scholarly journals Gender Differences in the Association of Brain Gray Matter and Pain-Related Psychosocial Characteristic

2019 ◽  
Vol 3 (22;3) ◽  
pp. E191-E203 ◽  
Author(s):  
Anneleen Malfliet
Keyword(s):  
Gender Differences ◽  
Gray Matter ◽  
Pain Catastrophizing ◽  
Personal Control ◽  
Spinal Pain ◽  
Psychosocial Characteristics ◽  
Pain Duration ◽  
Emotional Representations ◽  
Perceived Personal Control ◽  
Chronic Spinal Pain

Background: Although the association of gray matter morphology alterations and pain-related psychosocial characteristics with pain intensity and chronification in people with chronic spinal pain is evident, research on their mutual interaction is scarce and does not account for possible gender differences. Gender-based differences are, however, of utmost importance to consider when examining pain neurobiology. Objectives: To look for gender differences in the association between magnetic resonance imaging- (MRI) derived brain gray matter morphology and self-reported psychosocial characteristics. Study Design: An explorative, observational study. Setting: University Hospitals Ghent and Brussels, Belgium. Methods: Brain gray matter morphology (using MRI) and self-reported psychosocial characteristics were examined in women and men with nonspecific chronic spinal pain. Statistical analyses were performed in SPSS and R to identify differences between men and women regarding brain gray matter, self-reported psychosocial characteristics, as well as gender differences in the association between those outcome measures. Results: A total of 94 people with chronic spinal pain were studied, including 32 men (15 suffering from neck pain, 17 suffering from low back pain; demographics [mean ± SD] age: 45.00 ± 12.02 years; pain duration: 128.37 ± 110.45 months), and 62 women (36 suffering from neck pain, 26 suffering from low back pain; demographics [mean ± SD] age: 38.78 ± 12.69 years; pain duration: 114.27 ± 92.45 months). Woman showed larger (positive) associations of several central brain areas (paracentral, precentral, postcentral, etc.) with perceived consequences (P < 0.001), emotional representations (P < 0.001), chronicity (P < 0.001), and pain catastrophizing (P< 0.001). Men showed larger (both positive and negative) associations of the precuneus cortex, the precentral gyrus, and the insula with perceived personal control (P < 0.001) and kinesiophobia (P < 0.001). Limitations: Other factors, such as menstrual cycle and medication can have a certain influence, and were only partly taken into consideration in the present investigation to obtain sufficient power. Another limitation is the observational study design, which hampers the possibility to look for causal or temporal interactions. Conclusions: Gray matter morphology relates differently to psychosocial characteristics in women and men. These explorative findings provide ideas for further research to investigate if targeting perceived negative consequences of the illness, perceived emotional representations, perceived chronicity, and pain catastrophizing in women, and perceived personal control of the illness and kinesiophobia in men, could contribute to the normalization of brain alterations in people with nonspecific chronic spinal pain. Key words: Gray matter, brain morphology, central nervous system, illness perceptions, central sensitization

Influence of Baseline Kinesiophobia Levels on Treatment Outcome in People With Chronic Spinal Pain

2021 ◽  
Author(s):  
Wouter Van Bogaert ◽  
Iris Coppieters ◽  
Jeroen Kregel ◽  
Jo Nijs ◽  
Robby De Pauw ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Rating Scale ◽  
Pain Catastrophizing ◽  
Controlled Trial ◽  
Treatment Success ◽  
Experimental Treatment ◽  
Spinal Pain ◽  
Double Blind ◽  
Sf 36 ◽  
Chronic Spinal Pain

Abstract Background Pain neuroscience education (PNE) combined with cognition-targeted exercises is an effective treatment for people with chronic spinal pain (CSP). However, it is unclear as to why some patients benefit more from this treatment. We expect that patients with more pronounced maladaptive pain cognitions, such as kinesiophobia, might show poorer treatment responses. Objective The objective of this study was to assess the influence of baseline kinesiophobia levels on the treatment outcomes of PNE combined with cognition-targeted exercises in people with CSP. This study was a secondary analysis of a multicenter, double-blind randomized controlled trial. Methods Outcome measures included a numeric rating scale for pain (NRS), the Pain Disability Index (PDI), quality of life (Medical Outcomes Study 36-Item Health Survey [SF-36]), Pain Catastrophizing Scale (PCS), and Pain Vigilance and Awareness Questionnaire (PVAQ). Regression models were built using treatment (PNE plus cognition-targeted exercises or neck/back school plus general exercises), baseline scores on the Tampa Scale for Kinesiophobia (TSK), and time (in months) as independent variables. Results A significant three-way interaction effect was found for the models of PDI, PCS, PVAQ, and the SF-36 mental domain, with estimates of −0.01, −0.01, −0.01, and 0.07, respectively. A significant effect of baseline TSK scores was found for the physical domain of the SF-36 (estimate = −3.16). For the NRS, no significant effect of baseline TSK scores was found. Conclusions Our findings indicate that PNE plus cognition-targeted exercises can successfully decrease the unfavorable influence of pretreatment kinesiophobia on disability, mental health, pain catastrophizing, and hypervigilance over time in people with CSP. Nevertheless, higher scores in pretreatment kinesiophobia might still be a key factor for the lack of improvement in pain catastrophizing and hypervigilance following treatment. Regardless of the followed treatment program, pretreatment kinesiophobia was also shown to significantly influence physical health in people with CSP. Impact This study provides novel insight into the unfavorable influence of kinesiophobia on treatment outcomes in people with CSP, and how PNE plus cognition-targeted exercises can limit this impact. As this is one of the first studies to research possible predictors of this experimental treatment, its findings motivate further exploration of other possible influencing factors for treatment success of PNE plus cognition-targeted exercises.

Personal Problem Solving of Partners in Divorce Proceedings

2015 ◽  
Vol 36 (1) ◽  
pp. 82-103 ◽  
Author(s):  
Tereza Soukupova ◽  
Petr Goldmann
Keyword(s):  
Gender Differences ◽  
Problem Solving ◽  
Thematic Apperception Test ◽  
Scoring Systems ◽  
Personal Control ◽  
Personality Characteristics ◽  
Personal Problem ◽  
Thematic Apperception ◽  
And Gender ◽  
The Given

Abstract. The Thematic Apperception Test is one of the most frequently administered apperceptive techniques. Formal scoring systems are helpful in evaluating story responses. TAT stories, made by 20 males and 20 females in the situation of legal divorce proceedings, were coded for detection and comparison of their personal problem solving ability. The evaluating instrument utilized was the Personal Problem Solving System-Revised (PPSS-R) as developed by G. F. Ronan. The results indicate that in relation to card 1, men more often than women saw the cause of the problem as removable. With card 6GF, women were more motivated to resolve the given problem than were men, women had a higher personal control and their stories contained more optimism compared to men’s stories. In relation to card 6BM women, more often than men, used emotions generated from the problem to orient themselves within the problem. With card 13MF, the men’s level of stress was less compared to that of the women, and men were more able to plan within the context of problem-solving. Significant differences in the examined groups were found in those cards which depicted significant gender and parental potentials. The TAT can be used to help identify personality characteristics and gender differences.

Social Comparison for Concern and Action on Climate Change, Racial Injustice, and COVID-19

2021 ◽  
Author(s):  
Virginia Ulichney ◽  
Johanna Jarcho ◽  
Thomas Shipley ◽  
joy ham ◽  
Chelsea Helion
Keyword(s):  
Climate Change ◽  
Social Comparison ◽  
Social Issues ◽  
Personal Control ◽  
Personal Concern ◽  
Racial Injustice ◽  
Negative Impacts ◽  
Perceived Personal Control

Preventing the negative impacts of major, intersectional U.S. social issues hinges on personal concern and willingness to take action. We examined social comparison of COVID-19, racial injustice, and climate change during Fall 2020. Participants in a U.S. university sample (n = 288), reported personal levels of concern and action taken on these issues, and estimated their peers’ concern and action. Participants accurately estimated similar levels of personal and peer concern for racial injustice and climate change, but overestimated peer concern for COVID-19. At higher personal concern levels, people estimated that they took greater action than peers for all issues. Exploratory analyses found that perceived personal control over social issues increased participants’ concern and action for racial injustice and climate change, but yielded no change for COVID-19. This suggests that issue-specific features, including perceived controllability, may drive people to differently assess their experience of distinct social issues relative to peers.

An Overview of Chronic Spinal Pain

Spine ◽  
2017 ◽  
Vol 42 ◽  
pp. S35-S40 ◽  
Author(s):  
Ashwini Sharan ◽  
Jonathan Riley ◽  
Christian Hoelscher
Keyword(s):  
Spinal Pain ◽  
Chronic Spinal Pain

scholarly journals Interventional Techniques: Evidence-based Practice Guidelines in the Management of Chronic Spinal Pain

2007 ◽  
Vol 1;10 (1;1) ◽  
pp. 7-111
Author(s):  
ASIPP ASIPP
Keyword(s):  
Facet Joint ◽  
Spinal Pain ◽  
Evidence Based ◽  
Short Term ◽  
Steroid Injections ◽  
Interventional Techniques ◽  
Epidural Steroid Injections ◽  
Epidural Steroid ◽  
Chronic Spinal Pain

Background: The evidence-based practice guidelines for the management of chronic spinal pain with interventional techniques were developed to provide recommendations to clinicians in the United States. Objective: To develop evidence-based clinical practice guidelines for interventional techniques in the diagnosis and treatment of chronic spinal pain, utilizing all types of evidence and to apply an evidence-based approach, with broad representation by specialists from academic and clinical practices. Design: Study design consisted of formulation of essentials of guidelines and a series of potential evidence linkages representing conclusions and statements about relationships between clinical interventions and outcomes. Methods: The elements of the guideline preparation process included literature searches, literature synthesis, systematic review, consensus evaluation, open forum presentation, and blinded peer review. Methodologic quality evaluation criteria utilized included the Agency for Healthcare Research and Quality (AHRQ) criteria, Quality Assessment of Diagnostic Accuracy Studies (QUADAS) criteria, and Cochrane review criteria. The designation of levels of evidence was from Level I (conclusive), Level II (strong), Level III (moderate), Level IV (limited), to Level V (indeterminate). Results: Among the diagnostic interventions, the accuracy of facet joint nerve blocks is strong in the diagnosis of lumbar and cervical facet joint pain, whereas, it is moderate in the diagnosis of thoracic facet joint pain. The evidence is strong for lumbar discography, whereas, the evidence is limited for cervical and thoracic discography. The evidence for transforaminal epidural injections or selective nerve root blocks in the preoperative evaluation of patients with negative or inconclusive imaging studies is moderate. The evidence for diagnostic sacroiliac joint injections is limited. The evidence for therapeutic lumbar intraarticular facet injections is moderate for short-term and long-term improvement, whereas, it is limited for cervical facet joint injections. The evidence for lumbar and cervical medial branch blocks is moderate. The evidence for medial branch neurotomy is moderate. The evidence for caudal epidural steroid injections is strong for short-term relief and moderate for long-term relief in managing chronic low back and radicular pain, and limited in managing pain of postlumbar laminectomy syndrome. The evidence for interlaminar epidural steroid injections is strong for short-term relief and limited for long-term relief in managing lumbar radiculopathy, whereas, for cervical radiculopathy the evidence is moderate. The evidence for transforaminal epidural steroid injections is strong for short-term and moderate for long-term improvement in managing lumbar nerve root pain, whereas, it is moderate for cervical nerve root pain and limited in managing pain secondary to lumbar post laminectomy syndrome and spinal stenosis. The evidence for percutaneous epidural adhesiolysis is strong. For spinal endoscopic adhesiolysis, the evidence is strong for short-term relief and moderate for long-term relief. For sacroiliac intraarticular injections, the evidence is limited. The evidence for radiofrequency neurotomy for sacroiliac joint pain is limited. The evidence for intradiscal electrothermal therapy is moderate in managing chronic discogenic low back pain, whereas for annuloplasty the evidence is limited. Among the various techniques utilized for percutaneous disc decompression, the evidence is moderate for short-term and limited for long-term relief for automated percutaneous lumbar discectomy, and percutaneous laser discectomy, whereas it is limited for nucleoplasty and for DeKompressor technology. For vertebral augmentation procedures, the evidence is moderate for both vertebroplasty and kyphoplasty. The evidence for spinal cord stimulation in failed back surgery syndrome and complex regional pain syndrome is strong for shortterm relief and moderate for long-term relief. The evidence for implantable intrathecal infusion systems is strong for short-term relief and moderate for long-term relief. Conclusion: These guidelines include the evaluation of evidence for diagnostic and therapeutic procedures in managing chronic spinal pain and recommendations for managing spinal pain. However, these guidelines do not constitute inflexible treatment recommendations. These guidelines also do not represent a “standard of care.” Key words: Interventional techniques, chronic spinal pain, diagnostic blocks, therapeutic interventions, facet joint interventions, epidural injections, epidural adhesiolysis, discography, radiofrequency, disc decompression, vertebroplasty, kyphoplasty, spinal cord stimulation, intrathecal implantable systems

Radiofrequency lesioning and chronic spinal pain: A review of current concepts

2002 ◽  
Vol 14 (1) ◽  
pp. 1-28 ◽  
Author(s):  
Jos W. Geurts ◽  
Roelof M. Van Wijk ◽  
Gerbrand J. Groen
Keyword(s):  
Spinal Pain ◽  
Chronic Spinal Pain

Shadows of the Truth in Patients with Spinal Pain: A Review

1997 ◽  
Vol 42 (1) ◽  
pp. 44-48 ◽  
Author(s):  
Lynton GF Giles ◽  
Colin M Crawford
Keyword(s):  
Diagnostic Imaging ◽  
Health Problem ◽  
Spinal Pain ◽  
Referred Pain ◽  
Histopathological Changes ◽  
Imaging Device ◽  
Anatomical Structures ◽  
Histopathological Findings ◽  
Pain Symptoms ◽  
Chronic Spinal Pain

Objective: Spinal pain with or without referred pain is a major and costly health problem that can arise from many anatomical structures. Sophisticated diagnostic imaging devices cannot show some of these structures, and frequently imaging provides only a shadow of the truth. This review illustrates how symptoms may well have an organic cause that is not detectable by current methods of examination, including imaging. Method: This study reviews some histopathological findings that can be associated with spinal pain with or without referred pain but cannot be seen on imaging. Result: Some histopathological changes illustrate imaging device limitations. Conclusion: Awareness of the considerable limitations of even sophisticated imaging devices is necessary when managing patients with acute or chronic spinal pain with or without referred pain. Symptoms may well be genuine and not of psychogenic origin: a diagnosis of malingering, therefore, should not be made lightly.

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