Correction to: Comparison of cervical sagittal parameters among patients with neck pain and healthy controls: a comparative cross-sectional study

Background: Neck pain has an elevated prevalence worldwide. Most people with neck pain are diagnosed as nonspecific neck pain patients. Poor recovery in neck disorders, as well as high levels of pain and disability, are associated with widespread sensory hypersensitivity. Nevertheless, there is controversy regarding the presence of widespread hyperalgesia in chronic nonspecific neck pain (CNSNP); this lack of agreement could be due to the presence of different pathophysiological mechanisms in CNSNP. Objectives: To determinate differences in pressure pain thresholds (PPTs) over extracervical and cervical regions, and differences in cervical range of motion (ROM) between patients with CNSNP with and without neuropathic features (NF and No-NF, respectively). In addition, this study expected to observe correlations in these 2 types of CNSNP of psychosocial factors with PPTs and with cervical ROM separately. Study Design: Descriptive, cross-sectional study. Setting: A hospital physiotherapy outpatient department. Methods: This research involved 53 patients with CNSNP that had obtained a Self-completed Leeds Assessment of Neuropathic Symptoms and Signs pain scale (S-LANSS) score ≥ 12 (pain with NF, NF group); 54 that had obtained a S-LANSS score < 12 (pain with No-NF, No-NF group), and 53 healthy controls (control group, CG). Measures included: PPTs (suboccipital muscle, upper fibers trapezius muscle, lateral epicondyle, and anterior tibial muscle), cervical ROM (flexion, extension, rotation, and latero-flexion), pain intensity (Visual Analog Scale [VAS]), neck disability index (NDI), kinesiophobia (Tampa Scale of Kinesiophobia-11 [TSK-11]), and Pain Catastrophizing Scale (PCS). Results: A statistically significant effect was observed for the group factor in all assessed measures (P < 0.01). Both CNSNP groups showed statistically significant differences compared to the CG for PPTs in the cervical region (suboccipital and upper fibers trapezius muscles), but only the NF group demonstrated statistically significant differences for PPTs in the lateral epincondyle and anterior tibial muscle when compared to the CG or No-NF group. The largest statistically significant correlation found in the NF group was between PPT in the anterior tibial muscle and TSK-11 (r = -0.372; P < 0.01), while in the No-NF group it was between PPT in the suboccipital muscle and NDI (r = -0.288; P < 0.05). Statistically significant differences were found between the 2 CNSNP groups and CG in all cervical ROMs, but not between both CNSNP groups. The largest statistically significant correlation observed in the NF group was between cervical total rotation and TSK-11 (r = -0.473; P < 0.01), while in the No-NF group it was between cervical total latero-flexion and PCS (r = -0.532; P < 0.01). Limitations: Although the S-LANSS scale has been validated as a screening tool for pain with NF, currently there is no “gold standard,” so these findings should be interpreted with caution. Conclusions: Widespread pressure pain hyperalgesia was detected in patients with CNSNP with NF, but not in patients with CNSNP with No-NF. Patients with CNSNP presented bilateral pressure pain hyperalgesia over the cervical region and a decreased cervical ROM compared to healthy controls. However, no differences were found between the 2 CNSNP groups. These findings suggest differences in the mechanism of pain processing between patients with CNSNP with NF and No-NF. Key words: Neck pain, chronic pain, neuropathic pain, pain threshold, mechanical hyperalgesia, range of motion, pain catastrophizing

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Correlation between kinematic sagittal parameters of the cervical lordosis or head posture and disc degeneration in patients with posterior neck pain: retrospective cross-sectional study

10.21203/rs.3.rs-26105/v1 ◽

2020 ◽

Author(s):

Hyo Jeong Lee ◽

Dae Geun Jeon ◽

Jinyoung Park ◽

Jung Hyun Park

Keyword(s):

Neck Pain ◽

Disc Degeneration ◽

Cross Sectional Study ◽

Cervical Disc ◽

Cervical Lordosis ◽

Sectional Study ◽

Cross Sectional ◽

Head Posture ◽

Posterior Neck ◽

Sagittal Parameters

Abstract Background The aim of this study was to examine degrees of the cervical disc degeneration and the parameters of cervical sagittal balance in plain radiographs, representing cervical lordosis or head posture in subjects with posterior neck pain. Methods This study was a retrospective cross-sectional study that analyzed 113 patients with posterior neck pain with or without radiating pain. The kinematic sagittal parameters of cervical radiographs were obtained at the occipito-cervical (O-C2) angle, sagittal Cobb’s angles of C1-C2, C2-C7, and sagittal vertical axis (SVA) of C1-C7 and C2-C7. Cervical disc degeneration was evaluated using the sum of Pfirrmann grades and total modified Matsumoto scores calculated from magnetic resonance images (MRI) of the cervical spine. Pearson’s correlation analysis was conducted to evaluate the relationship of these parameters and a linear regression method was used to determine associations between sagittal cervical alignment and disc degeneration. Results A significant positive correlation was found for the C2-C7 angle using the sum of the Pfirrmann grades and total modified Matsumoto scores. The O-C2 angle was negatively correlated with the sum of the Pfirrmann grades and total modified Matsumoto scores. The C1-C2 angle was also negatively correlated with the sum of the Pfirrmann grades. No significant relationship was found between the cervical SVA and cervical disc degeneration. Conclusions The sagittal cervical parameters representing cervical kyphosis and jaw lifting posture, were found to be significantly correlated with the degree of cervical disc degeneration. These findings suggest that the loss of the natural sagittal lordosis of the cervical spine may contribute to the progression of disc degeneration, rather than the forward head posture.

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Central neuropathic pain in multiple sclerosis is associated with impaired innocuous thermal pathways and neuronal hyperexcitability

Pain Medicine ◽

10.1093/pm/pnab103 ◽

2021 ◽

Author(s):

Michal Rivel ◽

Anat Achiron ◽

Mark Dolev ◽

Yael Stern ◽

Gaby Zeilig ◽

...

Keyword(s):

Multiple Sclerosis ◽

Neuropathic Pain ◽

Cross Sectional Study ◽

Healthy Controls ◽

Sectional Study ◽

Sensory Testing ◽

Cross Sectional ◽

Central Neuropathic Pain ◽

Body Regions ◽

Thermal Grill Illusion

Abstract Objective About a third of patients with multiple sclerosis (MS) suffer from chronic and excruciating central neuropathic pain (CNP). The mechanism underlying CNP in MS is not clear, since previous studies are scarce and their results are inconsistent. Our aim was to determine whether CNP in MS is associated with impairment of the spinothalamic-thalamocortical pathways (STTCs) and/or increased excitability of the pain system. Design Cross sectional study Setting General hospital Subjects 47 MS patients with CNP, 42 MS patients without CNP, and 32 healthy controls. Methods Sensory testing included the measurement of temperature, pain, and touch thresholds and the thermal grill illusion (TGI) for evaluating STTCs function, and hyperpathia and allodynia as indicators of hyperexcitability. CNP was characterized using interviews and questionnaires. Results The CNP group had higher cold and warm thresholds (p < 0.01), as well as higher TGI perception thresholds (p < 0.05), especially in painful body regions compared to controls, whereas touch and pain thresholds values were normal. The CNP group also had a significantly greater prevalence of hyperpathia and allodynia. Regression analysis revealed that whereas presence of CNP was associated with a higher cold threshold, CNP intensity, and the number of painful body regions were associated with allodynia and hyperpathia, respectively. Conclusions CNP in MS is characterized by a specific impairment of STTC function; the innocuous thermal pathways, and by pain hyperexcitability. Whereas CNP presence is associated with STTC impairment, its severity and extent are associated with pain hyperexcitability. Interventions that reduce excitability level may therefore mitigate CNP severity.

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Sensorimotor and body perception assessments of nonspecific chronic low back pain: a cross-sectional study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04269-7 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

R. Meier ◽

C. Emch ◽

C. Gross-Wolf ◽

F. Pfeiffer ◽

A. Meichtry ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Cross Sectional Study ◽

Sensorimotor System ◽

Healthy Controls ◽

Low Back ◽

Sectional Study ◽

Clinical Tests ◽

Body Perception ◽

Cross Sectional

Abstract Background Low back pain (LBP) is one of the most common musculoskeletal disorders, causing significant personal and social burden. Current research is focused on the processes of the central nervous system (particularly the sensorimotor system) and body perception, with a view to developing new and more efficient ways to treat chronic low back pain (CLBP). Several clinical tests have been suggested that might have the ability to detect alterations in the sensorimotor system. These include back-photo assessment (BPA), two-point discrimination (TPD), and the movement control tests (MCT). The aim of this study was to determine whether the simple clinical tests of BPA, TPD or MCT are able to discriminate between nonspecific CLBP subjects with altered body perception and healthy controls. Methods A cross-sectional study was conducted. At one point in time, 30 subjects with CLBP and 30 healthy controls were investigated through using BPA, TPD and MCT on the lower back. Correlations among the main covariates and odds ratios for group differences were calculated. Results MCT showed an odds ratio for the presence of CLBP of 1.92, with a statistically significant p-value (0.049) and 95%CI. The TPD and BPA tests were unable to determine significant differences between the groups. Conclusions Of the three tests investigated, MCT was found to be the only suitable assessment to discriminate between nonspecific CLBP subjects and healthy controls. The MCT can be recommended as a simple clinical tool to detect alterations in the sensorimotor system of nonspecific CLBP subjects. This could facilitate the development of tailored management strategies for this challenging LBP subgroup. However, further research is necessary to elucidate the potential of all the tests to detect alterations in the sensorimotor system of CLBP subjects. Trial registration No trial registration was needed as the study contains no intervention. The study was approved by the Swiss Ethics Commission of Northwest and Central Switzerland (EKNZ) reference number 2015–243.

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Leakage of astrocyte-derived extracellular vesicles in stress-induced exhaustion disorder: a cross-sectional study

Scientific Reports ◽

10.1038/s41598-021-81453-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Johanna Wallensten ◽

Anna Nager ◽

Marie Åsberg ◽

Kristian Borg ◽

Aniella Beser ◽

...

Keyword(s):

Extracellular Vesicles ◽

Cd40 Ligand ◽

Cross Sectional Study ◽

Healthy Controls ◽

Sectional Study ◽

Major Depressive ◽

Cross Sectional ◽

Ligand Expression ◽

Minor Traumatic Brain Injury ◽

Exhaustion Disorder

AbstractPatients with stress-induced exhaustion disorder (SED) demonstrate cognitive dysfunction similar to patients with minor traumatic brain injury (TBI). We have previously detected elevated concentrations of astrocyte-derived extracellular vesicles (EVs) in patients with TBI. As such, we hypothesized that astrocyte-derived EVs could be higher in patients with SED than in patients with major depressive disorder (MDD) and healthy controls. Patients with SED (n = 31), MDD (n = 31), and healthy matched controls (n = 61) were included. Astrocyte-derived EVs (previously known as microparticles) were measured in plasma with flow cytometry and labeled against glial fibrillary acidic protein (GFAP) and aquaporin 4 (AQP4). In addition, platelet EVs and their CD40 ligand expression were measured. Patients with SED had significantly higher concentrations of AQP4 and GFAP-positive EVs and EVs co-expressing AQP4/GFAP than patients with MDD and healthy controls. Patients with MDD had significantly higher concentrations of GFAP-positive EVs and EVs co-expressing AQP4/GFAP than healthy controls. Platelet EVs did not differ between groups. CD40 ligand expression was significantly higher in patients with SED and MDD than in controls. In conclusion, the present study suggests that patients with SED, and to some extent, patients with MDD, have increased leakage of astrocyte-derived EVs through the blood–brain barrier.

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Comparison and Association of Neck Extensor Muscles’ Endurance and Postural Function in Subjects with and without Chronic Neck Pain – A Cross-Sectional Study

Physikalische Medizin Rehabilitationsmedizin Kurortmedizin ◽

10.1055/a-1395-1050 ◽

2021 ◽

Author(s):

Praveen Kumar Kandakurti ◽

Ravi Shankar Reddy ◽

Venkata Nagaraj Kakarparthy ◽

Kanagaraj Rengaramanujam ◽

Jaya Shanker Tedla ◽

...

Keyword(s):

Neck Pain ◽

Postural Control ◽

Chronic Neck Pain ◽

Cross Sectional Study ◽

Control Measures ◽

Endurance Capacity ◽

Control Parameters ◽

Sectional Study ◽

Cross Sectional ◽

Velocity Moment

Abstract Purpose Neck extensor endurance (NEE) and position sense are vital for maintaining cervical spine function and defects in these processes may be associated with impaired postural control in chronic neck pain (CNP) subjects. The study’s objectives are 1) to compare the cervical extensor endurance capability and postural control of CNP subjects with those of asymptomatic controls; 2) to investigate the association between NEE and postural control. Materials and Methods Sixty-four participants (38 asymptomatic, 38 with CNP) participated in this cross-sectional study. NEE was assessed using a clinical extensor endurance test. Under open and closed eyes conditions, postural control measures were tested with the Good Balance system. The postural control parameters were AP-velocity (mm/s), ML-velocity (mm/s) and Velocity moment (mm2). NEE capacity and postural control parameters were compared and correlated between asymptomatic and CNP subjects. Results and Discussion CNP subjects showed lower NEE capacity (p<0.001) and significantly larger AP-velocity (p<0.001), ML-velocity (p<0.001) and Velocity moment (p<0.001) than asymptomatic participants. NEE negatively correlated with AP-velocity (r=−0.51, p=0.001), ML-velocity (r=0.46, p=0.003) and velocity moment (r=0.38, p=0.020) in asymptomatic subjects in eyes open condition and no correlations in subjects with CNP. CNP subjects showed increased postural sway velocities and lowered extensor endurance capacity compared to asymptomatic participants. No correlations existed between NEE and postural control parameters in CNP subjects.

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