Publications by authors named "Jan Rosner"

Hip abductors are essential for hip function. To understand abduction weakness, it is important to know which muscles contribute to abduction force. Our aim was to investigate the effects of an experimentally induced weakness of the different muscles (tensor fasciae latae [TFL], gluteus medius and minimus (Gmed/min), gluteus maximus [Gmax]) on the abduction force.

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Background: Magnetic resonance imaging may suggest spinal cord compression and structural lesions in degenerative cervical myelopathy (DCM) but cannot reveal functional impairments in spinal pathways. We aimed to assess the value of contact heat evoked potentials (CHEPs) in addition to MRI and hypothesized that abnormal CHEPs may be evident in DCM independent of MR-lesions and are related to dynamic mechanical cord stress.

Methods: Individuals with DCM underwent neurologic examination including segmental sensory (pinprick, light touch) and motor testing.

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Article Synopsis
  • Neuropathic pain is categorized as pain resulting from a lesion or disease in the somatosensory nervous system and can have many different diagnoses.
  • A detailed patient history, along with standardized questionnaires and pain drawings, helps identify the type of neuropathic pain and accompanying sensory abnormalities, such as allodynia and hyperalgesia.
  • Differential diagnosis is crucial, as neuropathic pain can exist alongside other pain types, and additional diagnostic tests may assist in understanding the underlying issues, though the exact relationship between lesions and pain often requires clinical judgment.
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This chapter aims to review the current pharmacological options for neuropathic pain treatment, their mechanisms of action, and future directions for clinical practice. Achieving pain relief in neuropathic pain conditions remains a challenge in clinical practice. The field of pharmacotherapy for neuropathic pain has encountered significant difficulties in translating substantial advances in our understanding of the underlying pathophysiological mechanisms into clinically effective therapies.

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Article Synopsis
  • - The study explores the relationship between pain habituation (how pain response decreases over time) and conditioned pain modulation (CPM), which is a measure of the body’s ability to manage pain, in 45 healthy participants.
  • - Pain habituation was evaluated using subjective pain ratings and objective measures (CHEP and SSR) during heat stimuli, revealing significant variability in participants’ responses, particularly in subjective ratings.
  • - It was found that while subjective pain habituation correlated with cold-induced CPM effects, this correlation did not hold for other CPM measures, suggesting that subjective and objective pain responses may reflect different aspects of how our body modulates pain.
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Article Synopsis
  • - The study examined if pain habituation measures could be potential indicators of central sensitization in chronic pain patients compared to healthy controls (HC), involving 93 patients and 60 controls and using contact-heat stimuli.
  • - Results showed no significant differences in pain habituation between chronic pain patients and HC, even in those with clear signs of central sensitization; however, patients had longer latencies in contact-heat evoked potentials (CHEP) and sympathetic skin responses (SSR).
  • - The findings suggest that pain habituation may remain intact in chronic pain patients, questioning its role as a reliable marker for central sensitization and highlighting the need for further research on pain mechanisms using advanced neurophysiological methods.
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Article Synopsis
  • This study investigates new diagnostic methods for degenerative cervical myelopathy (DCM), focusing on how spinal cord motion and spinal stenosis impact mechanical strain on the spine.
  • It involved 84 patients who were divided into two groups based on MRI findings, assessing their neurological function alongside spinal motion and stenosis through advanced imaging techniques.
  • Results showed that patients with visible lesions on MRI (MRI+) faced more severe impairment, while spinal cord motion was identified as a key indicator for evaluating non-lesion patients (MRI-), suggesting it could help in making more timely surgical decisions.
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Introduction: In 85% of patients with chronic low back pain (CLBP), no specific pathoanatomical cause can be identified. Besides primary peripheral drivers within the lower back, spinal or supraspinal sensitization processes might contribute to the patients' pain.

Objectives: The present study conceptualized the most painful area (MP) of patients with nonspecific CLBP as primarily affected area and assessed signs of peripheral, spinal, and supraspinal sensitization using quantitative sensory testing (QST) in MP, a pain-free area adjacent to MP (AD), and a remote, pain-free control area (CON).

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Purpose: The pathophysiological mechanisms underlying the development of chronic pain in complex regional pain syndrome (CRPS) are diverse and involve both peripheral and central changes in pain processing, such as sensitization of the nociceptive system. The aim of this study was to objectively distinguish the specific changes occurring at both peripheral and central levels in nociceptive processing in individuals with chronic CRPS type I.

Patients And Methods: Nineteen individuals with chronic CRPS type I and 16 age- and sex-matched healthy controls (HC) were recruited.

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Central neuropathic pain arises from a lesion or disease of the central somatosensory nervous system such as brain injury, spinal cord injury, stroke, multiple sclerosis or related neuroinflammatory conditions. The incidence of central neuropathic pain differs based on its underlying cause. Individuals with spinal cord injury are at the highest risk; however, central post-stroke pain is the most prevalent form of central neuropathic pain worldwide.

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Introduction: First-line pain treatment is unsatisfactory in more than 50% of chronic pain patients, likely because of the heterogeneity of mechanisms underlying pain chronification.

Objectives: This cross-sectional study aimed to better understand pathomechanisms across different chronic pain cohorts, regardless of their diagnoses, by identifying distinct sensory phenotypes through a cluster analysis.

Methods: We recruited 81 chronic pain patients and 63 age-matched and sex-matched healthy controls (HC).

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Article Synopsis
  • Degenerative cervical myelopathy (DCM) is a significant non-traumatic spinal cord injury caused by spinal cord compression, but the underlying mechanisms remain unclear; new diagnostic methods are being researched to improve understanding and assessment of DCM.
  • A study using phase-contrast MRI (PC-MRI) investigated spinal cord motion in three directions (cranio-caudal, anterior-posterior, right-left) among healthy controls versus DCM patients, revealing distinct differences in oscillation patterns and amplitudes.
  • The results showed that DCM patients had markedly increased cranio-caudal oscillations and significantly constricted spinal canals compared to healthy subjects, indicating potential diagnostic markers for DCM severity.
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To advance evidence-based practice and targeted treatments of low back pain (LBP), a better pathophysiological understanding and reliable outcome measures are required. The processing of nociceptive information from deeper somatic structures (e.g.

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Study Design: Expert opinion, feedback, revisions, and final consensus.

Objectives: To update the International Spinal Cord Injury Pain Basic Data Set (ISCIPBDS version 2.0) and incorporate suggestions from the SCI pain clinical and research community with respect to overall utility.

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Endogenous pain modulation in humans is frequently investigated with conditioned pain modulation (CPM). Deficient pain inhibition is a proposed mechanism that contributes to neuropathic pain (NP) after spinal cord injury (SCI). Recent studies have combined CPM testing and neuroimaging to reveal neural correlates of CPM efficiency in chronic pain.

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Modulated autonomic responses to noxious stimulation have been reported in experimental and clinical pain. These effects are likely mediated by nociceptive sensitization, but may also, more simply reflect increased stimulus-associated arousal. To disentangle between sensitization- and arousal-mediated effects on autonomic responses to noxious input, we recorded sympathetic skin responses (SSRs) in response to 10 pinprick and heat stimuli before (PRE) and after (POST) an experimental heat pain model to induce secondary hyperalgesia (EXP) and a control model (CTRL) in 20 healthy females.

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Squatting is a common daily activity and fundamental exercise in resistance training and closed kinetic chain programs. The aim of this study was to investigate the effects of an experimentally induced weakness of the gluteal muscles on joint kinematics, reactions forces (JRFs), and dynamic balance performance during deep bilateral squats in healthy young adults. Ten healthy adults received sequential blocks of (1) branch of the superior gluteal nerve to the tensor fasciae latae (SGNtfl) muscle, (2) superior gluteal nerve (SGN), and (3) inferior gluteal nerve (IGN) on the dominant right leg.

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Objective: The aim of this feasibility study was to investigate the properties of median nerve somatosensory evoked potential (SEPs) recorded from segmented Deep Brain Stimulation (DBS) leads in the sensory thalamus (VP) and how they relate to clinical and anatomical findings.

Methods: We analyzed four patients with central post-stroke pain and DBS electrodes placed in the VP. Median nerve SEPs were recorded with referential and bipolar montages.

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Objective: Widespread pain hypersensitivity and enhanced temporal summation of pain (TSP) are commonly reported in patients with complex regional pain syndrome (CRPS) and discussed as proxies for central sensitization. This study aimed to directly relate such signs of neuronal hyperexcitability to the pain phenotype of CRPS patients.

Methods: Twenty-one CRPS patients and 20 healthy controls (HC) were recruited.

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Objective: The beneficial effects of thalamic deep brain stimulation (DBS) at various target sites in treating chronic central neuropathic pain (CPSP) remain unclear. This study aimed to evaluate the effectiveness of DBS at a previously untested target site in the central lateral (CL) thalamus, together with classical sensory thalamic stimulation (ventral posterior [VP] complex).

Materials And Methods: We performed a monocentric retrospective study of a consecutive series of six patients with CPSP who underwent combined DBS lead implantation of the CL and VP.

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Background: Allodynia and hyperalgesia are common signs in individuals with complex regional pain syndrome (CRPS), mainly attributed to sensitization of the nociceptive system. Appropriate diagnostic tools for the objective assessment of such hypersensitivities are still lacking, which are essential for the development of mechanism-based treatment strategies.

Objectives: This study investigated the use of pain-autonomic readouts to objectively detect sensitization processes in CRPS.

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To better characterize central modulation mechanisms involved in the processing of daily repetitive painful stimulation, laser-evoked potentials (LEPs) were recorded at and away from the conditioning area in healthy participants. In addition, we aimed to evaluate a repetitive painful stimulation paradigm that could be conducted in a shorter time frame than previous studies. Collectively, continuous pain rating, warm and heat pain threshold results suggest that sensitivity to pain was reduced 24 h after the shortened repeated painful stimulation.

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Background: Central sensitization is considered a key mechanism underlying neuropathic pain (NP) after spinal cord injury (SCI).

Methods: Two novel proxies for central sensitization were investigated in thoracic SCI subjects with (SCI-NP) and without NP (SCI-nonNP) compared to healthy controls (HC). Specifically, temporal summation of pain (TSP) was investigated by examining pain ratings during a 2-min tonic heat application to the volar forearm.

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Background: Deficient endogenous pain modulation and increased nociceptive excitability are key features of central sensitization and can be assessed in humans by conditioned pain modulation (CPM, anti-nociceptive) and temporal summation of pain (TSP, pro-nociceptive), respectively. This study aimed to investigate these measures as proxies for central sensitization in subjects with chronic neuropathic pain (NP) after spinal cord injury (SCI).

Methods: In paraplegic subjects with NP (SCI-NP; n = 17) and healthy controls (HC; n = 17), parallel and sequential sham-controlled CPM paradigms were performed using pressure pain threshold at the hand, that is, above lesion level, as test stimulus.

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