Douleur chronique

Author Names: Park J.,Nguyen A.,Wu L.,Toups E.,Harrop J.,Guest J.,Schmitt K.,Fehlings M.,Grossman R.,Chow D. Database Source: Embase Weekly Updates Journal Title: Clinical Pharmacology in Drug Development Article Title: Riluzole in Acute Spinal Cord Injury Study with the Bayesian Approach to Overcome Small Sample Size & Inter-subject Variability Year: 2023 Issue: Supplement 1 Volume: 12 Abstract: Statement of Purpose, Innovation or Hypothesis: Spinal cord injury (SCI) is a life-threatening and severely debilitating condition that results in permanent disabilities along with chronic pain, psychological trauma and social stigma. According to the 2013 American Association of Neurological Surgeons (AANS)/Congress of Neurological Surgeons (CNS) guidelines, currently, there is no standardized treatment for SCI. One of the main reasons for this delayed drug development in SCI stems from extreme inter-subject variability, which challenges the consistent pharmacokinetic (PK)/pharmacodynamic (PD) data analysis with a conventional approach. Furthermore, having a small population of SCI patients makes small sample sizes inevitable. Additionally, enrolling patients for PK study is challenging given the critical condition of patients upon hospital admission. To overcome the small sample size and inter-subject variability, we utilized the Bayesian approach for our Phase II/III clinical trial (NCT01597518), Riluzole in Acute Spinal Cord Injury Study (RISCIS). The Bayesian estimation is a powerful tool to assess both precision and variance in PK, by using conditional probability. It weighs the known prior knowledge ('prior') of a PK parameter and new data ('evidence'), to estimate a new probability ('posterior') for predicting its PK parameters. This updated probability then serves as the new prior probability as additional data becomes available, effectively allowing us to adjust our understanding in response to accumulating information. Our hypothesis is that the Bayesian approach improves in estimating the PK (Table present) parameters within the small-sized and heterogeneous RISCIS patients. Description of Methods and Materials: Patient data were obtained from RISCIS, a multi-center, randomized, placebo-controlled, double-blinded clinical trial. Patients in the treatment group […]

Author Names: anonymous Database Source: Embase Clinical Trials Journal Title: clinicaltrials.gov Article Title: Effect of Peri-Operative Music Therapy on Anxiety, Pain Catastrophising, and Pain in Chronic Pain Patients Undergoing Interventional Pain Procedures - A Randomised Controlled Trial Year: 2025 Issue: Volume: Abstract: Brief Summary,This study aims to find out whether listening to music before, during, and after pain procedures can help reduce anxiety, pain catastrophising, and acute pain in patients with chronic pain. Music therapy may provide a simple, safe, and non-drug way to help patients relax and feel more comfortable. In this study, adult patients with chronic pain who are scheduled for interventional pain procedures at Singapore General Hospital will be randomly assigned to one of two groups. One group will listen to self-selected music through headphones and speakers before, during, and after the procedure. The other group will receive standard care without music. Researchers will measure anxiety, pain catastrophising, and pain levels before and after the procedure using validated questionnaires. The main outcome will be the level of anxiety after the procedure. Other outcomes include pain catastrophising scores, pain scores during local anaesthetic injection, and overall patient satisfaction. This study will help determine if music therapy can be routinely used to improve comfort and emotional well-being for patients undergoing interventional pain procedures.,Detailed Description,This is a single-centre, randomised controlled trial conducted at the Singapore General Hospital Pain Management Centre. The study investigates whether peri-operative music therapy can reduce anxiety, pain catastrophising, and pain in patients with chronic pain undergoing interventional pain procedures in the ambulatory setting. A total of 110 adult participants (aged 21 years and above) with chronic pain lasting at least 3 months and scheduled for interventional pain procedures will be enrolled. Participants will be randomised in a 1:1 ratio to either the music therapy group or the control group using a computer-generated block randomisation sequence with sealed opaque envelopes. Intervention group: Participants will listen to self-selected music from curated playlists […]

Author Names: Maddox T.,Sackman J.,Bonakdar R.,Maddox R.,Darnall B.D. Database Source: Embase Daily Updates Journal Title: Journal of Medical Internet Research Article Title: Skill-Based Virtual Reality Therapy in High-Impact Chronic Pain: 2-Year Follow-Up Results From a Secondary Analysis of a Randomized Controlled Trial Year: 2026 Issue: Volume: 28 Abstract: Background: High-impact chronic pain (HICP) involves substantial interference in functioning, affects 8.5% of the population, and leads to higher health care costs relative to low-impact chronic pain (LICP). Behavioral interventions such as virtual reality (VR) offer scalable and accessible treatment, but testing is needed to ensure durable effectiveness in HICP. We conducted a secondary analysis of the largest real-world dataset for a therapeutic skill-based VR vs a sham VR control to test treatment efficacy in HICP vs LICP. Relative to LICP, we found significantly larger (and clinically meaningful; ie, >=2 points) pain interference and pain intensity reductions for HICP at end of treatment and 1 year posttreatment. End-of-treatment reduction in pain interference reclassified 70% (114/163) of participants with HICP as LICP, and this improvement held at 1 year posttreatment (104/155, 67%). <br/>Objective(s): This study examined the effectiveness of a 56-session skill-based VR therapy in HICP at 2 years posttreatment and compared the effects with those on LICP. <br/>Method(s): We conducted a secondary analysis of the skill-based VR sample (536/1067, 50.2%) at 2 years posttreatment from a randomized controlled trial involving an in-home chronic low back pain sample that was recruited and tested online and was diverse (female: 411/536, 77%; non-White individuals: 166/536, 31%; high school or lower educational level: 102/536, 19%; mean age 50.8 years) and had clinically severe pain at baseline (intensity=6.6; interference=6.2; 42% with severe or complete disability). Focusing on the skill-based VR participants (536/1067, 50.2%) and using a validated approach, we classified participants at baseline as either HICP (baseline Brief Pain Inventory pain interference score>7) or LICP (baseline Brief Pain Inventory pain interference score<7). Clinical effectiveness was examined using a general linear […]

Author Names: Arranz-Duran J. Database Source: Embase Preprint Journal Title: medRxiv Article Title: Meta-analytic Evidence for Four Amplifier Loops in Chronic Pain Chronification: Development of the Pain Amplifier Loop Framework (PALF) Risk Score Year: 2026 Issue: Volume: Abstract: Objective: To quantify the effect size of four biopsychosocial amplifier loops on chronic pain outcomes through systematic review and meta-analysis, and to develop a logistic regression-based risk stratification tool for interventional pain medicine. <br/>Method(s): We searched PubMed, Scopus, and Cochrane Library through March 2026 for studies reporting adjusted odds ratios for associations between (1) sleep disturbance, (2) pain catastrophizing, (3) metabolic/inflammatory markers, (4) preoperative opioid use/polypharmacy, and chronic pain chronification or treatment failure. Random-effects meta-analyses (DerSimonian-Laird) were performed for each loop. Effect sizes were translated into a composite logistic regression model - the Pain Amplifier Loop Framework (PALF) - using ln(OR) as first-order coefficient approximations. The neurobiological convergence of all four loops on TLR4-mediated microglial activation was examined. <br/>Result(s): Forty-four studies (>500,000 participants) were included. Pooled odds ratios were: sleep disturbance OR=1.80 (95% CI 1.65-1.96; k=16; I²=51%), pain catastrophizing OR=2.11 (95% CI 1.71-2.61; k=8; I²=0%), metabolic/fat mass OR=2.02 (95% CI 1.32-3.09; k=7), preoperative opioid use OR=4.48 (95% CI 2.87-6.97; k=6; I²=84%), and opioid-benzodiazepine co-prescription OR=2.62 (95% CI 1.76-3.89; k=7; I²=79%). All four loops converge on TLR4/NF- B microglial signaling. The PALF model produces a Systemic Load Score (Z) and probability of interventional failure P=1/(1+e^-Z), enabling stratification into low (<0.30), moderate (0.30-0.60), and high (>=0.60) risk categories. <br/>Conclusion(s): Four amplifier loops independently and substantially increase chronic pain risk, with the iatrogenic/opioid loop showing the largest effect. The PALF provides a transparent, clinically actionable risk score requiring prospective […]

Author Names: Chowdhury N.S.,Rawsthorne J.,Hesam-Shariati N.,Quide Y.,McIntyre A.,Restrepo S.,Chen K.,Lin C.-T.,John T.N.,Middleton J.W.,Craig A.,Jensen M.P.,McAuley J.,Gustin S.M. Database Source: Embase Preprint Journal Title: medRxiv Article Title: Evaluation of PainWaive: A consumer-grade EEG headset for remotely delivered neurofeedback and monitoring in chronic pain Year: 2026 Issue: Volume: Abstract: Affordable home-based electroencephalography (EEG) headsets could widen access to EEG assessment, but require rigorous validation before research or clinical use. Here, we evaluated a custom-developed 2-channel sensorimotor headset (PainWaive) intended for remote neurofeedback and longitudinal monitoring in chronic pain. Eighty participants (47 female; mean age 24.0 years, SD 7.9) completed two resting-state sessions with PainWaive and a research-grade 64-channel EEG system (LiveAmp), under eyes-open (EO) and eyes-closed (EC) conditions. Alpha, beta and theta power and peak alpha frequency (PAF) were derived from homologous sensorimotor channels (C1/C2). Relative reliability was quantified with intraclass correlation coefficients (ICCs), absolute reliability with SEM%, and cross-device consistency with between-device ICCs and Pearson correlations of overall spectral shape. ICCs/correlations were interpreted using pre-specified thresholds: fair 0.20-0.39, moderate 0.40-0.59, good 0.60-0.79, excellent >=0.80. PainWaive and LiveAmp showed comparable absolute reliability across metrics (similar SEM%). Under EC, PainWaive reliability was excellent for alpha (0.81), theta (0.85) and PAF (0.94), and good for beta (0.72). Under EO, reliability was excellent for alpha (0.82), good for beta and PAF (0.61-0.72), and moderate for theta (0.59). Spectral-shape correlations between devices were excellent (r>0.90). Cross-device ICCs were good under EC for alpha/theta/PAF (ICC=0.66-0.77) though fair for beta (0.35). Under EO, ICCs were good for alpha (0.62), moderate for PAF (0.53), and fair for beta/theta (0.26-0.32). To assess performance under real-world use, we additionally analysed 2 clinical samples of individuals (total n = 8) with chronic pain who each completed 20 home-based neurofeedback sessions using PainWaive (160 sessions total). Within-session stability was […]

Author Names: Kim M.G.,Yeh C.-Y.,Gao H.,Lee K.,Gupta K.,He B. Database Source: Embase Weekly Updates Journal Title: Journal of Neural Engineering Article Title: Low-intensity transcranial focused ultrasound engages parvalbumin-positive GABAergic interneurons in a humanized mouse model of chronic pain: from electrophysiology to cellular investigation Year: 2026 Issue: 2 Volume: 23 Abstract: Objective. Low-intensity transcranial focused ultrasound (tFUS) offers high spatial specificity and deep brain penetration, representing a promising non-invasive approach for modulating brain activity and behavior. Although emerging studies indicate that tFUS can modulate pain-related behaviors in rodents and humans, the underlying network-level and cellular mechanisms remain unknown. This study investigates the effects of tFUS neuromodulation on inhibitory neural circuits in a humanized mouse model of chronic pain, integrating electrophysiological, molecular, and histological analyses across a cohort of 50 animals, including wild-type controls. Approach. A 128-element random array transducer was used to precisely target the pain-processing brain circuit, while a non-invasive and flexible 30-channel electroencephalography electrode was applied to record local evoked responses, topographical activity, and global excitation and inhibition dynamics, which were further validated by optogenetics experiments. Cellular-level modulation and safety outcomes were evaluated through blinded histological examination. Main results. We found that tFUS produced robust modulation of local and global brain activity, characterized by suppression of local theta oscillations and enhancement of network-level inhibitory dynamics. These electrophysiological patterns aligned with those observed during optogenetic activation of parvalbumin (PV) interneurons. Immunohistochemistry further showed significant increases in inhibitory neuronal markers, including elevated expressions of glutamate decarboxylase 67 and PV. Blinded histological assessment confirmed the absence of tissue damage, supporting the safety of the stimulation paradigm. Significance. These findings demonstrated that tFUS stimulation non-invasively engages PV GABAergic inhibitory circuits in a chronic pain mouse model, providing mechanistic […]

Author Names: Walentynowicz M.,Junghaenel D.U.,Mackey S.C.,Korff M.V.,Stone A.A. Database Source: Embase Preprint Journal Title: medRxiv Article Title: Ecological Momentary Assessments of daily pain experiences in bothersome and high-impact chronic pain Year: 2026 Issue: Volume: Abstract: High-impact chronic pain (HICP), defined as persistent pain that substantially limits daily activities, affects millions of adults and poses a public health challenge. Yet relatively little is known about how HICP manifests in people's daily lives. To address this gap, this study used the comprehensive Ecological Momentary Assessment of pain (cEMAp) to assess pain-related experiences four times per day over 7 days in individuals with chronic low back pain. Based on the classification using the Graded Chronic Pain Scale-Revised, we compared individuals with HICP (n = 66) with those in the next most severe pain category, bothersome chronic pain (n = 41), defined as having similar pain frequency but less frequent interference with daily activities. On each prompt, participants completed 2-hour assessments of pain intensity, interference, catastrophizing, behaviors, coping strategies, and pain characteristics. In line with prior research, both groups reported similar pain intensity levels, but the HICP group reported more frequent interference with physical, mental, and social activities. There were no group differences in daily mood or catastrophizing. Exploratory analyses suggested that many daily experiences were similar across groups, with differences observed in selected pain qualities, coping strategies, and pain behaviors. Additional analyses of response distributions showed some similarity across groups in many experiences. Overall, although individuals with HICP on average experience higher pain interference in daily life, levels of many day-to-day experiences are similar between the two groups. Data obtained with cEMAp complement traditional retrospective assessment by providing a detailed view of chronic pain in everyday life.<br/>Copyright The copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license.

Journal of Headache & Pain; 04/02/2026Background: The nucleus accumbens (NAc) plays an important role in the chronic pain process and consists of core and shell subregions with distinct connectivity patterns. However, their roles in migraine progression remain unclear. This study explored static and dynamic functional connectivity (FC) patterns of NAc subregions across healthy controls (HCs), patients with episodic migraine (EM) and patients with chronic migraine (CM). Methods: 97 participants were enrolled: 70 migraine patients (24 EM, 46 CM) and 27 HCs. All underwent functional magnetic resonance imaging on a GE 3.0T system. Demographic and clinical characteristics were collected. The NAc core and shell were defined as ROIs, and static and dynamic seed-based FC analyses were performed across groups. Partial correlations between FC values and clinical variables were conducted. Significant static FC and dynamic FC were selected through multivariable logistic regression. Receiver operating characteristic curves were used to assess their diagnostic performance for distinguishing CM patients. Results: Compared with HCs, EM showed increased sFC between the right NAc core and right supplementary motor area (SMA), whereas CM exhibited decreased sFC, particularly between the left NAc shell and the left fusiform gyrus and between the right NAc core and the left cerebellum crus II. Relative to EM, CM showed reduced sFC mainly between the left NAc shell and the bilateral precentral gyrus and right superior frontal gyrus (SFG), and between the right NAc core and right SMA, right inferior frontal gyrus, and left inferior temporal gyrus (ITG). The dFC analysis revealed decreased connectivity between the left NAc shell and left precentral gyrus and right SFG, and between the right NAc core and left SMA. Reduced sFC between the right NAc core and left ITG and dFC between the left NAc shell and right SFG effectively distinguished CM from EM. The combined FC calculated from sFC and dFC further improved discrimination (AUC = 0.919). Conclusions: NAc subregions in CM showed reduced connectivity with multiple brain regions, mainly in sensorimotor, executive control, and default mode networks. Significant sFC and dFC of the NAc subregions may serve as potential imaging biomarkers for CM.(AN 192873749); ISSN: 11292369CINAHL Complete

Author Names: Wolkowicz, Noah R,Pittman, Brian,Schrader, Shannon W,Wesolowicz, Danielle M,Sofuoglu, Mehmet,Heapy, Alicia A,Maclean, R. Ross Database Source: APA PsycInfo <April 2026 Week 3> Journal Title: Journal of Studies on Alcohol and Drugs Article Title: Cognitive bias modification for individuals with opioid use disorder and chronic pain did not predict changes in clinical outcomes. Year: 2026 Issue: 2 Volume: 87 Abstract: Objective: Attentional bias, defined as the preferential focus on personally salient-compared with neutral-cues, has a hypothesized link to substance use disorders and chronic pain. Although growing research demonstrates that cognitive bias modification (CBM) can alter attentional biases, evidence is lacking to assess the extent to which such alterations predict changes in clinical symptoms or behaviors (e.g., pain severity, craving). <ovid:br/>Method: We conducted a secondary analysis of a clinical trial examining the feasibility, acceptability, and preliminary effectiveness of a 4-week CBM adjunct for veterans (N = 28) receiving medication treatment for opioid use disorder (mOUD) with moderate pain for the past 3 months. We examined CBM effects versus control on pain severity, interference, and catastrophizing, as well as opioid craving and withdrawal. <ovid:br/>Results: CBM for opioid and pain cues did not correspond with changes in the primary clinical outcomes of opioid craving and pain intensity (ps > .111). Additional analyses of other possible outcomes, including pain interference, pain catastrophizing, and subjective opioid withdrawal, were also not associated with CBM (ps > .125). <ovid:br/>Conclusions: Results from this pilot study did not show changes in pain severity or opioid craving corresponding to CBM for opioid and pain. Findings should be considered preliminary given our small sample size; however, findings indicate a distinction between attentional biases, their modification, and clinically salient outcomes. Future research should examine CBM in larger, more diverse samples and assess the impacts of addiction severity, substance type, naturalistic settings, and more engaging methodologies (e.g., gamification of CBM tasks, using gaze-contingent paradigms). (PsycInfo Database Record (c) 2026 APA, […]

Author Names: Kelleher, Eoin Maurice,Lange, Frederik,Wanigasekera, Vishvarani,Rathod-Mistry, Trishna,Nichols, Thomas,Seymour, Ben,Tracey, Irene,Segerdahl, Andrew Reilly,Irani, Anushka Database Source: APA PsycInfo <April 2026 Week 4> Journal Title: Brain: A Journal of Neurology Article Title: Brain signatures of nociplastic pain: Fibromyalgia index and descending modulation at population level. Year: 2026 Issue: 4 Volume: 149 Abstract: Nociplastic pain is defined by altered nociceptive processing in the absence of clear peripheral damage or somatosensory lesions. The Fibromyalgia Index (FMI), derived from the 2016 diagnostic criteria, is increasingly used as a marker of nociplastic pain severity in clinical studies, yet its neurobiological validity remains untested at scale. Using multimodal neuroimaging data from over 40 000 participants in UK Biobank, we examined whether FMI scores were associated with altered functional and structural connectivity within the descending pain modulatory system (DPMS), a brain network involved in endogenous pain control and implicated in nociplastic pain conditions. Functional connectivity was assessed using resting-state functional MRI (rfMRI), and structural connectivity using diffusion-weighted MRI (dMRI) tractography. Connectivity was quantified between seven DPMS regions: periaqueductal grey (PAG), rostral ventromedial medulla (RVM), hypothalamus, amygdala, rostral and subgenual anterior cingulate cortex (rACC, sgACC), and dorsolateral prefrontal cortex (dlPFC). Multi-group structural equation models tested associations between FMI scores and connectivity, stratified by chronic pain status. Mediation models evaluated which aspects of nociplastic pain accounted for the observed associations: widespread pain and SPACE symptoms (sleep disturbance, pain, affect, cognitive problems, and low energy). To assess specificity, we repeated analyses using the Douleur Neuropathique 4 (DN4), a measure of neuropathic pain, and average pain intensity as comparison outcomes. In 22 139 individuals with chronic pain (58% female; mean age 64.8, standard deviation 7.59), FMI scores were associated with altered structural connectivity between the PAG and amygdala [beta = 0.023, 95% confidence interval (CI): 0.0087 to 0.039; Pcorr = 0.0125] and […]

Author Names: Serdarevic, Mirsad Database Source: APA PsycInfo <April 2026 Week 4> Journal Title: Journal of Health Service Psychology: An Official Journal of the National Register of Health Service Psychologists Article Title: Chronic pain assessment and treatment strategies for older adults. Year: 2026 Issue: Volume: Abstract: Chronic pain is highly prevalent among older adults and contributes to disability, psychological distress, social isolation, and increased healthcare utilization. Older adults remain vulnerable to underassessment and undertreatment due to diagnostic complexity, comorbidity burden, polypharmacy, and limited access to behavioral health services. This article provides an applied overview of evidence-based assessment and intervention strategies for chronic pain among older adults within health service psychology settings. Using a clinical vignette to frame common presentation patterns, key diagnostic considerations and best practices in biopsychosocial pain assessment are reviewed, alongside integrated behavioral interventions such as CBT for chronic pain, ACT, mindfulness-based approaches, behavioral activation, and graded activity pacing. Clinical and ethical challenges-including autonomy/beneficence balance, opioid-related risk, and access inequities-are discussed. Practical recommendations for interdisciplinary collaboration and outcome monitoring are offered to support functional restoration and quality of life in later adulthood. (PsycInfo Database Record (c) 2026 APA, all rights reserved)

Author Names: Gore, Christina Database Source: APA PsycInfo <April 2026 Week 4> Journal Title: Dissertation Abstracts International: Section B: The Sciences and Engineering Article Title: An interpretative phenomenological analysis of the lived experiences of receiving cognitive behavioural therapy interventions for chronic pain by individuals living with chronic primary pain conditions. Year: 2026 Issue: 8-B Volume: 87 Abstract: Background Chronic Pain is a debilitating condition affecting billions worldwide with devastating consequences for the individual with chronic pain and those around them. Chronic Pain can be experienced as part of an underlying condition such as cancer (chronic secondary pain) or as 'a disease' in its own right (chronic primary pain). With chronic pain being a dynamic interplay between biological, social, and psychological factors, it is imperative for psychological treatments to be adequate in meeting the psychological needs of individuals with chronic pain. To date, Cognitive Behavioural Therapy (CBT) is the most commonly offered form of psychological therapy for chronic pain. This thesis sought to investigate how CBT interventions making up CBT treatment packages for chronic pain were experienced by participants with chronic primary pain conditions. Method An Interpretative Phenomenological Analytical approach was chosen as the most suitable theoretical framework aligned to the aims of this thesis. Seven participants who were living with chronic primary pain conditions based on the ICD-11 classifications and had received CBT treatment for chronic pain were recruited for participation. Through semi-structured interviews, participants shared their experiences of each CBT intervention making up their course of treatment. In keeping with IPA methodology, a case-by-case idiographic analysis was conducted followed by cross cases analysis. Findings Five CBT interventions for chronic pain were identified within the data set. Participants shared their experiences of 1) Behavioural Activation, also known as activity scheduling, 2) Problem Solving, 3) Graded Exposure, 4) Thought Challenging and 5) Pacing. Five Group Experiential Themes (GETs) representing participants' subjective experiences of these CBT interventions were developed. The first, […]