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chronic pain, posttraumatic stress disorder, and opioid intake: A systematic review

World Journal of Clinical Cases 2019年第24期7卷 4254-4269页

作者： Alicia E López-Martínez ángela Reyes-Pérez Elena Rocío Serrano-Ibá?ez Rosa Esteve Carmen Ramírez-Maestre Facultad de Psicología Instituto de Investigaciones Biomédicas (IBIMA)Universidad de Málaga

BACKGROUND The literature suggests that there is a high degree of co-occurrence between chronic pain and posttraumatic stress disorder(PTSD). An association has been found between PTSD and substance abuse. PTSD is a severe disorder that should be taken into account when opioids are prescribed. It has been found that the prevalence of opioid use disorder(OUD) in chronic pain patients is higher among those with PTSD than those without this *** To perform a systematic review on the association between PTSD, chronic noncancer pain(CNCP), and opioid intake(i.e., prescription, misuse, and abuse).METHODS We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The Patient, Intervention,Comparator, and Outcomes(PICOS) criteria were formulated a priori in the protocol of the systematic review. A search was conducted of the PROSPERO database. In March 2019, searches were also conducted of 5 other databases:Pub Med, MEDLINE, Psyc INFO, Web of Science, and PILOTS. The Scottish Intercollegiate Guidelines Network checklist for cohort studies was used to assess the selected studies for their methodological quality and risk of bias. Each study was evaluated according to its internal validity, participant sampling,confounding variables, and the statistical *** A total of 151 potentially eligible studies were identified of which 17 were retained for analysis. Only 10 met the selection criteria. All the studies were published between 2008 and 2018 and were conducted in the United States. The eligible studies included a total of 1622785 unique participants. Of these, 196516 had comorbid CNCP and PTSD and were consuming opiates. The participants had a cross-study mean age of 35.2 years. The majority of participants were men(81.6%). The most common chronic pain condition was musculoskeletal pain:back pain(47.14% across studies;range: 16%-60.6%), arthritis and joint pain(31.1%;range: 18%-67.5%), and

关键词： Posttraumatic stress disorder chronic pain Opioid prescription Opioid misuse Opioid abuse

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Satellite glial cells in sensory ganglia play a wider role in chronic pain via multiple mechanisms

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Neural Regeneration Research 2024年第5期19卷 1056-1063页

作者： Xiaoyun Qiu Yuanzhi Yang Xiaoli Da Yi Wang Zhong Chen Cenglin Xu Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province School of Pharmaceutical ScienceZhejiang Chinese Medical UniversityHangzhouZhejiang ProvinceChina

Satellite glial cells are unique glial cells that surround the cell body of primary sensory *** increasing body of evidence suggests that in the presence of inflammation and nerve damage,a significant number of satellite glial cells become activated,thus triggering a series of functional *** suggests that satellite glial cells are closely related to the occurrence of chronic *** this review,we first summarize the morphological structure,molecular markers,and physiological functions of satellite glial ***,we clarify the multiple key roles of satellite glial cells in chronic pain,including gap junction hemichannel Cx43,membrane channel Pannexin1,K channel subunit 4.1,ATP,purinergic P2 receptors,and a series of additional factors and their receptors,including tumor necrosis factor,glutamate,endothelin,and ***,we propose that future research should focus on the specific sorting of satellite glial cells,and identify genomic differences between physiological and pathological *** review provides an important perspective for clarifying mechanisms underlying the peripheral regulation of chronic pain and will facilitate the formulation of new treatment plans for chronic pain.

关键词： chronic pain primary sensory neurons satellite glial cells sensory ganglia

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Magnetic resonance imaging for chronic pain:diagnosis,manipulation,and biomarkers

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Science China(Life Sciences) 2021年第6期64卷 879-896页

作者： Yiheng Tu Jin Cao Yanzhi Bi Li Hu CAS Key Laboratory of Mental Health Institute of PsychologyBeijing 100101China Department of Psychology University of Chinese Academy of SciencesBeijing 100101China Department of Psychiatry Massachusetts General Hospital and Harvard Medical SchoolBoston 02129USA Department of pain Management The State Key Clinical Specialty in Pain MedicineThe Second Affiliated Hospital of Guangzhou Medical UniversityGuangzhou 510260China

pain is a multidimensional subjective experience with biological,psychological,and social *** acute pain can be a warning signal for the body to avoid excessive injury,long-term and ongoing pain may be developed as chronic *** are more than 100 million people in China living with chronic pain,which has raised a huge socioeconomic *** the mechanisms of pain and developing effective analgesia approaches are important for basic and clinical ***,with the development of brain imaging and data analytical approaches,the neural mechanisms of chronic pain have been widely *** the first part of this review,we briefly introduced the magnetic resonance imaging and conventional analytical approaches for brain imaging ***,we reviewed brain alterations caused by several chronic pain disorders,including localized and widespread primary pain,primary headaches and orofacial pain,musculoskeletal pain,and neuropathic pain,and present meta-analytical results to show brain regions associated with the pathophysiology of chronic ***,we reviewed brain changes induced by pain interventions,such as pharmacotherapy,neuromodulation,and ***,we reviewed emerging studies that combined advanced machine learning and neuroimaging techniques to identify diagnostic,prognostic,and predictive biomarkers in chronic pain patients.

关键词： chronic pain magnetic resonance imaging biomarkers machine learning

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Frontiers of Medicine 2015年第3期9卷 374-379页

作者： Hong Zhu Yuzhu Zheng Hui Gao Li Liu Lie Yang Department of Nursing Quality Control West China Hospital Sichuan University Chengdu 610041 China Department of Oncology The Third People's Hospital of Chengdu Chengdu 610041 China West China School of Medicine Sichuan University Chengdu 610041 China Department of pain Ward West China Hospital Sichuan University Chengdu 610041 China Department of Gastrointestinal Surgery West China Hospital Sichuan University Chengdu 610041 China

This study aimed to determine the relationship between the different factors of analgesic therapy and the compliance of chronic pain inpatients. We prospectively investigated 100 consecutive inpatients with non- cancer chronic pain who were hospitalized to receive oral analgesic treatment in the pain Department of West China Hospital from May 2013 to October 2013. Patients who completed the treatment plan were recorded as good compliance, whereas patients who partly completed or even refused the treatment were recorded as moderate or non-compliance, respectively. A total of 73 （73.7%）, 17 （17.1%）, and 9 （9.2%） patients showed good, moderate, and non-compliance, respectively. Univariate analyses showed significantly better compliance among farmers, patients educated in college or above, with family income of 〈 3000 CNY, and with severe or moderate pain than those employed and unemployed （P= 0.02）, patients educated below college （P= 0.013）, with family income of ≥ 3000 CNY （P = 0.025）, and with mild pain （P 〈 0.001）, respectively. Logistic regression analysis showed that the family income of≥ 3000 CNY （OR： 2.50, 95%CI： 1.65-4.51, P= 0.021） and mild pain （OR： 1.27, 95%CI： 1.03-3.31, P= 0.016） were associated with moderate or non-compliance with oral analgesic treatment. In conclusion, the low compliance with oral treatment of analgesics was found in Chinese inpatients with chronic pain and compliance was negatively associated with family income and degree of pain of patients.

关键词： chronic pain inpatient oral paregoric drugs compliance

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A randomized trial comparing the Tennant Biomodulator to transcutaneous electrical nerve stimulation and traditional Chinese acupuncture for the treatment of chronic pain in military service members

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Military Medical Research 2020年第2期7卷 140-150页

作者： Kimberly S.Peacock Erika Stoerkel Salvatore Libretto Weimin Zhang Alice Inman Michael Schlicher John D.Cowsar Jr David Eddie Joan Walter University of Texas Health San Antonio 7703 Floyd Curl DriveSan AntonioTX78229USA TLI Foundation 1750 Tysons BoulevardMcLeanVirginia22102USA Henry M.Jackson Foundation 6720A Rockledge DriveBethesdaMD20817USA BD Life Sciences 1 Becton DriveFranklin LakesNJ07417USA Brooke Army Medical Center 3551 Roger Brooke DriveFort Sam HoustonTX78234USA Madigan Army Medical Center 9040A Jackson AveJoint Base Lewis-McChordWA98431USA MedPost Urgent Care Center 513 Cibolo Valley DriveCiboloTX78108USA Massachusetts General Hospital Harvard Medical School151 Merrimac St.6th FloorBostonMA02114USA H&S Ventures Samueli Integrative Health Program1800 Diagonal RoadSuite 617AlexandriaVA22314USA

Background:The present investigation tested the efficacy of the Tennant Biomodulator,a novel pain management intervention that uses biofeedback-modulated electrical stimulation,to reduce chronic pain and its psychosocial sequelae in a sample of current and former military service *** Tennant Biomodulator used on its most basic setting was compared to two commonly used,non-pharmacological pain treatments—traditional Chinese acupuncture and transcutaneous electrical nerve stimulation(TENS)—in a comparative efficacy,randomized,open-label ***:Participants included 100 active duty and retired service men and women with chronic pain undergoing treatment at the Brooke Army Medical Center in Texas,USA,randomly assigned to receive six,weekly sessions of either Tennant Biomodulator treatment,traditional Chinese acupuncture,or TENS,in addition to usual *** was conducted between May 2010 to September *** measures were collected at intake,before and after each treatment session,and at a 1-month ***-to-treat analyses were used throughout,with mixed models used to investigate main effects of group,time,and group×time interactions with consideration given to quadratic *** measured included ratings of chronic pain,pain-related functional disability,and symptoms of post-traumatic stress disorder(PTSD)and ***:On average,regardless of their treatment group,participants exhibited a 16%reduction in pain measured by the Brooke Army Medical Center’s Clinic pain Log[F(1,335)=55.7,Ppain-related disability measured by the Million Visual Analog Scale[MVAS:F(1,84)=28.3,Ppain and pain-related disability were largely lost by 1-month *** of PTSD and depression did not change significantly as a function of time or ***:Findings build on previ

关键词： Tennant biomodulator Acupuncture Transcutaneous electrical nerve stimulation chronic pain Military service members

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Chemogenetic and Optogenetic Manipulations of Microglia in chronic pain

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Neuroscience Bulletin 2023年第3期39卷 368-378页

作者： Sebastian Parusel Min-Hee Yi Christine L.Hunt Long-Jun Wu Department of Neurology Mayo ClinicRochesterMN 55905USA Faculty of Psychology and Neuroscience Maastricht UniversityMaastricht MD6200The Netherlands Department of pain Medicine Mayo ClinicJacksonvilleFL 32224USA Department of Neuroscience Mayo ClinicJacksonvilleFL 32224USA Department of Immunology Mayo ClinicRochesterMN 55905USA

chronic pain relief remains an unmet medical *** research points to a substantial contribution of glia-neuron interaction in its ***,microglia play a crucial role in the development of chronic *** better understand the microglial contribution to chronic pain,specific regional and temporal manipulations of microglia are ***,two new approaches have emerged that meet these *** tools allow the expression of designer receptors exclusively activated by designer drugs(DREADDs)specifically in ***,optogenetic tools allow for microglial manipulation via the activation of artificially expressed,light-sensitive ***-and optogenetic manipulations of microglia in vivo are powerful in interrogating microglial function in chronic *** review summarizes these emerging tools in studying the role of microglia in chronic pain and highlights their potential applications in microglia-related neurological disorders.

关键词： chronic pain Microglia Optogenetics Chemogenetics DREADDs ReaChR

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Targeting the nitric oxide/cGMP signaling pathway to treat chronic pain

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Neural Regeneration Research 2023年第5期18卷 996-1003页

作者： Dan-Yang Li Shao-Jie Gao Jia Sun Long-Qing Zhang Jia-Yi Wu Fan-He Song Dai-Qiang Liu Ya-Qun Zhou Wei Mei Department of Anesthesiology and pain Medicine Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei ProvinceChina

Nitric oxide(NO)/cyclic guanosine 3′,5′-monophosphate(cGMP) signaling has been shown to act as a mediator involved in pain transmission and processing. In this review, we summarize and discuss the mechanisms of the NO/cGMP signaling pathway involved in chronic pain, including neuropathic pain, bone cancer pain, inflammatory pain, and morphine tolerance. The main process in the NO/cGMP signaling pathway in cells involves NO activating soluble guanylate cyclase, which leads to subsequent production of cGMP. cGMP then activates cGMP-dependent protein kinase(PKG), resulting in the activation of multiple targets such as the opening of ATP-sensitive K+ channels. The activation of NO/cGMP signaling in the spinal cord evidently induces upregulation of downstream molecules, as well as reactive astrogliosis and microglial polarization which participate in the process of chronic pain. In dorsal root ganglion neurons, natriuretic peptide binds to particulate guanylyl cyclase, generating and further activating the cGMP/PKG pathway, and it also contributes to the development of chronic pain. Upregulation of multiple receptors is involved in activation of the NO/cGMP signaling pathway in various pain models. Notably the NO/cGMP signaling pathway induces expression of downstream effectors, exerting both algesic and analgesic effects in neuropathic pain and inflammatory pain. These findings suggest that activation of NO/cGMP signaling plays a constituent role in the development of chronic pain, and this signaling pathway with dual effects is an interesting and promising target for chronic pain therapy.

关键词： bone cancer pain chronic pain cyclic GMP dorsal root ganglion inflammatory pain morphine tolerance neuropathic pain nitric oxide protein kinase G spinal cord

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Dissecting the Neural Circuitry for pain Modulation and chronic pain:Insights from Optogenetics

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Neuroscience Bulletin 2022年第4期38卷 440-452页

作者： Fang Guo Yu Du Feng-Hui Qu Shi-Da Lin Zhong Chen Shi-Hong Zhang Department of Pharmacology and Department of Anesthesiology of the Second Affiliated Hospital Zhejiang University School of MedicineHangzhou 310058China Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province College of Pharmaceutical SciencesZhejiang Chinese Medical UniversityHangzhou 310053China

pain is an unpleasant sensory and emotional experience associated with,or resembling that associated with,actual or potential tissue *** processing of pain involves complicated modulation at the levels of the periphery,spinal cord,and *** pathogenesis of chronic pain is still not fully understood,which makes the clinical treatment ***,which combines optical and genetic technologies,can precisely intervene in the activity of specific groups of neurons and elements of the related *** advantage of optogenetics,researchers have achieved a body of new findings that shed light on the cellular and circuit mechanisms of pain transmission,pain modulation,and chronic pain both in the periphery and the central nervous *** this review,we summarize recent findings in pain research using optogenetic approaches and discuss their significance in understanding the pathogenesis of chronic pain.

关键词： Optogenetics pain transmission pain modulation chronic pain Neural circu

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Potentiation of the lateral habenula-ventral tegmental area pathway underlines the susceptibility to depression in mice with chronic pain

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Science China(Life Sciences) 2024年第1期67卷 67-82页

作者： Chun-Kui Zhang Pan Wang Yuan-Yuan Ji Jian-Shuai Zhao Jun-Xiang Gu Xian-Xia Yan Hong-Wei Fan Ming-Ming Zhang Yu Qiao Xiao-Die Liu Bao-Juan Li Ming-Hui Wang Hai-Long Dong Hao-Hong Li Peng-Cheng Huang Yun-Qing Li Wu-Gang Hou Jin-Lian Li Tao Chen Department of Anatomy and K.K.Leung Brain Research Centre Fourth Military Medical UniversityXi’an 710032China Beijing Institute of Basic Medical Sciences Beijing 100850China Key Laboratory of Ministry of Public Health for Forensic Science Xi’an Jiaotong UniversityXi’an 710061China Department of Anesthesiology Xijing HospitalFourth Military Medical UniversityXi’an 710032China Department of Neurosurgery the Second Affiliated Hospital of Xian Jiaotong UniversityXi’an 710004China School of Biomedical Engineering Fourth Military Medical UniversityXi’an 710032China Affiliated Mental Health Centre and Hangzhou Seventh People’s Hospital Zhejiang University School of MedicineHangzhou 310013China The MOE Frontier Research Center of Brain&Brain-machine Integration Zhejiang University School of Brain Science and Brain MedicineHangzhou 310058China Department of Neurology The First Affiliated Hospital of Nanchang UniversityNanchang 330006China Department of Anatomy School of MedicineNorthwest UniversityXi’an 710069China

chronic pain often develops severe mood changes such as ***,how chronic pain leads to depression remains elusive and the mechanisms determining individuals’responses to depression are largely *** we found that depression-like behaviors could only be observed in 67.9%of mice with chronic neuropathic pain,leaving 32.1%of mice with depression *** determined that the spike discharges of the ventral tegmental area(VTA)-projecting lateral habenula(LHb)glutamatergic(Glu)neurons were sequentially increased in sham,resilient and susceptible mice,which consequently inhibited VTA dopaminergic(DA)neurons through a LHbGlu-VTAGABA-VTADA ***,the LHbGlu-VTADA excitatory inputs were dampened via GABAB receptors in a pre-synaptic *** of LHb-VTA pathway largely affected the development of depressive symptoms caused by chronic *** study thus identifies a pivotal role of the LHb-VTA pathway in coupling chronic pain with depression and highlights the activity-dependent contribution of LHbGlu-to-VTADA inhibition in depressive behavioral regulation.

关键词： chronic pain depression lateral habenula ventral tegmental area dopamine susceptibility

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CYP1B1-derived epoxides modulate the TRPA1channel in chronic pain

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Acta Pharmaceutica Sinica B 2023年第1期13卷 68-81页

作者： Lili Sun Jie Zhang Changshan Niu Cassandra E.Deering-Rice Ronald W.Hughen John G.Lamb Katherine Rose Kevin M.Chase Marysol Almestica-Roberts Markel Walter Eric W.Schmidt Alan R.Light Baldomero M.Olivera Christopher A.Reilly Department of Pharmacology and Toxicology Center for Human ToxicologyUniversity of UtahSalt Lake CityUT84112USA Department of Anesthesiology School of MedicineUniversity of UtahSalt Lake CityUT 84112USA Department of Medicinal Chemistry University of UtahSalt Lake CityUT 84112USA School of Biological Sciences University of UtahSalt Lake CityUT 84112USA

pain is often debilitating,and current treatments are neither universally efficacious nor without *** receptor potential(TRP)ion channels offer alternative targets for pain relief,but little is known about the regulation or identities of endogenous TRP ligands that affect inflammation and ***,transcriptomic and targeted lipidomic analysis of damaged tissue from the mouse spinal nerve ligation(SNL)-induced chronic pain model revealed a time-dependent increase in Cyp1b1 mRNA and a concurrent accumulation of 8,9-epoxyeicosatrienoic acid(EET)and 19,20-EpDPA post *** of 8,9-EET and 19,20-EpDPA by human/mouse CYP1B1 was confirmed in vitro,and 8,9-EET and 19,20-EpDPA selectively and dose-dependently sensitized and activated TRPA1 in overexpressing HEK-293 cells and Trpa1-expressing/AITC-responsive cultured mouse peptidergic dorsal root ganglia(DRG)***1 activation by 8,9-EET and 19,20-EpDPA was attenuated by the antagonist A967079,and mouse TRPA1 was more responsive to 8,9-EET and 19,20-EpDPA than human *** latter effect mapped to residues Y933,G939,and S921 of ***-plantar injection of 19,20-EpDPA induced acute mechanical,but not thermal hypersensitivity in mice,which was also blocked by ***,Cyp1b1-knockout mice displayed a reduced chronic pain phenotype following SNL *** data suggest that manipulation of the CYP1B1-oxylipin-TRPA1 axis might have therapeutic benefit.

关键词： CYPIB1 Spinal nerve ligation Epoxides TRPA1 Calcium imaging Hyperalgesia chronic pain Inflammation

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