32 results match your criteria: "Center for Interdisciplinary Pain Medicine[Affiliation]"

Chronic pain is a prevalent and debilitating condition whose neural mechanisms are incompletely understood. An imbalance of cerebral excitation and inhibition (E/I), particularly in the medial prefrontal cortex (mPFC), is believed to represent a crucial mechanism in the development and maintenance of chronic pain. Thus, identifying a non-invasive, scalable marker of E/I could provide valuable insights into the neural mechanisms of chronic pain and aid in developing clinically useful biomarkers.

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Chronic postoperative inguinal pain (CPIP) after pediatric inguinal hernia repair-a retrospective analysis.

Hernia

January 2025

Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital of Wuerzburg, Wuerzburg, Germany.

Background: Surgical treatment of inguinal hernias in children is one of the most common operative procedures worldwide. During surgery for inguinal hernias in adults, chronic pain develops in approximately 10% of all cases. In children, there has been limited research to determine whether they may also develop this chronic postsurgical inguinal pain (CPIP).

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Developing neuroimaging-based biomarkers of pain: systematic and coordinated approaches.

Pain

February 2025

Center for Interdisciplinary Pain Medicine, Department of Neurology and TUM-Neuroimaging Center, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany.

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Article Synopsis
  • Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are serious, mostly drug-related conditions that affect the skin and mucous membranes, categorized under the umbrella term epidermal necrolysis (EN), which varies in severity.* -
  • A new guideline for diagnosing and treating SJS/TEN was created based on extensive scientific research and consensus among experts, involving various medical specialties to provide a comprehensive approach to patient care.* -
  • The guideline is designed for healthcare professionals across multiple fields, as well as patients, their families, insurers, and policymakers, with the first part specifically addressing diagnosis, initial treatment, and systemic immunotherapy.*
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Magnetoencephalography/electroencephalography (M/EEG) can provide insights into migraine pathophysiology and help develop clinically valuable biomarkers. To integrate and summarize the existing evidence on changes in brain function in migraine, we performed a systematic review and meta-analysis (PROSPERO CRD42021272622) of resting-state M/EEG findings in migraine. We included 27 studies after searching MEDLINE, Web of Science Core Collection, and EMBASE.

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Bilateral deficiency of Meissner corpuscles and papillary microvessels in patients with acute complex regional pain syndrome.

Pain

July 2024

Department of Anesthesiology, Intensive Care, Emergency and Pain Medicine, Center for Interdisciplinary Pain Medicine, University Hospital Würzburg, Würzburg, Germany.

Complex regional pain syndrome (CRPS) presents postinjury with disproportionate pain and neuropathic, autonomic, motor symptoms, and skin texture affection. However, the origin of these multiplex changes is unclear. Skin biopsies offer a window to analyze the somatosensory and vascular system as well as skin trophicity with their protecting barriers.

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Lessons learned in translating pain knowledge into practice.

Pain Rep

December 2023

Department of Anesthesiology, Intensive Care, Emergency and Pain Medicine, Center for Interdisciplinary Pain Medicine, University Hospital Würzburg, Würzburg, Germany.

Article Synopsis
  • Over the past two decades, there was hope for new pain treatments beyond opioids and nonsteroidals, but only calcitonin gene-related peptide antagonists have reached clinical use.
  • This update reviews evidence on three key drug targets that were explored for pain treatment but ultimately failed to result in approved medications, emphasizing the need for improved patient stratification and preclinical models.
  • Stakeholders must collaborate to advance the discovery of analgesics by enhancing research methods, patient phenotyping, and participation in clinical trials.
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Biomarker discovery in neurological and psychiatric disorders critically depends on reproducible and transparent methods applied to large-scale datasets. Electroencephalography (EEG) is a promising tool for identifying biomarkers. However, recording, preprocessing, and analysis of EEG data is time-consuming and researcher-dependent.

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Myelin barrier breakdown, mechanical hypersensitivity, and painfulness in polyneuropathy with claudin-12 deficiency.

Neurobiol Dis

September 2023

University Hospital Würzburg, Center for Interdisciplinary Pain Medicine, Department of Anesthesiology, Intensive Care, Emergency and Pain Medicine, 97080 Würzburg, Germany. Electronic address:

Background: The blood-nerve and myelin barrier shield peripheral neurons and their axons. These barriers are sealed by tight junction proteins, which control the passage of potentially noxious molecules including proinflammatory cytokines via paracellular pathways. Peripheral nerve barrier breakdown occurs in various neuropathies, such as chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and traumatic neuropathy.

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Postoperative Analgesics Score as a Predictor of Chronic Postoperative Inguinal Pain After Inguinal Hernia Repair: Lessons Learned From a Retrospective Analysis.

World J Surg

October 2023

Department of General, Visceral, Transplantation, Vascular and Pediatric Surgery; Center of Operative Medicine (ZOM), University Hospital of Würzburg, Würzburg, Germany.

Background: Chronic postoperative inguinal pain (CPIP) is a common complication after inguinal hernia surgery and occurs in up to 10-14% of cases. CPIP has a significant impact on daily life, work ability and thus compromises quality of life. The aim of this retrospective study was an in-depth analysis of patients undergoing inguinal hernia repair to further refine the prediction of the onset of CPIP reliably.

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Molecular and clinical markers of pain relief in complex regional pain syndrome: An observational study.

Eur J Pain

February 2023

Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Center for Interdisciplinary Pain Medicine, University Hospital Würzburg, Würzburg, Germany.

Background: Complex regional pain syndrome (CRPS) is marked by disproportionate pain after trauma. Whilst the long-term outcome is crucial to patients, predictors or biomarkers of the course of pain or CRPS symptoms are still lacking. In particular, microRNAs, such as miR-223, decreased in CRPS, have been described only in cross-sectional studies.

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Unbiased analysis of the dorsal root ganglion after peripheral nerve injury: no neuronal loss, no gliosis, but satellite glial cell plasticity.

Pain

April 2023

Department of Anesthesiology, Center for Interdisciplinary Pain Medicine, Intensive Care, Emergency Medicine and Pain Therapy, University Hospital of Würzburg, Würzburg, Germany.

Pain syndromes are often accompanied by complex molecular and cellular changes in dorsal root ganglia (DRG). However, the evaluation of cellular plasticity in the DRG is often performed by heuristic manual analysis of a small number of representative microscopy image fields. In this study, we introduce a deep learning-based strategy for objective and unbiased analysis of neurons and satellite glial cells (SGCs) in the DRG.

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Hypersensitivity to mechanical stimuli is a cardinal symptom of neuropathic and inflammatory pain. A reduction in spinal inhibition is generally considered a causal factor in the development of mechanical hypersensitivity after injury. However, the extent to which presynaptic inhibition contributes to altered spinal inhibition is less well established.

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MicroRNA-21-5p functions via RECK/MMP9 as a proalgesic regulator of the blood nerve barrier in nerve injury.

Ann N Y Acad Sci

September 2022

Department of Anesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Würzburg, Center for Interdisciplinary Pain Medicine, Würzburg, Germany.

Both nerve injury and complex regional pain syndrome (CRPS) can result in chronic pain. In traumatic neuropathy, the blood nerve barrier (BNB) shielding the nerve is impaired-partly due to dysregulated microRNAs (miRNAs). Upregulation of microRNA-21-5p (miR-21) has previously been documented in neuropathic pain, predominantly due to its proinflammatory features.

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Chronic pain is a major healthcare issue posing a large burden on individuals and society. Converging lines of evidence indicate that chronic pain is associated with substantial changes of brain structure and function. However, it remains unclear which neuronal measures relate to changes of clinical parameters over time and could thus monitor chronic pain and treatment responses.

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The perception of pain is shaped by somatosensory information about threat. However, pain is also influenced by an individual's expectations. Such expectations can result in clinically relevant modulations and abnormalities of pain.

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Microvascular Barrier Protection by microRNA-183 via FoxO1 Repression: A Pathway Disturbed in Neuropathy and Complex Regional Pain Syndrome.

J Pain

June 2022

University Hospital Würzburg, Department of Anesthesiology, Intensive Care, Emergency Care and Pain Management, Center for Interdisciplinary Pain Medicine, Würzburg, Germany. Electronic address:

Blood nerve barrier disruption and edema are common in neuropathic pain as well as in complex regional pain syndrome (CRPS). MicroRNAs (miRNA) are epigenetic multitarget switches controlling neuronal and non-neuronal cells in pain. The miR-183 complex attenuates hyperexcitability in nociceptors, but additional non-neuronal effects via transcription factors could contribute as well.

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Background: Complex regional pain syndrome (CRPS) is an orphan disease occurring as a complication after trauma. Due to its acute onset and the typical clinical presentation of the inflammatory and autonomous signs, it is an eye-catching chronic pain disease affecting also young and working people. In social media and the internet, high pain severity and the unfavourable prognosis are often empathized.

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Netrin-1 as a Multitarget Barrier Stabilizer in the Peripheral Nerve after Injury.

Int J Mol Sci

September 2021

Center for Interdisciplinary Pain Medicine, Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, University Hospital of Würzburg, 97080 Würzburg, Germany.

The blood-nerve barrier and myelin barrier normally shield peripheral nerves from potentially harmful insults. They are broken down during nerve injury, which contributes to neuronal damage. Netrin-1 is a neuronal guidance protein with various established functions in the peripheral and central nervous systems; however, its role in regulating barrier integrity and pain processing after nerve injury is poorly understood.

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Diabetic polyneuropathy (DPN) is the most common complication in diabetes and can be painful in up to 26% of all diabetic patients. Peripheral nerves are shielded by the blood-nerve barrier (BNB) consisting of the perineurium and endoneurial vessels. So far, there are conflicting results regarding the role and function of the BNB in the pathophysiology of DPN.

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Chronic pain is a highly prevalent and severely disabling disease that is associated with substantial changes of brain function. Such changes have mostly been observed when analyzing static measures of resting-state brain activity. However, brain activity varies over time, and it is increasingly recognized that the temporal dynamics of brain activity provide behaviorally relevant information in different neuropsychiatric disorders.

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Modulating Brain Rhythms of Pain Using Transcranial Alternating Current Stimulation (tACS) - A Sham-Controlled Study in Healthy Human Participants.

J Pain

October 2021

Department of Neurology, School of Medicine, Technical University of Munich (TUM), Munich, Germany; TUM-Neuroimaging Center, School of Medicine, TUM, Munich, Germany; Center for Interdisciplinary Pain Medicine, School of Medicine, TUM, Munich, Germany. Electronic address:

Chronic pain is a major health care problem. A better mechanistic understanding and new treatment approaches are urgently needed. In the brain, pain has been associated with neural oscillations at alpha and gamma frequencies, which can be targeted using transcranial alternating current stimulation (tACS).

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Short-term impact of the COVID-19 pandemic on patients with a chronic pain disorder.

Medicine (Baltimore)

March 2021

Center for Interdisciplinary Pain Medicine, Department of Anesthesiology, University Medical Center of Regensburg, Regensburg, Germany.

Article Synopsis
  • The Covid-19 pandemic has affected daily life globally, with individuals having preexisting medical conditions likely to experience greater challenges.
  • An observational study involving 112 chronic pain patients revealed that 73.2% reported a worsening of their pain due to the pandemic, as per a self-designed questionnaire.
  • Despite these subjective reports, standard follow-up assessments indicated no significant changes in pain levels or associated mental health issues before and during the pandemic, suggesting chronic pain disorders remain relatively stable amidst external stressors.
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