Chronic pain involves both central and peripheral neuronal plasticity that encompasses changes in the brain, spinal cord, and peripheral nociceptors. Within the forebrain, mesocorticolimbic regions associated with emotional regulation have recently been shown to exhibit lasting gene expression changes in models of chronic pain. To better understand how such enduring transcriptional changes might be regulated within brain structures associated with processing of pain or affect, we examined epigenetic modifications involved with active or permissive transcriptional states (histone H3 lysine 4 mono and trimethylation, and histone H3 lysine 27 acetylation) in periaqueductal gray (PAG), lateral hypothalamus (LH), nucleus accumbens (NAc), and ventral tegmental area (VTA) 5 weeks after sciatic nerve injury in mice to model chronic pain. For both male and female mice in chronic pain, we observed an overall trend for a reduction of these epigenetic markers in periaqueductal gray, LH, and NAc, but not VTA. Moreover, we discovered that some epigenetic modifications exhibited changes associated with pain history, while others were associated with individual differences in pain sensitivity. When taken together, these results suggest that nerve injury leads to chronic chromatin-mediated suppression of transcription in key limbic brain structures and circuits, which may underlie enduring changes in pain processing and sensitivity within these systems.
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http://dx.doi.org/10.1111/gbb.12830 | DOI Listing |
Neurol Sci
January 2025
International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, 110, Taiwan.
Objectives: Fibromyalgia imposes a considerable burden of disability worldwide, and its therapies include rehabilitation interventions. However, the overall brain modulatory effects of rehabilitation interventions and their effects on clinical improvements in patients with fibromyalgia remain unclear. This systematic review of magnetic resonance imaging studies synthesised evidence for the brain modulatory effects of rehabilitation in patients with fibromyalgia.
View Article and Find Full Text PDFChronic fracture-related infection is a complex, costly clinical problem with a wide spectrum of clinical presentations. The goals of treatment are infection control with a healed fracture covered by well-vascularized soft tissue and improvement of patient pain and function. Management is both medical, with culture-targeted antimicrobial agents, and surgical, requiring meticulous irrigation and débridement.
View Article and Find Full Text PDFFracture-related infection (FRI) is a serious complication that occurs primarily in surgically treated fractures. FRIs occur when bacteria enter the site of bony injury and alter the healing inflammatory response within the bone. This can prevent bone regeneration and can lead to long-lasting complications such as chronic infection, pain, nonunion, and amputation.
View Article and Find Full Text PDFA A Pract
January 2025
From the Department of Pain Management, Cleveland Clinic, Cleveland, Ohio.
Intercostal neuralgia can be debilitating and extremely difficult to treat despite multi-modal therapies. The literature describing the role of neuromodulation in patients with intercostal neuralgia is scarce. In this medically challenging case report, we describe a 56-year-old male with a near complete resolution of intractable chronic intercostal neuralgia, secondary to traumatic rib fractures and multiple surgical interventions, with a single lead thoracic spinal cord stimulator (SCS) implant.
View Article and Find Full Text PDFClin Orthop Relat Res
December 2024
Federal University of Bahia, Salvador, Brazil.
Background: Several meta-analyses have evaluated the use of platelet-rich plasma (PRP) in the treatment of Achilles tendinopathy. Although they generally did not find PRP to be effective, an updated meta-analysis containing all the available, high-quality randomized trial evidence that addresses the methodological shortcomings identified in earlier meta-analyses needs to be performed.
Question/purposes: This systematic review and meta-analysis aimed to evaluate the efficacy of PRP in improving (1) pain and function as assessed using the Victorian Institute of Sports Assessment-Achilles (VISA-A) score 3 months, 6 months, and 1 year after treatment and (2) VAS pain scores 3 months after treatment in patients with chronic Achilles tendinopathy.
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