinical pain than it was in pain-free controls, but reflex size, latency, and duration were unaffected. The pattern of difference was not consistent with sensitisation of nociceptive neurones, as these changes were not isolated to the affected body part but was more consistent with top-down cognitive control reflective of heightened protection of body tissue. The pattern of modulation is dependent on potentially complex evaluative mechanisms. We offer recommendations for future investigations and suggest that defensive reflex threshold may reflect a biomarker of a broader psychological construct related to bodily protection, rather than sensitisation of primary nociceptors, spinal nociceptors, or pain.

The effects of low-ratio n-6/n-3 PUFA on biomarkers of inflammation: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Yali Wei ◽  
Yan Meng ◽  
Na Li ◽  
Qian Wang ◽  
Liyong Chen
Keyword(s):  
Systematic Review ◽  
Fatty Acid ◽  
Polyunsaturated Fatty Acid ◽  
Meta Analysis ◽  
Chain Polyunsaturated Fatty Acid ◽  
Inflammation Markers ◽  
Pufa Supplementation ◽  
Long Chain

The purpose of the systematic review and meta-analysis was to determine if low-ratio n-6/n-3 long-chain polyunsaturated fatty acid (PUFA) supplementation affects serum inflammation markers based on current studies.

The association between dietary inflammatory index and risk of central obesity in adults: An updated systematic review and meta-analysis

2020 ◽  
Vol 90 (5-6) ◽  
pp. 535-552 ◽  
Author(s):  
Mahdieh Abbasalizad Farhangi ◽  
Mahdi Vajdi
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Central Obesity ◽  
Assessment Tool ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Dietary Factors ◽  
Cross Sectional ◽  
Inflammatory Status ◽  
Obesity Indices

Abstract. Backgrounds: Central obesity, as a pivotal component of metabolic syndrome is associated with numerous co-morbidities. Dietary factors influence central obesity by increased inflammatory status. However, recent studies didn’t evaluate the association between central obesity and dietary inflammation index (DII®) that give score to dietary factors according to their inflammatory potential. In the current systematic review and meta-analysis, we summarized the studies that investigated the association between DII® with central obesity indices in the general populations. Methods: In a systematic search from PubMed, SCOPUS, Web of Sciences and Cochrane electronic databases, we collected relevant studies written in English and published until 30 October 2019. The population of included studies were apparently healthy subjects or individuals with obesity or obesity-related diseases. Observational studies that evaluated the association between DII® and indices of central obesity including WC or WHR were included. Results: Totally thirty-two studies were included; thirty studies were cross-sectional and two were cohort studies with 103071 participants. Meta-analysis of observational studies showed that higher DII® scores were associated with 1.81 cm increase in WC (Pooled weighted mean difference (WMD) = 1.813; CI: 0.785–2.841; p = 0.001). Also, a non-significant increase in the odds of having higher WC (OR = 1.162; CI: 0.95–1.43; p = 0.154) in the highest DII category was also observed. In subgroup analysis, the continent, dietary assessment tool and gender were the heterogeneity sources. Conclusion: The findings proposed that adherence to diets with high DII® scores was associated with increased WC. Further studies with interventional designs are necessary to elucidate the causality inference between DII® and central obesity indices.

Fear of pain and pain intensity: Meta-analysis and systematic review.

2020 ◽  
Vol 146 (5) ◽  
pp. 411-450 ◽  
Author(s):  
Tobias Markfelder ◽  
Paul Pauli
Keyword(s):  
Systematic Review ◽  
Pain Intensity ◽  
Meta Analysis ◽  
Fear Of Pain
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