Chronic whiplash, pain and pain tolerance

Chronic whiplash, pain and pain tolerance 210Abstracts / Scandinavian Journal of Pain 5 (2014) 207–213enrichment network analysis was performed using the String(Search Tool for the Retrieval of Interacting Genes/Proteins)databaseonallsignificantlydifferentiallyexpressedproteins.Results: We found 87 differentially expressed proteins. Network analysis showed a high level of enrichment in interactionsbetween the proteins involved in platelet degranulation andwound healing with p-values 2.48E−11 and 4.58E−08. Wealso recognized two additional clusters related to complement and coagulation cascades and neuropeptides. None ofthese proteins have been implicated in SCS mechanism previously.Conclusions: Up- and down-regulations of immunological proteins and neuropeptides may explain the prolonged relief ofneuropathic pain obtained after SCS. These findings contribute anew basis for understanding of SCS analgesic mechanism in humanneuropathic pain. Further verification studies of these initial findings are needed.E-mail: Anne-Li.Lind@surgsci.uu.sehttp://dx.doi.org/10.1016/j.sjpain.2014.05.018Placebo responses in patients with peripheralneuropathic painKaren Lund a,∗ , Dyveke T. Demant b , Lene Vase c ,Søren H. Sindrup b , Troels S. Jensen a , Nanna B.Finnerup aaDanish Pain Research Center, Aarhus UniversityHospital, 8000 Aarhus, Denmarkb Department of Neurology, Odense UniversityHospital, 5000 Odense, Denmarkc Department of Psychology, School of Business andSocial Sciences, Aarhus University, 8000 Aarhus,DenmarkBackground and aim: Treatment responses during placeboperiods in randomized clinical trials (RCTs) are quite often substantial and may impede a positive outcome of the trial. It wouldtherefore be beneficial to gain more knowledge on factors contributing to large placebo responses in RCTs. The aim of the currentstudy was to identify predictors of placebo responses in patientswith peripheral neuropathic pain.Hypotheses: We hypothesized that a high baseline pain intensity and variability will be predictive of large responses duringplacebo treatment. Furthermore, we hypothesized that expectationfor pain relief, few prior treatments and side effects, low scores ofpain catastrophizing, anxiety, depression and the personality traitneuroticism and high levels of positive emotions will be predictorsof placebo responses.Methods: This study is part of a randomized, double-blind,placebo-controlled, crossover study with the anticonvulsant oxcarbazepine. Pain intensity was registered at baseline and duringtreatment periods on a numerical rating scale (NRS, 0–10) alongwith expectation for pain relief (NRS), psychological measures(scores for anxiety, depression, catastrophizing, neuroticism, andpositive emotions), prior treatments, and side effects.Results: Multiple regression analysis with pain reduction during placebo treatment as the dependent variable and baseline pain,age, gender, and pain duration as explanatory variables was highlysignificant (R-squared = 0.53, p < 0.001), while other explanatoryvariables did not reach statistical significance. Further analyses willbe carried out.Conclusions: Age and gender were not significant predictors ofplacebo responses in this study. Further results will be presentedat the congress.Acknowledgements: This study is part of the InnovativeMedicines Initiative project EUROPAIN, www.imi.europa.eu.http://dx.doi.org/10.1016/j.sjpain.2014.05.019Chronic whiplash, pain and pain toleranceSolbjørg Makalani Myrtveit a,b,∗ , Jens ChristofferSkogen b , Børge Sivertsen b,c , Ólöf AnnaSteingrímsdóttir d , Audun Stubhaug e , ChristopherSivert Nielsen daDepartment of Clinical Science, University ofBergen, Bergen, Norwayb Division of Mental Health, Norwegian Institute ofPublic Health, Bergen, Norwayc Uni Health, Uni Research, Bergen, Norwayd Division of Mental Health, Norwegian Institute ofPublic Health, Oslo, Norwaye Institute of Clinical Medicine, Faculty of Medicine,University of Oslo, Oslo, NorwayAim: Among individuals who experience whiplash accidents,around 20% develop chronic pain. We aimed to compare numberof painful locations and pain intensity between individuals withchronic whiplash and individuals with other chronic pain, and toinvestigate whether differences could be explained by pain tolerance.Methods: Employing data from the sixth wave of the TromsøStudy, individuals reporting whiplash were compared to individuals with other chronic pain. Number of pain locations wascompared using Poisson regression, pain intensity using linearregression. Pain tolerance (cold-pressor test) was compared usingcox regression; one model compared individuals with whiplash tothose with other chronic pain, another model compared the twogroups with chronic pain to pain-free controls. In order to investigate whether pain tolerance could account for differences in pain,the regression models were adjusted for time-till-failure in thecold-pressor test.Results: Individuals with whiplash reported a higher numberof painful locations (IRR = 5.23, 95%CI: 4.93–5.53 versus IRR = 3.57,95%CI: 3.50–3.65) and higher pain intensity (mean: 7.80, 95%CI:7.58–8.02 versus mean: 7.14, 95%CI: 7.08–7.21) than individualswith other chronic pain. Pain tolerance did not differ between thesetwo groups, but compared to pain-free controls individuals in bothgroups had reduced pain tolerance.Conclusions: Individuals with chronic whiplash had reducedpain tolerance compared to individuals without chronic pain, butnot compared to individuals with other chronic pain. Reduced paintolerance can account for some of the increased pain reported byindividuals with chronic whiplash compared to controls but notcompared to individuals with other chronic pain.E-mail: makalanim@gmail.comhttp://dx.doi.org/10.1016/j.sjpain.2014.05.020Evaluation of spinal interventions in a singledoctor private practice in SwedenLeif. Måwe ∗ , Lena Thorén, Jan PerssonKarlstad Nacke & Rygg Klink, Karlstad, KarolinskaUniversity Hospital, SwedenAims: To evaluate the effect of spinal interventions followingISIS guidelines [1]. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Scandinavian Journal of Pain de Gruyter

Loading next page...
1 Page
 
/lp/degruyter/chronic-whiplash-pain-and-pain-tolerance-tPeO72bZzZ
Publisher
De Gruyter
Copyright
© 2014 Scandinavian Association for the Study of Pain
ISSN
1877-8860
eISSN
1877-8879
D.O.I.
10.1016/j.sjpain.2014.05.020
Publisher site
See Article on Publisher Site

Abstract

210Abstracts / Scandinavian Journal of Pain 5 (2014) 207–213enrichment network analysis was performed using the String(Search Tool for the Retrieval of Interacting Genes/Proteins)databaseonallsignificantlydifferentiallyexpressedproteins.Results: We found 87 differentially expressed proteins. Network analysis showed a high level of enrichment in interactionsbetween the proteins involved in platelet degranulation andwound healing with p-values 2.48E−11 and 4.58E−08. Wealso recognized two additional clusters related to complement and coagulation cascades and neuropeptides. None ofthese proteins have been implicated in SCS mechanism previously.Conclusions: Up- and down-regulations of immunological proteins and neuropeptides may explain the prolonged relief ofneuropathic pain obtained after SCS. These findings contribute anew basis for understanding of SCS analgesic mechanism in humanneuropathic pain. Further verification studies of these initial findings are needed.E-mail: Anne-Li.Lind@surgsci.uu.sehttp://dx.doi.org/10.1016/j.sjpain.2014.05.018Placebo responses in patients with peripheralneuropathic painKaren Lund a,∗ , Dyveke T. Demant b , Lene Vase c ,Søren H. Sindrup b , Troels S. Jensen a , Nanna B.Finnerup aaDanish Pain Research Center, Aarhus UniversityHospital, 8000 Aarhus, Denmarkb Department of Neurology, Odense UniversityHospital, 5000 Odense, Denmarkc Department of Psychology, School of Business andSocial Sciences, Aarhus University, 8000 Aarhus,DenmarkBackground and aim: Treatment responses during placeboperiods in randomized clinical trials (RCTs) are quite often substantial and may impede a positive outcome of the trial. It wouldtherefore be beneficial to gain more knowledge on factors contributing to large placebo responses in RCTs. The aim of the currentstudy was to identify predictors of placebo responses in patientswith peripheral neuropathic pain.Hypotheses: We hypothesized that a high baseline pain intensity and variability will be predictive of large responses duringplacebo treatment. Furthermore, we hypothesized that expectationfor pain relief, few prior treatments and side effects, low scores ofpain catastrophizing, anxiety, depression and the personality traitneuroticism and high levels of positive emotions will be predictorsof placebo responses.Methods: This study is part of a randomized, double-blind,placebo-controlled, crossover study with the anticonvulsant oxcarbazepine. Pain intensity was registered at baseline and duringtreatment periods on a numerical rating scale (NRS, 0–10) alongwith expectation for pain relief (NRS), psychological measures(scores for anxiety, depression, catastrophizing, neuroticism, andpositive emotions), prior treatments, and side effects.Results: Multiple regression analysis with pain reduction during placebo treatment as the dependent variable and baseline pain,age, gender, and pain duration as explanatory variables was highlysignificant (R-squared = 0.53, p < 0.001), while other explanatoryvariables did not reach statistical significance. Further analyses willbe carried out.Conclusions: Age and gender were not significant predictors ofplacebo responses in this study. Further results will be presentedat the congress.Acknowledgements: This study is part of the InnovativeMedicines Initiative project EUROPAIN, www.imi.europa.eu.http://dx.doi.org/10.1016/j.sjpain.2014.05.019Chronic whiplash, pain and pain toleranceSolbjørg Makalani Myrtveit a,b,∗ , Jens ChristofferSkogen b , Børge Sivertsen b,c , Ólöf AnnaSteingrímsdóttir d , Audun Stubhaug e , ChristopherSivert Nielsen daDepartment of Clinical Science, University ofBergen, Bergen, Norwayb Division of Mental Health, Norwegian Institute ofPublic Health, Bergen, Norwayc Uni Health, Uni Research, Bergen, Norwayd Division of Mental Health, Norwegian Institute ofPublic Health, Oslo, Norwaye Institute of Clinical Medicine, Faculty of Medicine,University of Oslo, Oslo, NorwayAim: Among individuals who experience whiplash accidents,around 20% develop chronic pain. We aimed to compare numberof painful locations and pain intensity between individuals withchronic whiplash and individuals with other chronic pain, and toinvestigate whether differences could be explained by pain tolerance.Methods: Employing data from the sixth wave of the TromsøStudy, individuals reporting whiplash were compared to individuals with other chronic pain. Number of pain locations wascompared using Poisson regression, pain intensity using linearregression. Pain tolerance (cold-pressor test) was compared usingcox regression; one model compared individuals with whiplash tothose with other chronic pain, another model compared the twogroups with chronic pain to pain-free controls. In order to investigate whether pain tolerance could account for differences in pain,the regression models were adjusted for time-till-failure in thecold-pressor test.Results: Individuals with whiplash reported a higher numberof painful locations (IRR = 5.23, 95%CI: 4.93–5.53 versus IRR = 3.57,95%CI: 3.50–3.65) and higher pain intensity (mean: 7.80, 95%CI:7.58–8.02 versus mean: 7.14, 95%CI: 7.08–7.21) than individualswith other chronic pain. Pain tolerance did not differ between thesetwo groups, but compared to pain-free controls individuals in bothgroups had reduced pain tolerance.Conclusions: Individuals with chronic whiplash had reducedpain tolerance compared to individuals without chronic pain, butnot compared to individuals with other chronic pain. Reduced paintolerance can account for some of the increased pain reported byindividuals with chronic whiplash compared to controls but notcompared to individuals with other chronic pain.E-mail: makalanim@gmail.comhttp://dx.doi.org/10.1016/j.sjpain.2014.05.020Evaluation of spinal interventions in a singledoctor private practice in SwedenLeif. Måwe ∗ , Lena Thorén, Jan PerssonKarlstad Nacke & Rygg Klink, Karlstad, KarolinskaUniversity Hospital, SwedenAims: To evaluate the effect of spinal interventions followingISIS guidelines [1].

Journal

Scandinavian Journal of Painde Gruyter

Published: Jul 1, 2014

There are no references for this article.

You’re reading a free preview. Subscribe to read the entire article.


DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Search

Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly

Organize

Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.

Access

Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

DeepDyve

Freelancer

DeepDyve

Pro

Price

FREE

$49/month
$360/year

Save searches from
Google Scholar,
PubMed

Create lists to
organize your research

Export lists, citations

Read DeepDyve articles

Abstract access only

Unlimited access to over
18 million full-text articles

Print

20 pages / month

PDF Discount

20% off