Effect of Physiotherapeutic Interventions on Biomarkers of Neuropathic Pain: A Systematic Review of Preclinical Literature

Matesanz-García, Luis; Schmid, Annina B.; Cáceres-Pajuelo, Julio Eduardo; Cuenca‐Martínez, Ferrán; Arribas-Romano, Alberto; González-Zamorano, Yeray; Goicoechea, Carlos; Fernández‐Carnero, Josué

doi:10.1016/j.jpain.2022.06.007

Cited by 11 publications

(5 citation statements)

References 131 publications

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“…Ultrasound may activate cutaneous thermosensitive TRP ion channels to alter peripheral and central pain sensitivity thresholds [ 116 ]. Emerging evidence suggests ultrasound increases BDNF, promoting synaptic plasticity and analgesia in pain pathways [ 117 ]. Ultrasound therapy may also restore balanced levels of pro- and anti-inflammatory cytokines to mitigate peripheral and central sensitization.…”

Section: Types Of Ninptmentioning

confidence: 99%

Multimodal non-invasive non-pharmacological therapies for chronic pain: mechanisms and progress

Shi,

2023

BMC Med

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Background Chronic pain conditions impose significant burdens worldwide. Pharmacological treatments like opioids have limitations. Non-invasive non-pharmacological therapies (NINPT) encompass diverse interventions including physical, psychological, complementary and alternative approaches, and other innovative techniques that provide analgesic options for chronic pain without medications. Main body This review elucidates the mechanisms of major NINPT modalities and synthesizes evidence for their clinical potential across chronic pain populations. NINPT leverages peripheral, spinal, and supraspinal mechanisms to restore normal pain processing and limit central sensitization. However, heterogeneity in treatment protocols and individual responses warrants optimization through precision medicine approaches. Conclusion Future adoption of NINPT requires addressing limitations in standardization and accessibility as well as synergistic combination with emerging therapies. Overall, this review highlights the promise of NINPT as a valuable complementary option ready for integration into contemporary pain medicine paradigms to improve patient care and outcomes.

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Section: Types Of Ninptmentioning

confidence: 99%

Multimodal non-invasive non-pharmacological therapies for chronic pain: mechanisms and progress

Shi,

2023

BMC Med

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“…This tool covers ten questions which assess the selection bias, performance bias, detection bias, attrition bias, reporting bias and other biases. Each question was scored by color coding, where high risk, low risk and unclear risk of bias were represented by red, green, and yellow, respectively (31). The score was calculated by two investigators (JTCP and IT).…”

Section: Risk Of Bias Analysismentioning

confidence: 99%

Preclinical research in paclitaxel-induced neuropathic pain: a systematic review

Bacalhau,

Costa-Pereira,

Tavares

2023

Front. Vet. Sci.

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IntroductionChemotherapy-induced peripheral neuropathy (CIPN) is a common consequence of cancer treatment and pain is a frequent complaint of the patients. Paclitaxel, a cytostatic drug, generates a well-described peripheral nerve injury and neuroinflammation, which may be experimentally mimicked in animal models. We conducted a systematic review analyzing the experimental design, reporting and mechanisms underlying paclitaxel-induced neuropathy in the included studies to establish the perspectives of translation of the current literature in models of CIPN.MethodsWe elected studies published in Pubmed and Scopus between 1 January 2018 and 3 December 2022.ResultsAccording to a defined mesh of keywords searched, and after applying exclusion and inclusion criteria, 70 original studies were included and analyzed in detail. Most studies used male Sprague-Dawley rats to induce paclitaxel-induced neuropathy, used low doses of paclitaxel, and the analyzed studies mainly focused at 14-28 days of CIPN. Mechanical nociceptive tests were preferred in the behavioral evaluation. The mechanisms under study were mainly neuroinflammation of peripheral nerves. The overall methodological quality was considered moderate, and the risk of bias was unclear.DiscussionDespite the ample preclinical research in paclitaxel-induced neuropathy, this systematic review alerts to some flaws in the experimental design along with limitations in reporting, e.g., lack of representation of both sexes in experimental work and the lack of reporting of the ARRIVE guidelines. This may limit the reproducibility of preclinical studies in CIPN. In addition, the clinical features of CIPN should be considered when designing animal experiments, such as sex and age of the CIPN patients. In this way the experimental studies aiming to establish the mechanisms of CIPN may allow the development of new drugs to treat CIPN and translation in the research of CIPN could be improved.

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“…However, for peripheral neuropathic pain conditions, the preventative effects of exercise are less clear. Exercise is recommended for patients with neuropathic pain ( 6 ), but research on the effect of exercise on neuropathic pain has mostly focused on exercise prescribed as a treatment after sustaining the injury ( 7 , 8 ). A recent review and meta-analysis about the effect of exercise on experimentally-induced neuropathic pain in animals included exercise programs that started both before and after peripheral neuropathy induction ( 9 ).…”

Section: Introductionmentioning

confidence: 99%

The potential protective effects of pre-injury exercise on neuroimmune responses following experimentally-induced traumatic neuropathy: a systematic review with meta-analysis

Koop,

Sleijser-Koehorst,

Hooijmans

et al. 2023

Front. Immunol.

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Pre-clinical evidence shows that neuropathy is associated with complex neuroimmune responses, which in turn are associated with increased intensity and persistence of neuropathic pain. Routine exercise has the potential to mitigate complications of future nerve damage and persistence of pain through neuroimmune regulation. This systematic review aimed to explore the effect of pre-injury exercise on neuroimmune responses, and other physiological and behavioural reactions following peripheral neuropathy in animals. Three electronic databases were searched from inception to July 2022. All controlled animal studies assessing the influence of an active exercise program prior to experimentally-induced traumatic peripheral neuropathy compared to a non-exercise control group on neuroimmune, physiological and behavioural outcomes were selected. The search identified 17,431 records. After screening, 11 articles were included. Meta-analyses showed that pre-injury exercise significantly reduced levels of IL-1β (SMD: -1.06, 95% CI: -1.99 to -0.13, n=40), but not iNOS (SMD: -0.71 95% CI: -1.66 to 0.25, n=82). From 72 comparisons of different neuroimmune outcomes at different anatomical locations, vote counting revealed reductions in 23 pro-inflammatory and increases in 6 anti-inflammatory neuroimmune outcomes. For physiological outcomes, meta-analyses revealed that pre-injury exercise improved one out of six nerve morphometric related outcomes (G-ratio; SMD: 1.95, 95%CI: 0.77 to 3.12, n=20) and one out of two muscle morphometric outcomes (muscle fibre cross-sectional area; SMD: 0.91, 95%CI: 0.27 to 1.54, n=48). For behavioural outcomes, mechanical allodynia was significantly less in the pre-injury exercise group (SMD -1.24, 95%CI: -1.87 to -0.61) whereas no overall effect was seen for sciatic function index. Post hoc subgroup analysis suggests that timing of outcome measurement may influence the effect of pre-injury exercise on mechanical allodynia. Risk of bias was unclear in most studies, as the design and conduct of the included experiments were poorly reported. Preventative exercise may have potential neuroprotective and immunoregulatory effects limiting the sequalae of nerve injury, but more research in this field is urgently needed.

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Effect of Physiotherapeutic Interventions on Biomarkers of Neuropathic Pain: A Systematic Review of Preclinical Literature

Cited by 11 publications

References 131 publications

Multimodal non-invasive non-pharmacological therapies for chronic pain: mechanisms and progress

Multimodal non-invasive non-pharmacological therapies for chronic pain: mechanisms and progress

Preclinical research in paclitaxel-induced neuropathic pain: a systematic review

The potential protective effects of pre-injury exercise on neuroimmune responses following experimentally-induced traumatic neuropathy: a systematic review with meta-analysis

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