Publications by authors named "Nanna Brix Finnerup"

Background: Neuropathic pain is pain due to a disease or lesion of the somatosensory system, and can be either spontaneous, evoked or both. Hyperpathia is a type of evoked pain defined by IASP as 'a painful syndrome characterized by an abnormally painful reaction to a stimulus, especially a repetitive stimulus, as well as an increased threshold'. The literature is sparse, and definitions are unclear and inconsistent.

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Purpose: To explore treatment-related, socio-economic, and psychological factors influencing body image and return to work.

Materials And Methods: 137 patients participated in the study. A questionnaire was completed before surgery and at 1-year follow-up, where patients were also interviewed in person with questions modified from the Body Image Scale and the sexual adjustment scale as well as questions about their work status.

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Neuropathic pain is a challenging chronic pain condition. Limited knowledge exists regarding the relative effectiveness of pharmacological treatments, and differences in trial design and impact of the placebo response preclude indirect comparisons of efficacy between drug classes. The purpose of this systematic review and meta-analysis of head-to-head trials was to compare the efficacy and tolerability of drugs recommended for neuropathic pain.

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Background: Multisystem functional somatic disorder is characterized by specific patterns of persistent physical symptoms with a complex biopsychosocial etiology. The disorder can lead to disability and personal suffering. Current treatment options require specialized settings, therefore patients often wait a long time to receive specific treatment.

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Background And Objective: Functional magnetic resonance imaging, in conjunction with models of peripheral and/or central sensitization, has been used to assess analgesic efficacy in healthy humans. This review aims to summarize the use of these techniques to characterize brain mechanisms of hyperalgesia/allodynia and to evaluate the efficacy of analgesics.

Databases And Data Treatment: Searches were performed (PubMed-Medline, Cochrane, Web of Science and Clinicaltrials.

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Background: Syringomyelia (SM) is a prevalent inherited developmental condition in Cavalier King Charles Spaniels (CKCSs) with Chiari-like malformation (CM), accompanied by a variety of clinical manifestations, including signs of neuropathic pain. Magnetic resonance imaging (MRI) is the gold standard in SM diagnosis. However, it is desirable to establish clinical predictors that can identify CKCSs with a large clinical syrinx that needs treatment, as some owners cannot afford or lack access to MRI.

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Background: Oxaliplatin-induced peripheral neuropathy (OIPN) in general and painful OIPN in particular is a debilitating late effect that severely affects cancer survivors' quality of life and causes premature cessation of potentially lifesaving treatment. No preventive treatments and no effective treatment for chronic OIPN exist despite many attempts. One of several suggested mechanisms includes neuroinflammation as a contributing factor to OIPN.

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Article Synopsis
  • The study explores the pharmacokinetics (how the drug moves in the body) and pharmacodynamics (the effects of the drug) of cannabis-based medicine (CBM) in patients with multiple sclerosis (MS) suffering from neuropathic pain and spasticity.
  • Out of 134 participants in a larger trial, 23 were focused on in this substudy, receiving either THC, CBD, a combination, or a placebo, with significant variability in dosages and individual responses observed.
  • Though the pharmacokinetic data was similar to previous findings in healthy individuals, no significant effects on the pain and spasticity parameters were noted, although adverse events were more common in the treatment groups compared to placebo.
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  • This study investigates the impact of placebo analgesia (pain relief) and nocebo hyperalgesia (pain increase) in patients with mild-to-moderate Alzheimer's disease (AD), which is not well understood.
  • Twenty-one AD patients and 26 healthy participants were exposed to thermal pain under different conditions involving lidocaine and capsaicin, with verbal suggestions to influence pain perception.
  • Results showed that healthy participants experienced placebo effects, while AD patients did not show significant placebo or nocebo effects, suggesting that AD might limit these phenomena, which is important for clinical trial design and treatment approaches.
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  • The study investigated the effect of cannabis-based medicine (CBM) on neuropathic pain (NP) and spasticity in patients with multiple sclerosis (MS) and spinal cord injury (SCI) through a randomized, placebo-controlled trial in Denmark.
  • A total of 134 patients were assigned to either THC, CBD, a combination of both, or a placebo for six weeks, but the results showed no significant differences in pain or spasticity levels between the active treatments and placebo.
  • Recruitment challenges due to COVID-19 led to fewer participants than planned, and ultimately, the findings indicated that CBM had no evident impact on NP or spasticity in the studied patient groups.
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Background: Neuropathic pain is common and difficult to treat. The sodium channel blocker lacosamide is efficacious in animal models of pain, but its effect on neuropathic pain in humans is inconclusive.

Methods: In a multicentre, randomized, double-blinded placebo-controlled phenotype stratified trial, we examined if lacosamide produced better pain relief in patients with the irritable nociceptor phenotype compared to those without.

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Objective: Standard nerve excitability testing (NET) predominantly assesses Aα- and Aβ-fiber function, but a method examining small afferents would be of great interest in pain studies. Here, we examined the properties of a novel perception threshold tracking (PTT) method that preferentially activates Aδ-fibers using weak currents delivered by a novel multipin electrode and compared its reliability with NET.

Methods: Eighteen healthy subjects (mean age:34.

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Paradoxical heat sensation (PHS) and the thermal grill illusion (TGI) are both related to the perception of warmth or heat from innocuous cold stimuli. Despite being described as similar perceptual phenomena, recent findings suggested that PHS is common in neuropathy and related to sensory loss, while TGI is more frequently observed in healthy individuals. To clarify the relationship between these two phenomena, we conducted a study in a cohort of healthy individuals to investigate the association between PHS and TGI.

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Article Synopsis
  • Cannabinoids like CBD and THC are commonly prescribed for neuropathic pain, but existing evidence suggests they may not be effective.
  • A study tested the effects of CBD, THC, their combination, and a placebo on patients with various types of neuropathic pain over 8 weeks, but none of the treatments significantly reduced pain compared to the placebo.
  • The trial included 145 patients, and results showed no meaningful pain relief from any treatment, leading to the conclusion that cannabinoids are not effective for this condition in patients who have already tried other treatments.
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Background: IMI2-PainCare-BioPain-RCT2 is one of four similarly designed clinical studies aiming at profiling a set of functional biomarkers of drug effects on specific compartments of the nociceptive system that could serve to accelerate the future development of analgesics. IMI2-PainCare-BioPain-RCT2 will focus on human spinal cord and brainstem activity using biomarkers derived from non-invasive neurophysiological measurements.

Methods: This is a multisite, single-dose, double-blind, randomized, placebo-controlled, 4-period, 4-way crossover, pharmacodynamic (PD) and pharmacokinetic (PK) study in healthy subjects.

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There is an urgent need for analgesics with improved efficacy, especially in neuropathic and other chronic pain conditions. Unfortunately, in recent decades, many candidate analgesics have failed in clinical phase II or III trials despite promising preclinical results. Translational assessment tools to verify engagement of pharmacological targets and actions on compartments of the nociceptive system are missing in both rodents and humans.

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Objectives: Chronic pain is common following cancer treatment. This is a brief discussion of pain assessment after cancer treatment.

Methods: Summary of a lecure for the SASP (Scandinavian Journal of Pain) annual meeting 2022.

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  • The study compares demographic and clinical characteristics between diabetic polyneuropathy (DPN) and idiopathic polyneuropathy (IPN), highlighting significant differences.
  • Patients with DPN were found to be older, heavier, and had more cardiovascular issues compared to those with IPN.
  • The findings suggest that DPN and IPN are distinct types of neuropathy, each with unique causes and characteristics.
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Objective: It is largely unknown whether individuals with diabetic neuropathy face an increased risk of developing mental illness. Therefore, in a population-based cohort study, we aimed to examine whether individuals with diabetic neuropathy are at elevated risk of being diagnosed with a mental disorder compared to diabetes-duration-matched individuals without diabetic neuropathy.

Methods: We used the nationwide Danish registers to identify all individuals diagnosed with diabetic neuropathy between January 1, 1996, and January 1, 2019.

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  • The study aimed to understand the characteristics and impact of painful diabetic polyneuropathy (DPN) and dysesthetic DPN in type 2 diabetes patients, focusing on pain symptoms and neuropathy severity.
  • Out of 126 patients with confirmed DPN, 53 experienced painful DPN, while 21 had dysesthetic DPN, showing that those with painful symptoms were less active and had more widespread pain.
  • Findings revealed a direct link between the severity of sensory loss and the presence of pain or dysesthesia, highlighting the need for careful assessment and treatment approaches for these symptoms in diabetic neuropathy patients.
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Background And Objectives: The mechanisms of pain in patients with diabetic polyneuropathy are unknown. Studies have suggested a role of inflammation and increased neuropeptides peripherally in pain generation. This study examined the possible skin markers of painful diabetic polyneuropathy (P-DPN): macrophages, substance P (SP), and calcitonin gene-related peptide (CGRP).

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Article Synopsis
  • The study investigates the effects of cannabis-based medicine (CBM) on spasticity and central neuropathic pain in patients with multiple sclerosis (MS) and spinal cord injury (SCI), who often seek such treatment for their symptoms.
  • Patients are randomly assigned to receive either THC, CBD, a combination of both, or a placebo, with major outcomes focused on pain and spasticity levels reported by the patients.
  • The research aims to shed light on the benefits and side effects of different cannabinoids and their dosage, while also gathering data on pharmacodynamics (PD) and pharmacokinetics (PK) for better understanding in a clinical setting.
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Several different reporting biases cited in scientific literature have raised concerns about the overestimation of effects and the subsequent potential impact on the practice of evidence-based medicine and human health. Up to 7% to 8% of the population experiences neuropathic pain (NP), and established treatment guidelines are based predominantly on published clinical trial results. Therefore, we examined published randomized controlled trials (RCTs) of first-line drugs for NP and assessed the relative proportions with statistically significant (ie, positive) and nonsignificant (ie, negative) results and their rates of citation.

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