Pain in neurological conditions

Nandi, Paul

doi:10.1097/spc.0b013e328352edff

Cited by 9 publications

(6 citation statements)

References 37 publications

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“…Clinicians working with patients with neurological and psychiatric disorders are familiar with the fact that there are some common difficulties that their patients experience, such as sleep problems, difficulties with affect, maintaining personal relationships and holding a job. There is also research that supports this clinical experience [ 4 , 5 , 9 – 11 ]. Finally, it is well known that co-morbidity within brain disorders is very high, making it more intuitive to detach PSD from specific brain disorders [ 3 ].…”

Section: Introductionmentioning

confidence: 77%

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Understanding the Impact of Brain Disorders: Towards a ‘Horizontal Epidemiology’ of Psychosocial Difficulties and Their Determinants

Cieza¹,

Anczewska

Ayuso-Mateos³

et al. 2015

PLoS ONE

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ObjectiveTo test the hypothesis of ‘horizontal epidemiology’, i.e. that psychosocial difficulties (PSDs), such as sleep disturbances, emotional instability and difficulties in personal interactions, and their environmental determinants are experienced in common across neurological and psychiatric disorders, together called brain disorders.Study DesignA multi-method study involving systematic literature reviews, content analysis of patient-reported outcomes and outcome instruments, clinical input and a qualitative study was carried out to generate a pool of PSD and environmental determinants relevant for nine different brain disorders, namely epilepsy, migraine, multiple sclerosis, Parkinson’s disease, stroke, dementia, depression, schizophrenia and substance dependency. Information from these sources was harmonized and compiled, and after feedback from external experts, a data collection protocol including PSD and determinants common across these nine disorders was developed. This protocol was implemented as an interview in a cross-sectional study including a convenience sample of persons with one of the nine brain disorders. PSDs endorsed by at least 25% of patients with a brain disorder were considered associated with the disorder. PSD were considered common across disorders if associated to 5 out of the 9 brain disorders and if among the 5 both neurological and psychiatric conditions were represented.SettingThe data collection protocol with 64 PSDs and 20 determinants was used to collect data from a convenience sample of 722 persons in four specialized health care facilities in Europe.Results57 of the PSDs and 16 of the determinants included in the protocol were found to be experienced across brain disorders.ConclusionThis is the first evidence that supports the hypothesis of horizontal epidemiology in brain disorders. This result challenges the brain disorder-specific or vertical approach in which clinical and epidemiological research about psychosocial difficulties experienced in daily life is commonly carried in neurology and psychiatry and the way in which the corresponding health care delivery is practiced in many countries of the world.

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Section: Introductionmentioning

confidence: 77%

“…They found no study that systematically examined the difficulties associated with the full range of brain disorders. Where comparisons across brain disorders are targeted, these are usually restricted to single PSD, mostly body functions such as fatigue [ 4 ] or pain [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Understanding the Impact of Brain Disorders: Towards a ‘Horizontal Epidemiology’ of Psychosocial Difficulties and Their Determinants

Cieza¹,

Anczewska

Ayuso-Mateos³

et al. 2015

PLoS ONE

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“…A recent review concluded that exercise with BFR may be an effective pain management strategy for people with musculoskeletal conditions 29) . Pain is also common in neurologic conditions 30) , and two feasibility trials of BFR in people with MS and SCI have both shown that resistance training with BFR at least does not increase pain or delayed onset muscle soreness compared to training without BFR 20,22) . Altogether, efficacy research is needed for exercise with BFR in people with neurologic conditions, and the results of this survey suggest that outcomes of strength, fatigue, and pain may be especially important to consider.…”

Section: Discussionmentioning

confidence: 99%

Clinical use of blood flow restriction in people with neurologic conditions: a cross-sectional survey

Mañago

Kimbrell²,

Hager

et al. 2022

J Phys Ther Sci

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There is little evidence for blood flow restriction (BFR), or Kaatsu, training in people with neurologic conditions. This study's purpose was to survey clinicians on BFR use in people with neurologic conditions. [Participants and Methods] One-hundred twelve physical therapists and other healthcare professionals who reported using BFR in the past 5 years completed an anonymous, online survey. [Results] Eighty-nine percent of respondents thought BFR was safe in people with neurologic conditions. Meanwhile, 38% reported BFR use in people with neurologic conditions. The most common intervention used with BFR was resistance training (n=33) and the most commonly reported benefit was improved strength (n=27). The most common side-effect causing treatment to stop was intolerance to pressure (n=6). No side-effects requiring medical attention were reported. In order to support future BFR use in neurologic populations, the most common response was the need for more research (n=63). [Conclusion] Despite the lack of evidence, clinical use of BFR in people with neurologic conditions may be somewhat common. Although this study had a relatively small sample size and collected data retrospectively, the results support the potential clinical feasibility and safety of BFR use in patients with neurologic conditions and suggest that more research is needed.

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“…Symptoms are many and vary from patient to patient. Pain phenotypes are not always specific to a neuropathy, and pain can result from neuropathy as well as from medications taken to treat the condition (Nandi, 2012). Patients may present multiple pain phenomena simultaneously, and their pain phenotypes can change over time.…”

Section: Neuropathic Painmentioning

confidence: 99%

“…Several groups of drugs have been utilized in neuropathic pain treatment; among them are analgesics like opiates, anti-inflammatory drugs including steroids, tricyclic antidepressants, anticonvulsants, antiepileptics, antihypertensives, local anesthetics, sodium channel blockers, NMDA receptor antagonists, SSRIs (selective serotonin-reuptake inhibitors), and cannabinoids (Moulin, 1998; Pöllmann and Feneberg, 2008; Park and Moon, 2010; Nandi, 2012). Side effects are common, and the use of nearly all these medications is complicated by concerns about their safety and efficacy.…”

Section: Neuropathic Painmentioning

confidence: 99%

Peroxisome proliferator-activated receptor agonists modulate neuropathic pain: a link to chemokines?

Freitag

Miller

2014

Front. Cell. Neurosci.

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Chronic pain presents a widespread and intractable medical problem. While numerous pharmaceuticals are used to treat chronic pain, drugs that are safe for extended use and highly effective at treating the most severe pain do not yet exist. Chronic pain resulting from nervous system injury (neuropathic pain) is common in conditions ranging from multiple sclerosis to HIV-1 infection to type II diabetes. Inflammation caused by neuropathy is believed to contribute to the generation and maintenance of neuropathic pain. Chemokines are key inflammatory mediators, several of which (MCP-1, RANTES, MIP-1α, fractalkine, SDF-1 among others) have been linked to chronic, neuropathic pain in both human conditions and animal models. The important roles chemokines play in inflammation and pain make them an attractive therapeutic target. Peroxisome proliferator-activated receptors (PPARs) are a family of nuclear receptors known for their roles in metabolism. Recent research has revealed that PPARs also play a role in inflammatory gene repression. PPAR agonists have wide-ranging effects including inhibition of chemokine expression and pain behavior reduction in animal models. Experimental evidence suggests a connection between the pain ameliorating effects of PPAR agonists and suppression of inflammatory gene expression, including chemokines. In early clinical research, one PPARα agonist, palmitoylethanolamide (PEA), shows promise in relieving chronic pain. If this link can be better established, PPAR agonists may represent a new drug therapy for neuropathic pain.

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Pain in neurological conditions

Cited by 9 publications

References 37 publications

Understanding the Impact of Brain Disorders: Towards a ‘Horizontal Epidemiology’ of Psychosocial Difficulties and Their Determinants

Understanding the Impact of Brain Disorders: Towards a ‘Horizontal Epidemiology’ of Psychosocial Difficulties and Their Determinants

Clinical use of blood flow restriction in people with neurologic conditions: a cross-sectional survey

Peroxisome proliferator-activated receptor agonists modulate neuropathic pain: a link to chemokines?

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