Pharmacologic Management of Neuropathic Pain

Nudell, Yoav; Dym, Harry; Sun, Feiyi; Benichou, Michael; Malakan, Jonathan; Halpern, L.

doi:10.1016/j.coms.2021.09.002

Cited by 6 publications

(2 citation statements)

References 69 publications

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“…Patients with PHN are often accompanied by prolonged and persistent pain, which triggers other symptoms such as anxiety, depression, and sleep disturbances [53]. Although a variety of treatment options have been proposed, first-line treatment options are still predominant in clinical practice [54], but their efficacy is not entirely reliable [8]. Acupuncture therapy based on meridian theory is widely regarded as potentially beneficial and safe for the treatment of neuropathic pain [55,56].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Efficacy of Acupuncture-Related Therapy in the Treatment of Postherpetic Neuralgia: A Network Meta-Analysis of Randomized Controlled Trials

Wang

Wan

Chen

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Background. Postherpetic neuralgia (PHN) is the most common sequela of herpes zoster, and the efficacy of the treatment regimens recommended in the guidelines is not entirely reliable. Acupuncture and moxibustion are widely used complementary alternative therapies that have a positive effect on the treatment of PHN. However, there are various forms of acupuncture and moxibustion, and there are differences in efficacy between the different forms. Methods. The retrieval work of randomised controlled trials (RCTs) of acupuncture for PHN in English databases (including PubMed, Cochrane Library, Embase, Web of Science) and Chinese databases (including China National Knowledge Infrastructure (CNKI), WeiPu database, WanFang database, and China Biomedical Literature Database) were conducted from the time of database creation to June 2022. Literature screening, data extraction, and evaluation of risk of bias for the included studies were carried out independently by two researchers, and data analysis was performed using Stata 14.2 software. Results. A total of 30 RCTs including 2138 patients with PHN were included. In terms of pain improvement, acupoint embedding + Western medicine group, bloodletting-cupping group, and bloodletting-cupping + Western medicine group ranked top. In terms of total efficiency, acupuncture + Western medicine group, bloodletting-cupping + Western medicine group, and acupoint embedding group ranked top. There were no statistically significant differences in the incidence of adverse events between treatment regimens. Conclusions. In a comprehensive comparison of the outcome indicators of 14 different treatment regimens, we considered acupoint injection + Western medicine and bloodletting-cupping + Western medicine to be the best combinations for the treatment of PHN. Due to the limitations of the study, the above conclusions still need to be validated in further multi-centre, large-sample prospective randomised controlled clinical trials.

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Section: Discussionmentioning

confidence: 99%

Comparison of Efficacy of Acupuncture-Related Therapy in the Treatment of Postherpetic Neuralgia: A Network Meta-Analysis of Randomized Controlled Trials

Wang

Wan

Chen

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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“…Due to the similarity of effects exerted by SNRIs to TCAs ones, their analgesic properties possibly result from increasing the level of noradrenaline in the dorsal horn of the spinal cord and locus coeruleus [ 111 ]. Common adverse reactions caused by SNRIs application include lack of appetite, constipation, dry mouth, anxiety, hyperhidrosis and nausea [ 117 ]. Moreover, SNRIs should be used with caution in patients with cardiovascular disease [ 160 ].…”

Section: Treatment Strategies For Neuropathic Painmentioning

confidence: 99%

Diagnosis and Management of Neuropathic Pain in Spine Diseases

Bielewicz

Kamieniak

Szymoniuk

et al. 2023

JCM

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Neuropathic pain is generally defined as a non-physiological pain experience caused by damage to the nervous system. It can occur spontaneously, as a reaction to a given stimulus, or independently of its action, leading to unusual pain sensations usually referred to as firing, burning or throbbing. In the course of spine disorders, pain symptoms commonly occur. According to available epidemiological studies, a neuropathic component of pain is often present in patients with spinal diseases, with a frequency ranging from 36% to 55% of patients. Distinguishing between chronic nociceptive pain and neuropathic pain very often remains a challenge. Consequently, neuropathic pain is often underdiagnosed in patients with spinal diseases. In reference to current guidelines for the treatment of neuropathic pain, gabapentin, serotonin and norepinephrine reuptake inhibitors and tricyclic antidepressants constitute first-line therapeutic agents. However, long-term pharmacologic treatment often leads to developing tolerance and resistance to used medications. Therefore, in recent years, a plethora of therapeutic methods for neuropathic pain have been developed and investigated to improve clinical outcomes. In this review, we briefly summarized current knowledge about the pathophysiology and diagnosis of neuropathic pain. Moreover, we described the most effective treatment approaches for neuropathic pain and discussed their relevance in the treatment of spinal pain.

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Black-white hole pattern: an investigation on the automated chronic neuropathic pain detection using EEG signals

Tasci,

Baygin,

Barua

et al. 2024

Cogn Neurodyn

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Electroencephalography (EEG) signals provide information about the brain activities, this study bridges neuroscience and machine learning by introducing an astronomy-inspired feature extraction model. In this work, we developed a novel feature extraction function, black-white hole pattern (BWHPat) which dynamically selects the most suitable pattern from 14 options. We developed BWHPat in a four-phase feature engineering model, involving multileveled feature extraction, feature selection, classification, and cortex map generation. Textural and statistical features are extracted in the first phase, while tunable q-factor wavelet transform (TQWT) aids in multileveled feature extraction. The second phase employs iterative neighborhood component analysis (INCA) for feature selection, and the k-nearest neighbors (kNN) classifier is applied for classification, yielding channel-specific results. A new cortex map generation model highlights the most active channels using median and intersection functions. Our BWHPat-driven model consistently achieved over 99% classification accuracy across three scenarios using the publicly available EEG pain dataset. Furthermore, a semantic cortex map precisely identifies pain-affected brain regions. This study signifies the contribution to EEG signal classification and neuroscience. The BWHPat pattern establishes a unique link between astronomy and feature extraction, enhancing the understanding of brain activities.

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Pharmacologic Management of Neuropathic Pain

Cited by 6 publications

References 69 publications

Comparison of Efficacy of Acupuncture-Related Therapy in the Treatment of Postherpetic Neuralgia: A Network Meta-Analysis of Randomized Controlled Trials

Comparison of Efficacy of Acupuncture-Related Therapy in the Treatment of Postherpetic Neuralgia: A Network Meta-Analysis of Randomized Controlled Trials

Diagnosis and Management of Neuropathic Pain in Spine Diseases

Black-white hole pattern: an investigation on the automated chronic neuropathic pain detection using EEG signals

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