Impaired chronic pain‐like behaviour and altered opioidergic system in the TASTPM mouse model of Alzheimer's disease

Aman, Yahyah; Pitcher, Thomas; Ballard, Clive; Malcangio, Marzia

doi:10.1002/ejp.1288

Cited by 21 publications

(18 citation statements)

References 53 publications

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“… 7 , 59 , 67 , 94 , 99 , 105 , 133 , 137 A chemically induced model of osteoarthritis through an intra-articular injection of monosodium iodoacetate within transgenic TASTPM AD mice has provided insights into interactions between clinically relevant pain, neurodegenerative pathophysiology, and opioid analgesia. 4 , 5 TASTPM mice demonstrate an age-dependent reduction in thermal nociception that coincides with amyloid pathology in pain-related brain regions. 4 Naloxone, an opioid antagonist, restored thermal nociceptive thresholds to that of wild-type controls.…”

Section: Parkinson Diseasementioning

confidence: 96%

“…Subsequent administration of morphine not only produced an antinociceptive effect but also increased the noxious threshold significantly greater than that seen in wild-type animals. 5 Conversely, gabapentin showed no efficacy. Thus, altered processing within opioidergic circuitry may partially mediate altered pain processing as well as influence both efficacy and centrally mediated side effects of opioidergic pharmacotherapy.…”

Section: Parkinson Diseasementioning

confidence: 99%

See 1 more Smart Citation

Pain in the neurodegenerating brain: insights into pharmacotherapy for Alzheimer disease and Parkinson disease

Lawn

Aman

Rukavina

et al. 2020

Pain

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Section: Parkinson Diseasementioning

confidence: 96%

Section: Parkinson Diseasementioning

confidence: 99%

Pain in the neurodegenerating brain: insights into pharmacotherapy for Alzheimer disease and Parkinson disease

Lawn

Aman

Rukavina

et al. 2020

Pain

View full text Add to dashboard Cite

“…Nurses can assess pain through a variety of pain assessment tools [18], but the quality and utility of these tools have been questioned [19][20][21]. Further, opioids are usually the first choice for analgesia at the end of life [22], but there is evidence that those with advanced dementia respond poorly to opioid treatment and experience more harmful side effects than people without dementia [22,23]. Since persons with dementia at the end of life find it difficult, or are unable, to self-report pain, many of the available pain assessment tools cannot be used [24].…”

Section: Introductionmentioning

confidence: 99%

End-of-life care for people with advanced dementia and pain: A qualitative study in Swedish nursing homes

Lundin¹,

Godskesen

2020

Preprint

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Background: Of the Swedish people with advanced dementia, the majority die in nursing homes. Unresolved pain can occur in people with a terminal illness such as dementia. However, pain management in people with advanced dementia is often suboptimal and inadequate, with fewer palliative care interventions than offered to cancer patients. Although they are largely responsible for the care of these people, few studies have addressed the experiences of registered nurses in this respect. Therefore, the aim of this study was to describe the experiences of nurses in caring for people with advanced dementia and pain at the end of life.Methods: The study had a descriptive explorative design. Individual qualitative, semi-structured interviews were carried out with thirteen nurses from twelve nursing homes in Sweden. The results were analysed using thematic content analysis.Results: The nurses described communicative, relational and organisational challenges. One major issue involved difficulties in communicating with the person with advanced dementia, resulting in uncertain pain assessment. Other difficulties involved the differentiation of pain from anxiety, the balance of benefits and risks with morphine administration, and the creation of good relationships with healthcare personnel and the persons’ relatives. Relatives can greatly affect the assessment and management of pain, both because of their ability to interpret pain behaviour and by questioning the care given. Good pain management was facilitated by good communication and relationships with healthcare staff and relatives, extensive professional nursing experience, and already knowing the person with advanced dementia. Conclusions: This study highlights the need for nursing homes to employ specialist nurses who have been trained in the appropriate knowledge and skills to deal with the challenges of end-of-life care for people with advanced dementia and pain. Additionally, there should be resources and strategies available for providing information to family members and for involving them in the decision-making process, as they are often unfamiliar with the multitude of considerations involved in decisions such as whether to administer morphine or not.

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“…Nurses can assess pain through a variety of pain assessment tools [15], but the quality and utility of these tools have been questioned [16][17][18]. Further, opioids are usually the first choice for analgesia at the end of life [19], but there is evidence that PWAD respond poorly to opioid treatment and experience more harmful side effects than people without dementia [19,20 ]. Since PWAD find it difficult, or are unable, to self-report pain, many of the available pain assessment tools cannot be used [21].…”

Section: Introductionmentioning

confidence: 99%

End-of-life care for people with advanced dementia and pain: A qualitative study in Swedish nursing homes

Lundin¹,

Godskesen

2020

Preprint

View full text Add to dashboard Cite

Background Of the Swedish people with advanced dementia, the majority die in nursing homes. Unresolved pain can occur in people with a terminal illness such as dementia. However, pain management in people with advanced dementia is often suboptimal and inadequate, with fewer palliative care interventions than offered to cancer patients. Although they are largely responsible for the care of these people, few studies have addressed the experiences of registered nurses in this respect. Therefore the aim of this study was to describe the experiences of nurses in caring for people with advanced dementia and pain at the end of life. Methods The study had a descriptive explorative design. Individual qualitative, semi-structured interviews were carried out with thirteen nurses from twelve nursing homes in Sweden. The results were analysed using thematic content analysis. Results The nurses described communicative, relational and organisational challenges. One major issue involved difficulties in communicating with the person with advanced dementia, resulting in uncertain pain assessment. Other difficulties involved the differentiation of pain from anxiety, the balance of benefits and risks with morphine administration, and the creation of good relationships with healthcare personnel and the persons’ relatives. Relatives can greatly affect the assessment and management of pain, both because of their ability to interpret pain behaviour and by questioning the care given. Good pain management was facilitated by good communication and relationships with healthcare staff and relatives, extensive professional nursing experience, and already knowing the person with advanced dementia. Conclusions This study highlights the need for nursing homes to employ specialist nurses who have been trained in the appropriate knowledge and skills to deal with the challenges of end-of-life care for people with advanced dementia and pain. Additionally, there should be resources and strategies available for providing information to family members and for involving them in the decision-making process, as they are often unfamiliar with the multitude of considerations involved in decisions such as whether to administer morphine or not.

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Impaired chronic pain‐like behaviour and altered opioidergic system in the TASTPM mouse model of Alzheimer's disease

Abstract: This study shows attenuated pain-like behaviour in a transgenic mouse model of Alzheimer's disease due to alterations in the opioidergic system and central plasticity mechanisms of persistent pain.

Cited by 21 publications

References 53 publications

Pain in the neurodegenerating brain: insights into pharmacotherapy for Alzheimer disease and Parkinson disease

Pain in the neurodegenerating brain: insights into pharmacotherapy for Alzheimer disease and Parkinson disease

End-of-life care for people with advanced dementia and pain: A qualitative study in Swedish nursing homes

End-of-life care for people with advanced dementia and pain: A qualitative study in Swedish nursing homes

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