Reduction in Pain Inhibitory Modulation and Cognitive-Behavioral Changes in Patients With Chronic Low Back Pain: A Case-Control Study

Moreira, Lana Paula Cardoso; Mendoza, Cristian; Barone, Mauro; Rocha, Raquel Sales; Santos, Renato Dias dos; Hazime, Fuad Ahmad

doi:10.1016/j.pmn.2021.05.004

Cited by 7 publications

(5 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…No remarkable differences in PPT were observed. Moreira's cross-sectional study [ 43 ] of 36 subjects found that PPT is substantially lower in patients with CLBP than in healthy subjects. Farasyn and Meeusen [ 44 ] conducted a cross-sectional analysis of 87 patients with CLBP and 64 healthy subjects and also found that PPT is considerably lower in patients with CLBP than in healthy subjects.…”

Section: Discussionmentioning

confidence: 99%

Differences and Correlations of Anxiety, Sleep Quality, and Pressure-Pain Threshold between Patients with Chronic Low Back Pain and Asymptomatic People

Wang

et al. 2022

Pain Research and Management

View full text Add to dashboard Cite

Background. Chronic low back pain (CLBP) is a clinically common and expensive disease. Patients frequently take sick leaves because of pain and dysfunction, and their unpleasant life and work experiences cause psychological depression and anxiety and affect their quality of life. Sleep disturbance is a common problem among patients with low back pain (LBP) with more than 50% complaining about poor sleep quality. This study aimed to explore the correlations between anxiety, sleep quality, and pressure-pain threshold (PPT) and their differences between patients with CLBP and asymptomatic people. Methods. Forty patients with CLBP and 40 asymptomatic people were recruited. Relevant data, including State-Trait Anxiety Inventory, Pittsburgh Sleep Quality Index, and PPT, were individually and independently collected by blinded physiotherapists with a practicing certificate and then statistically analyzed. An independent sample t-test was used to determine the intergroup differences between patients with CLBP and asymptomatic populations. Pearson correlation coefficient was employed for correlation analysis. Results. The CLBP group had significantly higher anxiety scores (41.64 ± 9.88 vs. 36.69 ± 8.31; t = −2.496, p = 0.015 ) than the asymptomatic group. A significant difference was found in the total score of the Pittsburgh Sleep Quality Index (6.41 ± 2.43 vs. 5.09 ± 2.18; t = −2.628, p = 0.010 ) but not in the trait anxiety (44.00 ± 7.83 vs. 42.67 ± 9.51; t = −0.695, p = 0.489 ) of the two groups. State−Trait Anxiety Inventory showed a low to moderate negative correlation with PPT. No remarkable correlation was observed between Pittsburgh Sleep Quality Index and PPT. Conclusions. Patients with CLBP showed considerably worse state anxiety and sleep quality than asymptomatic people; however, no substantial difference in PPT was found between the two groups. The results suggest that in clinical practice, the focus should include pain and related social and psychological factors. CLBP treatment could be considered from multiple perspectives and disciplines.This trial is registered with Chinese Clinical Trial Registry (Trial registration: ChiCTR-TRC-13003701).

show abstract

Section: Discussionmentioning

confidence: 99%

Differences and Correlations of Anxiety, Sleep Quality, and Pressure-Pain Threshold between Patients with Chronic Low Back Pain and Asymptomatic People

Wang

et al. 2022

Pain Research and Management

View full text Add to dashboard Cite

show abstract

“…119,120 Impaired CPM effects were observed in the CLBP patients, opposing the notion of deficient descending pain modulation in chronic pain conditions 121 and some previous reports in CLBP. [122][123][124] However, the recruited CLBP cohort presented with relatively low average clinical pain intensities over the past 4 weeks (median: NRS 4) and a meta-analysis indicated that CPM is only impaired in low back pain patients reporting high pain intensities (NRS >5). 125 This is substantiated by the observed association between higher average clinical pain intensities and smaller CPM effects at the hand.…”

Section: Reduced Cpm Capacities In Clbp Patients With More Severe Cli...mentioning

confidence: 99%

The periaqueductal grey in chronic low back pain: dysregulated metabolites and function

Sirucek

Schoenmacker

Gorrell

et al. 2023

Preprint

View full text Add to dashboard Cite

Mechanisms underlying chronic pain are insufficiently understood. Preclinical evidence suggests a potential contribution of excitatory glutamatergic and inhibitory GABAergic imbalances in pain-relevant brain areas, such as a lower excitatory/inhibitory tone in the brainstem periaqueductal grey (PAG). This cross-sectional magnetic resonance spectroscopy (MRS) study investigated whether a lower excitatory/inhibitory tone is also observed in the PAG of patients with non-specific chronic low back pain (CLBP) and whether this would relate to altered psychophysical measures of descending pain modulation and experimental pressure pain sensitivity. Specifically, the ratio between pooled glutamate and glutamine and GABA levels (Glx/GABA), Glx and GABA in the PAG were compared between CLBP patients and pain-free controls. Further, associations of Glx/GABA with conditioned pain modulation (CPM) effects and pressure pain thresholds (PPTs) were assessed. MRS was acquired on a 3T Philipps MR system using a point-resolved spectroscopy sequence optimized with very selective saturation pulses (OVERPRESS) and voxel-based flip angle calibration in a 1.1 mL volume of interest. Data from 41 CLBP patients (median [interquartile range]: 54 years [41 - 65], 22 females) and 29 age- and sex-matched controls (47 years [34 - 67], 17 females) fulfilled MRS quality criteria. CPM and PPTs were assessed at the lower back as most painful area and the non-dominant hand as pain-free control area. The CPM paradigm consisted of PPTs applied before, during (parallel CPM effect) and after a cold water bath and an ambient temperature water bath as control paradigm to identify 'true' CPM effects. In the PAG of CLBP patients, a lower Glx/GABA ratio, i.e. a lower excitatory/inhibitory tone, was observed (P= 0.002,partial η2= 0.14) driven by decreased Glx (P= 0.012,partial η2= 0.11) and increased GABA (P= 0.038,d= 0.46). CLBP patients showed disrupted associations between Glx/GABA and PPTs compared to controls in both areas (lower back:P= 0.004,partial η2= 0.12; hand:P= 0.002,partial η2= 0.16). In controls, lower Glx/GABA was associated with lower PPTs (lower back:r= 0.48,P= 0.009, hand:r= 0.53,P= 0.003), but this link was missing in CLBP patients (r's > -0.23,P's > 0.150). Additionally, CLBP patients with more severe clinical pain showed smaller CPM effects at the hand (rho= 0.54,P= 0.003). These findings suggest a dysfunction of the PAG in patients with CLBP and might indicate altered descending inhibition of deep tissue afferents.

show abstract

“…Subsequently, the patient was instructed to say "stop" when perceiving the first painful sensation arising from the mechanical stimulus. The procedure was repeated 3 times (15,16) . Dynamometry, based on grip strength, was used to assess patients' muscular strength, it is the simplest and least complicated of a multitude of instrumental measurements of muscular strength, some evidence, although inconsistent, shows that grip strength tends to reflect muscle strength (17) .…”

Section: Scales Questionnaires and Testsmentioning

confidence: 99%

Analysis of functionality in patients with post-COVID-19 pain

Mesquita de Sousa,

Da Silva Gomes,

Marinho Machado

et al. 2024

mtprehabjournal

View full text Add to dashboard Cite

Background: COVID-19, caused by the SARS-CoV-2 virus, resulted in millions of deaths and affected individuals indiscriminately. "Long COVID" presents persistent manifestations, such as pain, fatigue and cognitive problems. Objective: To analyze whether patients suffering from post-COVID-19 pain had an impact on their functionality. Methods: Cross-sectional observational study involving one hundred and three participants, between 18 and 59 years old, with post-COVID-19 pain complaints. A structured questionnaire, pain threshold assessment, dynamometry and functional capacity tests were applied. The Visual Analogue Scale (VAS) and post-COVID-19 functional status (PCFS) measured pain and functional status, respectively. Results: Data analysis showed a significant correlation between Visual Analogue Scale (VAS) and PCFS, dynamometry and lifting score. Age was statistically correlated with PCFS, with the score for sitting and standing, indicating worse performance in the activity of getting up with age. Conclusion: Post-COVID-19 musculoskeletal pain is linked to reduced functionality and muscle strength, compromising daily activities and quality of life. It can also be concluded that there is a need for preventive and rehabilitative strategies for persistent symptoms in post-COVID-19 patients.

show abstract

Reduction in Pain Inhibitory Modulation and Cognitive-Behavioral Changes in Patients With Chronic Low Back Pain: A Case-Control Study

Cited by 7 publications

References 56 publications

Differences and Correlations of Anxiety, Sleep Quality, and Pressure-Pain Threshold between Patients with Chronic Low Back Pain and Asymptomatic People

Differences and Correlations of Anxiety, Sleep Quality, and Pressure-Pain Threshold between Patients with Chronic Low Back Pain and Asymptomatic People

The periaqueductal grey in chronic low back pain: dysregulated metabolites and function

Analysis of functionality in patients with post-COVID-19 pain

Contact Info

Product

Resources

About