scholarly journals Modulation of the Negative Affective Dimension of Pain: Focus on Selected Neuropeptidergic System Contributions

2019 ◽  
Vol 20 (16) ◽  
pp. 4010 ◽  
Author(s):  
Francesca Felicia Caputi ◽  
Laura Rullo ◽  
Serena Stamatakos ◽  
Sanzio Candeletti ◽  
Patrizia Romualdi
Keyword(s):  
Subjective Experience ◽  
Pain Perception ◽  
Pain Treatment ◽  
Mood State ◽  
Neural Pathways ◽  
Limited Information ◽  
Thalamic Nuclei ◽  
Somatic Pain ◽  
Dimensions Of Pain ◽  
Lateral Pain

It is well known that emotions can interfere with the perception of physical pain, as well as with the development and maintenance of painful conditions. On the other hand, somatic pain can have significant consequences on an individual’s affective behavior. Indeed, pain is defined as a complex and multidimensional experience, which includes both sensory and emotional components, thus exhibiting the features of a highly subjective experience. Over the years, neural pathways involved in the modulation of the different components of pain have been identified, indicating the existence of medial and lateral pain systems, which, respectively, project from medial or lateral thalamic nuclei to reach distinct cortex regions relating to specific functions. However, owing to the limited information concerning how mood state and painful input affect each other, pain treatment is frequently unsatisfactory. Different neuromodulators, including endogenous neuropeptides, appear to be involved in pain-related emotion and in its affective influence on pain perception, thus playing key roles in vulnerability and clinical outcome. Hence, this review article focuses on evidence concerning the modulation of the sensory and affective dimensions of pain, with particular attention given to some selected neuropeptidergic system contributions.

Pathobiology of Visceral Pain: Molecular Mechanisms and Therapeutic Implications V. Central nervous system processing of somatic and visceral sensory signals

2000 ◽  
Vol 279 (1) ◽  
pp. G1-G6 ◽  
Author(s):  
Uri Ladabaum ◽  
Satoshi Minoshima ◽  
Chung Owyang
Keyword(s):  
Molecular Mechanisms ◽  
Pain Perception ◽  
Visceral Pain ◽  
Imaging Techniques ◽  
Functional Brain Imaging ◽  
Anterior Cingulate ◽  
Visceral Sensation ◽  
Therapeutic Implications ◽  
Somatic Pain ◽  
Dimensions Of Pain

Somatic and visceral sensation, including pain perception, can be studied noninvasively in humans with functional brain imaging techniques. Positron emission tomography and functional magnetic resonance imaging have identified a series of cerebral regions involved in the processing of somatic pain, including the anterior cingulate, insular, prefrontal, inferior parietal, primary and secondary somatosensory, and primary motor and premotor cortices, the thalamus, hypothalamus, brain stem, and cerebellum. Experimental evidence supports possible specific roles for individual structures in processing the various dimensions of pain, such as encoding of affect in the anterior cingulate cortex. Visceral sensation has been examined in the setting of myocardial ischemia, distension of hollow viscera, and esophageal acidification. Although knowledge regarding somatic sensation is more extensive than the information available for visceral sensation, important similarities have emerged between cerebral representations of somatic and visceral pain.

scholarly journals Test–retest reliability of laser evoked pain perception and fMRI BOLD responses

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yanzhi Bi ◽  
Xin Hou ◽  
Jiahui Zhong ◽  
Li Hu
Keyword(s):  
Resting State ◽  
Repeated Measures ◽  
Subjective Experience ◽  
Pain Perception ◽  
Primary Motor Cortex ◽  
Intraclass Correlation ◽  
Retest Reliability ◽  
Repeated Measures Design ◽  
Brain Responses ◽  
Test Retest Reliability

AbstractPain perception is a subjective experience and highly variable across time. Brain responses evoked by nociceptive stimuli are highly associated with pain perception and also showed considerable variability. To date, the test–retest reliability of laser-evoked pain perception and its associated brain responses across sessions remain unclear. Here, an experiment with a within-subject repeated-measures design was performed in 22 healthy volunteers. Radiant-heat laser stimuli were delivered on subjects’ left-hand dorsum in two sessions separated by 1–5 days. We observed that laser-evoked pain perception was significantly declined across sessions, coupled with decreased brain responses in the bilateral primary somatosensory cortex (S1), right primary motor cortex, supplementary motor area, and middle cingulate cortex. Intraclass correlation coefficients between the two sessions showed “fair” to “moderate” test–retest reliability for pain perception and brain responses. Additionally, we observed lower resting-state brain activity in the right S1 and lower resting-state functional connectivity between right S1 and dorsolateral prefrontal cortex in the second session than the first session. Altogether, being possibly influenced by changes of baseline mental state, laser-evoked pain perception and brain responses showed considerable across-session variability. This phenomenon should be considered when designing experiments for laboratory studies and evaluating pain abnormalities in clinical practice.

The Clinician’s Subjective Experience during the Interaction with Adolescent Psychiatric Patients: Validity and Reliability of the Assessment of Clinician’s Subjective Experience

2021 ◽  
pp. 1-8
Author(s):  
Angelo Picardi ◽  
Sara Panunzi ◽  
Sofia Misuraca ◽  
Chiara Di Maggio ◽  
Andrea Maugeri ◽  
...  
Keyword(s):  
Clinical Examination ◽  
Subjective Experience ◽  
Rating Scale ◽  
Mood State ◽  
Psychiatric Patients ◽  
Temporal Stability ◽  
Young Patients ◽  
Reliability And Validity ◽  
Mental States ◽  
Validity And Reliability

<b><i>Introduction:</i></b> The last decade has witnessed a resurgence of interest in the clinician’s subjectivity and its role in the diagnostic assessment. Integrating the criteriological, third-person approach to patient evaluation and psychiatric diagnosis with other approaches that take into account the patient’s subjective and intersubjective experience may bear particular importance in the assessment of very young patients. The ACSE (Assessment of Clinician’s Subjective Experience) instrument may provide a practical way to probe the intersubjective field of the clinical examination; however, its reliability and validity in child and adolescent psychiatrists seeing very young patients is still to be determined. <b><i>Methods:</i></b> Thirty-three clinicians and 278 first-contact patients aged 12–17 years participated in this study. The clinicians completed the ACSE instrument and the Brief Psychiatric Rating Scale after seeing the patient, and the Profile of Mood State (POMS) just before seeing the patient and immediately after. The ACSE was completed again for 45 patients over a short (1–4 days) retest interval. <b><i>Results:</i></b> All ACSE scales showed high internal consistency and moderate to high temporal stability. Also, they displayed meaningful correlations with the changes in conceptually related POMS scales during the clinical examination. <b><i>Discussion:</i></b> The findings corroborate and extend previous work on adult patients and suggest that the ACSE provides a valid and reliable measure of the clinician’s subjective experience in adolescent psychiatric practice, too. The instrument may prove to be useful to help identify patients in the early stages of psychosis, in whom subtle alterations of being with others may be the only detectable sign. Future studies are needed to determine the feasibility and usefulness of integrating the ACSE within current approaches to the evaluation of at-risk mental states.

Central and Peripheral Nervous System

2021 ◽  
Author(s):  
Esther Benedetti ◽  
James Burnett ◽  
Meredith Degnan ◽  
Danielle Horne ◽  
Andres Missair ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Nervous System ◽  
Neuropathic Pain ◽  
Cancer Pain ◽  
Pain Perception ◽  
Visceral Pain ◽  
Influential Factors ◽  
Electrical Transmission ◽  
Somatic Pain ◽  
Spine Pain

The neuronal, chemical, and electrical transmission of pain is a complex and intricate subject that continues to be studied and expounded. This review discusses the relevant physiology and influential factors contributing to the experience and subjective variation in a variety of acute and chronic pain presentations. This review contains 4 figures, 4 tables, and 30 references Keywords: acute pain, chronic pain, somatic pain, neuropathic pain, visceral pain, nociception, pain perception, gender-related pain, cancer pain, spine pain

Comparative Study between Bupivacaine-Dexmedetomidine versus Bupivacaine-Dexamethasone in Skin Infiltration as Post-Operative Analgesia for Patients undergoing Abdominoplasty Surgeries

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Ali Fawaz ◽  
Osama Ramzy Youssef ◽  
Ahmed Mounir Ahmed ◽  
Mohamed Adel Abdelfattah Salama
Keyword(s):  
Pain Treatment ◽  
Hospital Costs ◽  
Bowel Function ◽  
University Hospital ◽  
Wound Infiltration ◽  
Treatment Protocols ◽  
Somatic Pain ◽  
Group I ◽  
Skin Infiltration ◽  
Prolonged Hospital

Abstract Background Poorly controlled acute pain after abdominal surgery is related to somatic pain signals derived from the abdominal wall and is associated with a variety of unwanted postoperative consequences, including patient suffering, distress, respiratory complications, delirium, myocardial ischemia, prolonged hospital stay, an increased likelihood of chronic pain, increased consumption of analgesics, delayed bowel function and increase the requirement for rescue analgesics. Appropriate pain treatment protocols to reduce postoperative morbidity, improve the results of the surgery and decrease hospital costs. Aim of the Work To compare skin infiltration with bupivacaine-dexmedetomidine mixture versus bupivacaine-dexamethasone mixture for analgesia in abdominoplasty under general anesthesia. Patients and Methods A prospective randomized clinical trial study was conducted in Ain Shams university hospital on 40 adult patients undergoing Abdominoplasty surgeries. The patients were randomly divided into two groups using their computer-generated random numbers will be enrolled in group I for bupivacaine-dexmedetomidine and group II for bupivacaine-dexamethasone. Results This study demonstrated that the addition of dexmedetomidine to wound infiltration with local anesthetics improves postoperative pain and reduces the need for analgesics. Conclusion Wound infiltration with bupivacaine -dexmedetomidine mixture provides prolonged local anesthetic effect, decreases the need for rescue analgesics, and provides better sedation than bupivacaine–dexamethasone mixture in patients undergoing Abdominoplasty surgeries.

scholarly journals Modulation of nociception by corticotrigeminal pathway- A narrative review

Mediscope ◽  
2020 ◽  
Vol 7 (1) ◽  
pp. 51-57
Author(s):  
Sayema Ainan
Keyword(s):  
Nervous System ◽  
Trigeminal Nerve ◽  
Cortical Neurons ◽  
Pain Perception ◽  
Pain Treatment ◽  
Early Stage ◽  
Short Review ◽  
Inhibitory Neurons ◽  
Pain Sensation

Management of chronic pain is one of the most important reason to which medications are given. Traditional medicines which have been used to relieve pain are having a number of limitations. Therefore, novel therapies for pain treatment are essential. Our nervous system can process any kind of injurious stimuli, which is known as nociception. The mechanism of nociception involves a complex interaction of peripheral and central nervous system structures. Brain or cerebral cortex has its own controlling mechanism for pain perception. Trigeminal nerve is the fifth cranial nerve and it receives pain sensation from oro- and craniofacial region and sends the information up to cortex. Recent investigations demonstrate another important role of cortical neurons in addition to pain perception, that is, corticotrigeminal (cortex to trigeminal) pathway excites neurons in the trigeminal nerve that leads to decrease in the pain response induced by noxious stimuli. Thus, as this mechanism can be induced at early stage of nociception, it may reduce the pain sensation. So, the corticotrigeminal pathway could be a new potential target for pain therapies. This short review revisits the concepts how stimulation of primary somatosensory cortex can be transmitted via corticotrigeminal tract which aim for the inhibitory neurons in spinal trigeminal nucleus caudalis (SpVc) and thus potentially generate a feedforward inhibition, explaining the pain modulatory role of the corticotrigeminal pathway. Mediscope Vol. 7, No. 1: Jan 2020, Page 51-57

Interventional pain treatment – overview of available procedures

Ból ◽  
2019 ◽  
Vol 19 (3) ◽  
pp. 1-14
Author(s):  
Michał But ◽  
Andrzej Król ◽  
Teodor Goroszeniuk ◽  
Elwira Góraj ◽  
Kamil Starczewski ◽  
...  
Keyword(s):  
Subjective Experience ◽  
Pain Treatment ◽  
Hospital Setting ◽  
Anatomical Location ◽  
Heavy Burden ◽  
The Right ◽  
Fee Schedule ◽  
Interventional Pain Treatment ◽  
Based Medicine

Chronic pain has become dominant problem in recent years affecting not only patient quality of life but having economic impact and heavy burden on the health systems. The first line in pain management would be patient education, physical rehabilitation and pharmacotherapy. Unfortunately aforementioned treatment often appears incomplete and specialised, targeted pain interventions are warranted. With significant progress in pain medicine, the number of available and effective interventional procedures and techniques have increased. In this manuscript authors have carried out an up to date review of modern interventional techniques with emphasize of anatomy, level of advancement and complexity. Authors classified procedures according to anatomical location: head and neck, spine, upper and lower limb, trunk as well as pathophysiology: interventions in neuropathic pain, cancer pain including neuromodulation techniques. Whenever possible authors relied on evidence based medicine (EBM) but with emphasize of its limitation, especially in assessment of pain relief which remains patient subjective experience. In summary, reimbursement of up to date pain procedures, in the outpatient and hospital setting has been shown. It hopefully guide pain specialists to choose the right intervention and facilitate renumeration within NFZ fee schedule.

The Elicited Verbal Pain Language of Childbirth: A Closer Look at Pain Assessment Through a Critical and Interpretive Review of the Literature

2016 ◽  
Vol 6 (3) ◽  
pp. 134-148 ◽  
Author(s):  
Stephanie Power ◽  
Fiona E. Bogossian ◽  
Jenny Strong ◽  
Roland Sussex
Keyword(s):  
Pain Assessment ◽  
Pain Perception ◽  
Cross Cultural ◽  
Assessment Tools ◽  
Review Of The Literature ◽  
Pain Experience ◽  
Electronic Search ◽  
Dimensions Of Pain ◽  
The Impact ◽  
Affective Dimensions

OBJECTIVE:To provide a critical and interpretive review of the literature to investigate examples of pain assessment tools used in a childbirth context. Through these examples of pain assessment, the concept of elicited verbal pain language is introduced and explored.METHODS:Electronic search strategies were used to identify primary research regarding maternal reports of pain (during labor, postpartum and retrospectively), which were captured by standardized pain assessment tools.FINDINGS:The review revealed the physiological (the sensory and affective dimensions of pain, the intensity of pain, and the influence of parity on pain perception), psychological (the influence of maternal attitude, mood, and memory on pain perception), and ethnocultural (the impact of the ethnocultural context on pain perception) components of the pain experience. The strengths and limitations of pain assessment tools are highlighted. There were similarities in the reviewed studies’ approaches to pain assessment despite the cross-cultural representation of birth. Possible implications for cross-cultural pain assessment and communication are outlined.CONCLUSION:The question remains regarding the appropriateness of implementing standardized pain assessment tools across birth context. An ongoing critique of pain assessment may inform the provision of better care overall for birthing women in multicultural societies.

FC09-02 - Efficacy of distraction by means of virtual reality in the control and reduction of pain using the cold-pressor test

2011 ◽  
Vol 26 (S2) ◽  
pp. 1859-1859
Author(s):  
J. Gutiérrez-Maldonado ◽  
K. Cabas-Hoyos ◽  
O. Gutiérre Martínez ◽  
D. Loreto-Quijada ◽  
C. Peñaloza-Salazar
Keyword(s):  
Pain Intensity ◽  
Pain Perception ◽  
Pain Treatment ◽  
Cold Pressor Test ◽  
Time Estimation ◽  
Cold Pressor ◽  
Experimental Conditions ◽  
Pressor Test ◽  
Reduction Of Pain ◽  
Healthy Participants

IntroductionAttention plays an important rol in pain perception. Focusing attention in pain intensifies the painful experience whereas distraction may decrease its subjective sensation (Eccleston & Crombez, 1999).The purpose of the two studies is to establish the efficacy of distraction by means of VR in the control and reduction of pain using the cold-pressor test. In both studies threshold, tolerance, perceived pain intensity and time estimation were measured.Study 137 healthy participants were induced pain in two consecutive immersions using the cold-pressor test. The experiment was counterbalanced and all participants went through two experimental conditions: VR (stereoscopic screen) and black screen. A virtual environment “Surreal World” was designed based on distraction of attention techniques. Results showed that VR significantly increased threshold and tolerance, diminished pain intensity and perception of time.Study 235 healthy participants underwent two consecutive immersions using cold pressor: VR (using the updated version of Surreal World and 3D laptops) and black screen. VR significantly increased the threshold and tolerance, whereas variations in the estimation of time were barely significant.Differences in the results of the two studies could be accounted for by the immersive effect of the stereoscopic screen. Findings are discussed in relation to previous studies on VR and pain. Results support VR as an adjunctive method in pain treatment and allow proving its efficacy in patients with chronic pain.

Imaging CNS Modulation of Pain in Humans

Physiology ◽  
2008 ◽  
Vol 23 (6) ◽  
pp. 371-380 ◽  
Author(s):  
Ulrike Bingel ◽  
Irene Tracey
Keyword(s):  
Chronic Pain ◽  
Subjective Experience ◽  
Pain Perception ◽  
Survival Function ◽  
Human Experimentation ◽  
Major Focus ◽  
Pain Experience ◽  
Emotional Factors ◽  
Nociceptive Information ◽  
Nociceptive Input

Pain is a highly complex and subjective experience that is not linearly related to the nociceptive input. What is clear from anecdotal reports over the centuries and more recently from animal and human experimentation is that nociceptive information processing and consequent pain perception is subject to significant pro- and anti-nociceptive modulations. These modulations can be initiated reflexively or by contextual manipulations of the pain experience including cognitive and emotional factors. This provides a necessary survival function since it allows the pain experience to be altered according to the situation rather than having pain always dominate. The so-called descending pain modulatory network involving predominantly medial and frontal cortical areas, in combination with specific subcortical and brain stem nuclei appears to be one key system for the endogenous modulation of pain. Furthermore, recent findings from functional and anatomical neuroimaging support the notion that an altered interaction of pro- and anti-nociceptive mechanisms may contribute to the development or maintenance of chronic pain states. Research on the involved circuitry and implemented mechanisms is a major focus of contemporary neuroscientific research in the field of pain and should provide new insights to prevent and treat chronic pain states.

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