Sensory and Affective Pain Descriptors Respond Differentially to Pharmacological Interventions in Neuropathic Conditions

Gilron, Ian; Tu, Dongsheng; Holden, Ronald R.

doi:10.1097/ajp.0b013e31824ce65c

Cited by 22 publications

(17 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The cognitive (termed evaluative in the MPQ) and affective descriptors were grouped into a single category because they both reflected the meaning an individual gives to their pain and/or negative emotions associated with pain, whereas sensory and neuropathic descriptors are more representative of physical sensations of pain. The division between sensory and affective categories is consistent with prior studies [19,26,42,55]. Repeated studies have reported certain pain qualities, i.e.…”

Section: Discussionsupporting

confidence: 88%

“…The ability of pain qualities to discriminate between neuropathic (resulting from nerve injury or abnormal nerve functioning) and nociceptive (resulting from tissue injury) pain has been established using a diagnosis-based approach [11,36,43,56]. Further support for the relationship between pain quality and mechanisms of pain has been demonstrated by preferential improvement of specific pain qualities by pharmacological treatment [19,20]. Pain quality assessment for chronic geriatric pain, about which little is known, could capture information on mechanisms of pain in the setting of multiple pain-associated conditions and age-related effects on pain perception to develop more targeted prevention and intervention strategies.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pain quality descriptors in community-dwelling older adults with nonmalignant pain

Thakral

Shi

Foust

et al. 2016

PAIN

View full text Add to dashboard Cite

This study aimed to characterize the prevalence of various pain qualities in older adults with chronic non-malignant pain and determine the association of pain quality to other pain characteristics namely: severity, interference distribution, and pain-associated conditions. In the population-based MOBILIZE Boston Study, 560 participants aged≥70 years reported chronic pain in the baseline assessment, which included a home interview and clinic exam. Pain quality was assessed using a modified version of the McGill Pain Questionnaire (MPQ) consisting of 20 descriptors, from which 3 categories were derived: cognitive/affective, sensory and neuropathic. Presence of ≥2 pain-associated conditions was significantly associated with 18 of the 20 pain quality descriptors. Sensory descriptors were endorsed by nearly all older adults with chronic pain (93%), followed by cognitive/affective (83.4%) and neuropathic descriptors (68.6%). Neuropathic descriptors were associated with the greatest number of pain-associated conditions including osteoarthritis of the hand and knee. More than half of participants (59%) endorsed descriptors in all 3 categories and had more severe pain and interference, and multi-site or widespread pain than those endorsing 1 or 2 categories. Strong associations were observed between pain quality and measures of pain severity, interference, and distribution (p<.0001). Findings from this study indicate that older adults have multiple pain-associated conditions which likely reflect multiple physiological mechanisms for pain. Linking pain qualities with other associated pain characteristics serves to develop a multidimensional approach to geriatric pain assessment. Future research is needed to investigate the physiological mechanisms responsible for the variability in pain qualities endorsed by older adults.

show abstract

Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Pain quality descriptors in community-dwelling older adults with nonmalignant pain

Thakral

Shi

Foust

et al. 2016

PAIN

View full text Add to dashboard Cite

show abstract

“…Evidence indicates that self-report verbal pain descriptors, such as those in the NPS, depict important pain dimensions 36. The assessment of patterns of pain symptoms using descriptors might contribute to the identification of distinct pathophysiologic mechanisms and the development of mechanism-based treatment approaches 37.…”

Section: Discussionmentioning

confidence: 99%

A preliminary evaluation of the relationship of cannabinoid blood concentrations with the analgesic response to vaporized cannabis

Wilsey

Deutsch

Samara³

et al. 2016

JPR

View full text Add to dashboard Cite

A randomized, placebo-controlled crossover trial utilizing vaporized cannabis containing placebo and 6.7% and 2.9% delta-9-tetrahydrocannabinol (THC) was performed in 42 subjects with central neuropathic pain related to spinal cord injury and disease. Subjects received two administrations of the study medication in a 4-hour interval. Blood samples for pharmacokinetic evaluation were collected, and pain assessment tests were performed immediately after the second administration and 3 hours later. Pharmacokinetic data, although limited, were consistent with literature reports, namely dose-dependent increase in systemic exposure followed by rapid disappearance of THC. Dose-dependent improvement in pain score was evident across all pain scale elements. Using mixed model regression, an evaluation of the relationship between plasma concentrations of selected cannabinoids and percent change in items from the Neuropathic Pain Scale was conducted. Changes in the concentration of THC and its nonpsychotropic metabolite, 11-nor-9-carboxy-THC, were related to percent change from baseline of several descriptors (eg, itching, burning, and deep pain). However, given the large number of multiple comparisons, false-discovery-rate-adjusted P-values were not significant. Plans for future work are outlined to explore the relationship of plasma concentrations with the analgesic response to different cannabinoids. Such an appraisal of descriptors might contribute to the identification of distinct pathophysiologic mechanisms and, ultimately, the development of mechanism-based treatment approaches for neuropathic pain, a condition that remains difficult to treat.

show abstract

“…Multidimensional measures are strongly recommended for outcome measures of pain management in clinical trials [16], are very widely used in assessing pain in patients [17], and are widely used in basic pain research. Multidimensional tools have revealed phenomena invisible to unidimensional scales; for instance, they have shown different profiles of pain in different categories of patients [18], and have shown that sensory and affective dimensions can respond differentially to treatment [19–21]. The main elements of the multidimensional pain model are the sensory quality, sensory intensity, unpleasantness, and emotional impact; other elements included location and temporal properties.…”

Section: Introductionmentioning

confidence: 99%

Measuring dyspnoea: new multidimensional instruments to match our 21st century understanding

Banzett

Moosavi

2017

Eur Respir J

View full text Add to dashboard Cite

Sensory and Affective Pain Descriptors Respond Differentially to Pharmacological Interventions in Neuropathic Conditions

Cited by 22 publications

References 32 publications

Pain quality descriptors in community-dwelling older adults with nonmalignant pain

Pain quality descriptors in community-dwelling older adults with nonmalignant pain

A preliminary evaluation of the relationship of cannabinoid blood concentrations with the analgesic response to vaporized cannabis

Measuring dyspnoea: new multidimensional instruments to match our 21st century understanding

Contact Info

Product

Resources

About